Hydration is key and has health benefits for us all, especially for people living in care homes.
However, ensuring the correct levels of hydration necessary for good health are consumed by care home residents can present a number of challenges for care managers and their teams on a daily basis.
I was both humbled and also delighted to learn recently from Brian Preston, Catering Manager at Lister House Care Home part of the Royal British Legion, about the redesign work he is doing in his dining area for the people he supports with a Dementia and as a result, that his ladies and gents are enjoying a completely different mealtime experience.
Brian took part in my interactive Dementia Mealtime Challenge Workshop presentation back in October of 2018 at the annual Training and Development Forum for the National Association of Care Caterers, and I bumped into at him again this year’s event. He was very keen to tell me all about the changes that he had made, following on from what he had learnt in my workshop and in our Dignified Dining Guide.
It’s that time of year again when our care home customers are stocking up on hand sanitisers to help protect their staff and residents from unnecessary outbreaks.
Care homes unite large numbers of people in one place with many of them being highly susceptible to catching infections. In care home settings, residents, staff and visitors are in shared living environments and therefore also share bacteria which can lead to infection outbreaks (Utsumi et al, 2010).
The elderly are more susceptible to illness and in some cases, infections can be life-threatening. It should be in the interest of everyone involved in care to keep the risk of a spread of infections to an absolute minimum. Care home staff need to ensure that a high standard of infection prevention and control is always carried out. It is important for staff to understand how to avoid outbreaks and how to detect and manage them.
This week, one of our customers asked us for information on providing them with personal issue hand gel bottles for their staff to carry around with them, plus a 5 litre refill container so they could ‘top them up’ when they needed to.
This is what we told them:
We can supply you with the personal issue bottles of hand sanitiser no problem, however we don’t sell or promote the practice of refilling bottles from a bulk container, as we know from our experience and from talking to infection prevention professionals, that this is not best practice, and we will only ever actively promote product solutions which we know to be fit for purpose.
And here’s why:
Alcohol sanitisers are designed to be used when access to soap and running water is not practical.
This means that the alcohol is the only means by which transmission of infectious agents from the hands can be prevented, and as a result, the quality and efficacy of the product being used is absolutely critical.
Hand Washing, using sanitizing gelTo summarise, the potential problems associated with refilling bottles could lead to more significant risks to heath than may be posed by the correct disposal of plastic packaging.
NB: Our products are packaged in sealed containers so you can be assured that the product always meets our specification in full and is fully compliant with infection prevention and CQC standards. You can view our range here.
Here are some other things to consider when selecting a fit for purpose hand sanitiser to protect your staff and residents from outbreaks
How can I ensure that a hand sanitiser I select is going to be effective?
The Centres for Disease Control and Prevention (CDC) and World Health Organisation (WHO) guidance recommends use of an alcohol based hand sanitiser containing a minimum of 60% alcohol as the active ingredient ,compliant with BS EN 1500:2013
When is it safe to sanitise hands and when is it not?
It should be remembered that alcohol sanitisers are not suitable for use on hands that are dirty, contaminated and soiled, e.g. faeces and secretions, or during outbreaks of diarrhoeal illness, e.g. Norovirus and C diff. In these instances, washing hands with mild soap and water is of paramount importance.
The World Health Organisation (WHO) claims that ‘hand sanitising may be of benefit when used after hand cleansing, but it should not be regarded as a substitute for soap and water since sanitisers will not remove any contamination from the hands.’
Hand sanitising with an alcohol based sanitiser, with a minimum of 60% alcohol as an active ingredient, can be a very good substitute to washing hands, provided hands are not physically dirty, and does not require water, to kill germs and provide a high level of hand hygiene and skin disinfection on visibly clean hands.
So, I want to ask you two questions:
If so, you are currently non-compliant, and it is only a question of time before CQC and/or infection prevention will pick up on this and insist that you upgrade your hand hygiene provision to fit for purpose, hygienically sealed cartridge based systems.
If not, you are literally wasting your money and putting your staff and residents at greater risk of infection – which is ironic, since that is the purpose of the product in the first place, to reduce potential outbreaks!
Here at Hcsuk, we can provide a comprehensive range of support materials to provide timely hand hygiene reminders in your care home. Our support package offers innovative training and awareness materials to drive high rates of compliance amongst residents, staff and visitors.
We have a range of compliance materials, ranging from sanitising boards and dispenser surrounds to posters and hand hygiene guides, all aiming to drive hand hygiene awareness
If you would like further advice, guidance or assistance on any aspect of hand hygiene from an expert company who you can trust and who are passionate about working with you to help you improve your standards of hand hygiene, then please get in touch today on [email protected] or call us on 01773 713713 and will provide you with the right advice.
So, over the past few weeks we have been talking about ways to help you to improve standards and outcomes in your laundry, and offering you the opportunity to have the benefit of our FREE and unique laundry survey.
Several interested customers have come back to ask for an over view of what our laundry audit entails and what they can expect to receive and gain at the end of it, so we thought we would share that with you all just for clarification:
Hcsuk’s unique, FREE and innovative Laundry Audit for care homes:
Our laundry audit is carried out by Ken Moss, who is a technical laundry expert, having over 20 years experience of working in care sector laundries and who is also involved with new laundry product development. Believe me, what Ken doesn’t know about care home laundries isn’t worth knowing!
Ken follows a step by step process during the audit which looks like this:
Could they be causing any damage to fabrics?
I asked Ken if he could give me an average duration of a survey, just to give you an idea, and he simply said;
‘It takes as long as it takes to get the job done right’ which I loved! Your homes will have the benefit of Ken’s expertise for several hours. However, I will stress that he doesn’t disrupt the normal workings of the laundry, its business as usual and Ken will work round your staff.
I hope that you agree with me that this is a very comprehensive audit which we are offering and one which is unique in its depth and attention to detail.
We like to be different and genuinely want to work with you to help you achieve improved standards by providing expert advice, recommendations and fit for purpose product solutions which help you to get the job done right first time.
Also, it is very helpful in order to get the best outcomes, if you can identify key laundry staff and that they are available when Ken visits so that we get the best understanding of their challenges and can give them the best advice.
I hope that this gives you all of the information you need about out laundry audit, however if you do have any further questions, or to arrange a laundry survey for your home, then please don’t hesitate to contact us, either by email, [email protected] or by phone on 01773 713713
I look forward to hearing your thoughts on our audit and how you feel it could assist you in improving results and standards within your home.
Whilst we acknowledge that there is still a lot of uncertainty around Brexit and the outcome is far from decided, here at Hcsuk we have plans in place to mitigate any risk in our supply chain.
Several of our customers have asked us to share our strategy to give them confidence and trust in us as a responsible and responsive supply partner. We wanted to share this with all of our customers so that you understand and have the confidence that this is something we have thought about, considered and taken appropriate action where possible, to ensure that there is minimal disruption to your businesses.
I never tire of telling our story of how Hcsuk began, when asked, as it goes to show how great things can begin with simple conversations.
Last week, I thoroughly enjoyed reminiscing with Anita Astle, proprietor of outstanding local care home Wren Hall, about our 30 year journey together in the care sector and how she helped to get us started.
When was the last time you reviewed your laundry costings to assess how effectively and efficiently it is working for you?
And do you know how to do this accurately?
Do you know your ‘cost per wash cycle?’ which is the only effective way to correctly calculate the true cost.
Typically, what we find when we talk to our care home customers about their laundry is that they tend to focus on the cost per drum of product they are buying to get the ‘best deal’ on price.
What can sometimes get missed though is the concentration of the product and therefore how much volume is needed per wash cycle for that product to be effective, like the Fairy Liquid scenario where less is more.
Did you know that here at Hcsuk, we can offer you a FREE, No Obligation, Laundry Audit service?
Our unique and FREE LAUNDRY AUDIT service can give you an in depth review of your laundry’s performance and efficiency, including an accurate calculation of exactly how much each wash cycle is costing you - your true ‘cost per wash.’
Our laundry expert, Ken, who has over 20 years experience working in care home laundries will spend time with your laundry staff to understand the challenges they face and provide advice and solutions to help you to improve your systems.
And he will even do some washing for you too! ☺ giving you the opportunity to try out some of our unique and innovative laundry chemicals including our famous Supreme Fabric Softener featuring persistent fragrance technology, keeping your residents clothes and bedding smelling deliciously fragrant for up to 12 weeks. Also our fabulous Anti-bacterial Low Temperature Destainer which kills 99.999% germs in 5 minutes at 20oC.
The wash results always speak for themselves!
You will then receive a written proposal detailing our findings, recommendations and equivalent cost per wash comparison for your consideration.
How we helped one care home to save money on their laundry costs with a higher cost product.
One of our customers approached us for our laundry audit service because although they were buying their laundry products at a very low price they were conscious they weren’t getting satisfactory cleaning results.
Sheets and bedding was still stained after washing and they couldn’t get rid of the smell of urine. This was unpleasant for the residents and relatives were complaining at the poor standards, and they had hidden additional costs for labour, energy and water costs due to high numbers of rewashes.
During our survey, we found that their products were watered down and therefore higher volume of products were being dosed into each wash cycle to compensate for the low quality.
To give you an example,
The customer was having to dose 25-30 mls of laundry detergent per kilo of dry weight laundry( due to it being heavily diluted) into each wash cycle whereas our best selling Pearl 35 Laundry Detergent, (35% active) recommended dosage is 10-15 mls per kilo of dry laundry.
So, although the cost per drum of our competitors detergent looked lower than ours, in reality it was working out to be more expensive as they were having to use up to two and a half times as much product per cycle which increases the ‘cost per wash’ making it completely false economy.
We presented these finding to our customer and needless to say they moved onto our laundry products, enjoying free on loan state of the art auto-dosing equipment, regular 6 monthly engineer calls to check and service the equipment and very quickly fed back to us that they were getting very positive feedback from both residents and their relatives about the improves standards, quality and beautiful smelling laundry.
And they were saving money as well!
If you would like more information on our FREE LAUNDRY AUDIT service, or to book your audit today, please contact [email protected] or call us on 01773 713713.
What have you got to lose?
When we talk to our care home customers about the biggest challenges that they face in their laundry, we repeatedly hear that they struggle to effectively remove stains and eliminate unpleasant odours from residents’ clothing and linen.
This can raise many issues including:
Delicate fabrics and high energy bills mean that many care homes wash laundry at lower temperatures, while this can help reduce the cost of energy, not all temperatures kill germs and typically generic destaining products are not effective at removing stains at temperatures less than 50 degrees centigrade, so there is the risk of bacteria and other germs surviving or being passed from one item of clothing to another and also that linen won’t be physically clean.
Did you know that here at Hcsuk, we offer a FREE and unique Laundry Audit to evaluate exactly how efficiently your care home laundry is operating including an accurate calculation of exactly how much each wash cycle is costing you.
Our resident laundry expert, Ken, who has over 20 years experience working in care home laundries will spend time with your laundry staff to understand the challenges they face and provide advice and solutions to help you to improve your systems.
You will then receive a written proposal detailing our findings, recommendations and equivalent cost per wash comparison for your consideration.
Laundry Audit Case Study
When we completed our FREE LAUNDRY AUDIT at a local 88 bed care home, we learnt from their laundry manager that she was having to dispose of 6 bed sheets every week due to being unable to effectively remove staining – that equated to wastage of over 300 sheets every year and their bedding costs in excess of £3,000.
The laundry chemicals they were using were low in cost, heavily diluted and they were using higher than necessary volumes of product to compensate for poor cleaning performance.
As an experiment, we asked for one of the sheets she had written off and ran it through her machine, working at a similar temp and wash cycle that she would normally use, utilising our Crystalbrite Low Temperature Antibacterial Destainer, an effective oxygen-based low temperature liquid destainer, which removes stains even at temperatures as low as 20ºC, and Kills 99.999% germs in 5 minutes at 20oC.
The results were amazing! After the sheet going through 2 wash cycles, the stains were completely removed and the sheet, looking like new, was able to go back into service.
This enabled the home to save valuable resources on the replacement of sheets, improve the physical and hygienic cleaning results of their laundry, and improve infection prevention, a real WIN WIN!
Fast forward 3 years and the laundry manager tells us she would not be without her Low Temp Destain, she describes it as the ‘best laundry product she has ever had!’
This care home has since been rated ‘Outstanding’ with CQC.
When was the last time you evaluated the overall efficiency of your laundry?
How could you benefit from some free advice from a care sector laundry specialist with over 20 years experience?
Our *FREE LAUNDRY AUDIT has been successful in many care homes and has helped them to:
Why not book your FREE, no obligation, LAUNDRY AUDIT today by emailing [email protected] or calling her on her mobile 07968 994660.
*Terms and conditions apply
Managing the ladies and gents you support with Dysphagia and ensuring that they maximise on the correct levels of hydration represents a huge challenge to care managers and their teams, given that these residents are at high risk of being deficient due to finding it difficult to tolerate large volumes of fluids.
And Dysphagia is known to affect between 53%-74% of nursing home residents. It may occur in people who have a Dementia, stroke, Motor Neurone disease and other neurological conditions.
The Importance of Hydration
Water intake is often a secondary consideration in Dysphagia management. Water makes up 75% of the volume of the body and the NHS advises drinking 2.5 litres of water per day. Many older people and those with Dysphagia do not drink adequate amounts of water, consuming only 480–960 mls 2-4 glasses per day. However, drinking sufficient amounts of fluid can assist in preventing or treating the following ailments
• Pressure ulcers
• Urinary infections and incontinence
• Heart disease
• Diabetes management
• Dizziness and confusion leading to falls
• Skin conditions
• Constipation
• Kidney stones
• Low blood pressure
• Cognitive impairment
• Poor oral health
It can be challenging to assess hydration in older people however you can look out for these signs and symptoms:
Signs of dehydration
Dehydration is also indicated with a reduced and more concentrated urine output. As a general rule, the colour of urine can be a useful guide; urine that is odourless and pale in colour generally indicates good hydration, dark strong smelling urine is a common symptom of dehydration. However, there are a number of medical conditions and certain medications that can add colour to urine.
Monitoring fluid intake is a good guide to ensuring good hydration.
The key to maintaining hydration for people with Dysphagia is to promote safe swallowing and to ensure that the fluids are of the appropriate texture and thickness.
Advice on safer swallowing for improved hydration
Other strategies to help improve hydration include:
Thickened fluids
One way of helping patients with swallowing problems to take fluids without aspirating is to consume liquid of a thicker consistency. A speech therapist can give advice about thickened fluids. Fluid can be thickened artificially with powder or bought pre-thickened.
Positioning
The adopted position for drinking can also effect swallowing. A study showed that: “The chin down posture can have a positive effect on swallowing safety and reduce the incidence of aspiration and depth of penetration, in the context of cup drinking with thin liquids.” - Fraser (2012
Drinking smaller quantities with each sip
Sometimes residents with learning difficulties or Dementia may gulp fluid too quickly, risking aspiration. It is possible that limiting the amount of fluid consumed with each swallow can also make swallowing safer.
Choosing specialist Dysphagia drinking devices for safer hydration
We provide a range of drinking devices which restrict the volume of fluid delivered and allow safer independent drinking for people living with Dysphagia.
For more information or to arrange to see samples of our range of drinking vessels to help support your residents with Dysphagia, please contact Lucy by email at [email protected] or on her mobile 07968 994660.
The Care Quality Commission (CQC) has recently published the findings of an in-depth review on the state of oral health care in care homes across England.
The review draws on one hundred inspections of care homes on which CQC inspectors were accompanied by inspectors from dental regulation. It reveals that three years on from the publication of NICE guidance on oral health in care homes, steps are often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and that their dignity is respected.
Key findings include:
Why is good oral care so important?
So what is the difference between oral hygiene and oral care?
Research has found the following challenges to achieving and maintaining good oral health for residents in care homes.
So what do care homes need to do to comply with CQC latest guidelines for oral care?
What the Care Quality Commission expects
The Care Quality Commission expects registered managers to take account of nationally recognised guidance, including guidance from NICE.
Evidence about how you support residents to maintain good oral health will help you demonstrate that your service is both effective and responsive.
NICE’s guideline on oral health for adults in care homes, including the baseline assessment tool, can be used as part of your preparation for inspection and to support requests for help to other services.
Oral health assessment
All residents should have an oral health assessment when they move into the care home, with the result recorded in their care plan. Care staff should start by asking the following questions:
How do you usually manage your daily mouth care and what help would you like?
What dental aids do you currently use? For example, manual or electric toothbrush, mouthwash, floss.
Do you have dentures, and if so are they marked with your name? If not, would you like them to be marked?
When did you last see a dentist, and who did you see?
If you don't have a dentist would you like help to find one?
Using an oral health assessment tool - like the one here - will highlight any areas where residents need specific care and support. Using it for reassessments will indicate any changes that may need action.
Care staff knowledge and skills
Care staff need to know when to reassess the oral health of a resident and how to support residents with their daily mouth care to:
Brush their natural teeth at least twice a day with fluoride
toothpaste.
Use their choice of cleaning products for dentures.
Clean their dentures (brushing, removing food debris, and removing dentures overnight).
Use their choice of toothbrush, either manual or electric/battery powered, and mouth care products.
They also need to understand how dental pain or a mouth infection can affect residents’ general health, wellbeing and behaviour.
Make sure staff know who to ask for advice, how and when to report any concerns about a resident’s oral health, and how changes in a person’s condition might affect their ability to manage their mouth care.
For more information on Being CQC Ready in Oral Care we have attached a link to a Youtube training video by Knowledge Oral Health, which we hope you will also find useful.
If you have any questions or would like to discuss any of our fit for purpose oral health product solutions then please don’t hesitate to contact us on 01773 713713 or email us at [email protected]
