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RESTORE2 which includes the National Early Warning Score or NEWS2 promotes a standardised response to the assessment and management of unwell residents. It is not a replacement for clinical judgement and should always be used with reference to the persons care or escalated plan and any agreed limits of treatment. If you are concerned about the resident or if one observation has changed significantly ALWAYS ACT ON YOUR CONCERNS AND SEEK ADVICE from a competent clinical decision-maker e.g. a GP, Registered Nurse or Healthcare professional.

The RESTORE2 chart uses aggregated NEWS data.  It is important that you understand the resident's normal NEWS, which is the score when they are stable, to then decide on the appropriate escalation required. You should try and establish what is normal for residents on admission with a member of the multi-disciplinary team.

Use the RESTORE2 chart for all your routine observations as per your local policy. If your resident shows ANY of the soft signs of deterioration shown on the chart, record their observations and NEWS immediately on the chart and follow the escalation tool as appropriate, using SBARD to communicate to others.

There may be a need to re-consider what is normal for the resident, following any sustained improvement in their condition or non-acute deterioration.

All residents should have had the opportunity to discuss their end of life preferences in advance of any crisis. RESTORE2 must be used in conjunction with the expressed wishes of the resident, regarding treatment escalation plans or advanced care plans.

RESTORE2 can be used in residents with an agreed limit of treatment like requests for not being admitted to hospital, not for resuscitation or not for intravenous antibiotics, to identify what is recoverable deterioration with treatment. It is also useful for anticipating end of life and once the resident is on an end of life care pathway, RESTORE2 should be discontinued.