Quality standard

Quality statement 5: Recognition of physical problems

Quality statement 5: Recognition of physical problems

Quality statement

Older people in care homes have the symptoms and signs of physical problems recognised and recorded as part of their care plan.

Rationale

Physical problems can cause discomfort and affect activities of daily living, participation in social activities and independence, and therefore mental wellbeing. The recognition and recording of the symptoms and signs of physical problems by trained staff who are aware of the role of the GP in the route to referral can help to ensure early assessment and access to appropriate healthcare services. This is essential to improve the quality of life and mental wellbeing of older people in care homes.

Quality measures

Structure

Evidence of protocols to ensure that staff are trained to recognise the symptoms and signs of physical problems in older people in care homes, and record them as part of their care plan.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from training records.

What the quality statement means for different audiences

Organisations providing care ensure that staff are trained to be alert to symptoms and signs of physical problems in older people in care homes and to record them in a care plan.

Social care, health and public health practitioners look for symptoms and signs of physical problems in older people in care homes and record them in their care plan.

Local authorities and other commissioning services commission services from providers that can produce evidence of protocols for training staff to be alert to the symptoms and signs of physical problems in older people in care homes and to record them in care plans.

Older people in care homes are cared for by staff who recognise the symptoms and signs of physical problems (such as pain, dizziness, problems with walking, constipation and continence problems) and record them in their care plan.

Source guidance

GP services for older people: a guide for care home managers. Social Care Institute for Excellence (SCIE) guide 52 (2013), Managers' responsibilities and the NHS reforms: actions as a result of listening to residents and relatives, accurate, up-to-date recording; Workforce development, standards and regulation: developing trained, confident care workers

Dignity in care. SCIE (2006, updated 2013), A dignified life

Definitions of terms used in this quality statement

Care homes

This refers to all care home settings, including residential and nursing accommodation, and includes people accessing day care and respite care. [Expert opinion]

Physical problems

Examples of physical problems that could potentially affect a person's wellbeing include, but are not limited to:

  • joint and muscular pain

  • undiagnosed pain

  • incontinence

  • dizziness

  • constipation

  • urinary tract infection

  • reduced ability to move without support

  • unsteady gait.

[Expert opinion]

Recognised

Recognised in this context relates to the recognition by staff working with older people in care homes of physical problems and the sharing of information with healthcare professionals, including GPs. Staff should be continually alert to new physical problems and should monitor existing physical problems. [Expert opinion]

Trained staff

Trained staff refers to staff who have been trained to recognise and record the symptoms and signs of physical problems when caring for older people. Staff should be alert to the presentation of new symptoms and competent in recognising when older people need a referral for assessment and management of physical problems. [Expert opinion]

Equality and diversity considerations

When identifying an older person's needs arising from physical problems, be aware of any learning disabilities, acquired cognitive impairments, communication and language barriers, and cultural differences. Staff should ensure that they are aware of the needs and preferences of older people who are approaching the end of their life.

It is important that staff are aware that older people in care homes have the same right to access healthcare as people living independently in the community. This is stated in the NHS Constitution for England.