RESTORE2

What is RESTORE2?

RESTORE2 is a physical deterioration and escalation tool originally designed for care/nursing homes based on nationally recognised methodologies including early recognition signs (Soft Signs), the national early warning score (NEWS2) and structured communications (SBARD). It was originally co-produced by West Hampshire CCG and Wessex Patient Safety Collaborative.

The advantages and benefits of RESTORE2 have been so widely accepted that it is now being rolled out to home care businesses throughout the country. Your Home Care is the first business in Nottinghamshire to partner with RESTORE2 to deliver it to our clients. We’re working collaboratively with the NHS going forward helping build a better framework for all.

RESTORE2 is designed to support Home Care Assistants:

• Recognise when a client may be deteriorating or at risk of physical deterioration
• Act appropriately according to the client’s care plan to protect and manage the client
• Obtain a complete set of physical observations to inform escalation and conversations with health professionals
• Speak with the most appropriate health professional in a timely manner to get the right support
• Provide concise escalation history to health professionals to support their professional decision making.

Recognising Soft Signs

During our Home Care Assistants training induction they are educated on how to spot early signs of deterioration. These are called soft signs. Soft signs are early indicators that the client may be unwell or be starting to deteriorate due to an underlying issue. After all, our Home Care Assistants often spend large amounts of time with our clients and are often best placed to identify these soft signs:

• Lack of appetite
• Poor sleeping pattern
• Confusion
• Poor mobility
• General lack of interest

If our Home Care Assistant is concerned with any of these soft signs then a set of observations will be taken during the visit.

Client Observations

Your Home Care realises the value and importance of RESTORE2 and has invested significantly in equipment and training for staff to carry out observations without passing any costs on to our clients. The RESTORE2 programme is delivered free of charge to all Your Home Care clients.

During observations, when required, our Home Care Assistants take the following readings:

• Pulse
• Temperature
• Blood Pressure
• Respiration
• Oxygen Saturation
• Level of Alertness

Escalation

After taking observations our Home Care Assistants will record the readings on a chart in the clients home. If the readings are out of the norm the Home Care Assistant is trained to escalate the readings to the appropriate people. This can include but is not limited to:

• Our Registered Care Manager
• The client’s GP
• 111
• In extreme circumstances, 999

Also during their initial training our Home Care Assistants are taught how to deliver the information properly to any health care professional where necessary.

Already a Success

In the very first week of rolling out RESTORE2, Denise, our Registered Care Manager took the observations of one of our clients. The observations were being taken routinely as part of the client’s initial care consultation but the readings showed that the client had low blood pressure. The results were escalated (with consent) to the client’s GP and subsequently the client’s blood pressure tablets were removed from his prescription.

This is a great outcome and is a real positive impact on the client’s wellbeing. It was later discovered that the client had taken a fall prior to commencing with Your Home Care which was likely due to his low blood pressure. Since this time the client has not fallen again. This is exactly the type of results that RESTORE2 was designed to deliver.

Awards

In 2019 RESTORE2 were the winners of the prestigious “Excellence in Primary Care” award at the NHS Parliamentary Awards. More recently West Hampshire CCG, the creators of RESTORE2 along with Somerset CCG and Kernow CCG won the HSJ Values Award 2020. Here’s what the judges said:

The judges felt this project was a clear winner that addressed so many different needs with a straightforward tool which works for all involved. The programme had excellent results in the localities using it. There was a clear common goal that everyone could sign up to, a focus on outcomes and great potential for spread.