Preventing Hospitalisation: Introducing the Clinical Frailty Score at Taunton Home Instead

We strive to keep your loved ones healthy so they can continue to live at home as independently as possible and for as long as possible.

We use a number of early indicators to alert us to changes in our clients wellbeing such as Visual Health Check and Clinical Frailty score, both of which allow us to pick up on clients vulnerability early to enable treatment at home, and further assessment and to avoid the need for hospitals wherever possible.

Care in hospitals is recognised to lead to deconditioning in the elderly. The frailty index is an NHS recognised tool we use at Home Instead to monitor current health and to signpost any healthcare response that may be required. This is has been proven to improve outcomes significantly.

What is the Clinical Frailty Sore or Index?

As frailty increases, clients require more assistance with activities of daily living (ADLs) such as food preparation and instrumental activities of daily living (iADLs) such as medication management.

A move to a score of 6 or above in the list below, one of a variety of frailty indexes, indicates intervention may be required to avoid hospitalisation.

  1. Very fit Active, robust and motivated. Regularly exercise, fittest in age bracket.
  2. Well People who have no active disease symptoms, less fit than frailty score 1.
  3. Managed well People who’s medical conditions are well managed.
  4. Vulnerable Although not dependent on others, symptoms limit activity.
  5. Mildly frail More evident ‘slowing’ need help with high order IADLs.
  6. Moderately frail People need help with all outdoor activities, housework and cooking.
  7. Severely frail People completely dependent for personal care, have mobility needs.
  8. Very severely frail Completely dependent and approaching end of life.
  9. Terminally ill Approaching end of life, life expectancy <6 months.

How does the frailty score correlate with the need for home care and support?

Low frailty scores may indicate minimal or no assistance with ADLs and iADLs. Individuals can typically manage their daily activities independently or with minimal support. (They may benefit from occasional assistance with tasks such as household chores or transportation).

Moderate frailty scores suggest some assistance is needed. Help with tasks such as bathing, dressing, meal preparation, shopping, and managing finances. This level of frailty may necessitate regular support from family caregivers, home care aides, or community services.

Individuals with severe frailty scores may require substantial assistance. There are significant limitations in mobility, cognition, and self-care abilities, necessitating comprehensive care support. This level of frailty may require extensive assistance from the Home Instead Care Professionals, including assistance with personal hygiene, mobility, feeding, and medication administration.

When and how the frailty index applied by Home Instead can prevent hospitalisations.

Home Instead intervenes proactively to prevent unnecessary hospitalisations by recognising any changes. Using the frailty index, which may signal a deterioration and therefore an increased need for care and support. We assess and document this index over time. It is important to us, that each assessment is tailored to each individual and that our client and their loved ones are involved in discussions and assements with regards to their own health and frailty.

When someone scores 5/6, this will suggest the need for a comprehensive assessment for those at risk of admission to hospital. We record the frailty score at the initial consultation with the client and family and continually at face-to-face touch points. These reviews would typically be the Quality Assurance Review and the Service Review both held alternately every three months.

The Home Instead Care Team regularly communicates concerns about clients reported by our Care Professionals directly to GPs, such as at College Way Surgery, Galmington.  The Home Instead Care Team can now also communicate to the GP a change of this frailty score. This could trigger healthcare input and referrals such as OT (occupational therapist) for mobility difficulties or a SALT assessment (speech and language therapy) for a new eating issue.

Tools like the frailty index can help avoid unnecessary hospital admissions – remember home is best!

Dr Mark Hunt, GP & owner of Home Instead Taunton & West Somerset writes ‘Those with moderate frailty scores require regular support from our Care Professionals with tasks such as bathing, dressing, meal preparation, shopping, and managing finances. Individuals with severe frailty scores may require more extensive assistance from Care Professionals or benefit from Live-In Care Professionals such as personal hygiene, mobility, feeding, and medication administration.’

These are all activities our Care Professionals have been trained to support with and which they excel at when they visit your loved ones at home.

This frailty index will help predict risks and guide any future care decisions. This will ensure that whatever support is proactive and the overall outcome is an improvement in the quality of care provided in the home setting – and home is where our clients and your loved ones want to be!

If you would like to know more about our services you can get in touch here, or if it’s Live-In Care that you’re interested in, you can find more about it here.