Clinicians say all care homes should screen for diabetes
Caring Times, July/August 2014
Every care home in England should screen for diabetes to help detect the “masses” of undiagnosed residents with the condition, according to a set of wide-sweeping recommendations.
The call comes on the back of the full publication today of the first-ever, England-wide Care Home Diabetes Audit, with social care managers and NHS professionals also urged to improve lines of communication.
The recommendations are a follow up to the initial results of the study, led by the Institute of Diabetes for Older People (IDOP) and the ABCD (Association of British Clinical Diabetologists), which were published last autumn.
Professor Alan Sinclair, audit lead and Director of IDOP, which is based at the University of Bedfordshire, said: “We appreciate the strain placed on care home staff but the results of the audit demonstrated major concerns which need urgent attention.
“The results found one in 10 care home residents were reported as having diabetes, although this figure is at odds with previous research that showed as many as 26 per cent of all care home residents actually have diabetes.
“However, we also know there are masses of people with diabetes in care homes who are undiagnosed. The longer it takes them to become diagnosed, the more their health will suffer, leading to the potential of the development of unseen complications. Screening for diabetes should be a fundamental policy for every care home.”
The audit seeks to identify quality standards that can be picked up by the Care Quality Commission (CQC) to be used for assessment of the quality of diabetes care being delivered in care home settings.
The recommendations, which have addressed the findings of the study, have also been issued as a direct call to every care home to improve standards. They include:
· Patients who self-medicate should be monitored and their ability to self-medicate should be assessed at regular intervals, and if there is a change in their circumstances
· Care homes should establish good communication with primary care, liaising with GPs and community teams to ensure annual reviews and other scheduled checks take place and inform care practice
· All care homes should be aware of the good clinical practice guidelines for care home residents with diabetes and should base their care and policies on the guidelines as far as possible
· Care homes should have a screening for diabetes policy at admission to a care home and at intervals thereafter
· All care homes should have a fully-stocked hypoglycaemia kit
· All care homes should employ a diabetes foot evaluation scheme (risk stratification)
· All care homes should provide opportunities for care staff to participate in diabetes educational and training programmes
The study undertaken in 2012/13 found more than 60 per cent of the 2,043 premises surveyed did not have a designated member of staff with responsibility for diabetes management.
It also revealed a third of residents (35.17 per cent) did not know about the signs and symptoms of hypoglycaemia – a complication of diabetes, which can result in hospital admission due to a coma if left untreated. More than 35 per cent of homes did not have a written policy for managing hypoglycaemia.
However, the recommendations also call for care homes to have a policy on the management of hypoglycaemia and to ensure all staff members have the skill and training to deliver care according to the policy.