Comment

Value of many small big ideas

Enhanced health in care home vanguards are producing positive results.
Vanguard

Enhanced health in care home vanguards are producing positive results.

Our health and care services face a number of challenges in 2017. People are living longer and the population is ageing. While this is to be celebrated, older people are more likely to develop healthcare conditions that can restrict their lives and independence.

One in seven people over the age of 85 now live in a care home. They are often frail and vulnerable, with increasingly complex needs and dependency.

When I first trained as a nurse, many of the people I saw on what were previously called care of the elderly wards are now care home residents.

This situation is set against challenges concerning the viability of providers, staff recruitment and retention, and a reduction in the number of beds available in nursing homes.

New care models

In

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Enhanced health in care home vanguards are producing positive results.

Vanguard

Our health and care services face a number of challenges in 2017. People are living longer and the population is ageing. While this is to be celebrated, older people are more likely to develop healthcare conditions that can restrict their lives and independence.

One in seven people over the age of 85 now live in a care home. They are often frail and vulnerable, with increasingly complex needs and dependency.

When I first trained as a nurse, many of the people I saw on what were previously called ‘care of the elderly’ wards are now care home residents.

This situation is set against challenges concerning the viability of providers, staff recruitment and retention, and a reduction in the number of beds available in nursing homes.

New care models

In the six enhanced health in care home vanguards we have been working with as part of the new care models programme, nurses are central to the delivery of great care for residents and to the transformation of services.

When I trained in the 1990s, none of my placements or those on my nursing course were in the care home sector. It did not occur to me that this sort of care would form part of my career.

Having spent the last 18 months leading this work, however, I have been privileged to see the amazing care delivered by staff, particularly nurses, in the care home sector.

Nevertheless, nursing in the sector remains a hidden part of the health and care system. There is an untapped resource here to deliver great care for older people in our communities.

Staff are often isolated but, by joining groups of local nurses with those in other parts of the healthcare system and care sector, we can help them flourish and deliver high-quality care supporting people to live healthy and fulfilled lives.

Residents’ needs

The Sutton Homes of Care vanguard supports care homes to manage residents’ needs with a hospital transfer pathway that uses a ‘red bag’ (pictured) to enable shorter stays.

The vanguard’s approach is simple: they ask care home managers and nurses where they need support, and put appropriate training and development in place to meet these needs. Their approach builds on good relationships and starts with a simple conversation.

As part of the Gateshead Care Homes Project, meanwhile, two multidisciplinary teams work to support 20 care homes across the area. These teams ensure staff in the vanguard can call on a full range of skills and knowledge to help them manage and support frail residents to remain healthy for as long as possible.

All of their clinical work is built on the comprehensive geriatric assessment. This is an evidence-based process for assessing the needs of older people that uses the best skills of older people's nurses to ensure that care is high quality and appropriate to the population.

The work of the care home vanguards shows that, through a focused and coordinated approach to the implementation of small ‘big ideas’, residents can experience significant benefits.

Great ideas and care are not limited to the vanguards, however. We know great care is happening in many different organisations in many parts of the country.

New models of care, including the work of vanguards like ours, will be key to the delivery of sustainability and transformation plans, which are being developed across the country.

Added impetus has come from the recent launch by NHS England of the enhanced health in care homes framework.

The challenge will be to ensure that we spread this learning consistently across the country so that all residents benefit from high quality, integrated care with nurses in the vanguard.


About the author

William_Roberts

William Roberts is national lead, enhanced health in care homes, new care models programme, NHS England

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