Wessex PSC is working to implement a standardised common language for managing deterioration across all healthcare settings including the Domiciliary / Home Care Sector.
RESTORE2mini domiciliary - supporting Domiciliary Care Providers across Wessex
The RESTORE2mini domiciliary tool encourages Carers to look out for, and respond to, 'Soft Signs' of Deterioration in their clients. Using a simple question 'How are you today?' the card includes a series of prompts to support staff to consider possible 'soft signs' of deterioration.
Possible triggers include breathing difficulties; changes in appetite, mobility, consciousness or confusional state; bowel or urinary tract problems.
Carers can then raise the alert and communicate their concerns using the SBARD communication process.
Developing RESTORE2mini domiciliary
RESTORE2 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), the national early warning score (NEWS2) and structured communications (SBARD).
RESTORE2mini was subsequently published, without the NEWS2 component, for care settings preferring to use a "Soft Signs" approach as a pre-diagnostic indicator of concern. The RESTORE2mini domiciliary version of the tool was developed for use specifically in the home care sector.
A project team consisting of members from WPSC, WHCCG and 4 home care provider organisations (which included 2 members of the regional professional body) ran a six week PDSA pilot of RESTORE2mini domiciliary in the participating care settings.
Early signs of physical “unwellness” can be recognised intuitively by physical healthcare practitioners as evidenced by staff saying “I know something is wrong, I just don’t know what”. Even people without training, but who are familiar with someone’s usual behaviour and habits, can often sense a problem resulting in them reporting that the relative, resident or child in their care “just isn’t themselves”.
SBARD Communication Tool (WPSC)
SBAR and SBARD are easy to use, structured forms of communication that enables information to be transferred accurately between individuals.
SBARD (SBAR+D) is not copyrighted and Wessex PSC have developed an open version in Word format to assist Carers wanting either a generic form or a template that they can customise for local use.
The generic SBARD Communication Tool can be downloaded from the Resources Zone on the right hand side of this webpage.
More information about our work relating to SBARD and links to an NHS training video can be found on our SBARD webpage.
All versions of the RESTORE2 tool, including the RESTORE2mini domiciliary and associated resources and implementation materials can be downloaded from the West Hampshire CCG webpage. The WHCCG website contains full information about using RESTORE2 and ordering printed copies of any materials.
Spotting serious illness and sepsis in domiciliary settings
Carers working in domiciliary care settings and 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.
NHS website about Homecare / Domiciliary Care, what it is and how to access it.
For home care or domiciliary care agencies. Social Care Institute for Excellence's (SCIE) collection of key advice and support about Covid-19.
If you have any questions about the Wessex Patient Safety Collaborative's Domiciliary Care workstream or any other aspects of the Wessex PSC, please contact us via the link