RESTORE2 stands for: Recognise Early Soft-signs, Take Observations, Respond, Escalate.

The tool has been designed by West Hampshire CCG and Wessex AHSN to help care and nursing professionals to:

  • Recognise when a resident may be deteriorating or at risk of physical deterioration
  • Act appropriately according to the resident’s care plan to protect and manage the resident
  • Obtain a complete set of physical observations to inform escalation and conversations with health professionals
  • Speak with the most appropriate health professional in a timely way to get the right support
  • Provide a concise escalation history to health professionals to support their professional decision making

In March 2020, in response to the emergence of COVID-19, the British Geriatrics Society (BGS) released a new guideCOVID-19: Managing the COVID-19 pandemic in care homes, offering key recommendations to help all care home staff and the NHS staff who work with them to support residents through the epidemic. One of these recommendations advises staff in care homes in the practice of taking vital signs to use the RESTORE2tool to recognise deterioration in residents, measure vital signs and communicate concerns to healthcare professionals.

Later in July, guidance: Admission and care of residents in a care home during COVID-19, released from the Care Quality Commission, Department for Health and Social Care, NHS England, and Public Health England included the recommendation for the use of RESTORE2 to support resident care.

The RESTORE2Mini is a ‘soft signs’ only version of the RESTORE2 tool for use in settings where it is not possible to take clinical observations.

As a recognised tool, RESTORE2 is a useful resource at this time of COVID-19 as it can help care professionals spot deterioration from COVID-19-related illness or recognise non-COVID-19 related deterioration and act to decrease avoidable hospital admissions.

RESTORE2 training

In response to COVID-19, the South West Academic Health Science Network (SW AHSN) is working with its partners across Somerset, Devon and Cornwall to enhance the confidence of care home and domiciliary care staff in detecting and appropriately escalating deteriorating residents. Our partners include CCGs, local councils, primary care networks (PCNs), NHS trusts and training providers.

In addition, our partners from all three counties regularly come together in the South-West RESTORE2 Training Teams Collaborative to share best practice and resources as well as overcoming barriers and collectively sculpt solutions to common challenges. The collaborative space which supports this group sits on the models of care portal and allows members to have a common online space to share their work.

Sign up for online training in RESTORE2 and RESTORE2Mini

Facilitated online training in RESTORE2and RESTORE2Mini is now available across the South West.


To register an interest in training please contact Jude Glide at Judith.Glide@YDH.NHS.UK


RESTORE2 and RESTORE2Mini training in the Southern region of Devon is being delivered by Torbay and South Devon Trust. To find out more information please contact Helen Limmer, Deputy Head of Education at

For RESTORE2 training in the rest of Devon please contact the Devon Clinical Commissioning Group (CCG) at


To register an interest in training, please email Jenny Gramnes, ESF Cornwall Health and Care Forum Coordinator (

For free training resources for care home and domiciliary care workers in using RESTORE2 and recognising deterioration please visit the NHS West Hampshire Clinical Commissioning Group website.

RESTORE2 Train the Trainer Training

RESTORE2 Train the Trainer training which is currently being delivered by Torbay and South Devon Trust is open to other parts of Devon, Somerset and Cornwall too. For more information please contact Helen Limmer, Deputy Head of Education at

Already familiar with RESTORE2?

Use the RESTORE2 Adult Physiological Observation & Escalation Chart – available here.


New interactive toolkit to support virtual RESTORE2 and RESTORE2Mini training

To enable trainers to spread the training further afield, the SW AHSN has developed a new online toolkit featuring in-depth guidance, templates and resources to support the delivery of training in RESTORE2 and RESTORE2Mini. Click here to explore the interactive toolkit and request a copy.

RESTORE2 resources for primary care

Across the South West, primary care teams are working closely with care homes and domiciliary care providers to support RESTORE2 training. In Somerset, both care homes and GP surgeries have seen improvements in communication, information exchange and escalation as a result. Providing more concise and specific information has enabled more efficient use of staff time and resources and the relationship between these organisations has significantly improved.

RESTORE2 case studies and videos are available to download.