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The topic of General Health was added to this project to capture the ways frailty can interact with all aspects of a person’s health. This section includes nutrition, hydration, oral health, continence and catheter care. As these topics are broad and must be considered by all professionals when assessing and planning care for people living with frailty, there is only one level of training in this topic, and all staff responsible for providing care to people living with frailty would be expected to be trained in the learning objectives outlined below
Relevant Legislation
Mental Capacity Act
Health and Social Care Act
Resources
Pre and Post Knowledge Assessment
HCPA have developed word documents which can be used as a guide for pre and post knowledge assessments of the different levels outlines in this framework. The questions in this document can be copied into other formats such as Microsoft Forms or Excel and are a guide to the type of information you need your staff to know.
Nutrition & Hydration Pre & Post Assessment (42kB docx)
Continence and Catheter Care Pre & Post Assessment (39kB docx)
Oral Hygiene Pre & Post Assessment (39kB docx)
Learning Objectives
Please note that there is only one tier for General Health training. These objectives are relevant to anyone working with people living with frailty.
Nutrition & Hydration
- Staff understand symptoms of dehydration and the importance of early intervention to prevent UTIs. Staff understand that there are no accurate dehydration screening tools that can be used with older people
- Staff can use person-centred care when making an action plan to prevent dehydration in those at high risk. They understand that increasing fluids is more important than getting the correct amount when the correct amount is unfeasible and can ask the individual why they are not drinking. From their answer, an action plan can be made
- Staff understand the common hydration myths and can explain these to an individual receiving care
- Staff know that dip testing is not accurate in cases of UTI’s as bacteria may be present without infection. They can use the Assessment Tool to evaluate chances of an infection
- Staff can use the Nutritional Checklist to monitor risk of malnutrition and know how to take action and prevent need for referral. When necessary, staff understand when to refer
- Staff understand how to use MUST and to formulate an action/care plan relevant to the score.
- Staff understand basic nutritional needs and can communicate these to help people make informed decisions without imposing their own health beliefs. Staff understand different people have different needs and can follow nutritional guidance given
- Staff can differentiate nutritional requirements for people with specific needs and write or follow nutritional guidance as part of a care plan (i.e. people who are underweight)
- Staff can follow a food first approach for individuals with malnutrition and understand how to promote good nutrition including offering snacks and smaller but more regular meals where appropriate
- Staff can promote good hydration by encouraging an increase in fluids where necessary, by offering drinks that the individual enjoys. Staff know they should discuss the best times of day to provide drinks (typically with medication and at mealtimes) to encourage hydration
- Staff understand the importance of promoting sugar free drinks (i.e. tea/coffee with no sugar, sugar free/zero sugar sodas, no added sugar squash etc.) where possible to avoid oral health issues, or suggesting hydrating foods where an individual may be reluctant to drink.
- Staff have an understanding of healthy weight and how this can vary in older age and can promote weight maintenance or supportive weight loss as directed only by a dietitian
- Staff understand that physical movement plays an important part in health and can supervise and encourage activity as appropriate
- Staff understand nutrient density of foods including an understanding of micronutrients and the importance of protein in diets. Staff understand a varied diet should be encouraged
- Staff understand the importance of Vitamin D (100mcg a day) and can explain these to individuals to help them make informed decisions and can contribute to best interest decisions as appropriate for their role and the individual they are caring for
- Staff are able to monitor individual’s diabetes and can recognise red flags that require urgent attention
- Staff are able to monitor dysphagia and choking risk and can recognise red flags that need urgent attention
Oral Health
- Staff know the groups of people at higher risk of developing poor oral health (dementia, learning disabilities, frail older people etc.)
- Staff understand the implications of poor oral health
- Staff understand the effect poor oral health can have on overall health and nutrition
- Staff know the signs, causes and risks of dental decay
- Staff understand barriers to oral care and know the suggested ways of working with individuals who are opposed to or struggle with oral care
- Staff understand good denture hygiene and can advise individuals on this, and the risks associated with not following these guidelines
Continence and Catheter Care
- Staff understand the symptoms of a UTI in someone using a catheter
- Staff can follow a urine colour chart and address dehydration in a timely manner
- Staff know the symptoms of a UTI, including urine odour, pain when urinating, confusion and signs of dehydration
Education Resources and Case Studies
HCPA have developed PowerPoint presentations in line with learning objectives cited in this document for Nutrition and Hydration and Oral Health. If organisations choose to use these packages for training, they are responsible for editing content to be in line with organisation policies and local strategies, as well as ensuring there is training provided for continence and catheter care.
HCPA General Health Package – Coming Soon
Supporting Case Studies – Coming Soon
Actions
Over the next 12 months, Learning and Development Teams would be expected to undertake the below steps to ensure that all training is in line with HWE ICS Expectations.
- Ask staff to complete Training Needs Analysis for Frailty and review overall compliance
- Review learning objectives detailed in this document and check existing training compliance
- Explore alternative training available, or update existing training in line with learning objectives as required
- Review staffing levels against learning objective levels and ensure staff have received revalidation as needed