Always ask ‘could it be sepsis?’, that’s what we have learnt over recent years when noticing any of the insidious signs so easy to miss yet so life threatening for those living in care homes.

I have said throughout this year dominated by coronavirus that the virus hasn’t cured sepsis and in fact even as I type this sepsis remains the world’s biggest killer above Covid and cancer too with 11 million global deaths in 2017.  In the UK we see 56,000 deaths and 144,000 cases each year (box1).

Over the 9 years of the Devon Care Kite Mark, the predecessor to the Devon Care Home Collaborative, of the many things we have done together as a Devon residential care provider led initiative, introducing the reciprocal peer review programme has perhaps been one of the most impactful elements.  During all this time we have visited and been visited by many colleagues who understand the challenges and the importance of ‘sharing our treasure’.  Every peer review I have done has included asking appreciative inquiry based questions of the senior team being visited about sepsis (box 2).

DCKM Sepsis Peer Review questions:

1. Score your home on a 1-10 scale re overall re SEPSIS recognition and management…… Talk about this..
2. Have your staff had any training? Tell us about this..
3. Are you aware of the tools and material provided by the UK Sepsis Trust? Speak to 2 staff members about sepsis…….
4. Have you dealt with any cases at your home?
5. What learning, what went well & what didn’t?

I know there is greater expertise in our NHS system and working together in how we skill ourselves us is vital – we are so grateful to Pippa Richards for example – the Sepsis lead nurse at Musgrove Park Hospital, Taunton, who as a friend of the Kite Mark gave time to support us with key facts and do’s and don’ts on sepsis recognition, response and care including a talk at last year’s annual DCKM December ‘Jamboree’ also joined by Kate Terroni, Chief Inspector at the Care Quality Commission.  Whilst we have had our first year without our annual celebration of work, welcoming friends and guests as well as the marvellous festive cakes we always share, we do intend to make sure 2021 has lots of opportunities to come together and share work including our own best practice top tips on how we address Sepsis in our work.

All of our staff have been very receptive to the key message in this piece – if concerned about signs of decline or deterioration in any of our residents we must raise an alert and when speaking to colleagues or seeking external help and say “we are not sure but it could be sepsis”.  Reporting this as a risk could save a life mindful of another of the things I will always say when talking about sepsis; “every missed hour that passes where we don’t get help for a person with sepsis, the chance of fatality increases by 7%”.  So just to say again- always ask ‘could it be sepsis?’.

- George Coxon