Pauline Virgo is Founder and Lead Physiotherapist at Zest Physiotherapy for Life, a service created following market research with care homes in South Devon revealed the need for expert on-site physiotherapist services.

Below, Pauline shares her experience of the benefits of providing on-site physiotherapy to care homes. Here are Pauline’s 7 compelling reasons why YOUR care home should provide on-site physiotherapy and how it will save time, money and help to improve that all important CQC rating.

No 1. Managing Falls Risk –

This not only saves additional care costs but keeps residents feeling safe, comfortable and happy

Physiotherapists have specialist skills in assessment and re-ablement and provide evidence based exercise, education and advice programmes aimed to prevent falls, improve balance, increase self-confidence, reduce fear of falling and promote active and healthy lifestyles (The Chartered Society of Physiotherapy, 2014).

Physiotherapy led group exercise programmes have been shown to be effective and to reduce falls by 29% and the risk of falling by 15% and individual exercise programmes by 32% and 22% respectively (Gillespie et al, 2012).

Managing falls and injuries can be time consuming for care home staff and result in increased care needs for residents. An on-site physiotherapist can create personalised care plans to reduce the risk of falls and can provide tailored evidence based exercise programmes for your residents no matter how complex their care needs.

No 2. Provide Specialist Dementia Care –

More mobility means less pain and less dependence… in other words staff can focus on the many other jobs they need to do and let the physio take care of the physical

Physiotherapy plays an essential part in promoting and maintaining mobility for people with dementia (Oddy, 2011), and particularly has a vital role in end of life care, by managing positioning, seating and painful contractures (Chartered Society of Physiotherapy, 2011).

People with dementia often have difficulty expressing pain. Pain affects cognition, motivation and response to any intervention; physiotherapists are experts in identifying and treating pain (Marshall, 2005).

Dementia costs the UK economy £20 billion a year (Alzheimer’s Society, 2011). The annual costs per person with dementia living within the community are estimated as: £16,700 for people with mild dementia, £37,500 for people with severe dementia, and £31,300 for people in care homes (Alzheimer’s Society, 2007).

Physiotherapy, in particular physiotherapy-led exercise, is a clinically and cost effective, accessible intervention. It preserves and promotes activity for older people with dementia. Physiotherapy interventions improve the quality of life for those with dementia and reduce the burden of care (The Chartered Society of Physiotherapy, 2011).

An on-site physiotherapist offers continuity of care and allows residents to build a relationship of trust with their physiotherapist enhancing outcomes further.

No 3. Improve the quality of your care planning –

Staff who are fully trained by a specialist can provide better, safer care. And of course, well planned care saves time and money

An on-site physiotherapist can contribute to specialist person-centred care planning in areas such as mobility and transfers, activities, positioning for pressure areas, contracture management, pain management, and chest physiotherapy.

An on-site physiotherapist can provide staff training to ensure safe and effective implementation of care plans.

Physiotherapists are registered with the Health Care Professions Counctil (HCPC) and bound by the professional standards of the Chartered Society of Physiotherapy so you can be assured of a professional standard of care and quality documentation.

No 4. Promote active ageing and independence for your residents -

Active ageing is the overall key to happier residents and happy residents = happy families and a great reputation for your care home

There are many proven physiological, psychological and social benefits of exercise programming for your residents.

Physiological Benefits: Increased activity levels help to regulate blood sugar levels, enhance sleep quality and quantity, improved fitness levels, increased strength, maintenance of independence, preservation and restoration of flexibility, prevention or postponement of declines in balance and co-ordination that are a major risk factor for falls. A reduction in falls means a reduction in painful injury and further loss of confidence.

 Psychological Benefits: Enhanced relaxation, reduced stress and anxiety, enhanced mood state after physical activity, regular exercise can make an important contribution in the treatments of several mental illnesses, including depression and anxiety neuroses, improved reaction times, prevention or postponements of declines in both fine and gross motor performance.

 Social Benefits: Participation in physical activity can help empower older individuals and assist them in playing a more active role in their community, enhanced social and intercultural interactions, individuals are less likely to withdraw from society, formation of new friendships, widened social networks, provides opportunities for inter-generational contact.

(American College of Sports Medicine, 2014)

No 5. Sell your Competitive Advantage -

 You’ll be offering a level of care, happiness, professionalism and general wellbeing to residents that sets you apart from other care homes and gives families a reason to chose YOUR care home to look after their loved one

On-site Physiotherapy provides a competitive advantage when promoting your care home to prospective residents and their families.

 A survey of 274 private nursing homes in England, Scotland and Wales in 2001 found only 10 per cent of residents received physiotherapy. Three quarters of homes relied on referral to physiotherapy via a GP, while 25 per cent had a visiting physio who attended one to four sessions a week in the home.

 Increasingly, care homes are employing therapists on a private basis to provide on-site physiotherapy. It's a trend that perhaps is in part driven by care homes' desire to be competitive in a market that is set to grow as the population ages. Advertising you have a resident physiotherapist can provide that necessary competitive edge (Lyall, 2008).

 On-site Physiotherapy has the potential to improve your service user experience and feedback.

 Feedback from residents and their families who currently use on-site physiotherapy services are very positive. The most popular services in our experience are seated adapted Tai Chi and resistance band exercise for strengthening, passive stretching for bed bound residents and massage for relaxation. 

No 6. Support Staff Well-being -

 It’s well known that happy staff are more productive, work harder and save costs by working smarter

The introduction of corporate well-being packages for staff helps to reduce workplace injury, reduces stress and sickness levels and staff feel more valued by their employing organisation reducing the costs of high staff turnover.

Physiotherapy is clinically and cost effective at keeping people at work or helping workers return quickly after sickness absence (Chartered Society of Physiotherapy, 2010).

 On-site Physiotherapy for staff can promote wellbeing through manual handling training, by ensuring manual handling is appropriate and performed safely and through timely assessment and treatment of staff injuries.

No 7. Improve your CQC Rating -

 A good CQC rating gives prospective families the confidence to make YOUR care home their number one choice

CQC inspectors report positively on care homes using on-site physiotherapy.

 Check out these examples from recent 'Outstanding' and 'Good' CQC reports.

Is the service responsive?

"[Staff] told us having a physiotherapist available was invaluable. They said the physiotherapist assessed people’s moving and handling needs, gave advice about posture and encouraged safe movement either in a group or on an individual basis. The member of staff told us such exercise was important even for those people being nursed in bed. This was because keeping mobile reduced pain during
manoeuvres such as putting a nightie on. Another member of staff told us some people who had experienced chest infections, benefited from intervention from the
physiotherapist".

Ashgrove House Nursing Home, Swindon

CQC Inspection Report published April 2016.

 Is the service safe?

"Staff were trained in correct moving and assisting techniques [by the in-house physiotherapist]. In-house physiotherapists gave advice and monitored staff's work in this area"

Chiswick Nursing Centre, London

CQC Inspection Report published June 2015

Zest Physiotherapy for Life works with residential and nursing care home providers and supported living environments to provide tailor made, evidence based physiotherapy packages to help residents increase their activity levels, reduce the risk of falls and to maintain independence and quality of life.

Due to demand, we are now looking to expand our service throughout the UK.

For more information about the physiotherapy services we provide please visit our website on www.zestphysiotherapyforlife.com

or to discuss how our services can be tailored to the needs of your residents

call Pauline on 07975708130

References:

Gillespie Lesley D, Robertson MC, Gillespie William J, et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2012(9) URL: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/abstract

The Chartered Society of Physiotherapy (2014) Physiotherapy Works: Falls and Frailty. URL: http://www.csp.org.uk/publications/physiotherapy-works-falls-frailty

Marshall M. Perspectives on rehabilitation and dementia. London: Jessica Kingsley Pub; 2005.

Oddy, R. Promoting mobility for people with dementia: a problem-solving approach. 3rd ed. London: Alzheimer’s Society; 2011.

The Chartered Society of Physiotherapy (2011) Physiotherapy Works: Dementia Care. URL: http://www.csp.org.uk/publications/physiotherapy-works-dementia-care

Alzheimer’s Society. Support, stay, save. Care and support of people with dementia in their own home. London: Alzheimer’s Society; 2011. http://tinyurl.com/3p56ywj

Alzheimer’s Society. Dementia UK, The Full Report. 2007. http://tinyurl.com/krcyhg

Lyall, J. On Home Ground. Physiotherapy Frontline 14(1) 2008. URL: http://www.csp.org.uk/frontline/article/home-ground

Chartered Society of Physiotherapy (2010) Physiotherapy Works: Occupational Health. URL: http://www.csp.org.uk/publications/physiotherapy-works-occupational-health

American College of Sports Medicine/ Wojtek J. Choodzko-Zajko (2014) ACSM’s Exercise for Older Adults. Baltimore. Lippincott Williams and Wilkins.