1. Monitoring Health in Care Homes Training
Wade Tovey

2. Two projects
Darlington – 2 care homes using Docobo Telehealth hubs – one year project
Our initiative using some regional funding
Positive responses all round but hubs expensive , and too complex.
MHICH – Hartlepool and Stockton on Tees CCG – look at this in more detail – some similar issues but simpler technology

3. MHICH Process consists of
Four hours training for 4 -5 staff from each home
Workbook
Issue of a set of Health Monitoring kit for vital signs
Pulse oximeter [ Pulse and blood oxygen - routine]
Thermometer [Temperature - routine]
Blood pressure [ routine]
Urine analysis sticks [ basic analysis when required]
Assessment of application of procedures by the staff trained in each care home
[ Note - potential for learners to complete accreditation Unit HSC 3052 Undertake physiological measurements Level 3]
Free training and kit issued worth over £200
Noted that staff paid to attend training but the benefits in savings of staff time and improvements in quality of care, far outweigh the costs involved
Baseline – every day for 3 days then once a month in care homes and once a week in nursing homes but always when staff feel its necessary or there is an incident such as a fall

4. Four hours training Power point presentation
Questions & Answers – drawing out existing experience and expertise of the learners
Practical demonstration of equipment
Hands on sessions with the equipment
Case studies
Completion of observation forms
Evaluation
Issue of equipment
Just a quick summary – you can see the equipment and some of you may be familiar, with some or all of it

5. Joining up processes All About Me – yellow ring binder
Deciding Right – noting issues of
End of Life Care
Dementia
DNAR [do not attempt resuscitation]
NEAS [North East Ambulance Service] form
SBARD model – see over
All About Me – many homes will be aware of this?
A yellow ring binder containing key questions to assist hospital staff if an admission is required and it should be returned with discharge information

6. SBARD
SBARD model – key to clear standardised communication for making calls to clinicians [ GP, DN etc]
Situation – the problem – I am from Care Home concerned re Nancy Smith
Background – brief, related to the point of the call
Assessment – what you found, what you think
Response - from clinician – record
Decision – verbally reaffirm the response and agreed timescales and record

7. Feedback from pilots
Positive response from residents but note some , notably some with dementia, are not keen at times
Positive response from relatives
Positive response from staff – general feeling of being empowered and helps understanding with clinicians
Positive responses from clinicians
But as procedures were not widespread there were issues eg with All About Me file being misplaced
Key statistics [ from Pauline Townsend Senior Clinical Matron Older Persons, Integrated Care Services Directorate, University Hospital , North Tees] 1/3 reduction in admissions to hospital and increase in NEAS conveyance rate from 40% to 75%
Chimes with the project I did with two care homes in Darlington three years ago

8. Unsolicited feedback
‘The staff returned from the training and were very positive about what they had learnt and how this would impact on the people they care for within their respective homes. The training was then followed up with practical competency assessments which was again received positively by staff. The real test was when a staff member contacted the out of hours team regarding the deterioration in health of an individual in our care and the staff member was able to communicate to the GP baseline observations. Not only was the GP happy that the team had acted proactively and responded quickly but that the staff team were able to provide key information in order for the GP to respond accordingly and treat the individual in their own home. The overall outcome was very positive and I have to say the implementation of this training has been received well with not only the out of hours services but also with the GP’s linked to the home.’
Sharon Di Maio Regional Manager Hill Care Ltd

9. Going forward The training also provides opportunities for feedback
identification of best practice
opportunity to highlight issues which can be fed back to the group managing the MHICH project and appropriate organisations or staff
Ongoing monitoring of admissions, conveyance rates etc but also time saved in care homes and improvements in the quality of care

10. QUESTIONS Wade Tovey wade.tovey@gmail.com info@nescha.org