Partnership working in Hertfordshire care homes

Staff and residents at Stanborough Lodge have been benefitting from the Complex Care Premium, which is part of the Care Home Vanguard.

Case study: Staff and residents at Stanborough Lodge have been benefitting from the Complex Care Premium, which is part of the Care Home Vanguard. 

Staff are trained across five key pathways – dementia, nutrition, falls and fragility, wound management and health (including end of life, continence, neurological and respiratory conditions.) Stanborough Lodge has focused its training on nutrition, falls and dementia. 

Beauty Maruta, Care Home Manager at Stanborough Lodge said:

Some staff members have become ‘champions’ in these areas and are now making changes to the way they are working by implementing things they have learnt through the training. 

The nutrition champion has been making shakes for residents using real food, as an alternative to administering food supplements. She has also been creating meal plans incorporating high calorie foods for clients identified as being in need of additional sustenance. Staff also identified that often when dementia sufferers fail to eat and begin to suffer with malnutrition, it is because they simply don't recognise food any more. This can easily be remedied by having a member of staff sit with them whilst they are eating, encouraging them to eat. These simple steps are having remarkable results; two residents have already been taken off the food supplement ‘Ensure’ as they are gaining weight and getting all their nutrition from food.”

Falls and Fragility
The training that staff have received in relation to falls and fragility is helping to reduce the number of A&E admittances from residents as a result of falls. In recent months a number of individuals were having as many as three/four falls a month. Last month there were just three falls. 

As part of the training, assessed carers are now carrying out falls assessments for clients who regularly fall. This helps staff to identify whether there are times of the day when falls are more frequent and whether the falls are related to an underlying medical condition, fatigue or confusion.  

“From carrying out a falls assessment on one client we were able to establish a pattern to falls; they were falling over early in the morning and late in the evening, indicating this is due to fatigue. We’ve been able to remedy this by bringing in an additional member of staff for an hour in the morning and evening, so that this person has 1-2-1 care to prevent them falling,” said Beauty.

The falls champion identified another client who was regularly falling and discussed the case with the GP, who gave her some continence sheets and a swab test – to test for an underlying problem. This identified that the client had a urine infection which was leading to confusion and causing challenging behaviour. The urine infection was treated and the falls were prevented.” 

Beauty has found that it isn’t just the champions who have benefited from the additional training; this information has been cascaded down to the rest of the team. 

“All staff members have become more competent generally, especially in dementia care. Instead of trying to explain to a dementia client that they can’t go and visit someone from their past  - when they are trying to get their coat on to go out - the staff member will now use the distraction method and take them outside for a walk. Then the client returns feeling more relaxed and they have forgotten about the thing they were previously fixated upon.

Staff members are starting to take control of the situation before coming to me; staff members come to me at the end of the shift and tell me about things that have happened and what they have done to help clients through difficult situations."