Ipswich & East Suffolk Care Home Winter Preparation – 10 Top Tips
by Ben Harvey – Care Homes Clinical Support Manager
Hydration is a key player in preventing ill health in older people. Water UK suggest a minimum of 1.6L per day for older people and suggest that most care home residents drink less than 1L per day. Benefits of good hydration include: pressure ulcer prevention, reduction in urinary infections and constipation, lower risk of kidney and gallstone formation, reduction in risk of heart disease, blood pressure stabilisation, better diabetes control, better cognition and prevention of falls and better bone health.
Implement a homely remedies policy (support can be provided by Care Homes Clinical Support Manager and Medicines Management Team) – a ready to use protocol for care homes is available here.
Make sure you have good stock levels and check opening hours over the Festive period. A list of pharmacies in the area is available on the NHS Choices website.
Flu is a highly infectious illness that can spread rapidly. Most care home residents are eligible for a free flu jab. If you haven’t been contacted by your residents’ GP practice yet, please follow this up immediately. If you are a home with nursing, and are unable to administer the vaccine due to lack of competent staff (anaphylaxis trained), please do not leave your residents unprotected and contact your GP practice to discuss. Read more...
Food is a vital source of energy, which helps keep our bodies warm. Make sure that all residents are receiving hot meals and offered hot drinks regularly throughout the day. In addition to this try and encourage residents to keep active in the home if you can, as understandably many will not want to go outside. Food hygiene is also important, see the Food Standards Agency toolkit.
Norovirus, sometimes known as the winter vomiting bug, is the most common stomach bug in the UK. The virus is highly contagious. It can affect people of all ages and causes vomiting and diarrhoea. There's no specific cure for norovirus, so you have to let it run its course. It's usually mild and shouldn't last more than a couple of days. During this time residents may need to be segregated and staff should not attend work until at least 48 hours of no symptoms. The best way to avoid catching or spreading the virus is by practising good hand hygiene, so make sure you regularly wash your hands with hot water and soap, especially after using the toilet and before preparing food. Remember alcohol gel is not effective against norovirus.
Speak to your GP/nurse practitioner about giving people at risk of exacerbations a course of antibiotic and corticosteroid tablets. Monitor the use of these drugs and maintain contact with the healthcare professional if their symptoms do not improve. It is especially important to keep people with COPD warm, see Section 8, however it is better for people with COPD to wear several loose fitting layers of clothing so as to not constrict breathing.
Living in a cold environment can increase the risk of falls as strength and dexterity decreases as the temperature drops. For those people who are at risk of falls, especially recurrent fallers, please get them reviewed by a healthcare practitioner. Do not wait until they have fallen again – the next one could result in a fracture, or be fatal. Care home managers and senior staff may ask for a ‘falls assessment’ by contacting the Care Coordination Centre (CCC) directly on 0300 123 2425 – please have all your patient’s details to hand when making the call. Read more: Trips and falls
Good hydration by maintaining adequate fluid intake lowers the risk of contracting urine infections. Good practice is centred around hand hygiene – high standards of handwashing for staff and residents, as well as housekeeping and cleaning items, such as toilet seats in communal areas. Early detection is key – ensure that your home has a robust process for referrals to GPs and obtaining antibiotics. Remember these residents may become septic and display symptoms of confusion, agitation, pain, increased frequency of toileting and a high temperature – and so adjust care plans (closer observation) accordingly during this acute phase and maintain contact with your GP/nurse practitioner.
Keep the minimum temperature at 18C, preferable 22C for residents with reduced mobility, those who are 65 or over, or those that have a health condition such as heart or lung disease. Make sure residents are assisted to dress appropriately, especially those who are unable to voice when they are feeling cold. Check that temperature settings are being maintained throughout the night. Read more about keeping well in winter
For any residents that may be prone to chest infections, urine infections, or are frail it may be worth considering arranging for them to be assessed during your weekly visit from the nurse practitioner or GP. Advance care planning is vital in preventing unnecessary hospital admissions. This is important as residents’ family members may be away over this time.