scholarly journals 101 Avoiding Burnout of the Care Home Workforce During the COVID-19 Pandemic and Beyond: Sharing National Learning and Local Initiatives

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Johnston ◽  
C Malcolm ◽  
L Rambabu ◽  
J Hockley ◽  
S D Shenkin
Keyword(s):  
Case Studies ◽  
Online Survey ◽  
Care Home ◽  
Care Homes ◽  
Rapid Review ◽  
Staff Retention ◽  
Complex Needs ◽  
Health And Social Care ◽  
Wide Range ◽  
Home Workers

Abstract Introduction COVID-19 in care homes has heightened the risk of staff burnout, undermining already problematic staff retention and low morale. There has been an associated proliferation of resources and online initiatives to support frontline workers, however, few of these are directly targeted at the care home workforce. Care home workers are highly skilled in caring for people with complex needs, but have very variable levels of formal training, and just over half of care homes in Scotland include registered nurses. This project will rapidly collate existing resources and identify, direct from care home workers, their best practice, initiatives, and resources used to support resilience and retention during this pandemic and moving forward. Methods 1) Rapid review of care home specific evidence and resources (including published research and social media); 2) Online survey of Enabling Research in Care Homes (ENRICH) members across Scotland (n = 55); 3) Case studies within six care homes to identify what is working well and what is not in terms of promoting resilience and emotional support. Results The rapid review has identified a wide range of resources directed at supporting staff working in care homes; the survey and case studies will provide data on the key learning and resources that have supported staff, and outline the challenges identified. There are many resources available but staff do not access these. The role of the care home manager is key. Key conclusions This comprehensive review of resources and initiatives will make a valuable contribution to policy and practice designed to reduce burnout and foster retention not just in care homes but more widely across health and social care.

Enhanced healthcare in care homes for people with dementia: the Admiral nursing offer

2021 ◽  
Vol 23 (7) ◽  
pp. 1-10
Author(s):  
Karen Harrison Dening ◽  
Zena Aldridge
Keyword(s):  
Primary Care ◽  
Residential Care ◽  
Social Care ◽  
Care Home ◽  
Dementia Care ◽  
Care Homes ◽  
Complex Needs ◽  
Care Home Staff ◽  
People With Dementia ◽  
Health And Social Care

Background The UK older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia and comorbidity, many of whom will require 24-hour residential care. It is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it while residing in the care home, many of who will have complex needs with high levels of multimorbidity. However, there is a lack of consistency in the provision of primary care and specialist services to this population and a known gap in knowledge and skills of dementia care in care home staff and primary care teams. Methods This article considers the current health policy drivers to enhance integrated health and social care provision to care homes and proposes a model of care that would support the aims of the NHS Long Term Plan for care to be delivered closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes. It is crucial that such a model includes the correct skill mix to meet the needs of the care home population. Conclusions There are currently gaps in service provision to many care homes. Admiral nurse case managers and specialists in dementia care, are well placed to support the delivery of Enhanced Health in Care Homes and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system.

GPs’ experience of safeguarding in care homes: what do they see and what do they do?

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711269
Author(s):  
Elisabeth Alton ◽  
Caroline White
Keyword(s):  
Online Survey ◽  
Qualitative Data ◽  
Care Home ◽  
Health Needs ◽  
Care Homes ◽  
Electronic Records ◽  
Multiple Relationships ◽  
Home Context ◽  
Emerging Themes ◽  
Multiple Health

BackgroundAbuse of older people in care homes is an on-going problem. GPs, as the most frequent practitioner group visiting care homes, have an important role in detecting and reporting abuse. However, there is little research about GPs’ experiences of working in care homes and how they work to safeguard residents.AimTo explore the challenges experienced by GPs working in this unique environment and how these impact on safeguarding.MethodAn online survey collected qualitative data about GPs’ experiences as visiting professionals to care homes, with an emphasis on safeguarding. A thematic analysis identified key themes.ResultsIn total, 58 completed surveys were returned, with a range of practitioner experience represented (1–30 years). Approximately 70% were GP partners, with the remainder salaried and locum doctors. Over one third reported they had witnessed signs of definite or possible abuse within care homes. Emerging themes related to the complex care home context, in which residents had multiple health needs and GPs had to build multiple relationships with managers, carers, families, and residents. Difficulties in accessing information were reported; residents could not always provide information, GPs had to rely on others for information, and rarely had access to electronic records.ConclusionGP work in care homes is a complex and skilled role, in which GPs encounter evidence of poor care and abuse. Key themes in respect of barriers and facilitators of good care were highlighted. The reliance on others for information and the need to build relationships with staff/managers may raise tensions in respect of safeguarding practice.

scholarly journals Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Patrick Bodenmann ◽  
Miriam Kasztura ◽  
Madison Graells ◽  
Elodie Schmutz ◽  
Oriane Chastonay ◽  
...  
Keyword(s):  
Online Survey ◽  
Emergency Services ◽  
Healthcare Providers ◽  
Negative Consequences ◽  
Emergency Department Care ◽  
Frequent Users ◽  
Complex Needs ◽  
Wide Range ◽  
Ed Overcrowding ◽  
Ed Visits

Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

scholarly journals Quality improvement collaborative aiming for Proactive HEAlthcare of Older People in Care Homes (PEACH): a realist evaluation protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023287 ◽  
Author(s):  
Reena Devi ◽  
Julienne Meyer ◽  
Jay Banerjee ◽  
Claire Goodman ◽  
John Raymond Fletcher Gladman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Older People ◽  
Care Home ◽  
Realist Evaluation ◽  
Evaluation Framework ◽  
Care Homes ◽  
Quality Improvement Initiative ◽  
Quality Improvement Collaborative ◽  
Programme Theory ◽  
Health And Social Care

IntroductionThis protocol describes a study of a quality improvement collaborative (QIC) to support implementation and delivery of comprehensive geriatric assessment (CGA) in UK care homes. The QIC will be formed of health and social care professionals working in and with care homes and will be supported by clinical, quality improvement and research specialists. QIC participants will receive quality improvement training using the Model for Improvement. An appreciative approach to working with care homes will be encouraged through facilitated shared learning events, quality improvement coaching and assistance with project evaluation.Methods and analysisThe QIC will be delivered across a range of partnering organisations which plan, deliver and evaluate health services for care home residents in four local areas of one geographical region. A realist evaluation framework will be used to develop a programme theory informing how QICs are thought to work, for whom and in what ways when used to implement and deliver CGA in care homes. Data collection will involve participant observations of the QIC over 18 months, and interviews/focus groups with QIC participants to iteratively define, refine, test or refute the programme theory. Two researchers will analyse field notes, and interview/focus group transcripts, coding data using inductive and deductive analysis. The key findings and linked programme theory will be summarised as context-mechanism-outcome configurations describing what needs to be in place to use QICs to implement service improvements in care homes.Ethics and disseminationThe study protocol was reviewed by the National Health Service Health Research Authority (London Bromley research ethics committee reference: 205840) and the University of Nottingham (reference: LT07092016) ethics committees. Both determined that the Proactive HEAlthcare of Older People in Care Homes study was a service and quality improvement initiative. Findings will be shared nationally and internationally through conference presentations, publication in peer-reviewed journals, a graphical illustration and a dissemination video.

scholarly journals A comparative survey of the impacts of extreme rainfall in two international case studies

2017 ◽  
Author(s):  
Matthieu Spekkers ◽  
Viktor Rözer ◽  
Annegret Thieken ◽  
Marie-Claire ten Veldhuis ◽  
Heidi Kreibich
Keyword(s):  
Case Studies ◽  
Online Survey ◽  
Residential Buildings ◽  
Age Groups ◽  
Extreme Rainfall ◽  
Water Levels ◽  
Economic Losses ◽  
Biased Sampling ◽  
Wide Range ◽  
Damage Data

Abstract. Flooding is assessed as the most important natural hazard in Europe, causing thousands of deaths, affecting millions of people and accounting for large economic losses in the past decade. Little is known about the damage processes associated with extreme rainfall in cities, due to a lack of accurate, comparable and consistent damage data. The objective of this study is to investigate the impacts of extreme rainfall on residential buildings and how affected households coped with these impacts in terms of precautionary and emergency actions. Analyses are based on a unique dataset of damage characteristics and a wide range of potential damage explaining variables at the household level, collected through computer-aided telephone interviews (CATI) and an online survey. Exploratory data analyses based on a total of 859 completed questionnaires in the cities of Münster (Germany) and Amsterdam (the Netherlands) revealed that the uptake of emergency measures is related to characteristics of the hazardous event. In case of high water levels, more efforts are made to reduce damage, while emergency response that aims to prevent damage is less likely to be effective. The difference in magnitude of the events in Münster and Amsterdam in terms of rainfall intensity and water depth, is probably also the most important cause for the differences between the cities in terms of the suffered financial losses. Factors that significantly contributed to damage in at least one of the case studies are water contamination, the presence of a basement in the building and people's awareness of the upcoming event. Moreover, this study confirms conclusions by previous studies that people's experience with damaging events positively correlates with precautionary behaviour. For improving future damage data acquisition, we recommend to include cell-phones in a CATI survey to avoid biased sampling towards certain age groups.

scholarly journals An exploration of hydration practices in Maltese residential care homes for older people

2021 ◽  
Vol 23 (11) ◽  
pp. 1-12
Author(s):  
Francesca Micallef ◽  
Marisa Vella ◽  
Alan Sciberras Narmaniya ◽  
Glenda Cook ◽  
Juliana Thompson
Keyword(s):  
Older People ◽  
Residential Care ◽  
Care Home ◽  
Good Health ◽  
Care Homes ◽  
Complex Needs ◽  
Increased Risk ◽  
Adequate Hydration ◽  
Axial Coding ◽  
Sugary Beverages

Background/aims The integral relationship between adequate hydration and good health is widely recognised. Older people with complex needs and frailty can struggle to maintain adequate hydration, with residents in care home settings being at an increased risk of dehydration. The aim of this study was to explore current hydration practices in residential care homes in Malta. Methods An exploratory qualitative approach was adopted to explore staff's views and approaches in supporting residents' hydration. Data was collected via semi-structured, individual and small group interviews with staff from two care homes from the central and southern region of Malta. A process of open coding, followed by axial coding, was used to analyse the data. Peer debriefing was performed throughout, until agreement was reached among the research team about the final themes and sub-themes. Results Three themes emerged from the data: culture of promoting fluid intake; challenges in supporting older people to achieve optimum hydration; hydration practices and approaches. Conclusions A hydration promotion culture was demonstrated through various practices adopted in the care homes. The strong focus on water intake, in response to concerns about consuming sugary beverages, has implications for the promotion of a person-centred approach to hydration care. Inconsistencies in monitoring of fluids and daily recommended targets highlights the importance of policies or guidelines to guide hydration practice. Challenges related to refusal of fluids and language barriers among non-native staff were evident and justify further research is this area.

Educational Podcasts at University Campus Suffolk

2011 ◽  
pp. 187-208 ◽  
Author(s):  
Tim Goodchild ◽  
Sam Chenery-Morris
Keyword(s):  
Case Studies ◽  
Ad Hoc ◽  
Developmental Process ◽  
Learning Experience ◽  
Small Scale ◽  
University Campus ◽  
Health And Social Care ◽  
Wide Range ◽  
History Of ◽  
Evaluative Research

This chapter will explore the introduction and development of podcasts at University Campus Suffolk (UCS). The podcasts discussed in this chapter have all been developed in relation to pre-registration health and social care courses within the Faculty of Health at UCS. UCS is a relatively new university, and has a wide range of professional courses including nursing, midwifery, radiography, operating department practice and social work. The chapter will begin with a discussion of where podcasts sit in the paradigm of mobile learning and then a brief history of podcasting. The introduction of podcasts at UCS has been ad-hoc and mostly in response to ideas for developing the wider student learning experience. This ad-hoc approach has led to the development of a model for their educational use. Three case studies will be outlined, followed by presentation of the model. These case studies will show how podcasts came to be utilised, and the progression of our thoughts and experiences which have informed their current and future development at UCS. Small scale evaluations throughout the developmental period, and informal student feedback have helped inform the progression of podcasting at UCS. These evaluations have driven the increased use of podcasts at UCS, with students enjoying the experience of using podcasts, and also the ability to digest the podcasts at a time of their choosing. However, it should be noted that because of the nature of the developmental process, full scale evaluative research is only now being undertaken.

scholarly journals The Development of a Digital Dysphagia Guide with Care Homes: Co-Production and Evaluation of a Nutrition Support Tool

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 48
Author(s):  
Susan Pownall ◽  
Elizabeth Barnett ◽  
Julie Skilbeck ◽  
Angel Jimenez-Aranda ◽  
Sally Fowler-Davis
Keyword(s):  
Care Home ◽  
Well Being ◽  
Care Homes ◽  
Nutrition Support ◽  
Consensus Method ◽  
Support Tool ◽  
Care Workers ◽  
Good Nutrition ◽  
Poor Outcomes ◽  
Home Workers

Good nutrition is a recognised outcome in the health and well-being of older care home residents and dysphagia is a known risk factor associated with under nutrition and poor outcomes. The study co-produced a digital Dysphagia Guide with Care Homes using a consensus method with interviews and focus groups to prioritise the need for information and explore acceptability of an educational tool for care home workers. Evaluation of use, acceptability of design, and content of the guide were completed via remote monitoring. The workforce prioritised the need for training as well as the knowledge and skills in relation to planning resident-centred care and advice on textured diets. The technology was a means of offering ‘bite-size’ learning to enhance planning for nutrition across the whole organisation including managers, kitchen staff, and care workers. The Guide to Dysphagia was produced on a tablet and piloted in four care homes over 12 weeks, by 57 staff. Integrated analytics allowed user activity to be monitored. Findings showed that 73% of respondents reported the guide helped them in their job. Additionally, 88% of respondents stated they would recommend the guide to other staff, with 90% reporting it was easy to use. Engagement with staff and managers in four homes resulted in a co-designed, dysphagia guide.

PP34  Collecting experience-based expertise when planning prehospital care research: a stakeholder event about evaluating paramedics working in care homes

2020 ◽  
Vol 37 (10) ◽  
pp. e16.2-e16
Author(s):  
Bridie Evans ◽  
Mark Kingston ◽  
Alison Porter ◽  
Leigh Keen ◽  
Lesley Griffiths ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Prehospital Care ◽  
Care Home ◽  
Healthcare Services ◽  
Family Satisfaction ◽  
Care Homes ◽  
Research Development ◽  
Multiple Perspectives ◽  
Care Research ◽  
Wide Range

BackgroundDue to medical advances, the population of care homes is becoming increasingly frail, often with co-morbidities. Recent innovations have seen paramedics take on non-emergency roles within or supporting care homes. This workforce innovation requires urgent evaluation, taking account of the multiple perspectives at stake. Research is more relevant, feasible and accountable if those who commission, deliver and use healthcare services are able to input their professional and personal insights.MethodWe conducted a stakeholder event as part of research development work for paramedics working in care homes (PERCH: Preliminary Exploration of paramedic Roles in Care Homes). We invited representatives from care homes, including Enabling Research in Care Homes (ENRICH) network members, ambulance services, primary and secondary care, patient/resident and public members, and the research community. To inform discussion, we presented examples of paramedics working in care homes. We then facilitated small-group discussions about how to evaluate such innovations and recorded views on sticky notes and flipcharts.Results23 people attended the event. Clarity of roles and communication processes were considered important to implement the pilot project. Attendees agreed that research outcome measures should include changes in avoidable hospital admissions, emergency department attendances and 999 calls plus staff, patient and family satisfaction. They identified some potential benefits to ambulance services and general practice, such as time saved for other patients, but believed these could be difficult to measure.DiscussionGaining the insights of a wide range of stakeholders prior to research being designed is an important, but under-utilised approach in research development. People who deliver and receive community-based care have insight derived from personal and professional experience which complements research expertise. Research in care home settings is challenging, and insights from stakeholders were significant in the development of a research proposal about the role of paramedics in care homes (PERCH study). We submitted this to the Health and Care Research Wales Research for Public and Patient Benefit funding scheme in 2019.

scholarly journals Attracting, recruiting and retaining nurses and care workers working in care homes: the need for a nuanced understanding informed by evidence and theory

2020 ◽  
Author(s):  
Reena Devi ◽  
Claire Goodman ◽  
Sonia Dalkin ◽  
Angela Bate ◽  
Judy Wright ◽  
...  
Keyword(s):  
Care Home ◽  
Age Groups ◽  
Geographical Location ◽  
Care Homes ◽  
Complex Needs ◽  
Staffing Levels ◽  
Care Workers ◽  
Nuanced Understanding ◽  
Supportive Management ◽  
Training Opportunities

Abstract The care home sector relies on nurses and care workers to deliver care to residents living with frailty and complex needs. However, attracting, recruiting and retaining staff is one of the biggest challenges facing this sector. There is evidence available that describes factors that influence staff decisions to join and/or remain in the care home workforce, for example, individual rewards (such as feeling valued at work or training opportunities), relationships with colleagues and residents, supportive management or working arrangements (including flexible hours). However, it is less clear how different strategies are informed by evidence to improve recruitment and retention. Care homes are heterogeneous in terms of their size, staffing levels and mix, staff age groups, geographical location and working conditions. What matters to different members of the care home workforce will vary across nurses and care workers of different ages and levels of qualification or experience. Recognising this diversity is key: understanding how to attract, recruit and retain staff needs to discriminate and offer solutions that address this diversity. This important area of practice does not lend itself to a ‘one-approach-fits-all’ solution. This commentary provides a brief overview of known workforce challenges for the care home sector and argues for studies that use empirical evidence to test different theories of what might work for different staff, how and why, and in different circumstances.

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