scholarly journals 102 Online Supportive Conversations & Reflection Sessions [OSCARS] with Care Home Staff Following A Resident’s Death: Improving Coping Mechanisms, Team Cohesion and Communication

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
J Hockley ◽  
L Johnston ◽  
J Watson ◽  
S D Shenkin
Keyword(s):  
Care Home ◽  
Coping Mechanisms ◽  
Team Cohesion ◽  
Online Support ◽  
Frontline Staff ◽  
Care Home Staff ◽  
Team Working ◽  
Staff Wellbeing ◽  
Future Education

Abstract Introduction COVID-19 Trauma Guidance suggests opportunities for structured, time-limited discussions about challenging experiences should be offered. It is unknown if such discussions can be effectively delivered online by palliative care specialists to support care home (CH) staff in relation to death/dying. Funded by Scotland’s Chief Scientist Office COVID-19 “rapid research” fund, online OSCaRS is being piloted. Methods Fortnightly OSCaRS delivered to small groups of CH staff via a secure online platform in three local CHs over 10 weeks. Sessions are digitally recorded. The shortened version of the Chesney coping self-efficacy questionnaire is completed by all staff pre/post. Additional post-study questions asked of OSCaRS participants and in-depth staff interviews will be undertaken (n = 10). Thematic analysis of the recorded sessions and interviews will be undertaken and related to the staff questionnaire and context of each CH. Results New learning on the feasibility and acceptability of providing OSCaRS to frontline staff. The benefit of OSCaRS to CH staff coping mechanisms, team cohesion and communicaton with relatives during the COVID-19 pandemic will be presented. Initial results show that OSCaRS are feasible, valued by all care home staff and support staff in coping with the challenges of COVID-19/. Key Conclusions The analysis will inform future practice, and an Implementation Guide for OSCaRS in CHs will be produced. Key learning on the potential for online support in relation to death/dying during the pandemic and beyond will contribute to future education, training and staff wellbeing resources. It will also inform the role of such sessions in developing individual coping mechanisms and team working alongside communication with relatives during lockdown.

Sepsis in the older person

2021 ◽  
Vol 23 (8) ◽  
pp. 1-7
Author(s):  
Tony Conner ◽  
Juliana Thompson ◽  
Sue Tiplady
Keyword(s):  
Care Home ◽  
Signs And Symptoms ◽  
Common Condition ◽  
Older Person ◽  
Valuable Contribution ◽  
Older Population ◽  
Care Home Staff ◽  
Treatment And Prevention ◽  
Effective Care

Background: Sepsis is a common condition, with an estimated 30 million cases worldwide each year, resulting in 6 million sepsis-related deaths. Some 60% of all sepsis events and 80% of sepsis-associated deaths occur in the older population. This is because the ageing process, and the presence of multiple comorbidities, make many older people vulnerable to developing, and dying from, sepsis. However, serious illness and death from sepsis can be avoided if the signs and symptoms are identified quickly, and interventions started early. Methods: This article explains current research and guidelines with regard to the causes, recognition, treatment and prevention of sepsis in the older population, and considers the role of care home staff in supporting effective care of residents as risk of developing sepsis. Conclusions: Care home staff are well-positioned to recognise sepsis and contribute to treatment, as their in-depth knowledge of residents makes it easier for them to identify changes in residents' behaviours and health status, which may indicate sepsis. By taking steps to ensure the risk of developing infections is reduced, care home staff can make a valuable contribution to the prevention of sepsis.

scholarly journals Nobody ever questions—Polypharmacy in care homes: A mixed methods evaluation of a multidisciplinary medicines optimisation initiative

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244519
Author(s):  
Sue Jordan ◽  
Hayley Prout ◽  
Neil Carter ◽  
John Dicomidis ◽  
Jamie Hayes ◽  
...  
Keyword(s):  
Information Transfer ◽  
Care Home ◽  
Signs And Symptoms ◽  
Care Homes ◽  
Care Home Staff ◽  
Mixed Methods Evaluation ◽  
Team Working ◽  
Primary Care Nurses ◽  
Medicines Optimisation ◽  
Reaction Profile

Background Nurse-led monitoring of patients for signs and symptoms associated with documented ‘undesirable effects’ of medicines has potential to prevent avoidable harm, and optimise prescribing. Intervention The Adverse Drug Reaction Profile for polypharmacy (ADRe-p) identifies and documents putative adverse effects of medicines commonly prescribed in primary care. Nurses address some problems, before passing ADRe-p to pharmacists and prescribers for review, in conjunction with prescriptions. Objectives We investigated changes in: the number and nature of residents’ problems as recorded on ADRe-p; prescription regimens; medicines optimisation: and healthcare costs. We explored aetiologies of problems identified and stakeholders’ perspectives. Setting and participants In three UK care homes, 19 residents completed the study, December 2018 to May 2019. Two service users, three pharmacists, six nurses gave interviews. Methods This mixed-method process evaluation integrated data from residents’ ADRe-ps and medicines charts, at the study’s start and 5–10 weeks later. Results We recruited three of 27 homes approached and 26 of 45 eligible residents; 19 completed ADRe-p at least twice. Clinical gains were identified for 17/19 residents (mean number of symptoms 3 SD 1.67, range 0–7). Examples included management of: pain (six residents), seizures (three), dyspnoea (one), diarrhoea (laxatives reduced, two), falls (two of five able to stand). One or more medicine was de-prescribed or dose reduced for 12/19 residents. ADRe administration and review cost ~£30 in staff time. ADRe-p helped carers and nurses bring residents’ problems to the attention of prescribers. Implications ADRe-p relieved unnecessary suffering. It supported carers and nurses by providing a tool to engage with pharmacists and prescribers, and was the only observable strategy for multidisciplinary team working around medicines optimisation. ADRe-p improved care by: a) regular systematic checks and problem documentation; b) information transfer from care home staff to prescribers and pharmacists; c) recording changes. Registration NLM Identifier NCT03955133; ClinicalTrials.gov.

scholarly journals A qualitative analysis of trainer/coach experiences of changing care home practice in the Well-being and Health in Dementia randomised control trial

Dementia ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 237-252 ◽  
Author(s):  
Jane Fossey ◽  
Lucy Garrod ◽  
Azucena Guzman ◽  
Ingelin Testad
Keyword(s):  
Care Home ◽  
Well Being ◽  
Relationship Building ◽  
Randomised Control Trial ◽  
Main Theme ◽  
Training Methods ◽  
Care Home Staff ◽  
People With Dementia ◽  
Health And Social Care

Objectives This study explored the experiences of a range of health and social care professionals employed in the role of trainer/coaches to support care home staff to implement a psychosocial intervention for residents living with dementia. It aimed to identify the factors which are pertinent to these roles, in the context of a cascade model of training. Method A focus group was convened involving dementia trainer/coaches and supervisors who had worked on Well-being and Health for people with Dementia randomised control trial. Twelve participants explored their preparedness for and experiences of their role as ‘Well-being and Health for people with Dementia therapists’. They reflected on their perceptions of the resources and support required. The data were transcribed verbatim and subjected to inductive thematic analysis. Results Three main themes emerged from the data. Within the theme of ‘skills in relationship building’ were two subthemes of developing trust and getting to know individual staff and each care home. In the second main theme of ‘making use of tangible resources’ two subthemes relating to using the Well-being and Health for people with Dementia manuals and the supervision of the therapists arose. The third theme, ‘being an agent for change’ contained three subthemes: effective training methods, creating opportunities for Dementia Champions to reflect and therapists' perceived rewards of their role. Conclusion The findings provide new insights into the trainer/coach role applicable to the practices of services recruiting, training and providing ongoing professional support to practitioners in-reaching into care homes.

scholarly journals Understanding co-worker relationships for promoting quality in care homes: protocol for a scoping review.

2020 ◽  
Author(s):  
Kirsty Jayne Haunch ◽  
Karen Spilsbury
Keyword(s):  
Scoping Review ◽  
Social Care ◽  
Care Home ◽  
Evidence Base ◽  
Care Homes ◽  
Future Research ◽  
Care Home Staff ◽  
Team Working ◽  
Effective Interventions ◽  
Health And Social Care

Background: The relationships care home staff have with their co-workers influence how they feel about their work and their job performance. In care homes collaborative co-worker relationships are consistently linked to positive outcomes and have been identified as a key feature of overcoming challenges posed by COVID-19. Research on co-worker relationships in care homes to date however, is largely descriptive and poses knowledge gaps relating to the process of how co-worker relationships occur, along with what influences them. This hinders the development of targeted, effective interventions. Co-worker relationships to promote quality in care homes therefore demands clarity of understanding. The aim of the scoping review is to understand what is known about co-worker relationships and its applicability to care homes. We will synthesise evidence about both co-worker relationships in broader health and social care settings, which will allow us to draw on theories and find interventions potentially useful for a care home context.Methods: A scoping review will be undertaken to understand co-worker relationships in health and social care settings and to determine the volume, scope and quality of research in this field. Our review methods will follow scoping review guidance We will then work with stakeholders to understand the relevance and applicability of the evidence base for people living and working in, or visiting, care homes and to establish a future research agenda.Conclusion: This review is important and timely. Findings will assist care home managers to consider how to promote and improve effective team working. It will also provide the foundations for informing future research aimed at improving co-worker relationships in care homes for the benefit of residents.

scholarly journals Working in a care home during the COVID-19 pandemic: How has the pandemic changed working practices?

2021 ◽  
Author(s):  
Kerry L Hanna ◽  
Clarissa Giebel ◽  
Jacqueline Cannon ◽  
Justine Shenton ◽  
Stephen Mason ◽  
...  
Keyword(s):  
Care Home ◽  
Structured Interviews ◽  
Care Home Staff ◽  
The Everyday ◽  
Working Practices ◽  
The Uk ◽  
Staff Wellbeing ◽  
The Impact ◽  
Inductive Thematic Analysis ◽  
Practical Implications

The aim of this research was to explore the impact of COVID-19 on the working practices of care home staff, caring for people living with dementia. Remote qualitative, semi-structured interviews were conducted with care home staff caring for people living with dementia (PLWD) in the UK. Participants were recruited to the larger programme of research via convenience sampling. Interviews were conducted via telephone or online platforms. This research employed inductive thematic analysis. Sixteen care home staff were included in this study. Three overarching themes were developed from the analysis that conveyed changes to the everyday working practices of the care home workforce and the impact such changes posed to staff wellbeing: (1) Practical implications of working in a care home during the COVID-19 pandemic; (2); Staff values and changes to the staff roles (3): Impact to the care home staff and concerns for the care sector. The COVID-19 pandemic has significantly disrupted the daily working practices of care home staff, with staff forced to adopt additional roles on top of increased workloads to compensate for the loss of external agencies and support. Support and guidance must be offered urgently to inform care home staff on how to best adapt to their new working practices, ensuring that they are adequately trained.

scholarly journals Is area deprivation associated with greater impacts of COVID-19 in care homes across England? A preliminary analysis of COVID-19 outbreaks and deaths

2021 ◽  
pp. jech-2020-215039 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Michelle Degli Esposti
Keyword(s):  
Negative Binomial ◽  
Care Home ◽  
Negative Binomial Regression ◽  
Population Characteristics ◽  
Care Homes ◽  
Future Research ◽  
Area Deprivation ◽  
Binomial Regression ◽  
Index Of Multiple Deprivation

IntroductionThe COVID-19 pandemic has disproportionately impacted care homes and vulnerable populations, exacerbating existing health inequalities. However, the role of area deprivation in shaping the impacts of COVID-19 in care homes is poorly understood. We examine whether area deprivation is linked to higher rates of COVID-19 outbreaks and deaths among care home residents across upper tier local authorities in England (n=149).MethodsWe constructed a novel dataset from publicly available data. Using negative binomial regression models, we analysed the associations between area deprivation (Income Deprivation Affecting Older People Index (IDAOPI) and Index of Multiple Deprivation (IMD) extent) as the exposure and COVID-19 outbreaks, COVID-19-related deaths and all-cause deaths among care home residents as three separate outcomes—adjusting for population characteristics (size, age composition, ethnicity).ResultsCOVID-19 outbreaks in care homes did not vary by area deprivation. However, COVID-19-related deaths were more common in the most deprived quartiles of IDAOPI (incidence rate ratio (IRR): 1.23, 95% CI 1.04 to 1.47) and IMD extent (IRR: 1.16, 95% CI 1.00 to 1.34), compared with the least deprived quartiles.DiscussionThese findings suggest that area deprivation is a key risk factor in COVID-19 deaths among care home residents. Future research should look to replicate these results when more complete data become available.

scholarly journals Cultural and Institutional Issues in ACP for Care Home Residents: Perspectives of Loved Ones

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 754-754
Author(s):  
Brian de Vries ◽  
Gloria Gutman ◽  
Helen Kwan ◽  
Katrina Jang ◽  
Shimae Soheilipour ◽  
...  
Keyword(s):  
South Asian ◽  
Care Home ◽  
Decision Makers ◽  
Loved One ◽  
Targeted Interventions ◽  
Traditional Family ◽  
Institutional Issues ◽  
Bisexual And Transgender ◽  
Advance Care

Abstract Focus groups were held with family/decision makers of residents in an exclusively Chinese (EC; N=7) and a multi-ethnic (ME; N=8) care home, as well as South Asian (SA; n = 5) and lesbian, gay, bisexual and transgender caregivers (LGBT; n = 5) who had/have a loved one in a care home. Shared themes across groups included the role of the care home in Advance Care Planning (ACP) discussions, the timing of such discussions (i.e., at admission), and the extent to which another person was available and appropriate for such discussions. Issues unique to groups included superstition and the equation of ACP with funeral planning (EC), family history and regrets about not having planned (ME), gender differences and the need for education about ACP (SA) and the absence of traditional family among LGBT older adults. These themes highlight the challenges in ACP among diverse populations and the need for targeted interventions.

scholarly journals Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Marshall ◽  
Adam Gordon ◽  
John R. F. Gladman ◽  
Simon Bishop
Keyword(s):  
Central Government ◽  
Resource Constraints ◽  
Care Delivery ◽  
Care Home ◽  
Third Sector ◽  
Care Homes ◽  
Framework Analysis ◽  
Local Networks ◽  
Care Home Staff ◽  
East Midlands

Abstract Background From late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed. Methods Ten managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals. Results Three key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care. Conclusions This study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.

scholarly journals The Contribution of Pharmacists and Pharmacy Technicians to Person-Centred Care within a Medicine’s Optimisation in Care Homes Service: A Qualitative Evaluation

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Sally Fowler Davis ◽  
Rachel Cholerton ◽  
Louise Freeman-Parry ◽  
Jo Tsoneva
Keyword(s):  
Care Home ◽  
Pharmacy Practice ◽  
Qualitative Evaluation ◽  
Care Homes ◽  
Framework Analysis ◽  
Medicines Management ◽  
Team Members ◽  
Care Home Staff ◽  
Management Interventions ◽  
Pharmacy Technicians

Pharmacists and pharmacy technicians seek to improve person-centred care. Improvements to systems for care homes seeks to reduce medicines waste and inefficiency, particularly through supporting care home staff, to enhance safer administration of medicines. A complex evaluation used qualitative design and utilised narrative enquiry, and team members and key stakeholders were interviewed. Framework analysis was used, aligning findings to a person-centred care framework for older people. The Medicines Optimisation in Care Homes (MOCH) team brokered improvement practices across care homes to enhance person-centred care. The framework analysis confirms that the team used ‘authentic attention’ in relation to the residents’ experiences and flexibility in relation to negotiating medication. The importance of transparency of processes and systems in medicines management is highlighted, alongside requirements for person-centred care to make explicit the reason for taking a medication, and the continuous discussion with a range of stakeholders about the continuing need for particular medications. The outcome of the evaluation includes insights into a new area of pharmacy practice in community, based on the skills, knowledge, and experience of pharmacists and pharmacy technicians working in the care home sector. Further study is needed into the efficacy and outcomes of medicines management interventions.

Sign in / Sign up

Export Citation Format

Share Document