Falls are a major risk to our care home population. A fall can lead to a loss of confidence but often more seriously for frail vulnerable people is the risk of injury such as fracture. All homes will have residents who are at some degree of falls risk. Having one or more falls in the last 6 months significantly puts a person at risk of further falls, increasing the likelihood of a significant injury.

As care home managers the management of falls presents a massive challenge. As a quality improvement team we can support with this. Please feel free to contact Sharon Myers, Quality Improvement Nurse for help and support (sharon.myers4@nhs.net). In the meantime, here is some guidance and a list of actions which may be useful.

• Are you using the digital health service? They can provide immediate help and support in the minutes following a fall and can get help to you more quickly.
• If the person has had more than one fall, have you referred to IUCT (Intermediate Urgent Care Team). They can help with walking aides, strength and balance training etc and can provide this support at quite short notice
• If someone is still mobile, unsteady but hasn’t yet fallen, could community physio be involved. Have you made a referral?
• Have you analysed each fall? How may it have occurred, why may it have occurred? Have you considered the residents environment? Where are they falling? Could the room layout be altered?
• Have you analysed falls across the home? Are there themes, e.g are most of the falls happening in communal areas such as the lounge?
• Have you looked at individual factors such as a regular sight test, choice of footwear?
• Has the GP been informed? Is medication a factor? Does the GP want to refer to the Falls Clinic at the Hospital to look at medical factors
• Have you considered the use of falls technology such as sensors and beams?
• Have your staff had falls awareness training?

 

Falls safety cross

Falls Quality Standards - care homes

Preventing falls in older people preventing falls in older people overview

Quality Improvement Team

The Team’s initial focus has been on the Residential and Nursing Home homes rated “Inadequate/Requires Improvement” by the CQC, and an overall aim that with the support on offer from the team, all Homes will achieve Good or Outstanding ratings.

The team currently work in partnership with providers/Registered Managers in a supportive and non-judgemental way to identify areas for improvement.

The Team has continued to complete awareness sessions with staff including Care plans/DOLs applications , very much going back to basics and ensuring that the Managers are fully aware of how to meet the Regulations and Compliance.

Good relationships are being formed with other Social Care and Health professionals and also `pulling in` local resources to assist the Team.

The Team are working in partnership with ICFT, TMBC , Public Health, CQC, Contracts Performance (TMBC), Neighbourhood teams, Be Well Team, Community Mental Health Team and other Community Organisations, in order to provide the latest guidance and opportunities to Homes to try and improve the quality of those residents who live there.

QIT Newsletters

• QIT Newsletter - Spring 2019
• QIT Newsletter - Winter 2018
• QIT Newsletter - Autumn 2018
• QIT Newsletter - Summer 2018

 

The Medicines Management Team

The Medicines Management team is a team of pharmacists and technicians employed by NHS Tameside and Glossop Clinical Commissioning Group (CCG) to provide advice and support in relation to medication.  We assist GP surgeries, pharmacies, care homes, other health professionals and patients.

The main focus of their role is to support GPs to prescribe quality and cost-effective medicines, and most of the team work from GP surgeries across Tameside and Glossop (T&G) for the majority of their role.

The team is also available to offer:

• Advice to care homes (nursing and residential) with regards to medication queries; medication errors; problems involving pharmacies/GPs; best practice etc.
• Support to the council and/or continuing healthcare team in the form of medication audits at care homes
• Support at the surgeries to rationalise/bring in line medication
• Advice on appropriate treatments

 

The Team – contact details and working hours

Name	Job Title	Contact Details	Working Hours
Hannah Todd	Medicines Management Technician	Hannah.todd@nhs.net 07500 571 771	Weds-Friday
Elaine Gallagher	Medicines Management Technician	e.gallagher@nhs.net 07500 571 604	Mon – Fri
Danny Jebb	Medicines Management Technician	danny.jebb@nhs.net 07824 693 955	Mon, Tues, Thurs, Fri
Lois Kenny	Medicines Management Technician	Lois.kenny1@nhs.net 07881261306	Mon - Fri
Saarah Niazi-Ali	Antibiotic Pharmacist	s.niazi-ali@nhs.net	Weds – Fri

 

Best Interests Decision for Care Home Proxy access

Proxy access for residents with capacity

Nice guidance for managing medicines in care homes

Administration of medicines in care homes (with nursing) for older people by care assistants

Care home and with nursing – T&G medications management assessment tool

Controlled Drugs Reporting

The CQC website provides a wealth of information that will be useful for care home and with nursing home managers including:

• Guidance on care standards
• Registration
• Notifications
• Inspection and monitoring
• Contact information for providers on residential adult social care​.

Welcome to the Contract Performance and Quality Assurance section.  In 2017 we spent time looking at our contract performance and quality assurance processes for Tameside* Residential and Nursing Homes. Thank you to those of you who helped us in the development and testing of the new documentation and attended the engagement events in September and November 2017.

The new documentation is being implemented from January 2018 and all homes have been written to with details about how the process will work. A summary is provided below:

• Revised pre-visit questionnaire: this will be provided to you six weeks in advance of your annual contract performance visit. It should be completed with accompanying evidence and returned by email to: commissioningteam@tameside.gov.uk, no less than two weeks prior to the visit.  An accompanying guidance document has also been developed to support completion.   If you would like an electronic copy of the questionnaire and guidance please email: TGCCG.CAREHOMES@nhs.net.

• Tameside monthly contractual return (download and save): this should be completed and returned to TGCCG.CAREHOMES@nhs.net on the first working day of each month for the previous month, e.g. 1 February for 1 January - 31 January.  Advice and support with completion is available by emailing: TGCCG.CAREHOMES@nhs.net.

 

We will be reviewing how the documentation has worked in the summer of 2018, we welcome your views and suggestions, please contact us by email: TGCCG.carehomes@nhs.net.

NB: Please note Derbyshire County Council will continue with existing contractual performance processes for Glossop residential and nursing homes.

 

The purpose of the digital health scheme is to allow residents and their carers to contact clinicians at the Digital Health Centre to have consultations on health conditions as they arise, allowing the person to be treated remotely where this is clinically appropriate.  Initially the focus of the work relates to intervening at a point of perceived crisis but can be developed to avoid in some instances, where clinically appropriate, to reduce the need for residents in care homes to attend hospital where this could be delivered through a digital interaction.

It is acknowledged that interventions from neighbourhoods will be closely linked with digital health in care homes and therefore clinical pathways will be co-designed with localities.

This would mean, for example, that a patient with Parkinson’s disease living in a residential home will be able to access clinical advice and support through secure video conferencing at any time of the day or night, so in the event of a fall, an experienced nurse in the Digital Health Centre would be able to assess the patient using the video link and after consultation with the patient or staff access records and make an informed decision around a safe plan to allow them to be cared for in their familiar surroundings, rather than transferring them to A&E if unnecessary.

In addition, the enhanced care model provides links to social care to complete a falls prevention assessment of the layout of the patient’s room, and a multidisciplinary team including carers, nurses, therapists, social care and the voluntary sector work in partnership to deliver care and support, promoting independence and improving quality of life.

What are the benefits to residents?

• Treatment in their place of residence
• Professional safe up to date care
• Face to face conversations
• Offers reassurance to patient as we are able to see the problem
• Reduces waiting for the GP visit
• Accelerates other community services and wrap around care
• Gives relatives time to ask questions and speak with trained staff
• Follow up service
• Free at the point of access

 

What are the benefits to care staff

• Immediate advice and guidance
• Reassurance
• Saves time from waiting on the phone to contact GP and other health care services
• Reduces the need for staff to attend hospital with patients if patient able to remain at home
• Call back service check how patients are doing
• Ability to call back as many times as required should the situation change
• Simple to use equipment
• Training and development of staff
• No additional costs to the home 

 

Operational hours and contact details

• Monday to Friday from 8am to 10pm,
• Saturday and Sunday from 8am to 6pm - this will be extended in the near future to 10pm
• The contact numbers for the centre are 0161-922-4459 | 0161-922-4460 | 0161-922-4257

 

Useful information for care home and care home with nursing managers

• Digital Health - What is Delirium
• Head injury advice for carers
• Head injury clinical advice
• Project statement digital health
• Samsung tablet user guide 28032017
• Service leaflet
• Dehydration
• Gulp Chart
• Pee Chart

 

The Queens Nursing Institute has launched a new educational resource for nurses who work or are considering working in the care home.

The QNI offers a range of free online resources to support nurses who are new to community and primary care settings. These resources are designed to be useful for student nurses, nurses who have recently started working in the community, or who are considering a career move. The resources are designed to be used with the help of a mentor.  For further information visit the QNI website here. 

Free Catheterisation training Sessions for Registered Nurses!

Catheterisation training sessions are free for all Registered Nurses at T&G ICFT.  Dates are below, for further info. please contact Sharon Myers on Sharon.myers4@nhs.net

The Mental Health Service for Older People provides assessment and treatment to clients who are suspected or have a confirmed diagnosed mental health problem.  This can include a patient with a diagnosis of:

• Dementia
• Depression
• Delirium
• Psychosis

 

The teams are able to offer support with behavioural management; delirium management; medication advice; capacity assessment; diagnosis; managing risks associated with behaviour; education and advice on mental health issues to clients, carers, professionals.

Information is available by clicking on the links below:

• Referral information for older people’s mental health services 
• Information about how the referral system works and access to local mental health services

For course information click on the button above.

The Tameside and Glossop Integrated Care NHS Foundation Trust (T&G ICO)Tissue Viability service operate both in hospital and within community services.  They offer training to all care home staff, and will also visit patients within the care home settings via referrals from the district nurses and/or GP.

They are an integrated service which provides a wide range of services and education regarding all aspects of Tissue Viability, these being:

• Pressure area care
• Specialist dressings and advice
• Pressure relief equipment advice
• Lymphedema services

 

Their services are available through referral methods (GP, district nurse, etc).

They also provide pressure ulcer training to all care home staff at the hospital site, this is open to all staff working within the care home environment. Dates will be available soon via this web page.

Contact details

• To book telephone: 0161-922-4203
• Email: ET&DReception@tgh.nhs.uk

 

Useful Links

• React to Red 
• Pressure Ulcers – NHS choices 
• Greater Manchester Network

 

We are very keen to hear all of your comments, ideas and suggestions on how we can improve this webpage. Please contact us by e-mailing TGCCG.carehomes@nhs.net.

Tameside & Glossop Red Bag Scheme

Tameside & Glossop Red Bag Scheme is due to launch on Wednesday 19th September 2018

A Red Bag will be provided to all people who reside in a Care Home/Nursing Home when they need to be admitted to hospital.

When a Care Home Resident goes into hospital the Red Bag goes with them, it goes with them in the ambulance and stays with them throughout their journey.

Inside the Red Bag will be personal belongings including a set of clothes and a Patient Passport with important information about the person and important documentation relevant to their care/clinical needs (Medication sheet, DNAR (original Copy) and Herbert Protocol etc.)

The Tameside & Glossop Red Bag Scheme is part of a National Drive to improve communication, safety and the persons experience as they transfer across care settings.

For more information contact
Anna Livingstone/Tracey Hurst
0161 342 5525

Or Email
tgccg.redbags@nhs.net

Resources

Red Bag Consent

Red bag Confidentiality Brief

Red Bag Cleaning Protocol Tameside

Hospital Passport

Red bag Care Home Staff Briefing

Red Bag Scheme Poster

 

 

 

Safeguarding is the protection of adults and children from abuse neglect or harm.  The key pieces of legislation that we refer to in order to protect children and adults are Children Act 1989, Children Act 2004, Children and Families Act 2014 and Care Act 2014.

The Care Act 2014 describes an adult who may need protection under Adult Safeguarding Duties as:

• A Person who is 18 and over
• Have care and support needs
• And is experiencing neglect or abuse or is at risk of neglect or abuse
• And because of the care and support needs is unable to protect themselves

The Care Act requires that each Local Authority must make enquiries, or cause others to do so, if it believes an adult is experiencing, or is at risk of abuse or neglect.

Safeguarding is Everybody's business

• If you suspect a child or adult is being abused and there is immediate danger you must call the Police on 999.
• If you suspect a child is being abused or mistreated or you have concerns about their welfare but they are not in immediate danger you must contact: Children's Social Services (Tameside) on telephone: 0161 342 4101.
• Tameside Safeguarding Children Board - local policies, procedures and publications.
• If you suspect an adult is at risk of abuse or being abused you must speak to your organisations Safeguarding Adult Manager immediately following local multi-agency policy and guidelines.
• Tameside Metropolitan Borough Council - Adult Abuse (Safeguarding Adults).
• If there is not a Safeguarding Adult Manager in your organisation or they are not contactable then you must contact the Adult Social Services (Tameside) on telephone: 0161 342 4299/2400.
• For information about Safeguarding Adult Training including Safeguarding Adult Managers training contact the Adult Safeguarding Team on telephone: 0161 342 5217/ 5229/5243
• For the Greater Manchester CCG Safeguarding Standards please click here

 

Derbyshire Safeguarding Children’s and Adults Information and Contacts

• Derby Safeguarding Children Board - Helping to keep children and young people safe in Derby
• Derbyshire Safeguarding Adult Board

Updated GM Safeguarding Policy

GM Safeguarding Contractual Standards

Appendix 2 Audit Tool for MCA

Appendix 3 Audit Tool for Safeguarding

 

For information on local training opportunities provided by Tameside Training Consortium please click here.

 

The Infection Prevention team acts as a source of specialist advice within the Tameside and Glossop area. The team is based at NHS Tameside and Glossop Integrated Care NHS Foundation Trust and is available to provide residential and nursing homes with specialist advice and support with:

• Infection control issues
• Management of outbreaks
• Information about health care associated infections
• Leaflets and posters regarding information prevention
• Audit and audit advice for homes
• Support with infection prevention training

 

Contact Details

• Peter Morgan, Lead infection prevention nurse
• Lesley Murphy, Infection prevention nurse
• Michael Lickfold, Infection prevention nurse
• Tel 0161 922 6194
• 3rd Floor Charlesworth Building,Fountain Street,Ashton-Under-Lyne OL6 9RW

 

Infection Control

Below you can find links to general information about infection control and resources such as posters and educational information.

Education

• CPE_single point lesson - July 2015
• Infection prevention care homes workbook - V5

General

• DOH simple guide to MRSA
• Infection control guidance for care homes
• Prevention_and_control_of_infection_in_care_homes - An_information_resource
• The revised healthcare cleaning manual

Hand Hygiene

• Alcohol handrub - hand hygiene technique
• GPSC hand rub wash
• Hand hygiene single point lesson - August 2015
• Residential_care five moments
• Wet wash_and_rinse

Outbreak management

• PHL Resp sampling offer letter October 2018
• GM ARI Outbreak in Care Homes Joint SOP
• PHE NW (GM) Flu Resource Pack for Care Homes 2018
• Detailed resp virus testing kit instructions
• SOP managing outbreaks ILI Care Homes 2018/19
• Outbreak of diarrhoea and vomiting
• Sample_taking_3

Posters and leaflet

• Drink More Fluids
• Catch_it__Bin_it__Kill_it_poster
• Coughs_and_sneezes_spread_diseases_poster
• Flu_in_care_homes_guidance_- single point lesson
• MDA_2010_002_pattress_poster_website 1
• National_colour_poster (1)
• poster for visitors flu
• Sharps safety poster_1

Tools

• Infection prevention team audit tool

 

 

Tameside and Glossop Carer Information Sessions 2018  - Do you support / care for someone with a diagnosis of Dementia?	Carer Information Sessions 2018
Tameside and Glossop Dementia Awareness Training - 2018 dates for staff	Dementia Awareness Training and Events
John's campaign	PowerPoint slides
Printable leaflets on a selection of topics relating to Dementia	Dementia UK website
Admiral nurse in Tameside and Glossop.	Who we are and contact details
Admiral nurse referral form	Community referral form
Twiddle muff	Knitting pattern and crochet pattern
Do you care for someone who has dementia and worry they may go missing?	The Herbert Protocol

 

Six steps to success to providing end of life care in care homes. 

For course information click on the button above.

End of Life care; support and advice.  The Community Specialist Palliative Care Team provides specialist palliative care to the people of Tameside and Glossop. This includes people who live in nursing and care homes as well as in their own homes. They are also able to provide specialist advice and support to care home staff.

How to get in touch Name	Support	Contact
Fiona Horrocks	End of Life Care Facilitator for Care Homes and Community- education support	Fiona.horrocks@nhs.net TEL: 0161 342 7761
Julie Moran	Macmillan Clinical Nurse Specialist (Palliative Care) focusing primarily on Care Home residents	juliemariemoran@nhs.net Tel: 0161 342 7770
General Number/Advice	Macmillan Specialist Palliative Care Team (Community)	Tel: 0161 342 7770
District Nurses	General palliative care, support and symptom management	Contact own local DN team number

 

Useful links and documents

• Advance Care Planning and Communication Skills - One day course
• Training Dates 2019 Six Steps
• Foundations in Palliative Care Flyer
• Intermediate Level in Palliative Care Flyer
• One Chance to Get It Right – Improving people’s experience of care in the last few hours and days of life
• Good Decision Making – What you need to know about the Mental Capacity Act and End of Life care
• Priorities for care of the dying person – Poster
• Abbey Pain Scale (adapted) A useful tool for assessing pain in a person who is unable to describe it due to a cognitive difficulty, such as dementia).  Please contact the End of Life Team for support and guidance. 
• NICE Guidance - Oral health for adults in care homes
• Coroner Referal leaflet
• IPOC Communication booklet
• Individual Plan of Care for the Dying Person in the Last Days and Hours of Life (IPOC)
• Family leaflet ipoc June 2017
• North West DNACPR Patient Information leaflet

 

Advance Care Planning

• My Care My Way
• Statement of Wishes, Without Capacity
• For Staff ACP info

Tameside and Glossop Care Home and Support at Home Event – 8 March 2018

Workshop write-up and presentations - for details click here (word document for download).

Tameside & Glossop Strategic Commission have decided to implement a Buddy Scheme to assist new and junior Care Home Managers in the early months of their employment.

A buddy program is solely involved with providing a one-point access to operationally necessary information. 

The Buddy Program will match new Managers with Managers who have been established in the borough of Tameside & Glossop Borough for some time (typically 12 - 18 months), for a period of six months, with two goals:

• To provide the new Manager with a point of contact for general queries regarding day-today operational issues, such as the Adult Care and CCG Safeguarding Teams, Information Processing requirements and other relevant stakeholders/providers
• To help the new Manager integrate with the borough by providing access to someone who is familiar with the culture, attitude and expectations

The program is coordinated by the Quality Improvement Team  
For further information contact:   tgccg.qualityimprovementteam@nhs.net

Resources
Buddy Scheme Guidance
Buddy Scheme Poster                               

This guidance from the Health and Safety Executive (HSE) provides important information on ensuring a safe and healthy environment for both your residents and your staff.

Resources
Health and Safety in Care Homes

 

Mandatory Requirement to be completed annually
Two levels: Entry level and Standards met
Completion of Entry level gives you access to NHS Email Accounts
Completion of Standards met gives you access to
Skype and Summary Care Records

What you need to do next

Book on a WebEx or Tool kit Demo by emailing the contact name in brackets
Full WebEx:   Includes a presentation and overview of the DSPT and a brief demo of the tool kit at the end
Toolkit Demo : Full demo of the toolkit covering all 16 questions required for Entry Level
WebEx dates

Book On Free GM Roadshow

2nd July 09.30 –10.00 Room 4003 Level 4 Town Hall Extension Manchester M60 2LA
Contact: angela.king15@nhs.net, peter.adeyemo1@nhs.net
Roadshow dates