Supporting our care sector to keep their residents well

Identifying deterioration in health early and knowing how to respond

EMPSC is delivering the Managing Deterioration Safety Improvement Programme (ManDetSIP), commissioned by NHS England.

In 2023-2024 the programme aimed to reduce deterioration associated harm by improving the Prevention, Identification, Escalation of and Response to (PIER) physical deterioration through better system co-ordination.

We focussed on delivering training to care homes and to domiciliary care providers on deterioration management tools such as RESTORE2 and RESTORE2mini with the aim of keeping patients safe and well in their homes and in their care homes while reducing avoidable conveyances to hospital.

The SBARD tool forms part of the RESTORE2mini training. The tool sets out a clear framework to gather and convey information relating to the: Situation, Background, Assessment, Recommendation and Decision. It gives care staff and health staff a common language to improve communication and build relationships. We also delivered SBARD training to PCN teams, adult social care auditors and at our conference. Find out more about the SBARD training.

All 38 of our care homes are now trained and using SBARD, staff say they feel more listened to and their knowledge of the residents acknowledged more. Residents' lives have been enhanced by immediate reaction using soft signs and SBARD. It's empowering.

Learn more about ManDetSIP

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Impacts

Provided training to 1,576 people from 370 organisations.

A care conference and awards event attracted 200 attendees and 35 exhibitors. This year the awards were opened to domiciliary care as well as to care homes, as the programme’s reach extended.

Working with The University of Nottingham Pharmacy School we piloted a project to place students at Ashfields Care Home, Derbyshire to support care home staff to use the managing deterioration tools and learn about medicines management in care homes. Feedback was positive and we are supporting the University of Nottingham to expand the pilot to place 200 students in East Midlands care homes from September 2024.

Participants identified the following benefits of the training: increased staff confidence and job satisfaction, reduction in incidents and ambulance call outs, more residents able to stay in their preferred place of care.

In one care home – the increase in staff confidence led to a member of staff identifying a resident whose health was deteriorating; and pushing for the resident to go to hospital. The resident went on to be diagnosed with sepsis and survived thanks to early intervention.

Next Steps

In 2024-2025, the Managing Deterioration programme focuses on supporting designated pilot sites to implement Martha’s Rule to help patients and families to escalate concerns and request an urgent review if their condition deteriorates.