Katie Whittle: Programme Manager Document Review Date: 01.10.21

Evidence Record & Resource File

Safety Champions for Deterioration

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Introduction

Welcome to the Safety Champion evidence record and resource of information for you. First of

all thank you from the North West Patient Safety Collaborative for becoming a Safety Champion

for Deterioration for your care home. This evidence record is your personal resource to

document and gain knowledge about deterioration. This will enable you to empower your fellow

colleagues to recognise, manage and escalate deterioration in a timely manner. By becoming a

Safety Champion for Deterioration, you will have increased work satisfaction by having a positive

influence on clinical practice.

What is a Safety Champion for Deterioration?

A Safety Champion for Deterioration has an enhanced understanding of what deterioration

is, the clinical signs and symptoms, and a knowledge base around the recognition of early

soft signs, taking observations, responding and the escalation process and the RESTORE2

tool. They should be able to identify activities that a care home can do to improve resident safety

and also understand how it improves resident safety. They will need to be passionate about

safety so they can influence others around them to buy in to the initiative.

Role of the Safety Champion for Deterioration

The role of the Safety Champion for Deterioration is to act as a resource in their care home

and to liaise with the Care Home Patient Safety Network. They will act under the

supervision of the care home manager, to promote best practice in recognition of early soft

signs, taking observations, responding and the escalation process and the RESTORE2 tool,

by being an informed resource. They will act as role model for colleagues, bridging the

theory practice gap, thus enhancing the standard of care.

The Safety Champions for Deterioration will help create and maintain an environment which

will ensure the promotion of best practice, to promote identification of those at risk of/or are

physically deteriorating in a timely manner by using the RESTORE2 tool using knowledge,

communication, clinical, teaching and skills in taking observations.

Why is the role of the Safety Champion for Deterioration so important?

Physical deterioration can happen quickly, and without early recognition can lead to serious

illness or death. Detecting deterioration early through recognising soft signs, vital signs

monitoring, and acting quickly and appropriately on the results, are fundamental to prevent

avoidable morbidity and mortality. Safety Champions for Deterioration speak directly to

workers, not just with words but with their actions and leading by example. When they

support, disseminate and raise awareness of a safety guideline, others listen and follow. As

a result, Safety Champions for Deterioration act as a bridge between management and the

workforce. They can act as a go-between—translating important safety messages in a way

that will resonate with their peers.

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Information about RESTORE2

Here is some key information for you to have a look at and refresh your knowledge. You will

be provided with further information and resources during your training. Use this information

in your care home to inform staff about how to recognise a resident who is at risk of/or is

physically deteriorating and use it for your information boards.

What is RESTORE2?

RESTORE2 is a physical deterioration and escalation tool for care/nursing homes based on

nationally recognised methodologies including early recognition (Soft Signs), the national

early warning score (NEWS2) and structured communications (SBARD).

What are soft signs?

Soft signs are the early indicators that someone might be becoming unwell. You do not

have to be a health care professional to recognise these signs and as a carer you are

ideally placed to recognise small changes in your resident. Often family and friends will pick

up on the subtle changes in a person’s behaviour, manner or appearance.

Soft signs can be related to many things including the resident’s: physical presentation

mental state or behaviour and ability

Some soft signs are universal – for example new onset shortness of breath or decreased

urine output. Others may be unique to that particular person, for example a sudden inability

to participate in activities they enjoy like doing the crossword, a particular change in

behaviour such as withdrawal, agitation or hyperactivity. By getting to know your resident,

speaking with their family, friends and carers, you can build up a picture of soft signs that

are significant to each particular resident

What is NEWS2?

NEWS2 stands for National Early Warning Score. NEWS is a system developed to help

people assess how unwell someone is. It is based on six observations or ‘vital signs’ and

gives a score from 0-20. The higher the score, the more unwell the person is likely to be.

The current system is referred to as NEWS2 as this is the second version of NEWS. In the

RESTORE2 document we use NEWS to refer to the latest version of NEWS i.e. NEWS2.

What is SBARD

SBARD is an easy to use, structured form of communication that enables information to be

transferred accurately between individuals.

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Responsibilities of a Safety Champion for Deterioration

1. To liaise between their colleagues and the care home manager on issues regarding deterioration.

2. Access communications via email from the Care Homes Patient Safety Network.

3. To support the care home manager in the delivery of education of RESTORE2 in their care home, to help foster a team approach to awareness of the RESTORE2 tool and to encourage its use on all residents.

4. To promote the importance of taking a full set of observations to calculate a NEWS2

score to determine how unwell a resident is and to highlight the significance of pulse oximetry to support the diagnosis of COVID-19.

5. To help promote new developments within the home, including awareness of the

ceilings of treatment and end of life care.

6. To assist the care home manager in identifying specific training needs of care home staff.

7. To maintain notice boards and information resources kept up to date in your care

homes.

8. To participate in any audits relating to compliance with the RESTORE2 tool, feedback results to the care home manager and to identify areas for improvement. To assist in identifying necessary action plans relating to these improvements and to contribute to implementing actions.

Professional responsibilities

1. Maintain own professional development by: a. deputising where necessary at quarterly Care Home Patient Safety Network

Meetings b. attending Restore2 training delivered by the Innovation Agency c. completing e-learning Recognising and Responding to the Unwell Person in

Community Settings which is available on the Health Education England e-Learning for Health platform https://www.e-lfh.org.uk/

d. completing e-learning Standardising the assessment of acute illness severity in the NHS which is available at https://news.ocbmedia.com/

2. Maintain current, up to date knowledge and support evidence based practice. 3. To maintain a professional portfolio, inclusive of professional contribution and time

spent working on activities. Ideal for revalidation. 4. Sharing good practice in with colleagues and peers. Bring ideas for improvement to

the Care Home Patient Safety Network meetings for discussion.

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Support Requirements & Expectations

1. Innovation Agency to provide support and provision of training of RESTORE2 to Safety Champions for Deterioration and on-going support for RESTORE2.

2. Support from care home manager to allow attendance at education sessions/meetings, and where possible, to allow protected time to support delivery of action plans.

3. Safety Champion for Deterioration to support the care home manager in the cascade training of RESTORE2 and audit

I agree to undertake the role of Safety Champion for Deterioration as detailed above:-

Name of Champion (Print): _________________________________________________

Position Held: __________________________________________________

Signature of Champion: Date:

Care Home Manager

I have discussed and agreed with the Safety Champion for Deterioration what support can

be offered. Where possible, protected time will be allowed to support the role as needed.

Name of Care Home Manager: _______________________________________

Signature: Date:

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Appendix 1

SWOT ANALYSIS

It is often a good opportunity to look at what is good/bad about your learning environment and what could be improved upon. SWOT Analysis is a simple but useful framework for analysing your Care Home’s strengths

and weaknesses, and the opportunities and threats that you face. It helps you focus on your

strengths, minimise threats, and take the greatest possible advantage of opportunities

available to you.

Strengths

Weakness

Opportunities Threats

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From the SWOT analysis you should be able to identify specific needs for your care home

What do we need to do to make things better?

How are we going to do it?

Encourage colleagues to be involved. Delegate tasks, using strengths of those around you.

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Appendix 2

REFLECTIVE LOG

Date

Type of work

Hours

Signed

e.g. delivery of RESTORE2 training to

x number of staff/attending Care Home Patient Safety Network

meeting

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Appendix 3

RESOURCES

https://wessexahsn.org.uk/projects/329/restore2 https://westhampshireccg.nhs.uk/restore2/restore2-training-and-resources/

https://westhampshireccg.nhs.uk/wp-content/uploads/2020/06/RESTORE2_List-of-

approved-resources_July-2020.pdf

https://westhampshireccg.nhs.uk/wp-content/uploads/2020/09/RESTORE2-Training-

Pack_All_Modules2020.1.pdf