RESTORE2 (Soft Signs, NEWS2 and SBAR/D)
RESTORE2 is a physical deterioration and escalation tool for care/nursing homes based on nationally recognised methodologies including early recognition (Soft Signs), the national early warning score (NEWS2) and structured communications (SBARD).
RESTORE2 was co-produced by West Hampshire CCG and Wessex Patient Safety Collaborative.
It is designed to support homes and health professionals to:
RESTORE2 uses NEWS2 reproduced from: Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP, 2017.
RESTORE2 resources can be downloaded from the Resources tab Zone at the top right of this webpage. These resources (CS49286) have been designed and created in partnership with NHS Creative and you can find out more about their work on their website.
RESTORE2mini (Soft Signs and SBAR/D)
RESTORE2 has also been adapted for use by Care Homes wanting to use a "Soft Signs" approach as a pre-diagnostic indicator of concern" to facilitate earlier treatment and avoid unnecessary transfers to hospital.
Named RESTORE2mini the Soft Signs based tool has also been adapted for use in care settings including Care Homes, Domiciliary/Home care and Learning Disability.
RESTORE2mini resources can be downloaded from the Resources tab Zone at the top right of this webpage. These resources (CS51690, CS51710, CS52291) have been designed and created in partnership with NHS Creative and you can find out more about their work on their website.
Implementation Support
Please contact us if you would like to discuss the use of RESTORE2 and RESTORE2mini in your organisation or care setting using the contact link at the bottom of this webpage.
As a co-producer of RESTORE2, Wessex PSC is able to provide advice and support to organisations in Wessex considering or implementing RESTORE2 and RESTORE2mini.
We also have experience in advising organisations from outside Wessex, nationally and internationally, and may be able to help directly, or to provide contact details for local support networks (including the list of AHSNs across England lower down this webpage).
Users of RESTORE2 and RESTORE2mini are also able to join the RESTORE2 Project Advisory Group where members are able to share experiences, learning, challenges and successes as part of an active Community of Practice.
Training Resources
Free resources to support the use of RESTORE2 and RESTORE2mini can be downloaded from the Resources Zone at the top right of this webpage. Other related resources including RESTORE2, Soft Signs, the National Early Warning Score (NEWS2), the SBARD communication tool, End of Life considerations and virtual (video-based) staff training) can also be found on our Resources for Care Homes webpage, our Domiciliary Care webpage and our Learning Disability webpage.
More information about the SBARD Communication Tool, including some downloadable resources, can be viewed on our Safety Communications webpage.
RESTORE2 and RESTORE2mini Training Videos
Wessex PSC have recorded training sessions for RESTORE2 and RESTORE2mini which can be delivered virtually to support the implementation of these tools in your care setting.
The video presentations can be viewed on the Wessex AHSN YouTube channel at:
The Roll Out Handbook and slide decks used as the basis for these training presentations can be downloaded from the Resources Zone at the top right of this webpage.
A series of videos about implementing and using RESTORE2 in Care Home settings, together with some case study based scenarios, can be viewed via the links at the bottom of this webpage or by using the quick links here:
More videos including implementation guidance and case studies can be viewed on the Hampshire & Isle of Wight ICS RESTORE2 webpage.
Videos to support Carers to manage Deterioration in residents and clients using Soft Signs, NEWS2 and SBARD (PSCs in collaboration with Health Education England)
Wessex PSC and West of England AHSN have collaborated with West Hampshire CCG and Health Education England to produce a series of short videos (around 3 minutes each) to describe how to take measurements from residents correctly (such as blood pressure and oxygen saturation), spot the soft signs of deterioration, and prevent the spread of infection.
These videos can be used to support the implementation of RESTORE2 and RESTORE2mini in Care Homes and can be viewed via our Care Home Training Resources webpage or by using the quick link here to Health Education England's Youtube website.
The team have also collaborated to re-film 7 of the videos listed above specifically to support carers of people with a learning disability and these can also be viewed via our Care Home Training Resources webpage or by using the quick link here to Health Education England's Youtube website.
The AHSN Network
Find out how RESTORE2 is being used in care homes across England, supported by Patient Safety Collaboratives, in the AHSN report "Improving safety in care homes" which can be downloaded from the resource zone on the right of this webpage and a video presentation: Supporting safety in care homes
RESTORE2 and RESTORE2mini Tools and Implementation Resources (WHCCG/HIOW ICS)
Copies of the RESTORE2 tools, associated resources and implementation materials can be downloaded from the Hampshire & Isle of Wight ICS RESTORE2 webpage. The ICS website contains full information about using RESTORE2 and ordering printed copies of any materials.
Developers note: NHS West Hampshire CCG is keen to work with suppliers interested in developing digital versions of RESTORE2 and RESTORE2mini. Information and contact details for anyone interested in developing a digital product are provided at the bottom of this webpage.
Literature Review
This list is constantly being updated - please let us know if you are aware of any links we can add:
The National Deterioration forum
The National Deterioration forum provides a live interactive platform for network members to engage with each other, sharing challenges and best practice in the management of Physical Deterioration of all conditions across the NHS. The National Deterioration Forum is a membership based forum accessed via the FutureNHS platform.
AHSN and PSC Networks promoting RESTORE2 across the UK
This list is constantly being updated - please let us know if you are aware of any links we can add.
East Midlands AHSN
Managing Deterioration (including RESTORE2)
RESTORE2 & RESTORE2mini resources (NATH)
Eastern AHSN (Cambridgeshire, Norfolk, Suffolk, North East, Mid and South Essex, Herts and Eastern Beds)
Supporting the acute sector and care homes
Health Innovation Manchester
Kent, Surrey & Sussex AHSN
Listen to a care home manager in Kent talking about rolling Restore2 out here
Innovation Agency - AHSN for the NW Coast (Inc Cheshire, Merseyside, Lancashire and South Cumbria)
Oxford AHSN (Oxfordshire, Buckinghamshire and Berkshire)
Implementing RESTORE2 in care homes
South West AHSN (inc. Somerset, Devon and Cornwall)
RESTORE2 Recognising and Escalating Deterioration
RESTORE2mini e-learning package
RESTORE2 video series for those with a learning disability
West Midlands AHSN (inc. Shropshire, Herefordshire, Staffordshire, Warwickshire and, Worcester)
Guidance released on 'soft signs' of deterioration
Wessex AHSN
RESTORE2 Case studies and videos from Hampshire & Isle of Wight ICB
RESTORE2 training from NHS Dorset Quality Improvement team
West of England AHSN (inc Somerset, Gloucestershire and Wiltshire)
RESTORE2 Training resources for care providers
A case study: RESTORE2 in residential care
Resources, booking links, videos, and more for care staff in the West of England
RESTORE2mini film with Inclusion Gloucestershire
Yorkshire and Humber AHSN
Recognise Early Soft Signs, Take Observations, Respond, Escalate (RESTORE2) – NHS Sheffield CCG
RESTORE2 Endorsements
Guidance from the CQC, DHSC, NHSE and PHE (31/7/20) includes reference to RESTORE2 in their Admission and care of residents in a care home during Covid-19.The guidance states that the NHS will be supporting care home professionals to use well evaluated tools such as RESTORE2 and NEWS2, accompanied by support and access to specific equipment such as pulse oximeters, which can also help determine whether a resident is unwell and as a way of monitoring residents with symptoms.
The British Geriatrics Society have recommended the use of RESTORE2 in their "Covid-19: Managing the Covid-19 pandemic in care homes" (BGS 25/3/2020) which states: "If taking vital signs, care homes should use the RESTORE2TM tool to recognise deterioration in residents, measure vital signs and communicate concerns to healthcare professionals."
Learning Disabilities Mortality Review (LeDeR) programme have recommended that NEWS2, as used in tools such as RESTORE2 , is adapted and then adopted as a means to capture baseline and soft signs of acute deterioration in physical health for people with learning disabilities by:
• Involving people with learning disabilities, their families and professional organisations.
• Disseminating for use across acute, primary and community settings.
Action from Learning Report 2019/2020 (LeDeR July 2020)
These reports can also be downloaded from the resources zone on the top right of this webpage.
Spotting serious illness and sepsis in Care Homes and domiciliary settings - Carers working in a residential care home, or professional or family carers supporting someone in their own home, can access a number of tools including RESTORE2 and Soft Signs from the AHSN network to help recognise physical deterioration and take the appropriate actions.
The Scottish Government have endorsed the use of RESTORE2 in their National Clinical and Practice Guidance for Adult Care Homes in Scotland during the COVID-19 Pandemic (May 2020) stating that the RESTORE2 tool (Annex 2) may be useful in identifying new illness in older residents. Page one of the tool can help assess changes in the residents condition.
Blue Stream Academy
Blue Stream Academy is pleased to offer every carer throughout the UK free access to the RESTORE2mini eLearning module, created and developed alongside experts from the South West Academic Health Science Network (South West AHSN). This RESTORE2mini eLearning module helps carers to improve communication between their own setting and other health and social care providers by presenting case studies and video sequences to ensure the correct usage of SBARD.
RESTORE2 Awards
RESTORE2 is based on NEWS2 and has been a key element of the process of implementing NEWS2 within Care Homes, initially across Wessex and subsequently nationally via the AHSN network.
Since its release in 2018 RESTORE2 has attracted a number of Awards including the:
Read more about the National and Regional recognition for the work by West Hampshire CCG and Wessex PSC with RESTORE2 on the Hampshire, Southampton and Isle of Wight CCG webpage.
RESTORE2 Video resources (WPSC & WHCCG)
A series of 6 videos produced by WPSC and WHCCG about implementing and using RESTORE2 in Care Home settings together with some case study based scenarios can be viewed below.
Video 1: An introduction to RESTORE2
Video 4: Some scenarios based on RESTORE2
Video 5: GP information about RESTORE2
Video 6: Implementation advice about rolling out RESTORE2
Developers note regarding digitalising RESTORE2 and RESTORE2mini
We understand that a number of organisations across the country are exploring the creation of digital versions of the nationally recognised RESTORE2 tool. This has been brought to the forefront of consciousness in light of the recent Covid-19 pandemic, the impact of the virus within care/nursing homes and the speed at which solutions need to be developed to support this vital area of healthcare.
NHS West Hampshire CCG is keen to work with developers to ensure that all care/nursing homes have access to a digital version of RESTORE2 and RESTORE2mini as quickly as possible. When considering this it is important to recognise RESTORE2 has been trademarked by NHS West Hampshire CCG in order to ensure consistency across discrete implementations. This consistency applies to both the look and feel of the tool as well as the clinical pathways that will be impacted by a transition to a digital platform.
NHS West Hampshire CCG, with the help of Wessex AHSN, has developed a Market Specification for both RESTORE2 and RESTORE2mini. This Market Specification will enable organisations to develop digital solutions that remain familiar for those using the existing RESTORE2 and RESTORE2mini tools across the UK, whilst ensuring the clinical safety of patient pathways after the transition to a digital platform. Through establishing this specification, it is anticipated that care providers will adopt digital versions of the RESTORE2 tool more rapidly due to the assurance it provides.
Resources
RESTORE2 PowerPoint slide deck for Care Home settings (v5 WPSC)
RESTORE2 slide deck for Care Home settings (v5 WPSC) [PDF Version]
RESTORE2 Trainers Rollout Handbook
RESTORE2 Trainers Rollout Handbook (e-book version for Android and iOS Tablets)
RESTORE2mini PowerPoint slide deck for Care Home settings (v6 WPSC)
RESTORE2mini slide deck for Care Home settings (v6 WPSC) [PDF version]
RESTORE2mini PowerPoint slide deck for Domiciliary Care settings (v6 WPSC)
RESTORE2mini slide deck for Domiciliary Care settings (v6 WPSC) [PDF version]
RESTORE2mini PowerPoint slide deck for Learning Disability Care settings (v6 WPSC)
RESTORE2mini slide deck for Learning Disability Care settings (v6 WPSC) [PDF version]
2019 Learning Disabilities Mortality Review Annual report (LeDeR 16/7/20)
Action from Learning Report 2019/2020 (LeDeR July 2020)
Improving safety in care homes (AHSN Atlas)
CS51710 RESTORE2mini tool (A5)
