Posted By Jason Gould
Please bear in mind folkes that this is for my benefit only, as Im a student.

This is not a witch hunt or grievance its just a discussion me and partner had after incident.

We both appreciate the hard work and forever changing goalpost that care homes have to deal with.

Posted By Joe
Jason,

In addition to what Mike has been saying, there is some information on first aid in Care Homes in the HSE Publication "H & S in Care Homes" which carries forward the view that when completing a first aid risk assessment it is good practice to include building 'users' as part of that overall assessment, thus removing the comfort blanket of first aiders only being there for staff.

The problem of a large number of residents requiring 'nursing care' follows on from the ideology of keeping people in the community for longer which results in some residents requiring a much higher level of care in what was previously deemed 'care home' settings and not 'nursing homes'.

It's a tough nut to crack as when residents should be moving on to nursing care situations there is never any room at the inn!!

Posted By Mick Moring
I think a key word in Joe's reply is "expected". If an employer expects their staff to carry out any procedure, they have a responsibility to ensure that they are adequately trained. Does the care home in question have a policy for dealing with staff that need first aid? It may be simply: keep safe, ensure airway is clear, phone for an ambulance. This is now shifting the responsibility of competent care on to the ambulance service, which it could be argued is unfair. Are the staff aware of NHS Direct, whereby they could get advice on dealing with the situation?

Posted By Linda Westrupp
Jason
There are two basic issues here.
First - those of us who work in a care setting have seen many residential homes increasing having to deal with people who realy are on the borderline of nursing care and been unable to get them placed as the criteria for acceptance into nursing care have changed.
Second - In my own organisation we no longer have any first at work trained first aiders firstly because the training is inappropriate and tends to concentrate on 'factory' type accidents and secondly because you can train 5 people in Emergency Aid (Appointed Person) for the same price as one FAaW and then give them top up specialist training. Many of us H&S professionals in Care settings are aiming for all staff to be Emergency Aid trained with resuscitation or rectal diazepam training in addition and where risk assessments show a particular need.
These are relatively low risk environments so one first aider at night should be adequate (in many places this would be the 'sleep-in' staff who would have to be woken up if needed). The new care Standards are advocating NVQ qualifications for care staff which include emergency aid training so that everyone on duty at all times can cope with emergencies.
Some areas have local fast response paramedics who prefer on-site first aiders just to maintain breathing and make the patient comfortable rather then moving or treating them. Our advice to all our staff is that if someone has fallen they should suspect a fractured hip (the most common injury) or a head injury and should always call the paramedics anyway even if they feel they are competent first aiders themselves.
Previous responses are quite right in saying that the duty is to staff, but the Care Standards Commission, who are the regulatory body for care homes expect cover for residents as well as staff to a higher level suggested in the HSE Guidance, their inspectors may well be requiring more in this particular home when they carry out an inspection.
Hope this all helps
Linda

Posted By Jason Gould
Thanks for all your responces.

Linda what you were describing is what I think this company does.

From what Im told all care staff will have to have a minimum NVQ level and these will include first aid emergencies etc.

What threw me off what when a residential home starts to (due to shortages) take in nursing residents.

My partner was wondering if this affected level of first aid required (i.e. assessment including others affected by your work). Only emergency first aid as the homes policy leans towards ambulance under most circumstances.

Thanks all

Jason

Posted By Paul Murphy
I think there are several issues here coupled with a few myths. I am an ex NHS Paramedic, First aid instructor and now H & S professional.

In my view, first stop is Risk Assessment of First aid needs.

Myth 1 - Nurse = competent to deal with emergency situations - wrong, with the exception of A & E or ITU nurses most would I suggest not be deemed competent in what is a non clinical setting.

From the Paramedic point of view, little is best in rspect of first responder treatment. Concentrate on the basic ABC and don't move patients unless there is an immediate danger to them or staff. Well intentioned movement has led to fatalities which i have been unfortunate to witness.

First aid training for the HSE FAAW Qualification should be tailored to the specific workplace in which the people on the course work. The HSE defines a core syllabus but that should be applied to the appropriate setting. Linda, I think you should take this up with your provider if you think the course is too factory orientated.

I could go on but don't wish to bore.

Cheers and good luck