Wessex PSC is working to implement a standardised common language for managing deterioration across all healthcare settings including the Care Home Sector and this work aligns with the NHSE Enhanced Health in Care Homes initiative.
The framework for Enhanced Health in Care Homes 2020/21 - Version 2 (31 March 2020)
This implementation framework builds on experiences of those who have implemented the EHCH model since 2016 and describes best practice in doing so. It supports the delivery of the minimum standard and should be read alongside the relevant contractual requirements.
Version 2 of the framework document can be downloaded from the resources zone on the right hand side of the webpage and more information about the Enhanced health in care homes initiative can be found on the NHSE website.
Enhanced health in care homes framework (NHSE) (Sept 2016)
The EHCH framework (NHSE 29 Sept 2016) lays out a clear vision for working with care homes to provide joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of in reach services.
The framework document can be downloaded from the resources zone on the right hand side of the webpage and more information about the Enhanced health in care homes initiative can be found on the NHSE website.
RESTORE2TM (West Hampshire CCG & Wessex PSC)
National ‘Excellence in Primary Care’ Parliamentary Award Winners July 2019 (read more here)
RESTORE2TM is a physical deterioration and escalation tool for care/nursing homes co-produced by West Hampshire CCG and Wessex Patient Safety Collaborative and based on nationally recognised methodologies including early recognition (Soft Signs - see below), the national early warning score (NEWS2) and structured communications (SBARD).
More information about RESTORE2TM (full) and RESTORE2 MiniTM (soft signs) including training videos and downloadable resources can be found on our RESTORE2 webpage
New online video based NEWS2 and Deterioration training for community and care home staff
Wessex AHSN and West of England AHSN have collaborated with West Hampshire CCG (RESTORE2( and Health Education England to produce a series of free videos and e-learning materials to support staff working in care homes to care for residents who are at risk of deterioration.
A series of 14 short videos (around 3 minutes each) describe how to take measurements from residents correctly (such as blood pressure and oxygen saturation), spots the soft signs of deterioration, and prevent the spread of infection.
More information and links about the videos (and other Care Home resources) can be found on our Care Home Training Resources webpage
Soft Signs of Deterioration
Studies have shown that nursing assistants in a care home can spot signs of illness in people 5 days before they were seen in observations. (ref: Boockark1, Brodie HD, Lachs M, Geriatr Soc. 2000 Sept;48(9):1086-91.) The study found that nursing assistants were able to spot behavioural and functional state changes in residents before physiological signs were present.
More information about our Soft Signs projects including Interserve Healthcare's Soft Signs Taxonomy, West Hampshire CCGs RESTORE2 and Southampton City CCGs REACT to Soft Signs are included in a discussion article on Soft Signs by Geoff Cooper, Wessex PSC Programme Lead for Deterioration and can be read on our "Using Soft Signs to identify early indications of Physical Deterioration" webpage.
SBAR communication tool (Situation, Background, Assessment, Recommendation)
Emergency admissions to hospital from care homes: how often and what for? (Health Foundation 2019)
This Health Foundation briefing presents the results of a national analysis of emergency hospital admissions from care homes across England, to provide insight into how often care home residents are being admitted to hospital and the types of conditions that are causing their admissions.
The second part of the briefing draws on evaluations of four enhanced care packages provided to care home residents. By comparing and contrasting the different elements and contexts of these sites and bringing in other local evaluations of these sites, the report explores the factors that may be most influential in reducing hospital admissions.
The briefing concludes by pointing to the next steps for local health and social care providers and commissioners looking to better understand the quality of care being provided in order that they may improve care further.
The full briefing can be downloaded from the resources zone on the right hand side of this page.
ALERT (Portsmouth Hospitals NHS Trust)
ALERT™ (Acute Life Threatening Events Recognition & Treatment) is a multi-professional course designed to train staff in recognising patient deterioration and acting appropriately in treating the acutely unwell.
ALERT HQ have developed a suite of courses for different care settings including: ALERT (Adult); ALERT Obstetrics; BEACH (for unregistered healthcare staff) plus an ALERT Train the Trainer course.
More information about the ALERT Programme can be found on the ALERT HQ website.
Supplied in an "all-in-one" tele-health case WHZAN can be used to measure vital signs, record photos, perform multiple assessments and questionnaires including the Royal College of Physcians' National Early Warning Score - NEWS2 to check health.
Whzan automatically calculates a National Early Warning Score (NEWS2), in use throughout the UK supporting analysis of illness, nutrition, hydration and frailty and other conditions. Includes health and activity pattern recognition.
The Whzan tele-health system can be used to support the care of people with long term conditions such as COPD, asthma, diabetes and heart health, as well as monitoring people with short term needs, post-op & during pregnancy.
Provided in a distinctive Blue Box the Whzan tele-health system is portable with wireless instruments. Authorised carers & doctors can get access to patient results and analysis in real-time through WHZAN's own secure cloud-based portal.
More information about Whzan can be obtained from their website.
Early warning through camera based vital signs monitoring (Xim Lifelight)
Wessex Academic Health Science Network (AHSN is working with Hampshire-based digital innovators xim, and Badgerswood Surgery in Bordon to develop new technology capable of monitoring patients’ vital signs.
The LifeLight® system can check a patient’s vital signs - their pulse, breathing rate, blood pressure and blood oxygen level - by simply sitting in front of a computer screen.
LifeLight® does this by using a standard camera on the screen, which detects very small changes in a person’s forehead skin colour, and may help identify unknown health conditions or underlying problems.
Further information on this workstream can be obtained from Geoff Cooper (Programme Lead) via email or via the contact link at the bottom of this page.