Quality in Care Homes Newsletter Autumn 2017 Introduction Welcome to the latest edition of our Quality in Care Homes Newsletter. We are a team dedicated to working in partnership with care homes in the Surrey Downs area to improve the health and quality of care for residents. We provide training, support and signposting to further services and resources. Congratulations The Quality in Care Homes team wants to recognise the great work that has been going on across care homes in Surrey. In August Cossins House were awarded outstanding for care in their CQC report. We wish to congratulate all the staff at Cossins House for this wonderful achievement. If your care home or staff have something to celebrate don t forget to tell us so we can recognise the wonderful things you do to support your residents. Care Home Forum The Care Home Forum is held bi-monthly by the Quality Care Home team. The forum hosts guest speakers and training whilst providing the opportunity to network with carers from other homes. We would like to thank all those who attended the forum in June and Appleby House for hosting. This session included training from Continence Catheter Specialist Nurse Katrina Oakes and a presentation on the 111 service by Kirsty McMurray aimed at raising awareness of the service and its benefits. The next Care Home Forum is on Friday 24 th November. See Upcoming events at the end of the newsletter for more information. Hydration Keeping residents well hydrated can reduce the likelihood of developing an array of physical and psychological health problems, including urinary tract infections (UTIs), falls and associated injury, low mood, confusion, pressure ulcer and skin degradation, kidney stones and cardiac event, to name a few. Therefore, by improving hydration practice in your home you can help reduce this risk and consequently improve the health and wellbeing of your residents. Hosting an event in your home targeted at increasing fluid uptake amongst residents can be a fun and sociable way of keeping residents hydrated. Take a look at some of the ideas below for inspiration. Page 1 of 5
- Host a tea party How about raiding the local charity shops for china cups and saucers and hosting a tea party for your residents? - Smoothie/ tea / squash tasting sessions Individual taste preference could be impacting upon your resident s likelihood to consume enough fluid. You could also supply different flavours of tea/ squash/ smoothies and encourage residents to sample a selection, rating each flavour as they go along. - Mocktail evening You could host a mocktail evening for your residents, mixing fruit juices and fizzy drinks to create non-alcoholic versions of their favourite cocktails. - Seasonally themed events Food can also be a good source of liquid, how about hosting an autumnal themed dinner with pumpkin soup? Or a non-alcoholic mulled - wine tasting at Christmas time. Mocktail & smoothie stations at North East Hants & Farnham hydrate homes Have you hosted a hydration event in your home or do you have any further ideas for fun ways to keep residents hydrated? We d love to hear from you, email us at csh.qualitycarehometeam@nhs.net. For more information and resources to help improve hydration practices in your home please visit: http://www.kssahsn.net/what-we-do/supporting-our-ageing-population/hydrate/pages/informationand-resources-for-hydrate-homes.aspx Looking for further support and advice? Sign up to Project hydration! The aim of Project hydration is to improve the health of care home residents by reducing the incidence of falls, UTIs and associated acute admissions. We do this by improving hydration awareness and practices among care home staff though free training sessions, resources and support. Please contact jennifer.halliday1@nhs.net for more information. Nutrition Nourishing drinks contain extra calories, and vitamins which may give residents a useful boost when they need extra nourishment. Residents should aim to drink at least two nourishing drinks a day between meals. Use fortified milk, dairy free milk alternatives (eg soya or oat milk) or fruit juice instead of water as the base ingredients for drinks Choose full fat and full sugar products rather than diet sugar free lite zero or skimmed varieties as these provide more calories Try homemade or shop-bought fruit smoothies to improve vitamin, mineral and fibre intake A 200ml glass of fortified milk (see below) is an excellent drink Page 2 of 5
Fortified Milk Get a boost every time you use milk by fortifying with milk powder. 1 pint (568ml) full fat milk 4 heaped tablespoons (60g) milk powder (Nido, Marvel, or supermarket own brand) Mix a small amount of the milk with the milk powder to make a paste then stir in the rest of the milk. Once made keep the milk in the fridge and use in meals and drinks. Aim to use a pint of milk every day; make fresh every 24 hours discarding any left from the day before. Try some of the recipes below and on the next page to make your own high calorie drinks. The recipes can be adapted to suit your residents taste preferences. Simple Super Shake 2 teaspoons milkshake flavouring (powder or syrup) 1 scoop ice cream 2 tablespoon double cream Mix all the ingredients together with a fork until the ice cream has melted Approx. 405kcal 13.7g Chocolate Malted Milk 1 heaped tablespoon Horlicks or Ovaltine powder 1 heaped tablespoon Milo or other hot chocolate powder 1 tablespoon double cream Mix the malt and hot chocolate powders into a paste with a little of the warmed milk then add the remaining milk and cream and stir until fully mixed. Approx. 363kcal 16.7g Souped up Soup 1 packet powdered soup/cupa-soup 2 tablespoons double cream Grated cheese to taste Whisk together the soup powder and fortified milk with a fork or mini whisk then add the double cream and cheese. Serve with a slice of bread and butter Approx. 515kcal 22.7g Peanut Power CONTAINS NUTS 1 scoops vanilla ice cream 1 tablespoon condensed milk 2 tablespoons of smooth peanut butter 1 banana Add all ingredients into a blender and blend until smooth. Swap the banana for a handful of strawberries or other berries for a different flavour. Approx. 551kcal 22.7g Page 3 of 5 Iced Coffee 2 teaspoons instant coffee 1 scoop vanilla or coffee ice cream 2 tablespoons sugar Dissolve the coffee in the warmed fortified milk. Add the ice cream and stir until dissolved. Approx. 357kcal 13.7g Cranberry Cream 2 x 50g pots fromage frais or thick and creamy yoghurt 100ml cranberry juice 4 tablespoons double cream 1 tablespoon strawberry milkshake powder Gently whisk together all of the ingredients. If you have a blender, add some frozen berries for a fruitier taste Approx. 398kcal 8g
Custard Cream Crush Not suitable for people with swallowing difficulties 4 custard cream biscuits 1 x 50g pot custard/1 tablespoon custard powder Crush the biscuits. Stir into the fortified milk with the custard. Try ginger nuts, bourbon or malted milk biscuits to vary the taste Approx. 499kcal, 19.7g Pineapple and Coconut Passion 100ml coconut milk 100ml pineapple juice 1 tablespoon honey or golden syrup Mix together all of the ingredients. Tastes lovely with a tot of rum! Chocolate Nut Classic CONTAINS NUTS 2 tablespoons double cream 2 tablespoons hazelnut and chocolate spread 2 tablespoons condensed milk Whisk together all of the ingredients with a whisk or fork. If the ingredients don t mix easily gently head the milk before mixing. Approx. 647kcal, 19.7g Super Strawberry Soya Shake 150ml soya milk 2 tablespoons smooth strawberry jam Mix together all of the ingredients. For chocolate lovers replace the jam with chocolate spread Fruit Smoothie 100ml fruit juice 50g pot yoghurt or soya yoghurt 1 banana 2 teaspoons honey 4 tablespoons tinned, frozen or fresh fruit. Add all ingredients into a blender and blend until smooth Try different fruits for a rainbow of taste Can be made dairy free if soya yoghurt used Approx. 310kcal, 3g Sparkling Citrus Fizz 100ml lemonade 100ml orange juice 1 tablespoon honey or golden syrup. Whisk together all of the ingredients and serve. Try pineapple juice for a sharper taste Approx. 352kcal, 1g Approx. 212kcal, 5g Approx. 200kcal, 0g Information courtesy of Guildford and Waverley CCG Community Nutritional Management Specialist Dietician. Winter Planning The flu vaccination is available every year on the NHS to help protect adults and children at risk of flu and its complications. Some groups are more at risk of developing the potentially serious complications of flu, such as bronchitis or pneumonia, so it's recommended that they have a flu vaccine every year to protect them. Adults aged 65 and over are one of these groups and are therefore eligible for a free flu jab, which Page 4 of 5
they can get from their GP or local community pharmacy. Studies have shown that the flu jab helps prevent getting the flu, so it is worthwhile having. It won't stop all flu viruses and the level of protection may vary, so it's not a 100% guarantee that you'll be flu-free, but if you do get flu after vaccination it's likely to be milder and shorter-lived than it would otherwise have been. Being vaccinated against flu can help to prevent the caring scenario breaking down due to the carer becoming ill. Care staff should contact their employer about how they can get a vaccination through their organisation s occupational health scheme. For further information please visit: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/618591/flu_vaccina tion A5_booklet.pdf Assistive technology The Quality in Care homes team has been working with Docobo, a health and care technology company, to understand how care can be enhanced through the use of technology. The CAREPORTAL is a device that can be used by care home staff to record vital signs and other relevant information in order to capture early indicators of change in health status. This allows staff to intervene early, at the initial point their resident s health begins to decline, enabling the resident to receive the appropriate help before they require more serious, or even emergency, intervention. The Quality in Care Homes team is currently working with three homes in the Surrey Downs area on this initiative and we will be looking to expand the project further in the near future. If your home is interested in finding out more about the project and how you could get involved, please contact us at csh.qualitycarehometeam@nhs.net. Photos courtesy of Docobo Upcoming events Our next Care Home Forum will be held on Friday 24 th November 14:00-17:00 at Surrey Downs CCG, Cedar Court, 36 Guildford Rd, Fetcham, Leatherhead KT22 9AE. This will include MUST training by dietician Jo Ascione and a presentation from Pauline Robinson Tissue Viability Nurse. Do you want to host the next Care Home Forum at your residence or present on a topic of your choice? Let us know by emailing csh.qualitycarehometeam@nhs.net. Get in touch For any further enquiries please send an email to csh.qualitycarehometeam@nhs.net Page 5 of 5