Summary
Originally co-produced by West Hampshire CCG and Wessex Patient Safety Collaborative, RESTORE2 is an escalation tool for use in care settings to enable early recognition of deterioration.
Health Innovation West of England developed and delivered a programme of RESTORE2 training for local care providers to spot these signs and to improve patient safety. It has been delivered to 84% of care homes across the region.
This work is a local example of the Health Innovation Network’s Managing adult deterioration in care homes programme.
"
As a GP I can clearly see how RESTORE2 would benefit patients through the earlier identification of deterioration and treatment commencing earlier. When I am triaging home visits, having a NEWS2 score and soft signs available allows me to ensure that a visit is prioritised within an appropriate timescale.
"
Chris Turner, GP, Swindon Community Health Services
What the project involved
In March 2015, the West of England Patient Safety Collaborative became the first region to implement NEWS across all handovers of care, a simple scoring system, based on the six physiological measurements that make up the routine vital signs of an adult patient. National adoption and spread of NEWS2 took place across the Health Innovation Network from 2018-2020.
During this time, Health Innovation West of England also established Primary Care, Emergency Department and Community Collaboratives to enable colleagues to meet and share best practice on improving patient safety through the effective management of deterioration. Identifying that many of the most vulnerable patients reside in care homes or receive domiciliary care, training for care homes was launched in late 2019.
Prior to and during Covid, and in line with recommendations from the British Geriatrics Society to help care home staff support residents through the pandemic, the team recognised the importance of supporting care staff in managing deterioration through the observation and escalation of ‘softs signs’.
RESTORE2 is an escalation tool for use in care settings to enable early recognition of deterioration. It supports more effective communication, efficient workflow and improves patient safety at the handovers of care between care staff, primary care and the urgent care system. It also covers recognising ‘soft signs’ where individuals have difficulties in communicating, which is particularly valuable in care homes for people with learning disabilities or dementia.
Initially RESTORE2 training was offered face-to-face but the pandemic required a pivot to virtual learning.
Building on the success of this training, Health Education England commissioned Health Innovation West of England, Health Innovation Wessex and Hampshire and Isle of Wight ICB to produce a series of videos to help staff working in care homes spot and respond to the soft signs of deterioration.
Outcomes
553 care providers and 3,217 care staff have participated in the training programme. This represents 84% of care homes across the West of England, well exceeding the original target of 60%.
Staff who attended the training frequently got in touch with Health Innovation West of England afterwards to share how their use of RESTORE2 is making a huge difference to the care they are able to provide their residents. Many of these accounts are captured here.
Next steps
The videos commissioned by Health Education England as a result of the success of the RESTORE2 training have now been viewed more than 1.8 million times and this continues to rise steadily. The videos were shortlisted for a 2021 HSJ Patient Safety Award.
In February 2021, Health Innovation West of England delivered a ‘Super Trainer’ RESTORE2 model to 167 experienced trainers, who by the end of May 2021 had trained over 7,000 paid and unpaid carers. Training continues to be delivered across the country.
You can find out more about our Managing adult deterioration in care homes national work here.
