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Content ArticleIt is no secret that social care was under immense pressure well before the spread of the COVID-19. Those involved in social care have been calling for the introduction of long-term reforms to ensure that it is fit for purpose, that care workers are invested in and that appropriate support is in place for unpaid carers. Going into the 2019 General Election, all parties recognised the need to reform the system and the Conservative Party was elected on a pledge to find a long-term solution for social care.[ As the impact of the pandemic now takes hold, the ability of the social care system to respond to these issues is beginning to come into focus. In this blog, we look at the emerging patient safety issues the pandemic is creating in the sector, focusing on four main areas: Staff safety and lack of access to appropriate personal protective equipment (PPE). The pandemic’s impact on existing social care and provision for non COVID-19 patients. The impact on carers and families of those receiving social care. The reporting of COVID-19 deaths outside of hospitals. In response to these issues, Patient Safety Learning have identified some essential steps that that can be taken at a national and local level to tackle some of the most urgent patient safety concerns: Staff safety PPE distribution to social care should be treated with the same urgency as it is for healthcare. Clear guidance should be provided on PPE requirements for specific social care roles. Clear guidance should be provided on what steps staff can take to report problems accessing PPE. Steps must be taken to ensure that there is enough staffing and volunteer capacity to enable staff to work safely. Patient safety All patients and social care service users should receive the care requirements outlined in their care packages. There should be clear guidance on what steps families and staff can take to report problems in service provision or to report safety concerns. Mitigating the impact on existing care and treatment The rollout of testing for COVID-19 in social care needs to increase as soon as possible to identify and isolate outbreaks. We need to work with care providers to support the continued provision of services and provide adequate staffing levels during this period. We must work with third sector organisations to help provide guidance and support for carers and families. We need to ensure that the extra funding committed to the healthcare system is also available to provide to social care.
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News Article
Residential homes 'desperate' for PPE, as two care workers die
Patient Safety Learning posted a news article in News
The first two coronavirus deaths among care workers in England were announced, as industry leaders hit out at chronic shortages of protective equipment and urged the government to start treating social care as “a second front line”. Carol Jamabo, 56, a community carer for Cherish Elderly Care in Bury in Greater Manchester, died last Wednesday. Another carer died in a home run by MHA, the UK’s largest charitable social care provider, which said it was unclear where she contracted the virus. The death of a West Dumbartonshire care worker that emerged on Sunday was also confirmed by the Scottish first minister, Nicola Sturgeon. The fatalities came amid rising concern that those working in social care still do not have the protection they need amid the Covid-19 pandemic and that, without testing for the virus, staff risk contaminating care homes where elderly people are supposed to be “shielded”. Read full story Source: The Guardian, 6 April 2020 -
News Article
Non-acute services to receive 30 million PPE products
Patient Safety Learning posted a news article in News
Adult social care services are to receive millions of personal protective equipment products following a national audit of personal protective equipment (PPE), HSJ can reveal. The government will deliver more than 30 million items to local resilience forums in the coming days, for distribution among social care and other front-line services, according to a letter seen by HSJ. The stock should not be sent to acute trusts or ambulance services, the letter, from health and social care secretary Matt Hancock and housing, communities and local government secretary Robert Jenrick, stated. Describing an “urgent need” for PPE in front-line services, Mr Hancock and Mr Jenrick asked local planners to distribute this latest batch of stock “only where there is a clear and pressing need”. Read full story Source: HSJ, 6 April 2020 -
News Article
Coronavirus: Nearly 400 care groups 'face protection shortages'
Patient Safety Learning posted a news article in News
Almost 400 care companies which provide home support across the UK have told the BBC they still do not have enough personal protective equipment (PPE). Without protection, providers say they may not be able to care for people awaiting hospital discharge. Of 481 providers, 381 (80%) said they did not have enough PPE to be able to support older and vulnerable people. The government said it was working "around the clock" to give the sector the equipment it needs. The BBC sent questions to the nearly 3,000 members of the UK Homecare Association. About a quarter of respondents said they have either run out of masks or have less than a week's supply left. Read full story Source: BBC News, 6 April 2020 -
News Article
Oak Springs: Third fatality at Liverpool care home where 52 have symptoms
Patient Safety Learning posted a news article in News
On any normal day the Oak Springs Care home in Liverpool is a hive of activity, laughter ringing out as its elderly residents enjoy dancing, creative crafts and bingo. Yesterday it was quiet, the inhabitants confined to their bedrooms and stark notices on the door warning visitors against entering, as word spread that a third resident had died in hospital that morning after a corona-virus diagnosis. Of the 66 remaining residents, 52 are exhibiting symptoms. Four were put on end-of-life care plans this week, a situation described by Andrea Lyons, the general manager, as “our absolute worst nightmare”. She said: “These are people who we love, who we spend more time with than our families. It has been difficult beyond the worst you can imagine”. Read full story Source: The Times, 2 April 2020 -
News Article
Nurses treating coronavirus spat at and called ‘disease spreaders’
Patient Safety Learning posted a news article in News
Nurses caring for patients in the community have been spat at and called ‘disease spreaders’ by members of the public, according to England’s chief nurse and the Royal College of Nursing (RCN). The nursing union urged members of the public to support the UK’s “socially critical” nursing workforce during the coronavirus outbreak. The RCN said it had received anecdotal reports of community nurses receiving abuse while working in uniform. Separately, England’s Chief Nurse Ruth May said she had heard reports of nurses being spat at. Susan Masters, the RCN’s director of policy, said abuse of nurses was “abhorrent behaviour”. She said a number of nurses had raised concerns about abuse on forums used by members to talk confidentially. Describing one incident she told The Independent: “These were community nurses who had to go into people’s homes and were in uniform. Members of the public who saw them called out to them and said they were ‘disease spreaders’.” She added: “We don’t know how big this problem is, it is anecdotal, but it is absolutely unacceptable. Read full story Source: The Independent, 21 March 2020 -
News Article
COVID-19 health management service to care for patients at home
Patient Safety Learning posted a news article in News
NHS England is commissioning a “COVID-19 home treatment service” of primary and community healthcare for self-secluding patients. It is introducing “urgent primary care services to patients diagnosed with COVID-19” who are self-secluded at home. The service will care for patients’ symptoms relating to COVID-19 as well as other conditions until they are discharged from home isolation and referred back to their GP. “There is likely to be a gradual handover of patients to CHMS providers as they come onstream to provide the service,” according to a letter from NHSE’s primary care directors sent to GPs today. “As soon as the new service is up and running in your area, your clinical commissioning group will be able to tell you who will be providing care for patients in your locality.” Read full story (paywalled) Source: HSJ, 11 March 2020 -
News Article
Former minister says government would lose human rights challenge
Patient Safety Learning posted a news article in News
Sir Norman Lamb, chair of South London and Maudsley Foundation Trust and a former Liberal Democrat MP, has suggested the government would lose a legal challenge over its national programme for patients with learning disabilities and said the national Transforming Care programme was at the “very least a partial failure”. “I regard this as a human rights issue. We’re locking people up when we don’t need to lock them up. We’re subjecting them to force, when we shouldn’t do so, and this is how I think we need to frame it. If the government were challenged in court on this, I think there’s a very good chance, as an ex-lawyer, that they would lose.” Transforming Care was launched in 2011 following the Winterborne View scandal and aimed to discharge patients with learning disabilities and autism out of institutional inpatient units into the community. However, the most recent figures, from NHS Digital, show there were still more than 2,000 patients within inpatient units, ahead of the national programme’s expiration this month. Kevin Cleary, deputy chief inspector for hospitals and lead for learning disability and mental health services for the CQC, said: “We have allowed our patients to be placed within places like Whorlton Hall. I think the NHS provides very few services of this type, it has withdrawn from providing these services, and has become comfortable with providing that service, within the independent sector, several hundred miles away and that’s not right… absolutely not right." “We cannot say we are providing patient centred care or say we are placing the patient at the heart of everything we do and have that response from the system. We are all responsible for that.” Read full story (paywalled) Source: HSJ, 10 March 2020 -
News ArticleAlthough community-based treatment can improve outcomes for people with eating disorders, it must not be at the expense of vital inpatient services, says Lorna Collins in an article today in the Guardian supporting Eating Disorders Awareness Week. No single treatment or approach works for every patient experiencing an eating disorder and it is extremely hard to get help; there is too little money in the system to provide enough care. "Speaking to patients, carers and clinicians, I am struck by the sheer desperation of so many people saying the system has failed them. Too many find that nothing is done until they are at death’s door. Others say no one talks about binge-eating disorder, which is still too often seen as a weakness or a problem that dieting can fix, rather than a real eating disorder," says Lorna. Clinicians, too, paint a gloomy picture of the state of services. Oxford-based eating disorder consultant Agnes Ayton, who chairs the faculty of eating disorders at the Royal College of Psychiatrists, is frank about the problems. She believes NHS eating disorder services are on their knees and desperately need more money after years of austerity. However, there are some encouraging signs. In West Yorkshire and Harrogate, consultant psychiatrist William Rhys Jones, who works for the Connect community and inpatient eating disorders service, says he is seeing real change. Connect’s community outreach teams deliver home-based treatment for people with severe and enduring eating disorders. This is one of the NHSE new care models and Jones says results so far have been very positive. Clinical community services and early intervention result in a good prognosis, he says – and it is cost effective. While inpatient treatment costs about £434 a day, community treatment costs about £20 to £35 a day, with similar or even improved clinical outcomes. While there are concerns about limiting inpatient treatment and prioritising community treatment simply because it may be cheaper, positive examples like this can help hold the NHS to its promise to make treatment truly open to all who need it. Read full story Source: The Guardian, 2 March 2020
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News Article
Coronavirus ‘drive through’ testing service
Patient Safety Learning posted a news article in News
The NHS is currently rolling out services on NHS sites to test people for coronavirus, including a new service now in action in west London, offering ‘drive through’ coronavirus testing. The new service, provided by Central London Community Healthcare NHS Trust in Parsons Green, is only accessed through a referral from NHS 111, and means people worried about the virus can safely and quickly get checked close to home. The model is one of the ways in which community testing and home testing are being rolled out nationwide, with the NHS’ strategic incident director for coronavirus, asking health services in every part of England to set up home and community testing. After being referred through NHS 111, people are invited to an appointment in their car, during which two community nurses carry out a swab in the nose and mouth, which are checked and assessed within 72 hours. People are asked to self-isolate while checks are completed, to prevent any potential onward transmission of the virus. Dr Joanne Medhurst, medical director for Central London Community Healthcare NHS Trust, said: “Anyone who is worried about coronavirus should call NHS 111 for up to date advice. We’ve set up the ‘drive through’ service to make sure people in our community can get safe, convenient and quick checks for coronavirus, as part of NHS efforts to keep everyone safe." “It’s crucial that, as a community service, we help residents in our area to get accurate, timely advice while managing extra pressure on the NHS, and so far this week we’ve had good feedback from people that the swabbing service offers reassurance at what can be a difficult time.” Read full story Source: NHS England, 28 February 2020 -
News Article
Hundreds of social care residents allegedly sexually assaulted, watchdog reveals
Patient Safety Learning posted a news article in News
Hundreds of elderly and vulnerable social care residents have allegedly been sexually assaulted in just three months, a shock new report from the care regulator has revealed. According to the Care Quality Commission there were 899 sexual incidents reported by social care homes between March and May 2018. Almost half were categorised as sexual assault. In 16% of the cases members of staff or visiting workers were accused of carrying out the abuse. The watchdog said it was notified of 47 cases of rape and told The Independent local authorities were informed and 37 cases were referred to police for investigation. Kate Terroni, Chief Inspector of adult social care at the regulator, said: “Supporting people as individuals means considering all aspects of a person’s needs, including sexuality and relationships. However, our report also shows all too starkly the other side of this – the times when people are harmed in the very place they should be kept safe. This is utterly devastating, both for the people directly affected and their loved ones." “It is not good enough to put this issue in a ‘too difficult to discuss’ box. It is particularly because these topics are sensitive and complex that they should not be ignored.” Read full story Source: The Independent, 27 February 2020 -
News Article
Dementia patients being 'dumped in hospital'
Patient Safety Learning posted a news article in News
Dementia patients are being dumped in hospitals in England because of a lack of community care, a charity says. The Alzheimer's Society called for action, highlighting data showing one in 10 dementia patients spends over a month in hospital after being admitted. The figures also suggested the overall number of emergency admissions among people with dementia is rising - with some patients yo-yoing back and forth. Ministers said they were "determined" to tackle the problems. Central to this, the government said, would be plans for reforming the social care system, which encompasses care home places and support in people's homes. Alzheimer's Society Chief Executive Jeremy Hughes said people were falling through the "cracks of our broken social care system". "People with dementia are all too often being dumped in hospital and left there. Many are only admitted because there's no social care support to keep them safe at home. They are commonly spending more than twice as long in hospital as needed, confused and scared." Read full story Source: BBC News, 22 January 2020 -
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Content ArticleThis page is a catalogue of material to support CCGs, GP practices and others to undertake initiatives to support STOMP.
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News Article
Two patients die after hospitals ignore key safety warning
Patient Safety Learning posted a news article in News
Two patients have died as a result of NHS hospitals failing to heed warnings about the use of super-absorbent gel granules, which patients mistakenly eat thinking they are sweets or salt packets. A national patient safety alert has been issued by NHS bosses to all hospitals, ambulance trusts and care homes instructing them to stop using the granules unless in exceptional circumstances. An earlier alert in 2017 warned the granules, which are used to prevent liquid being spilled, had caused the death of one patient who choked to death after eating a sachet left in an empty urine bottle in their room. The 2017 alert warned hospitals there had been a total of 15 similar incidents over a six-year period between 2011 and 2017. The latest warning from NHS England says most hospitals concentrated on “raising awareness” rather than stopping the use of gel granules. Read alert Read full story Source: The Independent, 4 December 2019 -
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Far Beyond the Pale
Claire Cox posted an article in By patients and public
This short, moving, animation has been produced to support the Justice for LB campaign. -
Content Article
Delirium awareness and management of delirium superimposed dementia
Claire Cox posted an article in Dementia
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Content ArticleThe resources include peer-reviewed content on identifying and managing sepsis in the community, in older people and in children from Emergency Nurse, Nursing Children and Young People, Nursing Older People and Primary Health Care.
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Content ArticleThis guideline includes recommendations on: hand decontamination use of personal protective equipment safe use and disposal of sharps waste disposal long-term urinary catheters enteral feeding vascular access devices. Who is it for? commissioners and providers healthcare professionals working in primary and community care settings, including ambulance services, schools and prisons children, young people and adults receiving healthcare for which standard infection-control precautions apply in primary and community care, and their families and carers.
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Content ArticleKey learning points Sharing information with the multi-disciplinary team helps break down barriers and reduce anxiety. Women should have an opportunity to discuss concerns and have questions answered face-to-face rather than a written response. There is a huge benefit for women to have access to a service that supports closure and shared understanding following a poor experience whether from the birth or postnatally. Providing reassurance that their concerns are addressed and there is organisational learning from their feedback. Women are at the centre of midwifery care. Always listening to what women want/need to ensure a positive birth experience improves the quality of care delivery. Passionate patient engagement is essential. Staff working within the service must value patient feedback and be driven to use it to develop services not just resolve a complaint. It’s important to not be afraid of saying ‘sorry’, this simple word can validate someone’s feeling and has made a huge difference. Enabling parents to feel positive about their birth reduces anxieties, increase confidence and reduces mental health problems following the birth.
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Content ArticleKey points: Analysis of a national linked dataset identifying permanent care home residents aged 65 and older and their hospital found that on average during 2016/17 care home residents went to A&E 0.98 times and were admitted as an emergency 0.70 times. Emergency admissions were found to be particularly high in residential care homes compared with nursing care homes. A large number of these emergency admissions may be avoidable: 41% were for conditions that are potentially manageable, treatable or preventable outside of a hospital setting, or that could have been caused by poor care or neglect. Four evaluations of initiatives to improve health and care in care homes carried out by the Improvement Analytics Unit (IAU) in Rushcliffe, Sutton, Wakefield and Nottingham City show reductions in some measures of emergency hospital use for residents who received enhanced support. There are key learnings from these IAU evaluations, including a greater potential to reduce the need for emergency admissions and A&E attendance in residential care homes and the benefit of coproduction between health care professionals and care homes.
