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.
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.
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.
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.
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)
Copies of the RESTORE2 tools, associated resources and implementation materials can be downloaded from the Hampshire, Southampton and Isle of Wight CCG RESTORE2 webpage. The CCG 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.
This list is constantly being updated - please let us know if you are aware of any links we can add.
2. Detecting deterioration: Delivering RESTORE2 training to care homes (SW AHSN 7/7/20)
Association between National Early Warning Scores in primary care and clinical outcomes: an observational study in UK primary and secondary care (Lauren J Scott, Niamh M Redmond, Alison Tavaré, Hannah Little, Seema Srivastava and Anne Pullyblank - British Journal of General Practice 2020)
3. Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England (Emer Brangan, Jonathan Banks, Heather Brant, Anne Pullyblank, Hein Le Roux, Sabi Redwood - BMJ Open 2018)
4. Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review (Gooske Douw, Lisette Schoonhoven, Tineke Holwerda, Getty Huisman-de Waal, Arthur R H van Zanten, Theo van Achterberg, Johannes G van der Hoeven – PubMed.Gov May 2015)
5. Can Routinely Collected, Patient-Reported Wellness Predict National Early Warning Scores? A Multilevel Modeling Approach (Abigail Albutt, Jane OʼHara, Mark Conner, Rebecca Lawton - PubMed.Gov 21 Feb 2020)
6. A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision-making and referral processes. Hodgson, P., Greaves, J., Cook, G., Fraser, A., & Bainbridge, L. (2022). Nursing Open, 9, 519–526
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 Future NHS 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
Eastern AHSN (Cambridgeshire, Norfolk, Suffolk, North East, Mid and South Essex, Herts and Eastern Beds)
Health Innovation Manchester
Kent, Surrey & Sussex AHSN
Innovation Agency - AHSN for the NW Coast (Inc Cheshire, Merseyside, Lancashire and South Cumbria)
Oxford AHSN (Oxfordshire, Buckinghamshire and Berkshire)
South West AHSN (inc. Somerset, Devon and Cornwall)
West Midlands AHSN (inc. Shropshire, Herefordshire, Staffordshire, Warwickshire and, Worcester)
West of England AHSN (inc Somerset, Gloucestershire and Wiltshire)
Yorkshire and Humber AHSN
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.
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:
2021 Whilst not winning an Award in 2021 the RESTORE2mini Learning Disability project was shortlisted for both the ‘Learning Disabilities Initiative of the Year’ award and the ‘Videos to support the training of carers to identify deterioration and communicate concern’ award for the 2021 HSJ Patient Safety Awards.
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 2: What is RESTORE2?
Video 3: Why use 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.
Organisations should not progress their own independent adaptations of the RESTORE2 tool without the express permission of NHS West Hampshire CCG. If you have any queries, please direct them to West Hampshire CCG.
Further information on this workstream can be obtained via the contact link at the bottom of this page.
An Introduction to RESTORE2 - the physical deterioration and escalation tool for care/nursing homesBrowse all videos