New Guidance on Vitamin D Supplements in Care Homes Workshop
Explore the latest guidance on offering vitamin D supplements to eligible residents in care homes through a workshop designed for care home staff and professionals. The workshop aims to raise awareness of the importance of vitamin D, provide practical support for implementing the guidance, and feature insights from experts in the field.
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Vitamin D in Care Homes Vitamin D in Care Homes New guidance on offering vitamin D supplements to eligible residents in adult care homes Workshop for care home staff and professionals who support care homes
Housekeeping Housekeeping Please use the chat box to submit any questions Your camera and microphone will be off until after the presentations
Who We Are Who We Are Scottish Government Paul Baughan, GP and Clinical Advisor for Ageing Health/co-chair of the Vitamin D in Care Homes Short Life Working Group (SLWG) Food Standards Scotland Gillian Fraser, Senior Public Health Nutritional Advisor, Food Standards Scotland NHS Ayrshire and Arran Heather Fraser, Pharmacy Lead within NHS Ayrshire and Arran care home pilot Scottish Government Fee Hodgkiss, Unit Head, Social Care Immediate Response and Improvement Policy Division Kim Horner - Social Care Immediate Response and Improvement Policy Division
Purpose of Workshop Purpose of Workshop To raise awareness of new guidance on Vitamin D in care homes, published on 7th December 2023. To provide support to care home staff and professionals who may provide support to care homes, on the practicalities of implementing this guidance.
Agenda Agenda Overview of Vitamin D advice (Gillian) Work of the Vitamin D in Care Homes SWLG (Paul) Care home pilot of guidance within NHS Ayrshire and Arran (Heather) New guidance for care homes (Paul) Questions and Answers (All) Next steps (Paul)
Vitamin D: an overview Vitamin D: an overview of our advice of our advice Gillian Fraser, Senior Public Health Nutrition Advisor, Public Health Nutrition Branch, FSS
What is vitamin D and why is it important? What is vitamin D and why is it important? Vitamin D is a fat-soluble vitamin which is essential for our health. It helps regulate the amount of calcium and phosphate in our body, which are required to keep our bones and muscles healthy. Not getting enough vitamin D can lead to rickets in children, osteomalacia in adults and increased risk of falls in older adults. The recommended intake of vitamin D is 10 micrograms (400 IU) per day for the general population.
Where do we get it? Where do we get it? Most people should be able to get all the nutrients they need from a healthy, balanced diet. Vitamin D is an exception because it is only found in small amounts in some foods. Sunlight is our main source of vitamin D, but we only get enough of the right kind of sunlight for our bodies to make vitamin D between April and September. It s not possible for our bodies to make vitamin D from sunlight between October and March.
Food sources Food sources The average adult in the UK only gets around 3 micrograms of vitamin D from food.
What is our advice? What is our advice? We encourage everyone, including children, to take a daily supplement containing 10 micrograms of vitamin D, particularly between October March. Some groups have a higher risk of vitamin D deficiency and are encouraged to take a daily supplement all year round: All pregnant and breastfeeding women, and infants and children <5 years old. People with low/no sun exposure e.g. those who cover their skin for cultural reasons, are housebound, confined indoors for long periods or live in an institution People from minority ethnic communities with dark skin such as those of African, African-Caribbean and south Asian origin, who require more sun exposure to make as much vitamin D
Where does our advice come from? Where does our advice come from? Advice to take vitamin D supplements is based on recommendations from the Scientific Advisory Committee on Nutrition. Recommendations made on the basis of protecting bone and muscle health. 10 micrograms is the average daily intake of vitamin D required to maintain our vitamin D status over winter.
FSS Campaign FSS Campaign We're currently running a social media campaign to raise awareness of vitamin D advice and encourage people across Scotland to take a daily vitamin D supplement over winter. Vitamin D campaign toolkit | Food Standards Scotland Vitamin D | Food Standards Scotland Your questions on vitamin D answered by Food Standards Scotland s expert | Food Standards Scotland
Thanks for listening! Get in touch: gillian.fraser@fss.scot
Vitamin D in Care Homes Group Vitamin D in Care Homes Group Background and formation of the group The Chief Medical Officer recommended that vitamin D supplementation considered for all care home residents as per 2016 SACN advice. A Short Life Working Group (SLWG) - care home representatives, those supporting care homes to develop guidance on implementation following request.
Recommendations of Group Recommendations of Group That all care home residents be offered the supplement as per guidance. This is done in a person-centred choice-based way, taking into account needs and circumstances, without over medicalising. Care home staff support conversations and decisions, with input from families or healthcare professionals as appropriate. A pilot to test vitamin D resource materials, access, uptake and recording.
Vitamin D Supplements for Care Home Residents Heather Fraser Senior Pharmacist Primary Care NHS Ayrshire & Arran
Pilot Overview Six care homes took part across 2022 & 2023 Provided with support materials and assessment forms Acceptance & exclusion data gathered from each care home Researchers conducted interviews with lead pharmacist and representatives from each care home Findings and feedback used to update and improve materials
Pilot Results % % Excluded for Medical/ Other Reason Total Residents receiving Supplement Current Vit D users (prescribed) Current Vit D users (not prescribed) Establishment* (e.g. Care/Residential Home) No. of Residents Accepted of Residents Offered Offered Accepted Care Home a (over 65) 38 11 0 17 10 10 100% 26.3% Care Home b (over 65) 28 11 1 1 15 15 100% 53.6% Care Home c (over 65) 70 21 0 36 13 13 100% 18.6% Residential Unit d (over 65) 11 3 0 0 8 5 63% 45.5% Care Home e (over 65) 40 13 0 0 27 27 100% 67.5% Care Home f (18-65) 20 4 0 0 16 14 88% 70% * Names of Care Homes redacted for confidentiality
Percentage of participation per care home (Takahashi and Scott 2023)
Average proportion of residents accepted and excluded (Takahashi and Scott 2023)
Participant Feedback so many families were willing to uptake the offer of them so that was really positive for us the families were fine they all consented, they were quite happy, they knew it can only benefit them Straightforward process They are happy to have their parents take anything that will benefit them. They have been very supportive It was easy to understand Very straight forward everyone that was able to consent to it has been quite happy to take it, and equally the odd couple without capacity their relatives gave consent and there s no issues It has been really helpful, really easy (Takahashi and Scott 2023)
Supplement or Medicine
How to identify patients
Assessment Process
Storage and follow-up
Appendix 2: Decision making flowchart
Appendix 3: Assessment & Consent form
Appendix 3: Assessment & Consent form
Appendix 3: Assessment & Consent form
References TAKAHASHI, J. & SCOTT, R., 2023. Pilot of Vitamin D Supplements in Care Homes in NHS Ayrshire and Arran. NHS Ayrshire and Arran.
Thank you Internal Use
New guidance for care homes and New guidance for care homes and practical advice practical advice The guidance is hosted on the Care Inspectorate s webpage: Vitamin D in care homes. Two letters were issued to the sector. One for care homes and another for professionals who may support care homes.
Practical Advice for Care Homes Practical Advice for Care Homes
Healthcare Framework for Care Homes Healthcare Framework for Care Homes My Health, My Care, My Home healthcare framework for adults living in care homes.
Questions Questions
Next steps and Conclusion Next steps and Conclusion PowerPoint presentation will go onto the Care Inspectorate s guidance webpage Same workshop 23rd January Questions on implementation contact teams supporting care homes e.g. care home collaborative support teams, general practices, pharmacy and nursing teams. Thank you for attending and we hope this has been helpful. .
