An innovative Rapid Response and Treatment service for care home residents is currently being piloted in Berkshire West.

It aims to avoid hospital admissions for our most vulnerable citizens. One of the first people to benefit from the new Rapid Response and Treatment service (RRaT) was a resident of a 52-bed care home in West Berkshire.

The new service meant that Maureen was able to stay at the home when she fell ill and avoid a hospital stay. It also meant that nursing staff at the home were empowered and upskilled to provide additional care for their residents.

A chest infection had led to breathing difficulties for Maureen and her care nurses were concerned about a possible blood clot and the potential health complications this could cause. Like many care home residents, she did not want to go to hospital for tests; “I worry that I’d never come out.”

rrat image3Bella Balaci, Manager of Hungerford Care Home explains; “Avoiding going in to hospital is incredibly important to our residents. People are much more comfortable here in the home being looked after by staff who know their needs, even if they’re no longer able to verbalise their wishes.”

In the past when Maureen’s condition deteriorated, she would be seen by the GP and then attend hospital for tests. It was a drawn out process that could often result in an overnight stay in hospital for Maureen, and the care home nurses were kept busy coordinating referrals and logistics. The new RRaT service for Berkshire West has transformed this approach.

rrat image1Maureen’s care home nurse, Mihaela, takes up the story; “We’d noticed some changes in Maureen’s breathing. A change in prescription and bed position hadn’t made a difference and I was concerned about a possible blood clot. Maureen was clear with both me and her GP that she didn’t want to go to hospital for further investigations, so I called the Rapid Response and Treatment Team for advice.”

“They were brilliant. After checking Maureen’s care records online, they arrived within an hour to assess her. After that a specialist nurse came to see her every day. When it was time for Maureen to go for a chest X-ray it was an incredibly short trip to the Royal Berkshire Hospital because everything had been pre-planned by the team and the hospital consultant was fully informed about Maureen’s condition before she arrived. She was back here with us the very same morning!”

rrat image2“I was getting very out of breath,” says Maureen “the GP came to see me and wanted me to go to hospital but I don’t like hospitals. I worry that I’d never come out. The specialist nurse came to see me; she talked me through everything about my breathlessness. She came every day and did my blood pressure and blood tests. When I had to have my chest X-ray, I was in and out very quickly. The hospital had everything ready for me.

Support for avoiding admission to hospital, and an improved process to discharge patients from hospital makes a significant difference to care home residents and staff alike; “I don’t always need to refer residents to the GP or hospital for the things I can’t do,” explains Mihaela, “Patients can stay in their environment, in their own rooms. If a hospital visit is needed then I’m not trying to arrange everything. It gives me more time to care for the residents.”

Bella Balaci sees the benefits for her staff; “The RRaT team can do the things we can’t do here ourselves such as Intravenous drug treatment. Our staff get on the job training too with advice on taking blood for testing and reviewing basic parameters such as heart rate and blood pressure. “My nurses and care assistants are learning a lot from this new service. In time I expect our call rate to reduce, for example as we’re better able to spot early signs of urine infections and chest infections.”

A printed copy of this case study is available to download here.