Firstly thanks to Jessie Retallick, prescribing support dietician for NHS Kernow, for being our guest blogger last time and her fab work to promote #ButFirstADrink which encourages everyone from GPs to friends to offer the person a drink when they arrive to see them, and #FoodFirst, which is about fortifying food to get the most calories and protein as an idea before relying on supplements. Her team is also encouraging the completion of the Malnutrition Universal Screening Tool (MUST) because being malnourished can be a huge set back in both recovering and maintaining health when unwell or elderly. I not only love the simplicity of these messages but the incredible differences they can make to the health of people.
In the last blog I noted the spring flowers appearing and now summer is fully upon us! In that time so much has happened. Right deep breath, here goes:
My role as enhanced health in care home nurse manager can be defined as this:
As you can see the biggest part of my job remains with the nine care homes. I have spent a lot of time chatting with residents, relatives, staff, and managers to delve into the things that really matter to them and the barriers that stop them delivering the care they want to. The bit that I love is that my objectives have been established from this relationship. The RESTORE2 tool is my main work stream within the programme and it will be implemented into the nine care homes over the next few weeks. This has been done successfully in west Hampshire but Cornwall are one of the first to follow.
This involves training to take and record observations (blood pressure, respiratory rate, temperate etc) and then to calculate a score. This is called a ‘national early warning score’ (NEWS2), and gives health care professionals an immediate idea of how unwell someone is. For example a score of zero to one - one tells me that person is well whereas a score of five will indicate that someone is unwell and would need specialist medical input very quickly. Obviously there’s more to it than just a score which is why the RESTORE2 tool combines NEWS2 with the soft signs of deterioration such as not wanting to get dressed or eat to produce a clinical ‘picture’ of a person. The tool also features a guide for communicating this called SBARD (situation, background, assessment, recommendation and decision).
The RESTORE2 tool aims to help assess residents and then communicate any concerns accurately and informatively to other people involved in their care such as out of hours teams, call operators and GPs.
It may sound complicated but it’s actually very simple! Carers are excited to feel empowered to use clinical language to explain what they want for a resident who they often know very well, and add leverage to get the best possible outcome.