1. SKIntelligence Wantage Nursing Care Home Olga Parry – Deputy Manager

2. Nursing Home Background Wantage Nursing Care Home is a purpose-built home which provides nursing and dementia care. Our highly trained and dedicated team is committed to providing the highest standards of care in a comfortable ‘home from home’ environment. We have 50 beds (20 Nursing beds and 30 Dementia beds) The team consists of the Home Manager, Deputy Manager, the Nursing team (11 full time nurses and 4 part- time, 2 bank nurses) the Care team (6 full time senior carers 1 part-time senior carer, 21 full time carers and 4 part time carer, 6 bank carers on the care team), the GP and community disciplines.

3. SKINtelligence Project Engagement Myself, the Deputy Manager, and two members of our nursing team attended the first phase of the IHI Quality Improvement workshops offered to us as part of the project. We were unable to attend the 2 day training event run by the project nurse. We are hoping to be able to attend the next round of training workshops provided by the project nurse.

4. Improvement methods used As a direct result of attending the IHI Quality Improvement workshops we are consistently carrying out: – Daily skin inspections – Daily reporting – Daily Safety Cross recording – Weekly weight reviews – GP reviews – Family review And we have successfully implemented the safety cross calendar, for pressure harm, within the home.

5. Compliance data collection tool- in use

6. Safety Cross – in use

7. Benefits We have benefitted from the IHI workshops and are using the methodologies to support best practice within the home. Having the training material and resources on the Thames Valley Health Knowledge Team website is very useful. The project has raised awareness within the home and resulted in improved carers reporting, prompt RGN responses, and open communication with the GP, family and residents.

8. Reflections and Successes Reflections: – All staff should feel humble enough to take step forward and learn new information, methods and should feel Zero tolerance to avoidable pressure harm. – We should continue the training how to prevent pressure harm, and include it in our induction process as compulsory at local level. – Some RGN require more support and understanding of physiology and equipment usage to prevention of tissue damage. – More emphasis should be placed on prevention than on cure or treatment. Successes – We are managing complex cases and frailty to avoid pressure harm Reporting and prompt action on reporting is supporting us in managing avoidable harm. Care team communication has improved. – There were over 28 days since last avoidable pressure ulcer

9. Barriers and Lessons Learnt Barriers – Different skill set and level of knowledge within lead team of nurses and senior carers. Lessons Learnt – Implementation of changes, and uplift standard and quality requires patience, team work and practice and the focus needs to be consistent and with commitment – The driving force behind the adoption of change needs to be more then one or two people.