475 DEVELOPING A VIRTUAL CARE HOME SUPPORT FORUM DURING THE COVID-19 PANDEMIC

Abstract Introduction COVID-19 has had a devastating effect on care homes, increasing both morbidity and mortality of residents and staff. Between 2 March and 12 June 2020, COVID-19 was the main cause of death in male care home residents (33.5%) and second for female (26.6%).1 By 1 May 2020, the death rate from all causes in care homes exceeded that in hospital (6,409 versus 6,397).2 Thus, care homes had to rapidly adapt to facilitate safe care of patients and staff. Method An expert outreach team visited a number of care homes in Surrey and Sussex to explore COVID-19 issues in care homes. Key themes were identified that informed topics for the Virtual Care Home Forum, where a series of virtual teaching, training and peer support sessions were hosted either live or on-demand, accessible for all care home staff. Results 12 sessions were held with an average attendance of 25 people, predominantly care home managers and community healthcare professionals. Real time qualitative feedback was collected and an electronic survey was completed at the end of the series which showed 100% felt the sessions had improved their understanding of the topic, 100% felt the knowledge and skills obtained from the sessions would be useful in their job, 87.5% agreed the sessions would impact or change their practise and 100% felt more supported during the pandemic. Conclusion It has been an unprecedented year for the NHS, and the care home sector has suffered significantly. In order to provide the best level of care for patients and support for our community colleagues, we must work collaboratively, including provision of education and training. To ensure equal access for all, maintaining user-safety and compliance with government legislation, virtual webinars proved to be an excellent modality. We plan to continue providing training, teaching and support through this means in the future.

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

BMC Geriatrics ◽

10.1186/s12877-021-02053-9 ◽

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.

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

Pharmacy ◽

10.3390/pharmacy9010034 ◽

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.

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Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00872-6 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Georgios Tsakos ◽

Paul R. Brocklehurst ◽

Sinead Watson ◽

Anna Verey ◽

Nia Goulden ◽

...

Keyword(s):

Health Promotion ◽

Oral Health ◽

Complex Intervention ◽

Assessment Tool ◽

Care Home ◽

Care Homes ◽

Routine Practice ◽

Oral Health Promotion ◽

Nice Guideline ◽

Care Home Staff

Abstract Background Evidence for interventions promoting oral health amongst care home residents is weak. The National Institute for Health and Care Excellence (NICE) guideline NG48 aims to maintain and improve the oral health of care home residents. A co-design process that worked with residents and care home staff to understand how the NG48 guideline could be best implemented in practice has been undertaken to refine a complex intervention. The aim of this study is to assess the feasibility of the intervention to inform a future larger scale definitive trial. Methods This is a protocol for a pragmatic cluster randomised controlled trial with a 12-month follow-up that will be undertaken in 12 care homes across two sites (six in London, six in Northern Ireland). Care homes randomised to the intervention arm (n = 6) will receive the complex intervention based on the NG48 guideline, whilst care homes randomised to the control arm (n = 6) will continue with routine practice. The intervention will include a training package for care home staff to promote knowledge and skills in oral health promotion, the use of the Oral Health Assessment Tool on residents by trained care home staff, and a ‘support worker assisted’ daily tooth-brushing regime with toothpaste containing 1500 ppm fluoride. An average of ten residents, aged 65 years or over who have at least one natural tooth, will be recruited in each care home resulting in a recruited sample of 120 participants. Assessments will be undertaken at baseline, 6 months and 12 months, and will include a dental examination and questionnaires on general health and oral health administered by a research assistant. A parallel process evaluation involving semi-structured interviews will be undertaken to explore how the intervention could be embedded in standard practice. Rates of recruitment and retention, and intervention fidelity will also be recorded. A cost-consequence model will determine the relevance of different outcome measures in the decision-making context. Discussion The study will provide valuable information for trialists, policymakers, clinicians and care home staff on the feasibility and associated costs of oral health promotion in UK care homes. Trial registration ISRCTN10276613. Registered on 17th April 2020. http://www.isrctn.com/ISRCTN10276613.

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Active residents in care homes: A holistic approach to promoting and encouraging meaningful activity for residents living in care homes: Innovative Practice

Dementia ◽

10.1177/1471301217727129 ◽

2017 ◽

Vol 18 (5) ◽

pp. 1942-1947 ◽

Cited By ~ 4

Author(s):

Raymond Smith ◽

Julia Wood ◽

Fiona Jones ◽

Liezl Anderson ◽

Michael Hurley

Keyword(s):

Residential Care ◽

Systems Approach ◽

Care Home ◽

Family Members ◽

Occupational Therapists ◽

Holistic Approach ◽

Care Homes ◽

Care Home Staff ◽

Meaningful Activity ◽

Whole Systems

The active residents in care homes intervention aim to promote meaningful activity among care home residents. Residents, family members and staff from three residential care homes in South London are participating. It is a whole systems approach which involves formal and ‘on the floor’ training to empower care home staff to facilitate activity. Training is delivered by two occupational therapists, a physiotherapist and a rehabilitation assistant. This paper describes the active residents in care homes intervention, the evaluation methods and discusses some preliminary findings.

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Urinary catheterization in care homes for older people: self-reported questionnaire audit of catheter management by care home staff

Journal of Hospital Infection ◽

10.1016/j.jhin.2005.03.008 ◽

2006 ◽

Vol 62 (1) ◽

pp. 29-36 ◽

Cited By ~ 15

Author(s):

C.A.M. McNulty ◽

J. Bowen ◽

C. Foy ◽

K. Gunn ◽

E. Freeman ◽

...

Keyword(s):

Older People ◽

Care Home ◽

Care Homes ◽

Urinary Catheterization ◽

Care Home Staff

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Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

10.21203/rs.2.21638/v1 ◽

2020 ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Chi Square Analysis ◽

Vision Care

Abstract Background: Hearing and vision loss in older people has proven to affect physical and mental health and increase the speed of cognitive decline. Studies have proven certain practices and aspects of staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which of these are being implemented in care homes. This study aims to identify the gaps in staff knowledge and underused practices evident in long term care homes when identifying and managing hearing and vision difficulties in older residents. Methods: This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. The survey was sent to care homes across England between November 2018 and February 2019 both via Email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis was used to assess the factors particularly influencing the current care being provided to care home residents. Results: A total of 400 care home staff responded from 74 care homes. The results revealed that screening tools are rarely used by staff to identify hearing and vision impairments, care homes have limited access to other assistive devices, and audiology services do not regularly assess care home residents. A majority of staff were also not entirely confident in their knowledge of ear and eye care. Responses were also affected by the respondents’ job role, length of time working in care homes and also the care home type and care home capacity revealing a lack of standardised practice and shared communication. Conclusion: This study identifies which practices known to facilitate ear and eye care are currently under used in care homes across England and what particularly staff are not knowledgeable on when it comes to ear and eye care. This can now inform future research of the areas requiring improvement to as effectively address to acknowledged slow identification and poor management of hearing and vision loss in older people residing in care homes.

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The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences

British Journal of Healthcare Management ◽

10.12968/bjhc.2020.0145 ◽

2021 ◽

Vol 27 (8) ◽

pp. 1-8

Author(s):

Chris Harvey ◽

Simon Froggatt ◽

Bryan Lightowler ◽

Andrew Hodge

Keyword(s):

Qualitative Study ◽

Care Home ◽

Community Services ◽

Ambulance Service ◽

Care Staff ◽

Care Homes ◽

Service Demand ◽

Staff Members ◽

Care Home Staff ◽

Advanced Practitioner

Background/Aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

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Adopt a Care Home: An intergenerational initiative bringing children into care homes

Dementia ◽

10.1177/1471301217725420 ◽

2017 ◽

Vol 18 (5) ◽

pp. 1679-1694 ◽

Cited By ~ 4

Author(s):

Laura Di Bona ◽

Sheila Kennedy ◽

Gail Mountain

Keyword(s):

Mixed Methods ◽

Focus Groups ◽

Social Inclusion ◽

Care Home ◽

Care Homes ◽

Care Home Staff ◽

Impact Data ◽

School Care

Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, 10 people living with dementia and 8 school/care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme’s feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children’s dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme’s potential to contribute towards dementia friendly communities by increasing children’s knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion.

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