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Found 287 results
  1. Content Article
    This year, the World Health Organisation’s annual World Patient Safety Day on 17 September 2022 will focus on medication safety, promoting safe medication practices to prevent medication errors and reducing medication-related harm. Patient Safety Learning has pulled together some useful resources from the hub about different aspects of medication safety - here we list six top Learn articles about medication safety in social care.
  2. News Article
    The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022
  3. News Article
    Millions of people will be invited for their autumn Covid booster jab in England and Scotland, with care home residents the first to receive them. Although infections are falling, health bosses are predicting a resurgence of Covid and flu this autumn and winter. They are urging those eligible to protect themselves from serious illness by getting vaccines against both. A recently approved vaccine against the Omicron variant will be used first. However, there is not enough of Moderna's "bivalent" vaccine to protect everyone aged over 50 so health officials say people should take whichever booster they are offered. These will be the vaccines used in the spring. The UK's Medicines and Healthcare products Regulatory Agency (MHRA) announced on Saturday that it had approved a second "bivalent" coronavirus vaccine from Pfizer/BioNTech for people aged 12 and over. Read full story Source: BBC News, 4 September 2022
  4. Content Article
    Medication safety has long been a major issue in long-term social care due to the number of medications taken by many older people. This editorial in BMJ Quality & Safety looks at why managing medications in care homes is so complex and highlights potential interventions to improve medication safety in long-term care settings.
  5. News Article
    Thousands of vulnerable people are suffering inadequate care as severe staffing shortages in previously good care homes push operators to break rules and put residents at risk. A wave of inspections has revealed the human impact of a worsening nationwide staffing crisis, with people being left in their rooms 24 hours a day, denied showers for over a week, enduring assaults from fellow residents, and left soaking in their own urine. Stretched staff have described scrambling to help residents with buzzers going off and fear the squeeze on their time is dangerous. Analysis by the Guardian revealed that staff shortages were identified as a key problem in three-quarters of all the care homes in England where the Care Quality Commission regulator had cut their rating from “good” before Covid-19 to “inadequate” this summer. A further 10% of homes whose rankings slumped had enough staff, but failed to recruit safely, either not taking references properly, carrying out criminal records checks, or training staff adequately. Families said the staffing shortages had reached “crisis point”. “Older people are paying a heavy price for these failings, as poor care robs them of their dignity, breaks their will and makes them feel unsafe in their own home,” said Helen Wildbore, director of the Relatives and Residents Association. “Older people need much more than empty slogans from the next prime minister about ‘fixing social care’.” Read full story Source: The Guardian, 21 August 2022
  6. News Article
    The Irish health services did “relatively well” during Covid-19 but, as in other countries, the pandemic unmasked existing problems, a renowned patient safety expert has said. Peter Lachman of the Royal College of Physicians of Ireland (RCPI), was one of nine international experts who consulted on a new World Health Organization (WHO) report on the implications of the Covid-19 pandemic for patient safety. Dr Lachman said the impact is only starting to be understood. “Ireland did very well early on [in the pandemic], then opened up over Christmas [2020] which led to our numbers going sky-high, then we clamped down again,” he said. "We did well on some things and not so well on others. We have done relatively well when compared with other countries." “Covid-19 was an event which around the world unmasked problems which were there already rather than creating them necessarily,” he said. “The findings start with safety problems — we’ve had safety problems in Ireland but things are getting better. There is a good strategy coming on. I’ve worked with hospitals around the country on this. It’s no worse than other countries.” Read full story Source: The Irish Examiner, 12 August 2022
  7. News Article
    A care home nurse has been struck off after he gave a brain tumour patient sugar and water instead of pain relief. Vijayan Rajoo said he felt the patient was "just being lazy" and did not need pain relief. Rajoo, 64, also failed to check supplies in the controlled drug cupboards at the start and end of his shifts, according to a misconduct panel. He was struck off for 18 months after a deputy manager at the home, St Fillans in Colchester, Essex, discovered 20ml of liquid morphine Oramorph was unaccounted for in June 2019. Rajoo later confessed to not giving the brain tumour patient a dose of Oramorph as a form of pain relief as he felt the patient "did not need it". It was reported the patient could immediately tell the sugar and water mix "didn't taste right". The misconduct panel found all charges against Rajoo proven. In their conclusions, the panel said Rajoo showed a "serious lack of compassion". Read full story Source: ITV News, 13 August 2022
  8. Content Article
    Adverse incident research within residential aged care facilities (RACFs) is increasing and there is growing awareness of safety and quality issues. However, large-scale evidence identifying specific areas of need and at-risk residents is lacking. This study from St Clair et al. used routinely collected incident management system data to quantify the types and rates of adverse incidents experienced by residents of RACFs.
  9. News Article
    Prescribing potentially harmful antipsychotic drugs to people with dementia has increased by more than 50% on average in care homes during the pandemic, new research suggests. It found that the number of people with dementia receiving these prescriptions had soared from 18% to 28% since 2018 – with prescription rates of over 50% in a third of care homes. Professor Clive Ballard, who was part of a national campaign in 2009 to reduce antipsychotic prescribing by half, said: “Covid-19 put tremendous pressure on care homes, and the majority of them must be applauded for maintaining relatively low antipsychotic prescribing levels amid incredibly difficult circumstances." “However, there were very significant rises in antipsychotic prescribing in one third of care homes and we urgently need to find ways to prioritise support to prevent people with dementia being exposed to significant harms.” Antipsychotic drugs are used to treat some of the more distressing behavioural and psychological symptoms of dementia, such as agitation and psychotic episodes. They have only very limited, short-term benefits in treating psychiatric symptoms in people with dementia – but significantly increase the risk of serious side effects, including stroke, accelerated decline and death. Dr Richard Oakley, from the Alzheimer’s Society, added: “This study shows the shocking and dangerous scale of the use of antipsychotic drugs to treat people with dementia in care homes. “Alzheimer’s Society has been campaigning for a move away from the model of ‘medicate first’ and funded research into alternatives to antipsychotic prescriptions, focused on putting people living with dementia at the centre of their own care. “This drug-free, tailored care can help avoid the loss of lives associated with the harmful side effects of antipsychotic medications.” Read full story Source: The Independent, 4 August 2022
  10. News Article
    A nurse who recorded she had given medication to care home residents when in fact she had delegated the task to unqualified staff has been struck off. Adelaide Maloane was working a night shift at Somerleigh Court in Dorchester, Dorset, in August 2019 when the incident took place. Ms Maloane delegated giving 16 medicines to residents to an unqualified healthcare assistant at the home. The Nursing and Midwifery Council said Ms Maloane had "failed to acknowledge the seriousness of her misconduct and dishonesty and the implications of her actions for residents, colleagues and the reputation of the nursing profession". Read full story Source: BBC News, 21 July 2022
  11. Content Article
    This article discusses how medication safety can be improved in Canada. It explores the complexities of aging, what can go wrong with medication, 'Best Possible Medication Histories', the role of pharmacists and paramedics, engaging with patients and their families, and improving communication across the healthcare system.
  12. Content Article
    Medication errors are a common issue within the care home sector, impacting on the health and wellbeing of residents as well as creating challenges for care home staff and managers. This report addresses the issue of medication safety in care homes in England. Through intense engagement with a representative sample of care homes and stakeholders involving an electronic survey, workshops and conversations, Patient Safety Collaboratives have sought to understand the reasons for medication errors and how these could be avoided in the future.
  13. News Article
    Heather Lawrence was shocked at the state she found her 90-year-old mother, Violet, in when she visited her in hospital. "The bed was soaked in urine. The continence pad between her legs was also soaked in urine, the door wide open, no underwear on. It was a mixed ward as well," Heather says. "I mean there were other people in there that could have been walking up and down seeing her, with the door wide open as well. My mum, she was a very proud woman, she wouldn't have been wanted to be seen like that at all." Violet, who had dementia, was taken to Tameside General Hospital, in Greater Manchester, in May 2021, after a fall. Her health deteriorated in hospital and she developed an inflamed groin with a nasty rash stretching to her stomach - due to prolonged exposure to urine. She died a few weeks later. Heather tells BBC News: "I don't really know how to put it into words about the dignity of care. I just feel like she wasn't allowed to be given that dignity. And that's with a lot of dementia patients. I think they just fade away and appear to be insignificant, when they're not." New research, shown exclusively to BBC Radio 4's File on 4 programme, has found other dementia patients have had to endure similar indignity. Dr Katie Featherstone, from the Geller Institute of Ageing and Memory, at the University of West London, observed the continence care of dementia patients in three hospitals in England and Wales over the course a year for a study funded by the National Institute for Health and Care Research. She found patients who were not helped to go to the toilet and instead left to wet and soil themselves. "We identified what we call pad cultures - the everyday use of continence pads in the care of all people with dementia, regardless of their continence but also regardless of their independence, as a standard practice," Dr Featherstone says. Read full story Source: BBC News, 21 June 2022
  14. News Article
    Severe restrictions imposed on care home residents in Scotland during the Covid pandemic caused "harm and distress" and may have contributed to some deaths, academics have said. A 143-page report has been produced by Edinburgh Napier University. It had been commissioned by the independent inquiry into the country's handling of the pandemic. The report says that the legal basis for confining residents to their rooms and banning visitors was "unclear". And it said care home residents were arguably discriminated against compared to other citizens. The report is 1 of 14 that have been published by the Scottish Covid-19 Inquiry, which is chaired by Lady Poole. It found that in the early months of the pandemic there was "little evidence" that the human rights of residents and their families had been considered. It said: "There is substantial evidence of the harm and distress caused to residents and their families by the restrictions imposed in care homes. "This includes concerns that, particularly for people with dementia, being unable to maintain contact with their family exacerbated cognitive and emotional decline, potentially hastening their death." Read full story Source: BBC News, 16 June 2022
  15. News Article
    A chief executive has described her ‘considerable regret’ that growing difficulty in discharging patients has resulted in nearly half of her trust’s inpatients being clinically ready to leave. Debbie Richards, who leads Cornwall Partnership Foundation Trust, a community and mental health provider, highlighted the issue at the trust’s board meeting last month, amid a “dearth of adult social care provision” across the country. In her update to the board, Ms Richards said delays in finding onward care for patients awaiting discharge meant “almost 50 per cent of our community hospital beds are occupied by patients who have no medical need to be in hospital”. In her report to the board, Ms Richards said: “Despite having over 5,000 care home beds in Cornwall, the majority of these are full, or care home providers are unable to offer beds because of a lack of staffing. “Where there is capacity, this tends to be for lower-level residential beds where unfortunately there is much less demand.” Siobhan Melia, chair of the NHS Community Network and CEO of Sussex Community FT, said the “dearth of adult social care provision” was the biggest limiting factor in discharging delayed patients home, followed by high staff vacancies and sickness absence." She called for a national long-term funding settlement for social care and reform of the sector to address the key challenges. Read full story (paywalled) Source: HSJ, 10 May 2022
  16. News Article
    Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court. The ruling comes after two women took former Health Secretary Matt Hancock and Public Health England to court. Dr Cathy Gardner and Fay Harris said it had caused a "shocking death toll". Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic. Dr Gardner and Ms Harris partially succeeded in claims against Mr Hancock and Public Health England. The women claimed key policies of discharging patients from hospitals into care homes were implemented with no testing and no suitable isolation arrangements in the homes. A barrister representing Dr Gardner and Ms Harris told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales. Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be "uniquely vulnerable" to Covid. "The government's failure to protect it, and positive steps taken by the government which introduced Covid-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era," he added. Read full story Source: BBC News, 27 April 2022
  17. News Article
    A nurse with no qualifications gave a care home resident a fatal dose of the wrong drug, leading to her death before she then tried to cover up her mistake. Katherine Hutchinson gave Fiona Jayne Thorne a fatal overdose of a powerful anti-psychotic drug, which was meant for another patient, an inquest heard. She then tried to cover up her errors which contributed to the death of the 36-year-old with learning difficulties, Derbyshire Live reported . Ms Hutchinson had, at the time, been the nurse in charge at Whitwell Park Care Home, in Whitwell, Derbyshire despite not having any qualifications. She gave Miss Thorne clozapine, which had been intended for another resident, on October 6, 2010. Instead of owning up to what she did, Ms Hutchinson then tried to cover up her mistake by taking Miss Thorne to bed and leaving her there until she was discovered, Senior Coroner Dr Robert Hunter said. Miss Thorne was "found by the care support worker around midnight, when undertaking routine checks on residents”, the inquest heard. And then Ms Hutchinson’s mistake was only discovered after an audit was carried out of the medication trolley and a dosage of clozapine was found. Read full story Source: Mirror, 8 April 2022
  18. Content Article
    This Joint Committee on Human Rights inquiry will look at human rights concerns in care settings in England, highlighting areas in which the human rights of patients, older people and others living with long-term disabilities, including learning disabilities and autism, are currently undermined or at risk.
  19. News Article
    A trust has admitted it is having to discharge patients inappropriately into care homes or community hospital beds because of a shortage of home care workers. A report to East Kent Hospitals University Foundation Trust’s board last week revealed that 160 extra beds had been commissioned to maintain flow across the local health economy “due to insufficient domiciliary/care package capacity.” It went on: “The clinical commissioning group have tried via Kent County Council to commission additional domiciliary care without success. It is acknowledged by the local health economy that it is important to withdraw from these additional beds as quickly as possible as they are not a cost-effective resource and more importantly, in many cases, they are not the ideal discharge destination for those patients who could have been discharged home with a care package. “Patients are being transferred into community hospital beds or residential home beds due to a lack of domiciliary care packages. Although this is a national issue, it will not be resolved locally until appropriate pathway capacity is commissioned.” Professor Adam Gordon, president elect of the British Geriatrics Society, said: “If people have been sent to a care home when they don’t want or need to be there that can affect their motivation and result in a form of deconditioning. One of the principles of effective rehabilitation in older people is that if you don’t use it, you lose it.” Read full story (paywalled) Source: HSJ, 17 March 2022
  20. News Article
    A hospital in Devon has declared a second critical incident following extreme pressures, as Covid-19 admissions in the region double, The Independent has learnt. North Devon Healthcare Trust declared a critical incident on Monday, after it declared another earlier this month it has confirmed. The news comes as the number of people with Covid-19 across two hospitals in Devon has doubled in just two weeks. As of Thursday, there were 292 Covid positive patients in across hospitals in Devon, with a further 37 awaiting test results. According to a statement from healthcare leaders in Devon, Plymouth and Torbay, as of Thursday there were almost 1,200 NHS staff off work due to Covid. Meanwhile 183 care services, such as care homes and other social care providers, in the area have reported Covid outbreaks, making it harder to discharge patients, the leaders said. NHS data published on Thursday showed there were 213 patients across three hospitals in Devon, waiting to be discharged. Covid-19 infections are also continuing to rise across most of the UK, with levels in Scotland hitting another record high, new figures show. Read full story Source: The Independent, 19 March 2022
  21. News Article
    An inspection of a county's urgent and emergency services found delays were caused by a lack of empty beds and prolonged waiting times. The Care Quality Commission (CQC) inspected Gloucestershire emergency care services in November and December. The report found staff worked well in challenging circumstances but the CQC said pressures on workers across the system needed addressing. Dr Jeremy Welch said: "The system is being stretched and we need to adapt." CQC deputy chief inspector for hospitals, Nigel Acheson, said: "We found the system to be complicated. As a result, staff and patients weren't always able to understand which urgent and emergency care service was best suited to their needs. "This meant people sometimes attended the emergency department when they could have been treated more appropriately elsewhere." In addition the report touched on adult social care and the possibility of using empty care home beds when hospitals were struggling to cope. Dr Welch recognised "it's been a blinking tough time in care homes" over the pandemic and credited the relaxing of rules to allow visits but said there are other factors that would need to be considered. However he added: "We've got enough beds when we map across, it's just getting patients through the hospital and home because home is where they want to be." Read full story Source: BBC News, 17 March 2022
  22. News Article
    Hundreds of England’s care homes could be closed and care rationed because the government has “seriously underestimated” the costs of a shake-up, experts are warning. Widespread closures would leave hundreds of thousands of elderly and vulnerable residents homeless. Those in the southeast, the east and the southwest would be hardest hit, according to a new study. Under a package of social care reforms announced in September, ministers are aiming to make care fees fairer between private and state fee payers. At the moment, residents who self-fund all their care pay up to 40% more on average than those eligible for state support, for whom their local authority arranges care, and care homes charge councils lower rates. Read full story Source: The Independent, 18 March 2022
  23. News Article
    More than 1,300 patients a year are having NHS funding for their palliative care withdrawn after living longer than expected, BBC analysis shows. Terminally ill or rapidly-declining patients are given fast-track support, allowing them to live outside hospital. From 2018 to 2021, a total of 9,037 people had this funding reviewed in England and Wales, with 47% of them losing all support. A further 15% of patients had their continuing healthcare support replaced with the more limited NHS-funded nursing care. Sandra Hanson was referred to the fast-track pathway of the NHS continuing healthcare scheme in mid-2020, after her needs were judged by a clinician to be "end of life". She was diagnosed with end-stage dementia, and had been in hospital eight times in the previous year following multiple falls and bouts of pneumonia. The funding covered the costs of a nursing home, where she suffered fewer falls. But in March 2021, this funding was reviewed by her local Clinical Commissioning Group (CCG). These assessments, usually undertaken by a multi-disciplinary team including health and social care professionals, consider the severity of a person's needs in areas such as mobility, cognition and behaviour. Sandra's daughter, Charlotte Gurney, said the family was represented by a social worker they had not previously met, and describes the meeting as "traumatic" as she tried to explain her mum's needs. "We just felt not listened to... we were treated as if we were trying to swindle the system. Sandra's support was withdrawn, and she had to be moved to a new nursing home, financed by her husband Malcolm. Shortly afterwards, she broke her wrist following a fall and injured her face. The family believe had the review correctly identified Sandra's needs and risks, this could have been avoided. Read full story Source: BBC News, 17 March 2022
  24. News Article
    Lateral flow tests could cost care home visitors £73 a month, a leading UK charity has said, as it renewed calls to keep the devices free in such settings. The government has previously announced that free testing for the general public will end from 1 April, and that this will include care home visitors. However, charities have warned the shift away from free tests could place a heavy financial burden on those visiting care homes, where testing is still advised. James White, the head of public affairs and campaigns at the Alzheimer’s Society, said the proposed charge on lateral flow tests for visitors to care homes was a cruel tax on care. “Over the past two years, we’ve consistently heard many tragic stories from families struggling to visit their loved ones in care homes. For many people with dementia, this isolation has led to a significant deterioration in their condition and mental health,” he said. “With infection rates rising once again, the government must provide free lateral flow tests for all visitors to care homes so that families are not put in an agonising position where they are forced to ration visits, leaving people with dementia once again isolated and alone.” Caroline Abrahams, Age UK’s charity director, said: “No one should have to pay out of their own pocket for tests in circumstances where the expert advice is clear that testing remains an important safeguard against Covid,” she said. “If care home visitors are going to continue to be asked to keep testing to protect their loved ones, it would be completely unacceptable to expect them to pay.” Read full story Source: The Guardian, 15 March 2022 Further reading Visiting restrictions and the impact on patients and their families: a relative's perspective
  25. News Article
    The White House has announced plans to boost nursing home staffing and oversight, blaming some of the 200,000-plus covid deaths of nursing home residents and staff during the pandemic on inadequate conditions. Officials said the plan would set minimum staffing levels, reduce the use of shared rooms and crack down on the poorest-performing nursing homes to reduce the risk of residents contracting infectious diseases. The White House also said it planned to scrutinise the role of private equity firms, citing data that their ownership was linked with worse outcomes and higher costs. Nursing homes have been an epicenter of covid spread during the pandemic, as the virus initially tore through facilities before vaccines were available in 2020, and then continued to sicken and kill residents at an elevated rate last year. Advocates have demanded better policies to ensure the facilities are prepared for emergencies and follow practices to curb the spread of infections. Under Biden’s plan, officials at the Centers for Medicare and Medicaid Services will propose minimum staffing levels within the next year, which the White House said would improve safety by ensuring residents receive sufficient care and attention. The administration also cited a study that found increased staffing levels were linked with fewer covid cases and deaths. The nursing home industry has warned that the pandemic has exacerbated long-running staffing shortages, noting that roughly 420,000 employees in nursing homes and long-term care facilities, many of whom complained about low pay, have departed over the last two years. Read full story (paywalled) Source: The Washington Post, 28 February 2022
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