On 19th March 2019 North Devon Care Homes Team facilitated a Kitchen Table event which was hosted by Fremington Manor Care Home, Barnstaple.
This event united three organisations, South West Ambulance Service, Northern Devon HealthCare Trust and the Independent care sector with a view to sharing innovation and improve partnership working. The event was attended by managers and/or deputies from both nursing and residential homes from across North Devon, Northern Devon Healthcare Trust’s (NDHCT) Admiral and Deputy Chief Nurse along with an Operations Officer from South West Ambulance Service Foundation Trust (SWASFT).
There was no agenda at this Kitchen Table event other than demonstrating kindness and respect to each other throughout. Conversations naturally developed in discussions about wanting to improve the service user’s experience with transitions from care home to hospital and vice versa. Each organisation openly and positively shared some of their frustrations about this process and it was unanimously agreed that working in closer partnership with each other was a logical step forward to improve this experience for the person and all staff involved in the process.
In addition to some very positive feedback regarding discharges from hospital to care home TEP’s and hospital discharge forms are not always returning to the care home with the resident. The care homes representatives expressed that this meant that communication was not always as good as it should be following discharge. They also noted that TEPs are not always being updated in the hospital environment when the patient’s condition changes..
Care homes having access to NHS email, the implementation of the Red Bag Pathway and having a robust Transfer In/Transfer Out form which captures relevant information on one form which can be utilised by all three organisations was discussed as positive moves in the right direction to address some, if not all of the issues that had been highlighted and discussed. The Chair of the Kitchen Table, Sarah Winfield-Davies from North Devon Care Homes Team was pleased to share with the group that following on from an action at the kitchen table event in 2017, NHS email accounts were currently being offered to all care homes within North Devon and that she was already working on devising a Transfer In/Out document, with review & input from care homes and SWASFT being the next logical step of the quality improvement process for this piece of work. Angela walter the Admiral Nurse talked about the benefits of the Red Bag Pathway in terms of safety and quality of the resident being admitted and discharged to and from the hospital. She talked to the group about her work to-date on this national initiative which includes being able to offer a Red Bag to all residential and nursing care homes within North Devon very soon. All care homes present at the Kitchen Table event signed up to this pathway there and then.
Initiatives discussed at the Kitchen Table included some of the care home managers/deputies sharing their experience using electronic care planning and medication systems, giving examples of how these had contributed towards the quality and safety of their residents. This was a very beneficial conversation for those care homes not yet using these systems.
One of the care homes had embedded ‘safety check’ questions, similar to those used in aviation into their working day. This includes ‘safety’ type questions being asked by the lead on each shift during handovers or ‘Huddle’ type meetings to staff members throughout the shift.
Benefits of The Care Homes Team training were also discussed in terms of quality and safety. One manager shared how a recent training session on sepsis delivered to her care staff resulted in the early recognition of this to one of the residents, resulting in prompt and skilled action from her care staff.
The benefits of NDHCT’s Trusted Assessor scheme to reduce delays to transfers in care were also talked about positively by the care home staff who had experience of this model. The benefits of including the ‘This is Me’ document with this assessment were discussed at the Kitchen Table and will be passed back to the team leading on this within the Trust for consideration
The Deputy Chief Nurse gave an overview and update on the success of the NDHCT’s Trainee Nurse Associate (TNA) programme and talked about the positive impact these staff have in relation to quality and safety of patients. She indictaed that the Trust TNA Lead would welcome discussions with any nursing homes interested in hosting a TNA for a placement which was already scheduled at Fremington Manor to start in May 2019.
The theme of topics discussed and learning from this Kitchen Table event will be shared with all Independent care providers within North Devon in addition to senior staff working within NDHCT and SWASFT to disseminate throughout organisations as a learning opportunity for all.
What we learnt was that an hour and a half for a Kitchen Table isn’t quite long enough!