Significant 7+ Training for Care Homes

Significant 7+ Training for Care Homes


IMAGE Significant 7+ is an innovative training tool for Care Homes to ensure the prevention of avoidable A&E attendances and acute admissions for complex and frail patients. The aims of Significant 7+ are to improve systematic identification of early signs in residents, while empowering care home staff to recognize and manage deteriorating residents. This is a bespoke tool and the training is ideal for care home staff, domiciliary staff and informal carers. It is an engaging training which increases carers confidence in their role. This tool has helped reduce attendance to A&E, and assists with pressure ulcer prevention as well as fall prevention.

The training provides staff with supportive tools to help recognise signs of deterioration and develop their skills to manage residents’ needs effectively. Staff will be well equipped to take appropriate action; resulting in a much better personalised quality of care for residents, which means deterioration of residents is spotted sooner and staff are feeling empowered and confident in their role as carers.

Significant 7+ started as a local initiative that has since been recognised and has won awards nationally and CQC have also reflected Significant 7+ as good practice in many care homes’ CQC reports.



IMAGE During the training session each area of the tool is explored through the use of discussion and role play. We train staff to use both the checklist and the booklet in parallel while assessing their residents who may be showing signs of becoming unwell. Each person receives a tool card and a decision tree booklet to enable them to apply the training into practice.

The training has been shown to reduce Emergency Department admissions by 31% in Care Homes and 50% in special sheltered accommodation, 17% reduction in falls and 23% reduction in pressure ulcers.



image of significant 7

Patient Safety Award Winner for Community 2017
Patient Safety Shortlist for Older People 2017
Healthy Business Award – Recommendation 2017
RCNI Finalist for Older People 2018


  • Publications:
    • Rodgers, G., Humpreys, S. Hilton, R., Handcock, L. (2019)  Significant 7 BHR Care Home Project, Queen’s Nurse Institute (QNI) , London
    • Rodgers,G., Little, S.  (2017) Significant 7 – Recognising  Deterioration. Age and Ageing, Volume 47, Issue suppl_2, April 2018

    • Little, Sarah & Rodgers, Geraldine & Fitzpatrick, Joanne. (2019). Managing deterioration in older adults in care homes: A quality improvement project to introduce an early warning tool. British Journal of Community Nursing. 24. 58-66. 10.12968/bjcn.2019.24.2.58

  • CQC – Referenced in various reports as good practice


image of word cloud Feedback from the Significant 7 Conference

“I will take more time to listen to the service users, at all times”.

“I will be taking the knowledge back to the ward to improve the care of patients by showing more empathy”.

“Without a purpose in life there is no meaning to life. A little gesture can help a patient to discover their purpose. Hereby giving him/her the reason to live”.

“One small act can make a big difference to how someone feels”.

“All of the speaker’s information was very useful and new to me”.

“Everything I have learnt has been all significant and I am taking all to my practice”.

“It is what you do or not do that adds or subtracts days from a patient’s life”.

“Today reminded me of my love of care for the elderly - As a manager you sometimes get caught up in the process rather than 1st hand care”.

“It is sometimes good to remember the basics”.

“This will help to improve our resident’s health and keep to an acceptable level”.


  1. WF CCG & NELFT Project (1 year)

    • Reduction of admission by 30% in care homes

    • Reduction of admissions by 51% in special sheltered accommodation

  2. Thurrock  Fellowship Project – NELFT (in 4 months

    • Episodes of pressure ulcers were reduced by 23%

    • Reduction in the falls by 17%

  3. Barnet CCG  Project

    • One year project – through a train the trainer programme – reduction of admission by 12% in care homes

  4. Confidence in Role -  Overall all projects reported of that 95% care home staff have more confidence in their role


  • Significant 7+ BHR Care Home Launch (September 2018)
    • Introducing Care Homes to Significant 7 Training.
  • Significant 7+ Spring Conference (May 2019)
    • Significant 7 Conference with workshops focusing on Delirium, Skin and UTI’s.
  • Significant 7+ Winter Conference (November 2019)
    • Significant 7 conference with workshops focusing on Hydration + Nutrition, Oral Health, Constipation.
  • The 4th Virtual Conference was to be held on the 26/04/2021.
    • Postponed because of COVID-19. Will take place in 2022 - Date to be announced.
  • Significant 7+ virtual webinar (June 2021) - Face to face conference was not possible due to COVID-19 restrictions.
    • Significant 7 webinar over the period of four days focusing on Sepsis Awareness, SBAR and Significant Care.


Bolanle Sowole Clinical Facilitator
Isabel Robson Clinical Facilitator


To arrange training or to find our more about Significant 7+, please contact us via email:


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