Tissue viability in care homes

Tissue viability in care homes

Maintaining skin health is an important part of good standards of care in health and social care settings.

When skin breaks there is pain, discomfort and loss of function which can lead to more serious risk of harm and infection, so prevention of damage is an everyday concern in care homes.

The Care Quality Commission (CQC) monitors standards in care homes. The CQC uses its essential standards to guide its inspections; outcome 20 refers to skin care.

Care homes have a duty to report Grade 3 and 4 pressure ulcers to the CQC. Homes providing placements of funded nursing care and continuing healthcare arrangements are required to also report to CCG as part of its contractual obligations set out in the NHS Standard Contract. This contract will require you to adhere to the terms of the CCG Serious Incident Requiring Investigation (SIRI) Policy. In the event of a SIRI occurring, the HCAI team may be able to provide some support when conducting your investigation.

The CCG monitors published CQC reports and may offer support or guidance to help resolve issues.

Below you will find more information to assist you with this task.

What is NHS Safety Thermometer?

It’s not just counting, it’s caring. The NHS safety thermometer is a web-based tool that provides a ‘temperature check’ on four core harms - pressure ulcers, falls (with harm), urine infections (in patients with catheters) and venous thromboembolism (VTE) newly acquired.

The tool allows teams to measure harm and the proportion of patients that are free by counting those protected from harm during their working day.

This isn't limited to hospitals; patients can experience harm at any point in a care pathway and the NHS safety thermometer helps teams in a wide range of settings, from acute wards to a patient's own home or care home, to record, assess, learn and improve the safety of the care they provide.
The NHS safety thermometer explained (video) Please click here to find more information on the safety thermometer Further information on 'harm free' care - a new mind set in patient safety improvement'

Safety thermometer in our area

Northern Devon Healthcare NHS Trust’s advantages of using the safety thermometer:

“For us, one of the major pluses has been knowing instantly what is happening on our wards.

"I think the way to use it is alongside other quality measures to give you an overall and rounded quality picture.

"When combined with measures such as incident reporting, themes from investigations, clinical outcomes and patient experience feedback, you get a complete picture. “
To view the full case study into their use of the safety thermometer click here 10 steps to success - please click here For a helpful guide on how to use the tool, please click here

Moisture Lesion or Pressure Ulcer?

This is a useful tool designed to help distinguish between moisture lesions and pressure ulcers. It was created in Worcestershire and has been shown to be effective in studies there.
Moisture Lesion or Pressure Ulcer tool

Education and training

'Stop the Pressure' have developed a specific section of their website for care homes, providing helpful advice and guidance to raise awareness of pressure ulcers and how to prevent them. Please see the below link.
'Stop the Pressure' for care homes The 5 key messages to prevent pressure ulcers- educational video

Useful documents and links

Serious Incidents Requiring Investigation (SIRI) framework and policy DCC Community Equipment Service Catalogue - Pressure Care section NHS NEW Devon CCG - SIRI policy 'Your Turn' campaign 'Your Turn' poster/leaflet Pressure ulcer leaflet for patients and health professionals Incontinence Associated Dermatitis The 'touch your toes' test Wounds UK Wounds International Venous leg ulcers - Royal College of Nursing Diabetes Foot Assessment and Care e-learning Wound Care Societies Gingerbread Men pressure ulcer teaching initiative (video)
For further resources, guidance and information, please click the below link
National guidance, information and publications

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