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The NHS nurses helping care home staff deal with a crisis

22nd May 2017

From the team that brought you ‘Pimp My Zimmer’… the NHS nurses helping care home staff deal with a crisis

Two NHS nurses are touring care homes in central Norfolk, on a mission to support staff in keeping residents safe and well.

The dynamic duo – Kate Wyatt and Irene Karrouze – are running a free training programme for care homes. They have already visited more than 50 care homes and worked with more than 400 care staff from Norwich to Fakenham and Thetford to Cromer.

Nurse Kate Wyatt said: “We think our training really is making a difference. We are helping care home staff with skills and knowledge to prevent problems becoming a crisis. And if it comes to the crunch and they need to call 111 or 999, we’re helping them communicate in the best way to get the right response from the NHS.

“We make it really clear that when a person needs an ambulance or a visit from a doctor, they will get it. But if we can prevent illness, prevent a fall or prevent an ambulance call out or hospital admission then everyone is much better off.”

Reaction from care homes and GPs

Two of the care homes that have received Nurse Kate and Irene’s training are St Michael’s Court in Aylsham and Mill House in Horstead. Manager of both, Nikki Culleton, said: “The training was amazing. Many of our staff attended in their own time, which shows how committed they are, and they said the training was really helpful.”

Like many GP Practices, Harleston Medical Practice works closely with local care homes and always looks for new ways to improve patient care. So when they heard about Kate and Irene’s training they invited them to join one of their regular patient-focused open evenings.

Known carers were contacted by the practice and welcomed along to the training, which focused on avoiding falls and pressure ulcers, the importance of proper hydration and good communication with the health service in an emergency.

15 carers, plus members of the Patient Participation Group attended and, says the practice, the feedback was overwhelmingly positive – carers really appreciated the top tips to help keep their loved ones safe and well.

More on the training

The ambulance service and the NHS111 service have both been closely involved in drawing up the training and guidelines for care home staff when it’s urgent or an emergency. If they say the right things in the right way it helps help 999 or 111 call handlers get the right response quicker.

And when a health crisis does occur, care home staff are now being trained to use the same patient assessment tools used by nurses and doctors in hospitals:

  • The ABCD guide is for an emergency – The ABCD assessment helps in an urgent situation – Airway, Breathing, Circulation, Disability
  • If a stroke is suspected, use the FAST checklist: Face – is one side drooping? Arm – is one weak? Speech – it is slurred? Time to call 999.
  • Gather the information needed using SBAR: Situation, Background, Assessment, Recommendation.

The training also covers other important areas to support care home staff look after their residents.

Kate and Irene are encouraging care homes to use a ‘Quick Look Care plan’. This is an at-a-glance sheet of paper kept in a handy place where staff can remind themselves of individual residents’ needs. It is simply a checklist of the patient’s day to day needs, the things they like to eat, do or talk about, or the help they need to stand and walk to prevent a fall. It means busy staff can make sure they’re aware of someone’s preferences, make sure they get the right care and prevent problems.

There is really important training on hydration. If an older person does not drink enough their medical conditions can get worse, the risk of falling increases and they could develop a debilitating water infection which needs antibiotics or even a stay in hospital. So the nurses guide care home staff through a step by step guide to hydration.

Irene - a continence specialist – said: “It’s really hard for staff if a resident does not want to drink enough every day to stay well. But we advise helping them to drink fluids that they enjoy, little and often and putting more fluids in meals. We have written  leaflets on hydration, preventing urinary tract infections and setting daily fluid target levels for residents.”

Irene and Kate have even trained kitchen staff to increase fluids in food and understand “fabulous fortified feasts” – meals for people who need special diets.

“There are lots of tips and ideas that we’ve taken from best practice across the country and we are really pleased to pass them on to care home colleagues here,” Irene said.

Nurses Kate and Irene work for the NHS Clinical Commissioning Groups for South Norfolk, North Norfolk and Norwich. Together with colleague Joe Farrow they have been encouraging care homes to take part in “Pimp My Zimmer”. This involves getting older people to decorate or adorn their walking frame with personal colours or frills. It’s more than just a bit of social fun, it helps them identify which frame is theirs and reduce the risk of accidents.

They are encouraging care homes to tag walking frames using a traffic light system to highlight risk. Green – assessed as safe to mobilise; Amber – change in condition/behaviour therefore now at risk of falls; Red – high risk of falls or has a history of falls and needs supervision when mobilising.

St Michael’s Court and Mill House care homes have adopted ‘Pimp My Zimmer’ as a direct result of the training they received.

And whilst the training has focused on central Norfolk, the CCGs in West Norfolk and Great Yarmouth and Waveney are now using the back-up resources put together by Kate and Irene to issue to care homes in their patches.