Care Homes/Residential Homes: Patient Safety & Quality Improvement Programme

Caring for oder people in residential and care homes is one of the most important priorities for the health and care system in Wales.  Older people are an asset and preparing for an increasingly ageing population is a national challenge. The need for residential and nursing care is increasing and because of this we need to change how we deliver care.  

Care home residents typically have multiple physical and/or cognitive impairments, and adverse events like falls often lead to hospital attendance or admission.  There are often changes to the profile of the workforce and a ‘deficit’ in the number of unpaid carers.  This will require a shift in the balance of resources, so we will need to focus on measures that can improve care to prevent avoidable hospital admissions.Using the idea of the ‘Quadruple Aim’ 1000 Lives Improvement recognise that the backbone of any effective health and care system is an engaged and productive workforce.  There is huge potential for providers of care for older people to free up resources from non-value added and inefficient practices i.e. ‘we have always done it this way’, and to use its resources to test and learn what works well to accelerate change to improve the experience of providing care.  

Our programme will support residential / nursing care homes to improve the care they provide for older people, celebrate and spread areas of good practice.  We will develop outcomes to enable measurement of success and improve service planning. We understand there will be significant demographic challenges, but we will work in partnership to meet those challenges.

We know that there is variation within the current care system for older people. 1000 Lives has identified that improving outcomes for older adults, both in care and being cared for in their own homes is an area where a more relationship centred care approach which focuses on the interdependent well-being of residents, families and staff could deliver improved outcomes. The care home quality and safety programme will aim to build and improve supportive care home environments, and learn from good practice to improve the quality of care for older people in care homes in Wales over the next three years.

Programme contact details:

Wayne Jepson (Wayne.Jepson@wales.nhs.uk)

Rosalyn Davies (Rosalyn.Davies2@wales.nhs.uk)

Making Choices Together Project

This is a movement in Wales to encourage open conversations between patients and their clinicians to make decisions together about the right care for the patient  informed by good evidence and responsive to the needs and wishes of the patient.

http://www.makingchoicestogether.wales.nhs.uk/home 

Resources include information on choosing chemotherapy, and which questions patuents may want to consider asking of their clinicians. Aims:• Embed a broad culture change in healthcare where clinicians and patients regularly discuss the value of treatments and make shared decisions.• Ensure reliable and valid information is available for patients and clinicians regarding agreed interventions of low value, i.e. where there is a low chance of a beneficial outcome.• Enable participating professional health organisations such as the health professional colleges and societies, to produce with patients lists of commonly used treatments and interventions whose necessity should be questioned.• Encourage local clinical teams to use shared decision making skills in consultations and adopt or select locally relevant interventions of low value to concentrate on when applying shared decision making.• Reduce harm to patients caused by inappropriate use of tests or interventions.