Enhancing Care in Care Homes
Meet the team
- Michelle Beddows, Communications Lead, Walsall Together
- Sara Bailey, Deputy Chief Nurse, NHS Walsall CCG
- Donna Roberts, Clinical Intervention Team Lead
- Gary Perry, Head of Patient Relations
- Tracie Wilson, Quality Team, Walsall CCG
- Simon Cooper, Walsall Together Project Manager
- Dan Hodgkiss, Deteriorating Patient Workstream, WMAHSN
- Jane Rumble, CQC Representative
What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?
During the first wave, Care Homes faced huge challenges and unprecedented numbers of deaths.
In response the Walsall Together Integrated Care Partnership built on our published work to develop a multi-agency Enhanced Quality in Care Team (EQiCT) from across health and social care.
EQiCT made daily contact with care homes, working with staff to spot and manage deteriorating patients. We provided infection control training, supported the supply of PPE and provided psychological support. Care home staff became more autonomous and were making well-informed decisions faster.
Within weeks there was a drop in the number of COVID related deaths, a reduction in hospital admissions and staff said they felt supported and more confident.
We saw positive changes in working relationships between organisations with historical resistance due to the nature of commissioner/provider relations. Our work at EQiCT was also recognised by the CQC as an example of excellent practice.
What does your project aim to achieve?
We will build on similar work done in this sector to improve outcomes for care home residents. Care home staff will co-design the interventions from the start based on their needs and then be taught frameworks such as the Model for Improvement.
Measures of participation:
- number of care homes teams recruited onto the programme
- attendance at the QI training sessions
- participation in online discussions on the (closed) Hexitime group
- Number of ideas, offers and requests for help responded to on Hexitime
Feedback from the sessions:
- individual satisfaction following sessions
- overall satisfaction with the programme
Impact on healthcare staff using:
Outcomes for residents:
- Patient Reported Outcome and Experience Measures
- Number of emergency calls/month
- Variation in outcomes between care homes
- Number of graduates who become champions
- Funding to continue the programme after completion
- Improved Care Homes CQC Ratings
How will the project be delivered?
Test and Refine Initiative Jan 2021-Mar 2021
- Understand context and feasibility
- Reframe project around care home needs
Care Home Recruitment campaign: Apr 2021-May 2021
- Stratification of Care Homes by health outcomes
- Invite those with worse outcomes to participate
- Multidisciplinary team applications
- Modest financial incentive to participating teams
QSIR Virtual Cohort 1: Jun 2021-Aug 2021
- Theme- Managing deterioration
- Eight 1-hour sessions, coaching, action learning sets and QI Café
- Online community of practice on Hexitime
- Incorporate upcoming regional digital programme
QSIR Virtual Cohort 2: Oct 2021-Dec 2021
- Theme- Reducing inequity within homes
- Trainers from EQUiCT and Hexitime
- Format and training material reviewed
QSIR Virtual Cohort 3: Feb 2022-Apr 2022
- Theme- TBC
- Trainers from EQiCT team and Hexitime
- Format and training material reviewed
Walsall Together Report Jun 2022
- Outcomes and lessons learnt
- Sustainability plans
- Translation to LD and residential homes
Celebration and Learning Events Jul- Aug 2022
- Virtual conference
- Recognition of most improved care homes
- Institute of Healthcare Management and AHSN case studies
How is your project going to share learning?
- Local care homes forum
- Black Country and West Birmingham care homes app
- Quality review service and Frailty Working group
- Walsall Together Integrated Care Programme Board overview
- Academic publications and conference presentations
The care home forum will be a way of sharing the learning from care homes involved in the project.
The app is already available on the App Store and could host all the resources, information and shared learning required to deliver enhanced care within a care home.
The local QRS, Frailty Working Groups and and ICP programme boards will offer challenge to the project group and ensure the outputs are aligned with local and regional priorities.
Project Group includes members from the CQC, AHSN and Institute of Healthcare Management and hence there are opportunities to share case studies through regional and national events. Care Home delivery is a WMAHSN priority, so there is significant regional support.
How you can contribute
- We appreciate this is a national challenge. We would therefore appreciate if you could put us in touch with other Q members who are working in this area, so we can collaborate and avoid reproducing good work already done and hence utilise the funds productively.
- If you personally have had experience of a friend or relative in a care home over the last few months then your story would be very valuable to us in refining our focus and developing our training materials.
- One of the areas we would like us to focus on is using quality improvement to build equity in care provision in care homes. How have you seen QI in this setting?
- What work have you seen to reduce disparity of health outcomes on the basis of race, ethnicity and language of care home residents, for example? How can we measure and improve equity in this group?
|1 Dec 2020||Test and Refine the Intervention|
|1 Mar 2021||Recruitment of Care Home Teams|
|1 Jun 2021||QI Cohort 1|
|1 Oct 2021||QI Cohort 2|
|1 Feb 2022||QI Cohort 3|
|1 Jul 2022||Celebration and Learning Event|