Case Study: Safer provision and caring excellence (SPACE)

What is SPACE?

In December 2016, the HIWM funded a two-year programme, known as SPACE, to upskill 35 care homes in the Walsall and Wolverhampton areas with Quality Improvement (QI) methodology.

The SPACE programme aims to strengthen safety culture and reduce the incidence of adverse safety events. Through training and workshops, the programme helps care home staff and managers develop relevant skills and enhance their understanding of patient safety.

Since the programme ended in 2018, the SPACE approach has been scaled up, with toolkits supporting the implementation of NHS England’s Managing Deterioration Safety Improvement Programme (ManDetSIP) and Medicines Safety Improvement Programme (MedSIP) across the West Midlands. Most recently, the SPACE approach has played a pivotal role in supporting our region’s care home staff in managing deterioration during the pandemic.

For further information on the National Patient Safety Improvement Programmes (NatPatSIP) please click here.

What were the aims of SPACE?

• To up-skill care home staff through facilitation and training in basic QI techniques and methodologies
• To improve the quality and safety of care delivered to care home residents
• To reduce avoidable harm such as falls, pressure injuries and UTIs

What did we do?

QI tools and techniques were introduced to whole teams including managers, care, administrative, kitchen and maintenance staff. The Model for Improvement was used to develop QI projects and training also included Appreciative Inquiry (AI) and Human Factors (HF).

Care home staff were encouraged to identify and gather baseline data about potential areas for improvement, to identify how to measure improvement and test possible solutions out on a small scale, using Plan Do Study Act (PDSA) cycles.

What were the outcomes?

Since the original SPACE programme commenced in December 2016, staff at over 600 care homes have received QI training – approximately 37% of the total number of care homes in the West Midlands.

Results have shown a significant reduction in falls, urinary tract infections (UTIs), and grade 4 pressure ulcers. There have also been improvements in safety culture with care homes introducing tools like safety crosses to monitor harm events, as well as adapting the tools to monitor risks in other areas like nutrition and hydration.