Recognising deterioration

This page contains useful information and resources to support recognising signs of deterioration in care homes.

Spotting signs of deterioration

Significant 7 and What’s best for Lily? are two new and highly effective educational training programmes that have been developed to support care home staff to recognise the signs of deterioration in residents and improve how people are cared for at the end of their lives.

Staff are given tools to help them take appropriate action; resulting in a much better personalised quality of care for residents, a reduction in the number of unnecessary calls to emergency services and admissions to hospitals, whilst increasing staffs confidence and empowering them to do their job well.

Significant 7 training – recognising deterioration in residents

During 2018/19, we partnered with NELFT NHS Foundation Trust to support training care home staff within north east London, so they can identify when their residents are deteriorating and what steps they should take.

The aim of the training is for care home staff to identify deterioration earlier. Care home staff will be:

  • Trained in a supportive and engaging session, which reflects best practice.
  • Provided with user friendly tools to use in practice.
  • Supported to build on the qualities and relationships they already have.
  • Empowered to monitor clients differently in their own homes.
  • Communicate more confidently with professions and relatives.

Commissioning guidance and supporting documents were produced to outline and help identify the roles and responsibilities of all parties involved in the coordination, roll out and embedding of the Significant 7 training within care homes.

What’s best for Lily? – end of life care training for care workers

End of life care teaching resources: UCLPartners have developed educational materials for facilitators to teach end of life care to non-specialist staff across all health and care settings.

The aim of the training is to increase staff knowledge and confidence in delivering excellent care for residents at the end of their life. Care homes are invited to participate and can choose from the following training topics:

  • Support loved ones and advocate for dying resident.
  • Care in the last days of life.
  • Recognise and use Lily symbol when a resident is dying.
  • Look after ourselves after death of a resident.

To find out more about workforce training and development for care home staff please contact Cerrie Baines at

Further resources

NEWS 2 – National Early Warning Score website

NEWS 2 – Royal College of  Physicians report

End of Life care learning and development resources

Dementia learning & development resources

Spotting signs of deterioration case studies


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