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Recognising and responding to deterioration in care homes

Posted: - 8th June 2020

There are certain early signs that carers can spot if a resident in a care home is becoming unwell; such as  losing their appetite, becoming confused, tired and unsteady (the so called soft signs of deterioration). Understanding what is normal for their residents is the key to detecting changes.

These and other signs that a resident is deteriorating, are the focus of a project that we are working on to help staff, informal carers and residents spot these symptoms early, by acting quickly to improve their residents’ wellbeing. We used our knowledge and expertise to work with staff to learn together how to successfully implement softer signs tools such as Stop & Watch & RESTORE2 and how to use the Situation – Background – Recommendation- Decision (SBARD) structured communication tool when calling for help.

The Yorkshire and Humber Patient Safety Collaborative worked in Partnership with Vale of York, Sheffield and Bradford Clinical Commissioning Groups to carry out initial testing and our learning to date was shared at an event in York in November 2019 and has been adopted by several care homes in the region.

Mel Johnson, Programme Manager for the Patient Safety Collaborative said:

“It has been a privilege to work closely with the care home teams and learn what is helpful together. The key is that the staff really know the residents well and are in the best position to spot early when residents start to become unwell so they can get the help they need.”

Diane Mougan, Manager at Riccall House Care Home in the Vale of York said:

“Stop & Watch gets staff to consider what might be causing the issue and think about actions, they can then act accordingly. It doesn’t just identify deterioration but also changes in condition – for better or worse!  It allows staff on subsequent shifts to see how the resident has been so they can judge if they are deteriorating or actually remain the same/improved.”

We have produced a range of materials to help teams implement these tools and are happy to provide support and advice.

If you would like further support and information, please contact