Safety In Care HomesWhy this priority?

Care homes providers use different benchmarks for care quality. Large chains, in particular, collect data in different ways, making cross-sector comparisons difficult. System wide improvement in this area is difficult to attain as there are currently no reliable measures for benchmarking the prevalence of common care problems.

How big is the problem?

There are no reliable, nationally agreed benchmarking tools for pressure ulceration in care homes so it is impossible to know the true incidence or prevalence of these. Pressure ulcers have been indicated by stakeholders as a major focus for this priority area.

Our goal

We will work with the care home sector to improve the safety of residents.

How will we achieve it?

By increasing care home capacity and capability to recognise, prevent and manage care problems through the introduction of measurement tools and techniques supported with quality improvement interventions. We have chosen LPZ, an annual prevalence audit of care problems from the Netherlands. Along with pressure ulcers, we added continence because of the incidence of moisture lesions and their association with pressure ulcers. These two care problems have been selected for a pilot.

We will work to establish a mechanism for measuring, recording, analysing and sharing prevalence of common care problems at an individual home level across the East Midlands.

We will identify and describe how such benchmarks can be used to drive quality improvement work and improve patient safety. This will sit alongside activity including the identification and sharing of best practice materials from homes including case studies, training interventions and networking.

How will we know if we’re making an impact?

We will evaluate the LPZ’s suitability for use in the UK system alongside a bespoke programme of support to care homes including training packages, peer to peer learning and facilitated support.

At the end of the audit we will have data on the prevalence of pressure ulcers and continence issues for around 30 care homes in the East Midlands. We will know the extent to which care homes can accommodate standard measurement protocols from the LPZ into their daily routine. We will be able to outline the barriers to systematic, consistent audit across multiple homes of different size, infrastructure and provenance and to consider how and whether these barriers might be overcome. We will understand how homes use benchmarking from systematic audit to drive quality improvement and the resources to deliver this.

Further resources

React to moisture training resource - produced for care home staff in preventing moisture lesions (incontinence-related dermatitis)
pdfCare after Cure - Fast Track Pathway

Safety in Care Homes - LPZ Infographics

We have produced a two page LPZ Infographic with details from the East Midlands LPZ pilot.

The Infographics for the East Midlands were based on a much more detailed data pack which summarises the LPZ pilot results.

pdfEMAHSN Care Home LPZ Infographic results 2015 and 2016 
pdfLPZ Data relating to Infographics
pdfSafety in care homes poster 2017

Safety in Care Homes - LPZ pilot information video

This video explores the perspectives of some of the team who delivered the pilot, and highlights some o the initial findings.

NHS Sign up to Safety (Su2S) webinar - 14 April 2016: Measuring quality and safety within and between care homes

Safe care in Care Homes


Below is a suite of resources designed to help Care Home staff to identify and provide safe, effective care.   These have been produced by EMAHSN PSC working with 360 Assurance and the National Institute for Health and Care Excellence.

pdfSafe care in Care Homes - Medicines Management
pdfSafe Care in Care Homes - Nutrition
pdfSafe Care in Care Homes - Pressure Ulcers
pdfSafe Care in Care Homes - Preventing & Managing Falls
pdfSafe Care in Care Homes - Preventing Delirium
pdfSafe Care in Care Homes - Promoting Continence

Care home case studies

pdfAlexandra Lodge care home
pdfBaily House care home
pdfBeechdale House care home
pdfCamden care home
pdfOakdene care home

Please see below a collaboration of a group of international experts to review knowledge deficits in incontinence associated dermatitis (IAD) with the aim of advancing best practice principles to address these gaps.  The outcome was a publication containing practical guidance on how to assess, prevent and manage IAD. 

pdfBest Practice IAD guidance