Understanding Sepsis: What Care Home Staff Need to Know

By, Fusion
15 Sep 2025
News

Understanding Sepsis: What Care Home Staff Need to Know

Sepsis is a life-threatening medical emergency that can affect anyone, but older adults and those living with chronic conditions are particularly at risk. For care home staff, being able to spot the early signs and respond quickly can save lives.

What is Sepsis?

Sepsis happens when the body overreacts to an infection. Instead of just fighting the infection, the immune system causes widespread inflammation, which can damage organs and tissues. Without urgent treatment, sepsis can lead to septic shock, organ failure, and death.

Why is it Important in Care Homes?

Older people are more vulnerable due to weaker immune systems and underlying health conditions.

Infections are common in care homes, such as urinary tract infections (UTIs), chest infections, and skin infections.

Subtle changes in behaviour or physical condition may be the only early signs of sepsis in frail residents.

Early Signs to Watch For

Remember: Sepsis can develop quickly, and early recognition is vital. Look out for:

· Changes in behaviour: confusion, drowsiness, agitation, or unusual withdrawal.

· Breathing difficulties: rapid or shallow breathing.

· Circulation changes: pale, blotchy, or cold skin; rapid heartbeat.

· Reduced urine output: going much less often than normal.

· Shivering, fever, or feeling very unwell.

If something doesn’t feel right – trust your instincts. Even small changes can be significant.

NEWS2 (National Early Warning Score 2)

NEWS2 is a scoring system used in the UK and internationally to detect early signs of patient deterioration, including sepsis. It assigns points based on six key vital signs:

1. Respiratory rate

2. Oxygen saturation (SpO₂)

3. Systolic blood pressure

4. Pulse rate

5. Level of consciousness / new confusion (using AVPU scale)

6. Temperature

Higher NEWS2 scores = higher risk of deterioration or sepsis.

Vital signs entered into the TPR/BP daily note in Fusion will populate the NEWS2 report. This plots all documented vitals onto a NEWS chart, calculating the escalation score for you, supporting clinical decision making.

A score of 5 or more usually prompts urgent review, and 7 or more often triggers emergency response. (see table below)

NEWS2

Score Risk

SUGGESTED ACTIONS

(always consider resident’s total NEWS2 in relation to their normal reference score)

OBSERVATIONS

Observe - likely stable enough to remain at home

Escalate if any concerns/gut feeling/soft signs of deterioration (Is My Resident Unwell? questionnaire). NEWS2 is an indicator of deterioration, so do complete the score every time a full set of observations are taken.

Baseline NEWS2: To be agreed between the Care Home and GP Practice. Please contact the residents’ GP so they can set the parameters for the individual. Once these alarm limits are set, please continually review in case any changes occur in the resident’s condition.

A baseline NEWS2 will be checked depending on the agreement between the Care Home and GP Practice.

At least 12 hourly until no concerns

Senior staff review. Escalate if concerned. Repeat observations within 6 hours.

The resident’s normal baseline NEWS2 needs to be considered when making the decision to increase monitoring.

If the resident’s NEWS is usually between 1-4 then they may not need increased monitoring. If next observations remain elevated with no obvious cause, arrange for GP review (suggest in next 24 hours).

If NEWS2 worsening, move to appropriate escalation point.

At least 6 hourly

Immediate senior staff review. If no improvement in NEWS2 (or the same) within 2 hours seek GP telephone advice within 2 hours =/- GP review within 6 hours.

The resident’s normal baseline NEWS2 needs to be considered when making the decision to increase monitoring.

If the resident’s NEWS is usually between 1-4 then they may not need increased monitoring.

If NEWS2 is worsening, move to appropriate escalation point.

At least 2 hourly

3-4

or Single

observation of

Immediate senior staff review. Repeat observations within 30 minutes

If repeat observations = NEWS2 score 3 or more, seek urgent GP telephone advice or face to face review within 2 hours.

The resident’s normal baseline NEWS2 needs to be considered when making the decision to increase monitoring.

If the resident’s NEWS is usually between 1-4 then they may not need increased monitoring.

If NEWS2 is worsening, move to appropriate escalation point.

At least every 30 minutes

5 – 6

Immediate clinical review/advice required. Refer to GP or phone 111 to contact out of hours. Registered nurses can use the HCP-to-HCP facility to speak to 111 clinicians.

Urgent transfer to hospital may be needed – be prepared.

Admission to hospital should be in line with any appropriate, agreed, and documented plan of care.

Every 15 minutes

Blue light 999 call with transfer to hospital, follow guidance of call handler.

Admission to hospital should be in line with any appropriate, agreed, and documented plan of care.

Continuous monitoring until transfer

Please note NEWS should not be used alone to determine a clinical response. The tool should be used to support concerns, decision making and facilitation of effective clinical handover.

The entire resident picture should be considered when deciding on clinical response i.e. Advance Care Planning, if the resident is considered End of Life etc., ReSPECT/ADRTconversations.

Key Takeaway

Sepsis is a medical emergency. Vigilance and quick action can make the difference between life and death. Always act on concerns immediately, even if you’re unsure – your role is vital in protecting residents.