Nursing teams in care homes could reduce hospital admissions

Bringing a community nursing and physiotherapy team into residential care homes for older people improves quality of life and reduces hospital admissions, according to a new evaluation study's reports published by the Joseph Rowntree Foundation.

The research, undertaken by the University of the West of England, Bristol (UWE) and the University of Warwick, found that savings made through reduced hospital admissions and delayed transfer to nursing homes offset any potential costs of the scheme. The study suggests that the overall cost ranged from an added £2.70 a week per resident to a more likely weekly saving of £36.90.

The two-year pilot scheme was set up in a group of local authority residential homes caring for 131 long-term residents as a joint initiative between Bath & North East Somerset (B&NES) Local Authority and the local Primary Care Trust. In tandem with providing nursing and physiotherapy to residents, the dedicated team also developed the nursing skills of designated care home staff through a training programme funded by Skills for Care.

Researcher Deidre Wild from UWE said, "Allowing people to remain in their care homes by bringing in specialist care during episodes of illness was greatly valued by both residents and staff. Staying in a familiar environment gave care home residents a greater sense of security during challenging times."

The dedicated team (known as 'the in-reach team') was able to detect and deal with undiagnosed illnesses, producing long-term benefits for residents' health and quality of life. This was especially important in cases where, due to conditions such as dementia, residents found it difficult to communicate their symptoms to staff.

Professor Ala Szczepura of Warwick University reported that, "During the two year study, between 80 and nearly 200 potential hospital admissions were averted, and 20 early discharges made possible. Beyond the clear benefits cited by residents and staff, we estimate that investment in such a service could produce savings of up to £250,000 per annum to the Primary Care Trust and Local Authority."

Commenting on the research, Jane Ashman, Strategic Director of Adult Social Services and Housing, B&NES said: "This has been a really important project for the Council and the Primary Care Trust looking at an often neglected area, the health needs of people in residential care homes. We are now looking, with the PCT, at how to take the best learning from this and build it into our future joint community provision. Meeting the health needs of people in care homes is as important as for those in their own homes in reducing hospital admissions as well as improving quality of life."

This research emerges at a time of change in health care provision with increasing emphasis on the integration of health and social care by community services so that hospital trusts can concentrate on providing acute care. It highlights the need for more detailed health assessments of residents in care homes than is currently carried out.