Avoiding unnecessary hospital admissions among older people: residential care

As care homes now support some of the most frail and ill older people in this country, they need to plan and deliver care carefully if they are to avoid adding to the numbers needing hospital admissions.

This film presents the approach of Lime Court Care Home, which has introduced a number of new policies and practices with the specific aim of reducing hospital admissions amongst its residents. Lead by manager Mike Richardson, Lime Court has focused on infection control, mental health support, reducing falls, better medication management, nutrition and planning for end of life care.

The attention placed on each of these areas, combined with increased community health input and a stable team able to provide continuity and consistency of care, has enabled Lime Court to significantly reduce hospital admissions whilst improving outcomes for residents.

Messages for practice

Care homes support some of the most frail people in this country and need a strategic approach to avoid frequent unnecessary hospital admissions.
Hospital admissions can be particularly traumatic for people with dementia, often resulting in significant distress and deterioration.
Strong relationships with community health professionals, including community matrons, are essential to support informed decisions about the need for hospital admissions.
Care home staff must be skilled and confident and must receive effective support so that they can cope with residents’ complex health care needs.
Good infection control, careful management of medication, attention to nutrition and hydration and the involvement of the falls prevention service can all help to reduce the need for hospital admissions.
Planning for end of life care, including a preferred place of care agreement, and involving residents, relatives and staff, helps ensure individuals do not get admitted to hospital in the final days of their life.
Older people have as much right as anyone else to acute hospital care when they need it – this can often be forgotten.