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Enhanced Health in Care Homes Programme Winter Readiness Pack 19/20 Supporting your care homes

This pack provides resources and information for STP teams, CCGs, and LAs to support local discussions with care homes, particularly in preparation for winter. It covers topics such as the EHCH framework, flu vaccinations, flu outbreaks, and the NHS 111 *line service.

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Enhanced Health in Care Homes Programme Winter Readiness Pack 19/20 Supporting your care homes

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  1. Enhanced Health in Care Homes Programme Winter Readiness Pack 19/20 Supporting your care homes • Developed by Healthy London Partnership (HLP)

  2. Purpose of the pack… • The pan-London Enhanced Health in Care Homes (EHCH) programme team have developed the following pack for Sustainable Transformation Partnership (STP) teams, Clinical Commissioning Groups (CCGs) and Local Authorities (LA) to support local discussions with care homes, during forum meetings or as part of local campaigns. • We encourage teams to use this pack to compliment existing resources; extracting information you feel is most valuable for your care homes. • A series of webinars have been arranged to support the EHCH networks to prepare for winter. They will cover all topics mentioned in this pack. If you wish to receive further information or to join, please email hlp.ehchprogramme@nhs.net and further details will be sent to you. • #ActNow4Winter

  3. What is the Enhanced Health in Care Homes Framework? • The enhanced health in care homes framework • is based on successful initiatives which can be delivered within and around a care home in a coordinated way. • It helps to deliver a high quality, efficient and consistent service to residents in care homes or supportive living. • This series of slides show some of the things we could all do to support each other and improve the health of our residents this winter. • #ActNow4Winter

  4. Influenza (Flu)

  5. Influenza (Flu) 2019/20 #ActNow4Winter • Never underestimate the flu… • In 2017 a care home in Sutton experienced a flu outbreak in their home. • This short film based on true events, shows the impact of the flu outbreak to • staff and residents at the home click here to watch video • Facts about Flu • Catching flu can be serious. In 2017/18 it is estimated that 26,000 deaths were associated with flu. • You can have flu without any symptoms and pass it on to residents, family and friends, many of whom may be at increased risk of flu. • There is good evidence that the vaccine reduces the amount of severe illness and helps stop people needing to be in hospital. • Sometimes side effects of the vaccine can mimic mild flu like symptoms, but these are short lived. The vaccine cannot give you flu and is continually tested and monitored.

  6. What care homes need to do for residents? #ActNow4Winter • Have all your residents been offered their vaccinations this year? • Please ensure your care home residents have been offered the following • vaccines: • Flu vaccine – to protect against Influenza • Pneumococcal vaccine – to protect against invasive Pneumococcal disease • Shingles vaccine – to protect against Shingles (recommended for those aged >70yrs) • Who will provide the vaccinations for our residents? • Your GP will administer the vaccinations for your residents. Ensure you contact the appropriate GP practice to make arrangements.

  7. What do our care home staff need to do? #ActNow4Winter • Have you & your staff been vaccinated? • All health and social care staff can get a free flu vaccine under the national flu • vaccination scheme. This includes: • Staff employed by a registered residential care/nursing home or registered domiciliary care provider, who are directly involved in the care of vulnerable patients/clients who are at increased risk from exposure to influenza. • Vulnerable means those patients/clients in a clinical risk group for flu or who are aged 65 years and over. • How can staff receive their vaccination? • Vaccinations can be provided in community pharmacies; all staff will need to disclose the name of the care home they work for and their role. • Vaccination pop up clinics can be arranged at care homes for >10 staff or visit your local pharmacist – for more information or to book your vaccinations visit www.londonflu.co.uk

  8. Influenza (Flu) 2019/20 #ActNow4Winter • What is a flu outbreak? • An outbreak is where two or more people in a home have similar symptoms, suggesting they may have the same infection Or a higher than normal number of people in a home that have the same infection. • What to do if you have a flu outbreak in your Care Home • A standard operating procedure (SOP) has been developed to support you with responding to a flu outbreak in a/your care home. To access the Flu SOP and other useful resources on how to assist with responding to a suspected outbreak, visit the Healthy London Partnership website: Enhanced Health in Care Homes - Winter Readiness • Concerned about the vaccine? • For more facts about flu and the vaccine visit the NHS website

  9. NHS 111 Star(*) line for care homes

  10. NHS 111 *line for care home #ActNow4Winter • Are all your care homes and staff aware of the NHS 111 *line service for care homes? • The service is designed to avoid 999 calls and unnecessary hospital admissions. • NHS 111 star line is a specialist service designed to support care homes. The service enables staff to speak to a senior clinician if they need urgent clinical support or adviceabout a resident. • NHS 111 call handlers will take resident details from the caller and transfer the call to a senior clinician. If all clinicians are already on a call there is a guaranteed call back within 20 minutes. • Are you using communication support tool when calling NHS 111 *line for care homes? • SBAR (Situation, Background, Assessment, Recommendation) is a widely used communication tool developed by NHS Improvement. The tool provides a structure to support interactions across different specialities and between different levels of staff. It seeks to support staff with providing accurate resident/patient informationand stating the reasons for escalation to a senior clinician. • For further information contact your local CCG

  11. NHS 111 *line for care homes #ActNow4Winter • Improving the NHS 111 * lines • During the Summer (2019), NHS 111 * lines were reviewed to ensure the service was providing the right level of support to the different users; paramedics (LAS), care home workers and rapid response (community services) teams. • Please note: each service is provided with a different dedicated *number. • Following this review and the invaluable feedback received from users of the service; new guidance documents and supporting materials will be developed and made available at the beginning of November 2019 • … watch this space! • For further information contact your local CCG

  12. NHSmail

  13. NHSmail #ActNow4Winter • How can NHSmail support care homes? • NHSmail enables your care home to communicate with local GPs, pharmacies, hospital teams and other health services securely and with confidence. • Having direct contact with local services will enable you to ask questions or raise concerns about your residents without delay. • How can care homes access NHSmail? • Your care home will need to complete Entry Level of the Data Security & Protection Toolkit (DSPT) to access NHSmail. If your home wishes to send and receive resident care plans you will need to complete Standards Met. • The Data Security & Protection Toolkit (DSPT) is designed to ensure providers have Information Governance (IG) policies, procedures and records in place. • Further information and resources are available on the Healthy London Partnership website

  14. NHSmail #ActNow4Winter • Ready to start your NHSmail journey? • A workbook has been developed to support you and your team to complete your DSPT and get you on your way to setting up NHSmail. • If you need assistance with completing the DSPT and would like to understand how to use NHSmail, the Enhanced Health in Care Homes team at Healthy London Partnership are ready to support you (hlp.ehecprogramme@nhs.net) • Care homes are now using NHSmail… • A short film has been produced to share how NHSmail is being used by care homes across London - click here to watch the video. • Further information and resources are available on the Healthy London Partnership website

  15. CarePulse • London Care Homes bed capacity tracker

  16. CarePulse #ActNow4Winter • Are all of your care homes and staff aware of CarePulse? • CarePulse is a bed capacity management system for all care homes across London. • Bed vacancies can be updated in less than 10 seconds and shared in real time with registered NHS, council and hospital teams. • A resource centre is also available with helpful information shared by local hospital teams and commissioners alongside up-to-date information about your local health and care systems to support with keeping residents well. • Have you activated your care home’s CarePulse account? • The CQC provide all care home information that is on the system; this includes services provided, contact details, ratings etc. • All care homes in London are on the system, however you must activate your account in order to start sharing your live vacancy information. • Register your account today • Visit www.carepulse.co.uk to register • Further information and resources are available on the Healthy London Partnership website

  17. Hydration

  18. Hydration #ActNow4Winter • Why it is important to ensure residents are hydrated • Care home residents are five times more likely to be admitted to hospital at risk of dehydration with impact on increased falls, UTIs and general deterioration. • Well-nourished residents will have increased energy and will feel much stronger both physically and emotionally. • Improved recognition and early treatment of dehydration will support the reduction of admissions to hospital. • Are you aware of your residents nutrition and hydration needs? • All residents should have ongoing assessments of their nutrition and hydration needs. Assessments should also include allergies, likes and dislikes and any support the individual needs to eat and drink. • Be aware not only of each resident’s care needs, but also of their likes and dislikes food-wise and be observant for any changes in their nutritional status (e.g. weight, skin, hair etc). • For more information about how to achieve a healthy balanced diet, read the NHS Eatwell Guide. • Further information and resources are available on the Healthy London Partnership website

  19. End of life care & expected death in a community setting

  20. End of life care #ActNow4Winter • Do all of your residents have Treatment Escalation Plans? • This allows the residents wishes for further treatment to be documented allowing your teams to confidently act on these when further clinical support is needed at the end of life. • PEACE (Proactive Elderly Advance CarE) & ReSPECTdocuments • PEACE & ReSPECT documents are used to support advance care planning (ACP) for nursing home residents prior to being discharged from hospital. • The documents include clinical advice and escalation decisions for future medical care, and acts as a guide for care home staff providing information about what they need to do for their residents when returning from hospital and how to support symptom control. • They aresent with residents when returning back to their nursing home, as agreed with GPs and care homes. • Coordinate my Care (CmC) • Coordinate my Care is an electronic care planning system which can be seen by London Ambulance staff, NHS 111 staff and GP Out of Hours services. • Coordinate my Care plans can be accessed by care homes who have completed the Data Security and Protection Toolkit (DSPT) to Standards met.

  21. Expected death in a community setting #ActNow4Winter • Existing challenges with managing expected death in a community settings? • Recent case studies identify there are system failures that can result in expected deaths being considered as suspicious/unexpected; leading to the involvement of the ambulance service, police, coroners, delays in transfer to funeral directors, distress to family and staff. • It is so important to ensure discussions take place with residents and their relatives;that they share their wishes such as preferred place of death, maximum agreed medical support at end of life and whether they would want to be resuscitated. Having these details documented makes all the difference if someone dies. Please ensure all staff are aware of residents end of life care wishes and any relevant documents are easily accessible. • An agreed single approach across London • Representatives from the London Ambulance Service, Metropolitan Police, Coroners office and NHS have formed a working group to develop and agree a single process across all services when managing an expected death in a care home or other care setting. The agreed pan-London approach will be available in the Winter (2019).

  22. National resources & campaigns

  23. National resources & campaigns#ActNow4Winter • Public Health England & NHS England / Improvement • A brand new flu vaccination campaign for health and social care workers has been launched “Time to get your flu jab” , delivered by Public Health England (PHE) and NHS England and NHS Improvement. • The campaign emphasises the protective benefit of the flu vaccination with a “Shield” motif and the message “Take care of others by taking care of yourself. If you work in the community, it’s time to get your annual flu jab”. • All materials, including adaptable artwork and social media tools, are available in the Campaign Resource Centrefor colleagues to download or print locally. • Campaign materials have been designed to show social care staff going about their work protected by the shield of flu vaccination. • We encourage all social care settings to adopt this campaign and • brand when encouraging staff to get their flu vaccinations.

  24. Your local support teams London Borough of XXX

  25. Contact details of your local support teams…

  26. Enhanced Health in Care Homes Programme Healthy London Partnership Please do not hesitate to get in touch for any further information or if you would like someone to attend a local forum or team meeting hlp.ehchprogramme@nhs.net You can also find resources on our website at www.healthylondon.org search for Enhanced Health in Care Homes

  27. Links in presentation #ActNow4Winter If you have problems with accessing any of the hyperlinks in this presentation please use full links below: Slide 3 https://www.england.nhs.uk/publication/the-framework-for-enhanced-health-in-care-homes/ Slide 5 https://www.youtube.com/watch?v=cyrYR1z-oRI&t=1s Slide 6 https://www.nhs.uk/conditions/flu/ https://www.nhs.uk/conditions/vaccinations/pneumococcal-vaccination/ https://www.nhs.uk/conditions/shingles/ Slide 7 www.londonflu.co.uk Slide 8 https://www.healthylondon.org/resource/accelerated-improvement-resources/enhanced-health-in-care-homes/winter-readiness/winter-readiness-2/ https://www.nhs.uk/live-well/healthy-body/facts-about-flu-and-the-flu-vaccine/ Slide 10 https://improvement.nhs.uk/documents/2162/sbar-communication-tool.pdf Slide 13 https://www.digitalsocialcare.co.uk/latest-guidance/completing-entry-level/ https://www.healthylondon.org/resource/accelerated-improvement-resources/enhanced-health-in-care-homes/harnessing-digital-technology/nhsmail/ Slide 14 https://www.digitalsocialcare.co.uk/wp-content/uploads/2019/06/DSPT-Entry-Level-Workbook-201920-2.pdf https://www.youtube.com/watch?v=ELdLFGbNxPs&t=2s

  28. Links in presentation #ActNow4Winter If you have problems with accessing any of the hyperlinks in this presentation please use full links below: Slide 16 www.carepulse.co.uk https://www.healthylondon.org/resource/accelerated-improvement-resources/enhanced-health-in-care-homes/harnessing-digital-technology/care-pulse/ Slide 18 https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/ https://www.healthylondon.org/resource/accelerated-improvement-resources/enhanced-health-in-care-homes/workforce-training-and-development/hydration-and-nutrition/ Slide 23 https://campaignresources.phe.gov.uk/resources/campaigns/92-healthcare-workers-flu-immunisation-

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