If you always do what you have always done, you will always get what you have always got: commissioning and regulating care homes to prevent abuse

2017 ◽  
Vol 19 (6) ◽  
pp. 418-430 ◽  
Author(s):  
Steve Moore
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Care Home ◽  
Care Homes ◽  
Content Type ◽  
Limited Impact ◽  
Regulatory Processes ◽  
Limited Efficacy ◽  
Regulatory Functions ◽  
Practical Implications

Purpose The purpose of this paper is to present a review of some of the fundamental theoretical and contextual components of commissioning and regulatory processes as applied to care home services, revisiting and examining how they impact on the potential prevention of abuse. Design/methodology/approach By revisiting a number of the theoretical bases of commissioning activity, some of which may also be applied to regulatory functions, the reasons for the apparent limited impact on the prevention of the abuse that occurs in care homes by these agencies are analysed. Findings The paper demonstrates how the application of commissioning and regulatory theory may be applied to the oversight of care homes to inform proposed preventative strategies. Practical implications The paper offers strategies to improve the prevention of abuse in care homes for older people. Originality/value A factual and “back to basics” approach is taken to demonstrate why current strategies that should contribute to tackling abuse in care homes are of limited efficacy.

scholarly journals The “Cameos of Care Homes” project – care home staff’s Vanguard involvement and reflections

2019 ◽  
Vol 23 (2) ◽  
pp. 107-115
Author(s):  
Jess Harris ◽  
Jill Manthorpe
Keyword(s):  
Design Methodology ◽  
Research Output ◽  
Care Home ◽  
Care Homes ◽  
Content Type ◽  
Care Home Staff ◽  
Learning Cultures ◽  
Care Workers ◽  
The Impact ◽  
Practical Implications

Purpose The Cameos of Care Homes project is an opportunity to use the medium of film to showcase the experiences and reflections of frontline care home staff whose employers participated in the National Health Service (NHS) England Vanguard programme. Reflecting on their involvement in one of the Enhanced Health in Care Homes Vanguards, 12 staff describe, in front of the camera, the impact on themselves and their colleagues, on their care for their older residents, and on the wider culture of the care home. The paper aims to discuss this initiative. Design/methodology/approach The paper reports the experiences of care home staff that were purposefully recorded on film about their participation in a care home Vanguard. The recruitment of the care homes and staff is described, as are the development of interview questions and approaches needed when filming is considered as a research method. Findings Participating care home staff reported that their involvement in the Vanguard programme had improved knowledge, confidence, morale, communication skills and the homes’ learning cultures. They were enthusiastic about reporting their experiences on film. Examples were given of proactive early support from local NHS staff leading to improvements in care, thereby reducing demand on the NHS. However, participation was resource intensive for care homes. Care home staff hoped the support that accompanied the Vanguard programme would continue but were uncertain to what degree this would happen once the Vanguard programme ceased. Research limitations/implications The interviews were undertaken with a self-selecting group of care home staff from two care homes operating in one of the six Vanguard sites in England. By their very nature, interviews for a public film cannot provide anonymity. Practical implications Researchers seeking the views of care home staff may wish to consider filming interviews and presenting the film as a research output that is engaging and informative for care home and wider audiences. Originality/value The paper presents an analysis of filmed interviews with care home managers and care workers working with older people. Their views on the Vanguard initiative have not been widely considered, in contrast to the sizeable literature relating to NHS activity and expenditure.

Care homes lay assessor project – using volunteers to improve the quality of life of older people living in care homes

2016 ◽  
Vol 20 (2) ◽  
pp. 94-100
Author(s):  
Kenneth Walter Dolbear
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Care Home ◽  
Care Homes ◽  
Meaningful Change ◽  
Content Type ◽  
Local Council ◽  
Practical Implications

Purpose – The purpose of this paper is to outline the learning from an innovative approach to using volunteers as lay assessors in order to secure improvements in the quality of life of older people in care homes. Design/methodology/approach – The paper describes the implementation of pilot lay assessor scheme in Bristol and systematically explores the learning from this case study. Findings – The paper concludes that despite a number of important challenges and limitations, a lay assessor approach, particularly when conducted in close co-operation with a local council, can indeed provide demonstrable quality of life benefits for older people in closed institutions such as care homes. Practical implications – The case study highlights a number of key implications for practice including: it is possible to recruit, motivate and train volunteers to provide a lay assessor scheme; working with a local council and providers of care homes can produce real improvements in quality of life; lay assessor schemes are an important way of “shining a light” into closed institutions; defining quality of life and balancing this with institutional attitudes towards risk can be extremely challenging; and working with care home managers, providing them with ideas and support can be effective in bringing about meaningful change. Originality/value – This case study reports on one of the first volunteer lay assessor initiatives in the country. There has been very little if any reporting or analysis of such schemes. This paper therefore adds significantly to this important are of public policy and provision.

The sound of silence: evidence of the continuing under reporting of abuse in care homes

2019 ◽  
Vol 22 (1) ◽  
pp. 35-48
Author(s):  
Steve Moore
Keyword(s):  
Private Sector ◽  
Older People ◽  
Design Methodology ◽  
Qualitative Data ◽  
Care Home ◽  
Significant Proportion ◽  
Care Homes ◽  
Research Projects ◽  
Content Type ◽  
External Scrutiny

Purpose The purpose of this paper is to present findings from two research projects undertaken between 2015 and 2019 that reveal continued underreporting and sometimes active concealment of abuse in private sector care homes for older people in England. Design/methodology/approach An anonymously completed questionnaire was used among newly appointed staff in 11 newly opened care homes to elicit both quantitative and qualitative data relating to the reporting of occurrences of abuse within the care homes in which they had previously worked. In total, 391 questionnaires in total were returned, 285 of which indicated that respondents had witnessed the perpetration of abuse on at least one occasion. Findings A significant number of respondents indicated their awareness of acts of abuse that had not been reported within the care home(s) in which they had worked, or externally to the appropriate authorities. Some respondents were aware that where occurrences of abuse had been reported within care homes no subsequent action was taken, or that external authorities were not always involved in responses to abuse. A significant number of respondents described strategies that had been used to deter reports of abuse to external agencies and to conceal its occurrence from the statutory regulator and service commissioners. Research limitations/implications Though the research draws upon the experiences of only 285 questionnaire respondents who had witnessed episodes of abuse, data suggest that a significant proportion of abuse in care homes remains unreported. Originality/value The research has revealed experiences of continued underreporting and concealment of abuse among staff in private sector care homes. Findings indicate that a strengthening of incentives and protections extended to the staff who should report abuse are essential, and that changes to current methods of external scrutiny to which care homes are subject are required.

scholarly journals The importance of a room with a view for older people with limited mobility

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Structured Interviews ◽  
Content Type ◽  
Limited Mobility ◽  
Human Element ◽  
Health And Social Care ◽  
Vantage Points ◽  
Practical Implications

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.

scholarly journals Renegotiating power in adult safeguarding: the role of advocacy

2017 ◽  
Vol 19 (2) ◽  
pp. 78-91 ◽  
Author(s):  
Sarah P. Lonbay ◽  
Toby Brandon
Keyword(s):  
Older People ◽  
Social Workers ◽  
Design Methodology ◽  
Content Type ◽  
North East ◽  
Critical Realist ◽  
Research Findings ◽  
Depth Interviews ◽  
Practical Implications

Purpose The increased involvement of adults at risk in the safeguarding process has become a prominent issue within English safeguarding policy. However, there is evidence to suggest that actual levels of involvement are still low. The purpose of this paper is to present findings from a PhD study in relation to the benefits of advocacy in supporting this involvement in adult safeguarding for older people. Design/methodology/approach Participants in the study included advocates and social workers who had experience of working with older people through the safeguarding process within two North East England local authorities. A critical realist approach through in-depth interviews was taken with all the participants. Findings The research findings in relation to the benefits of advocacy in supporting older people going through safeguarding processes are reported. The practical limitations and factors which help and hinder advocacy support within the process are also considered. The theoretical implications for power, empowerment, and advocacy are also explored. Research limitations/implications A key limitation of this research is that it did not include older people who had been through safeguarding amongst the participants. Practical implications Key implications for practice and policy are discussed. Originality/value The paper provides an overview and critique of empowerment in adult safeguarding and the role that advocates play in promoting this key principle.

How older people will vote in the 2015 general election: a review of existing polling evidence

2015 ◽  
Vol 16 (1) ◽  
pp. 65-68
Author(s):  
Raphael Malek
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Conservative Party ◽  
Voting Behaviour ◽  
Content Type ◽  
Policy Issues ◽  
Ideological Position ◽  
Ethnographic Interviews ◽  
The Uk ◽  
Practical Implications

Purpose – The issues of concern to older people and likely to shape their voting behaviour need to be understood and appreciated. The paper aims to discuss these issues. Design/methodology/approach – This policy-oriented review draws on recent research, including surveys, focus groups and ethnographic interviews to identify such issues in the UK older population. Findings – Older people are more likely to vote and to prioritise policy issues relating to immigration, the NHS and the economy–but the outcome of their vote is more likely to be determined by affinity with a party’s broader ideological position than with the specific policies contained in their manifesto?. Practical implications – Older people appear more likely to support Conservative party values and priorities, but their potential growing support for UKIP may be underestimated as several major surveys do not prompt for this party. The less certain standing of both Conservative and Labour may therefore be further undermined by unappreciated shifts in the “grey vote”. Originality/value – This commentary highlights the increasing importance of the “grey vote” at a time of increasing unpredictability in support for mainstream parties.

What’s in a word? The importance of the concept of “values” in the prevention of abuse of older people in care homes

2017 ◽  
Vol 19 (3) ◽  
pp. 130-145 ◽  
Author(s):  
Steve Moore
Keyword(s):  
Older People ◽  
Mixed Methods Research ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
Contributory Factor ◽  
Structured Interviews ◽  
Content Type ◽  
Personal Value ◽  
Provision Of Care

Purpose The purpose of this paper is to present some of the findings from an empirical, mixed methods research project that reveal the importance of the personal value frameworks held by individual staff in the prevention of abuse of older people in private sector care homes. Design/methodology/approach Semi-structured interviews were undertaken with a sample of 36 care home personnel, including proprietors, care managers and care staff. Findings A significant number of respondents identified the importance of personal value frameworks among staff providing care as a potential contributory factor in the prevention of abuse of older people. Research limitations/implications Though the research draws upon the experiences of only 36 care home personnel through interviews, data suggest that the personal evaluations of staff towards those in their care is a significant contributory factor to the occurrence of abuse. Originality/value The research has identified individual staff value frameworks as a causal factor in the occurrence of abuse. The research also confirms that the perceptions of “values” among respondents directly involved in the provision of care are at odds with common understanding of “values” often cited elsewhere in connection with staff recruitment and training as a means of preventing the occurrence of abuse.

Oops! Its happened again! Evidence of the continuing abuse of older people in care homes

2018 ◽  
Vol 20 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Steve Moore
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Significant Proportion ◽  
Postal Questionnaire ◽  
Care Staff ◽  
Care Homes ◽  
Content Type ◽  
Anonymous Questionnaire ◽  
Textual Data ◽  
Abuse And Neglect

Purpose The purpose of this paper is to present findings from an empirical research project designed to enhance knowledge of the current extent and nature of abuse in contemporary care homes for older people. Design/methodology/approach A self-completion, postal questionnaire was used to elicit both numerical and textual data that was subsequently subjected to both quantitative and qualitative analysis. The questionnaire was distributed to newly appointed care staff in six participating care homes providing care to older people to determine the nature of any abuse they may have witnessed in the homes in which they had previously worked. Findings A significant proportion of respondents described instances of predominantly psychological and physical abuse and neglect. Research limitations/implications Though the research draws upon the experiences of only 194 anonymous questionnaire respondents, of whom 140 had witnessed abuse; data suggest that abuse continues to occur in some care homes for older people. Originality/value The research has revealed staffs’ recent experiences of a range of abusive acts and practices. Findings suggest that changes are required to current methods of external scrutiny and investigation of practices in care homes.

Why is it important to consider so-called “invisible” older people in UK healthcare?

2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Policy Makers ◽  
Content Type ◽  
Academic Literature ◽  
Health And Social Care ◽  
Preliminary Account ◽  
Government Statistics ◽  
Practical Implications

Purpose – The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach – The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one “invisible” group each and comparisons and conclusions were then made collaboratively. Findings – Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Research limitations/implications – This is not a systematic review but a preliminary account of the problem. Practical implications – There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications – There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value – There is little written which brings together the lack of attention paid to these groups as a whole.

scholarly journals A qualitative study of older people with minimal care needs experiences of their admission to a nursing home with Registered Nurse care

2015 ◽  
Vol 16 (2) ◽  
pp. 94-105 ◽  
Author(s):  
Alice K. Stevens ◽  
Helen Raphael ◽  
Sue M. Green
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Older People ◽  
Registered Nurse ◽  
Care Home ◽  
Care Homes ◽  
Care Needs ◽  
Content Type ◽  
Health And Social Care

Purpose – Residential care for older people in the UK includes care homes with and without 24-hour Registered Nurse (RN) care. Reduced autonomy and personal wealth can result when people assessed as having minimal care needs, enter and reside in care homes with RN care. The purpose of this paper is to explore the experiences of older people with minimal care needs admission to care homes with RN care. Design/methodology/approach – A qualitative study using a grounded theory method was undertaken. In total, 12 care home with RN care residents assessed as not requiring nursing care were interviewed. Initial sampling was purposive and progressed to theoretical. Interviews were analysed using the grounded theory analysis method of constant comparison and theory development. Findings – Two main categories emerged: “choosing the path”, which concerned the decision to enter the home, and “settling in”, which related to adaptation to the environment. Findings suggested participants who perceived they had greater control over the decision-making process found it easier to settle in the care home. The two categories linked to form an emerging framework of “crossing the bridge” from independent living to care home resident. Research limitations/implications – The findings contribute to the understanding of factors influencing admission of older people with minimal care needs to care homes with RN care and highlight the importance of informed decision making. Practical implications – Health and social care professionals must give informed support and advice to older people seeking care options to ensure their needs are best met. Originality/value – This study enabled older people with minimal care needs admission to care homes with RN care to voice their experiences.

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