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Date: 1 June 2020

Time: 03:11

Queen Elizabeth Hospital Birmingham

Falls prevention training for care homes

Story posted/last updated: 03 September 2014

University Hospitals Birmingham (UHB) is helping to reduce the number of care home residents who suffer hip fractures due to falls after introducing a staff training programme.

Falls are a major cause of disability and the leading cause of mortality resulting from accidents in older people aged 65 and over in the UK.

Around 30 per cent of those who suffer a hip fracture die within a year, so early diagnosis and prevention could have huge benefits.

UHB began providing training sessions after noticing an increase in visits by care home residents to the Emergency Department at Queen Elizabeth Hospital Birmingham (QEHB).

The trust has now received funding to take on an additional 100 Birmingham residential homes over the next 12 months after achieving positive results.

The care home sector has come under much scrutiny recently with the screening of an undercover BBC Panorama investigation into care homes and the announcement of extra powers for the Care Quality Commission to deal with poorly performing homes.

The Taking Positive Steps training at UHB aims to share knowledge and expertise from the acute sector with those working in community care to ensure best practice becomes the norm in the care home sector.

Alison Doyle, Falls and Fracture Prevention Nurse Specialist at UHB, said: “We were seeing a large proportion of patients admitted due to falls from the care home setting.

“It’s well documented that this is a high-risk group and very likely to be admitted to hospital, so we decided to do something to address this as we had the expertise within the Trust to make a difference.”

Sue Gray, Education Lead for the Taking Positive Steps initiative, said: “There has previously been very little training of this type available for care homes. We have met staff who have worked in care homes for many years and have had no opportunity to undertake falls prevention training.”

Although the training centres on falls prevention, this is only one part of fundamental good care which also covers dignity, dementia, nutrition, hydration, understanding challenging behaviour, and recognising changes in a person’s condition.

The training, comprising two full days for managers and half day sessions for carers, nurses and ancillary staff, was intended for a wide range of nursing and residential homes, including private homes, charitable homes, and those commissioned by the local authority.

The training sessions for the care staff are delivered on site in the individual care home which means that staff do not have to travel and spend periods away from the home.

Alison stated: “The training is for all staff, including domestics, but we also target the managers. Getting them on board is essential. If any staff are experiencing barriers, then we need to tackle that first. As well as giving staff practical falls prevention information, our training aims to provoke a change in culture with a greater focus on safety and transformation of the workforce.”

After an initial six-month pilot involving 11 care homes, training was extended to a further 54 care homes within South Birmingham PCT, which is the hospital’s catchment area.

Alison explained. “The first two phases have demonstrated a significant reduction in harm compared to the homes that didn’t take part.”

Some of the homes were also revisited, resulting in a total of 75 training sessions and more than 800 care home staff receiving training.

A research grant from the Local Education and Training Board (LETB) has now enabled the scheme to expand to an additional 100 care homes in Birmingham up to July 2015.

During the course of the initial phase of the project, 12 Care Quality Commission inspectors have also received training and a tool developed to help with future CQC inspections if required.

The training also includes what to do following a fall, how to learn from incidents, trends and analysis of falls, and enhancing the environment for safety and safe care.

Alison said: “There was a need to put prevention measures in the care homes. One home put in a comfy chair and table halfway down a corridor for residents to sit in and have a rest if they were tired on the way to the bathroom.

“Some of the homes changed mealtimes to fit in better with the residents. In some cases they were getting hungry because of a long gap between meals, and that’s when they would start to wander.

“One home changed their meal pattern and gave the residents their main meal at night instead of lunchtime so they wouldn’t wake up hungry in the night and go wandering, resulting in a reduced number of falls.”

She added: “We have systems we monitor through which we can identify patients who are admitted through care home settings. We can then talk to these homes about their training needs.”

As part of the project, a validated programme of seating and standing exercises has been compiled onto a DVD aimed at building up residents’ muscle strength to help prevent falls.

UHB is also developing a training passport where staff can demonstrate that they have received training.

Sue concluded: “The Panorama programme has probably left care homes feeling more vulnerable, but we don’t go in there to tell them how to do their job. The training is all about us doing something to support the staff in reducing falls for frail older people.”

The project has involved a number of key partners including local Clinical Commissioning Groups, Third Sector organisations, Bournville Village Trust, the care home managers network, Birmingham City Council, and the LETB.

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