The challenge

73. Pharmacy - smiling staff.jpgThe COVID-19 pandemic posed significant challenges to Care Homes. The directive to bring forward the implementation and roll-out of the key elements of the primary and community health service-led enhancement Health in Care Homes Service from October 2020 to May 2020 was advised. 

The guidance incorporated and updated key elements of existing evidence-based guidance and good practice in order to bring in line with the needs of care home residents during the current COVID-19 situation.

CHAW Care Community developed a high-level plan and pathway for referrals to the wider MDT. Each care home was supplied with a BP machine, thermometer and pulse oximeter for remote monitoring and all clinical priority residents monitored regardless of COVID-19 status. 

Weekly calls were initially established with a trainee Advanced Clinical Practitioner to check in re PPE needs, COVID cases, support for residents and staff. Weekly phone calls evolved and now form one of the components of a remote weekly ward round undertaken by the Trainee ACP and MOCH Pharmacist which are supported by the Care Community and General Practice. 

The ward round is scheduled in the respective GP EMIS system allowing swift communication with primary care and for GP practice staff to schedule patients alongside residents being put forward by the Care Home. Medication reviews are completed by MOCH pharmacist. Collaborated and incorporated with Mental Health Nurse for EMI Nursing Home Round. 

The roll-out of ward rounds has been a staged approach. See the numbers below for what we have achieved in the first 4 weeks:

  • 13 Ward Rounds
  • 68 Patient Reviews
  • 31 Pharmacy Reviews
  • 0 Hospital Admissions

  • Explore options for local variation of ward rounds MDTs in conjunction with Primary Care & Mental Health and the CCG Care Home LES initiative
  • Establish weekly MDT to include wider MDT such as Therapies, Social Care, Dietetics and Mental Health
  • Create and embed bespoke training plans for Care Homes in CHAW
  • Support the CCG role out of iPads to Care Homes to for remote communication