Strategies to reduce avoidable hospital admissions are not new. For many years winter pressures have sparked conversations around home care for the elderly because of fears concerning hospital acquired pneumonia and deconditioning. More than 80% of ambulance calls are to assist the elderly frail, many of whom have fallen,
Covid-19 has exacerbated the issue exponentially and no where more so than for the 400,000 plus residents living in UK care homes. The risk of infection is so high for this group, that those charged with their care go to extreme lengths to protect residents from the outside world. Many living with conditions such as dementia, have a high risk of falls because of balance impairment and frailty.
Right now, the priority is to limit the flow of people visiting care homes and the risk of transmitting COVID to the resident population. This includes healthcare professionals, including ambulance workers, GPs and district nurses called to help lift people that fall. In the UK, more than 1,000 residents a day living in care homes will fall and although more than 50% are uninjured they need help getting up again.
Some Health Boards and CCGs in the UK were beginning to address the issue well before COVID impacted the current situation. It was acknowledged that by upskilling care home staff and investing in lifting equipment calls to the ambulance service and would reduce and avoidable hospital admissions could be prevented.
A ground breaking post fall management initiative, first trialled by Aneurin Bevan Health Board in Wales, piloted a project to empower staff to perform health assessments on fallen residents and use lifting equipment to move them from the floor. (Traditional hoists are not not always suitable for lifting people from the floor, so an alternative method of lifting is essential.)
Early success with the project led to the Welsh Government rolling out the initiative to every care home in Wales. Winncare and the Welsh Ambulance Service partnered to train 600 care homes on the importance of safe lifting and when calling for an ambulance is the right course of action.
Simon Claridge, CEO at Mangar Health said; “It was an honour to be involved in the Wales Care Home Project, especially when you see the positive feedback and results. Early project evaluation has shown an 80% reduction in decisions to call an ambulance within the first month of receiving the support package.”
CCGs in north Manchester, West Midlands, Essex and East Suffolk, have also seen the benefit of the post fall management initiative.
Lisa Elmy from East Suffolk CCG says, “we are committed to supporting the care homes in our region to provide the best possible care for residents. This initiative provides training in the ISTUMBLE health assessment tool, combined with a Mangar Camel lifting cushion, so providing staff with the skills and equipment they need to move residents safely and with dignity.”
Traditionally care homes may call for an ambulance to help with lifting a fallen resident but regularly wait 4 hours of more for support to arrive. As a non-life-threatening event, these calls are not categorised as urgent, however, the longer an elderly resident is on the floor waiting for assistance, the greater the impact on long term health. Ideally a resident should be lifted within 10 minutes of a fall in order to reduce the likelihood of an associated condition developing.
Head of Strategic Partnerships at Mangar Health, Dan Colclough has been gathering economic data to help understand the impact of empowering care homes to lift residents safely. Dan says, “early estimates suggest that best practice in post fall management could save the NHS savings of £50m per annum. However, the priority right now is safeguarding the lives of the resident population by protecting them from the risk of infection.”
For more information on post fall management please call Dan on 07580 280321 or