Well Connected Care Homes

The Well Connected Care Homes (WCCH) project aim is have care homes which are internally and externally ‘well connected’ in the digital age adding value for service users, carers, families and care providers and the wider health and social care system.

The programme is well connected to the regional EPaCCS project and is working with the region wide Great North Care Record, as well as North of England Commissioning Support (NECS) to ensure that care homes and their residents are included in the advances in communication of relevant information within the NHS and strictly within bounds of relevant governance and with relevant permission of patients.

The programme has two parts.

  • Improving record keeping for care home residents by using tablet based Apps to allow electronic recording of care plans – for example the EPaCCS system for recording patient’s wishes about their care and their life – and to allow clinical record keeping for individual residents, and particularly by introduction of the NEWS (National Early Warning Score).
  • To promote use of electronic communication of patient (resident) clinical information between care homes and primary care (GP electronic patient records), emergency care, including out of hours and ambulance services, and community services.

The focus of the programme in its early stages will be on the evaluation and research on the work already carried out within Sunderland Care Home Vanguard and its care homes technology project.

‘Is my resident unwell?’ Communication Tool

The ‘Is my resident unwell?’ communication tool was launched at an event in Durham on 4 March 2020.  The tool has been developed by the AHSN NENC Well Connected Care Homes programme. It is hoped the communication tool will assist staff in recognising signs and in recording a set of observations – and a further aspiration is that it could be incorporated into the system and will be something that all care home staff in the North East and North Cumbria region will use.  A downloadable version of the ‘Is your resident unwell?’ communication tool Is available below as well as a poster to be displayed in participating care homes.

‘Is my resident unwell?’ tool

Poster


Sunderland Digital NEWS Tablet

Sunderland Care Home Vanguard introduced technology to each of its care homes, combined with training and support, consisting of a digital tablet, blue tooth blood pressure cuff, pulse oximeter and thermometer. Non qualified staff are trained to use the equipment providing baseline NEWS scores, repeated whenever there is a clinical concern for a resident.

A small scale local evaluation of the project suggested reductions in use of A&E, acute admissions and use of Ambulance, alongside reported increases in staff confidence when communicating with health professionals and distinct changes in the language used in care plans and care notes. There was sufficient evidence within this small evaluation to suggest a larger scale evaluation would be justified, to this end the AHSN NENC has commissioned a large scale project alongside local universities and the CCG.

Delivery in the AHSN NENC

The aim of the research is threefold.

  1. To analyse the NEWS scores to ascertain any trends or patterns, understand the component physiological measures and how they may be interpreted. Compare to existing research and outcomes.
    – There is to date around 2500 individual clinical measures and NEWS scores within the database, this represents a significant opportunity to analyse NEWS and its composite scores in an environment not previously researched, not least in an attempt to validate its use as a tool within the care home setting.
  2. Consider the impact on those using the new technology and the interfaces with others in the health and social care system.
    – Staff within care homes reported significant increases in confidence in referring to and requesting input from qualified health professionals from both primary, secondary and emergency care. External health professionals reported increase in the quality of information being relayed thus improving clinical decision making and appropriate response.
  3. To understand the economic impact on the system and its component parts from the introduction of the new technology.
    – The opportunity to compare care homes using the new technology and those not within the same health care system represents a significant opportunity to assess any economic impact on the wider system through changes in use of secondary care.

A significant opportunity exists in the near future to provide a transfer of care home NEWS scores to the digital platform of attending ambulance crews, thus permitting the transfer of valid clinical measures across the system and at a time of clinical need. Those NEWS scores on admission then transferred to the acute system allowing analysis in real time of any deterioration in the patient.

Results

The Learning from the WCCH project and associated event has been collated into the following documents:

Learning from the Well Connected Care Homes Project – Full Report

Summary Learning Points WCCH

The Well Connected Care Homes Project has a case study on the National AHSN Network Atlas portal, view the case study.

Publication:  Distribution of the National Early Warning Score in Care Home Residents (Age and Ageing, Volume 49, Issue 1, January 2020)

For more information please contact Dave Belshaw.