Care Homes - August 2016

In August 2016 we looked at how we can join up services and provide better healthcare to people who live in care homes in Liverpool.

You can find out more about this engagement process and the findings below. 

Key Documents  

The report is available here.

Frequently Asked Questions (August 2016)

How is healthcare currently provided?

In many cases, when somebody living in a care home gets ill the dedicated care home staff will look after them. 

However, if someone needs additional help from other health and care professionals, depending on the type of care home, response times for interventions may vary.  

Sometimes residents may be transferred to hospital, which can often cause distress to residents, especially if they are living with dementia. It can also put added pressure on care home staff. 

What is being proposed?

We are proposing that the staff involved in providing healthcare to people living in care homes - such as doctors, nurses, social workers and therapy staff - work in a more joined up way to support people in their place of residence. 

It would mean that each care home will have a dedicated team of people, called an enhanced care team, who work together so that care can be provided at the right time, by the right person.

These enhanced care teams would have a dedicated day and time each week that they would meet at the care home to see patients and review their care. 

This could involve carrying out holistic assessments of rehabilitation and care needs and then developing individual treatment plans. These plans would be regularly reviewed with the care home, to ensure people’s individual needs are being met. 

Sometimes it could mean members of the enhanced care team making referrals or consulting with another specialist - such as social services or a community mental health team - to make sure people get the right care for their needs.

In addition to providing routine healthcare, we are proposing that these enhanced care teams also focus their attention on people they identify as vulnerable and at high risk of deteriorating health. 

The care teams will proactively support people who need this type of care, enabling them to stay well for longer, keeping them out of hospital unless they really need to be there and putting them in touch with other services they may benefit from.

How is this different?

This would mean a few important differences.

• All of the people involved in providing an individual’s care will work together to ensure the needs of the patient are met in a coordinated way. The enhanced care team would have shared access, with permission, to a person’s health records and can work with the individual to provide care that is meets their needs.
• In addition to the care received from their normal GP, people living in care homes would be supported by an enhanced care team. This will include an enhanced GP, who will support the core team working with a person’s normal GP. This enhanced GP would assist with care planning and, if somebody living in a care home needed to see a GP on the same day and their normal GP was not available, the enhanced GP would be on hand to help understand how to deal with the problem in the best way. They could provide a face to face appointment, arrange for the person to be seen by a different member of the enhanced care team, or they may be able to help by providing advice or a prescription. This would help more people living in a care homes get the care they need on the same day, if needed, and be seen by the right person.
• Currently, care staff tend to focus on treating people when they are already sick, rather than doing more to prevent people becoming unwell in the first place. The enhanced care teams will work with people living in care homes and care home staff to help more people to stay well longer and stay in the same care home, rather than being moved around due to their medical or physical needs.
• Too many care home residents are admitted to hospital, particularly near the end of their life, because advance care planning or access to end of life care is limited. We believe more regular medical reviews and more responsive support from an enhanced care team may reduce the need for a person to be admitted to A&E and repeated hospital admissions, enabling people to stay in their preferred place of residence for longer.

What are the benefits?

People living in care homes will:

• Receive medical care and support quickly when they are ill
• Receive more care in their place of residence, rather than having to be taken to hospital, for example. We know that going to A & E is stressful, so by joining up care and having an enhanced care team who can support people living in care homes we will reduce the number of people having to go to A & E.
• Care home staff will have the support of a dedicated team who can offer them advice and guidance should somebody living in the care home become unwell. Care home staff will also be better trained to support residents.