Supporting the resilience and retention of frontline care workers in care homes for older people: A systematic scoping review and thematic synthesis

The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approaches to retain high quality, resilient frontline care home workers, who are not registered nurses, are informed by context specific, high quality evidence. We therefore conducted this scoping review to address the question: What is the current evidence for best practice to support the resilience and retention of frontline care workers in care homes for older people? MEDLINE, PubMed, PsycINFO, Embase, MedRxiv, CINAHL, ASSIA, Social Science Premium were searched for literature published between 2010 and 2020. The search strategy employed combinations of search terms to target frontline care workers in care homes for older people and the key concepts relevant to resilience and retention were applied and adapted for each database. Thirty studies were included. Evidence for best practice in supporting the resilience and retention specifically of frontline care workers in care homes is extremely limited, of variable quality and lacks generalisability. At present, it is dominated by cross-sectional studies mostly from out with the UK. The small number of intervention studies are inconclusive. The review found that multiple factors are suggested as being associated with best practice in supporting resilience and retention, but few have been tested robustly. The thematic synthesis of these identified the analytical themes of - Culture of Care; Content of Work; Connectedness with Colleagues; Characteristics and Competencies of Care Home Leaders and Caring during a Crisis. The evidence base must move from its current state of implicitness. Only then can it inform intervention development, implementation strategies and meaningful indicators of success. High quality, adequately powered, co-designed intervention studies, that address the fundamentally human and interpersonal nature of the resilience and retention of frontline care workers in care homes are required.

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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/v5 ◽

2020 ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Vision Care

Abstract Background: Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.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. A convenience sample of care home staff were recruited from care homes across England between November 2018 and February 2019 via email and in paper format. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents. Results: A total of 400 care home staff responded from 74 care homes. The results revealed that less than half of staff respondents reported to use screening tools to identify hearing (46%) and vision impairments (43.8%); that care homes rarely have limited access to other assistive devices for hearing (16%) and vision loss (23.8%), and that audiology services do not regularly assess care home residents (46.8%). A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion: This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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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/v2 ◽

2020 ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Vision Care

Abstract Background: Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.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 via email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the 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; that care homes have limited access to other assistive devices for hearing and vision loss, and that audiology services do not regularly assess care home residents. A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion: This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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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/v4 ◽

2020 ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Vision Care

Abstract Background:Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.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. A convenience sample of care home staff were recruited from care homes across England between November 2018 and February 2019 via email and in paper format. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents.Results:A total of 400 care home staff responded from 74 care homes. The results revealed that less than half of staff respondents reported to use screening tools to identify hearing (46%) and vision impairments (43.8%); that care homes rarely have limited access to other assistive devices for hearing (16%) and vision loss (23.8%), and that audiology services do not regularly assess care home residents (46.8%). A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion:This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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Handovers in care homes for older people – their type, timing and usefulness. Findings from a scoping review

Ageing and Society ◽

10.1017/s0144686x17001301 ◽

2017 ◽

Vol 39 (4) ◽

pp. 851-871 ◽

Cited By ~ 5

Author(s):

JO MORIARTY ◽

VALERIE LIPMAN ◽

CAROLINE NORRIE ◽

REKHA ELASWARAPU ◽

JILL MANTHORPE

Keyword(s):

Older People ◽

Scoping Review ◽

English Language ◽

Care Home ◽

Good Practice ◽

Care Quality ◽

Care Homes ◽

Regulatory Body ◽

Health And Social Care ◽

Care Quality Commission

ABSTRACTThere is a considerable body of literature on the importance of effective shift handovers in hospitals and other health-care settings but less is known about the transfer of information between staff starting and completing stints of paid work in care homes. In the first of two articles considering this under-explored topic, we report findings from a scoping review examining what is known about shift-to-shift handovers in care homes for older people and their equivalents. It is based on systematic searches of electronic databases of English-language journals on ageing and internet searches for material published between January 2005 and October 2016. Guidance from the regulatory body for health and social care in England, the Care Quality Commission, highlights the importance of handovers in care homes but the degree to which they are embedded into care home routines appears to be variable, influenced by factors such as workplace culture, shift patterns and the extent to which they involve all those on duty or just those with professional qualifications. Staffing shortages and whether or not members of staff are paid for their time attending handovers appear to be further constraints on their use. We conclude that there is considerable scope for further research in this field to identify and develop good practice.

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Identifying and Managing Hearing and Vision Loss in Older People in Care Homes: A Scoping Review of the Evidence

The Gerontologist ◽

10.1093/geront/gnz087 ◽

2019 ◽

Vol 60 (3) ◽

pp. e155-e168

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Scoping Review ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Screening Tools ◽

Care Homes ◽

Care Home Staff ◽

Sensory Impairments ◽

Design And Methods ◽

Effective Service

AbstractBackground and ObjectivesPoor identification of sensory impairments in care homes can be due to multiple factors. This scoping review identifies and synthesizes the literature into the detection of hearing and vision loss in the care home environment, and the management of these sensory losses once identified.Research Design and MethodsA scoping review methodology was used to identify primary research of any design published from 1985 to September 2018. Six electronic databases were searched, and articles were also sourced from reference lists, relevant charity organizations and published experts.ResultsSix electronic databases and multiple gray literature sources identified 51 articles for inclusion. The evidence confirmed that lack of knowledge in care home staff, poor management of assistive aids, unsuitable environment, lack of connections with optometrists and audiologists, underuse of effective screening tools, and the added complexity of assisting those with dementia are all barriers to effective practice. Conversely, flexible training programs, availability of a variety of assistive aids, simple screening tools, and adaptions to the environment are effective facilitators.Discussion and ImplicationThis review acknowledges that the barriers to identification and management of hearing and vision loss in care homes are multifaceted and that collaboration of multiple stakeholders is required to implement change and improve the residents’ ear and eye care. Recommendations are offered to support more effective service provision tailored to meet the needs of people with sensory impairments living in care homes, and this could subsequently improve best practice.

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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/v3 ◽

2020 ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Vision Care

Abstract Background:Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.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 via email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the 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; that care homes have limited access to other assistive devices for hearing and vision loss, and that audiology services do not regularly assess care home residents. A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion:This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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

BMC Geriatrics ◽

10.1186/s12877-020-01959-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wendy Andrusjak ◽

Ana Barbosa ◽

Gail Mountain

Keyword(s):

Older People ◽

Best Practice ◽

Vision Loss ◽

Care Home ◽

Care Homes ◽

Eye Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Home Staff ◽

Vision Care

Abstract Background Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England. 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. A convenience sample of care home staff were recruited from care homes across England between November 2018 and February 2019 via email and in paper format. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents. Results A total of 400 care home staff responded from 74 care homes. The results revealed that less than half of staff respondents reported to use screening tools to identify hearing (46%) and vision impairments (43.8%); that care homes rarely have access to other assistive devices for hearing (16%) and vision loss (23.8%), and that audiology services do not regularly assess care home residents (46.8%). A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice. Conclusion This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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A Scoping Review of Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals (Preprint)

10.2196/preprints.20587 ◽

2020 ◽

Author(s):

Krishna Krishna Prasad Pathak

Keyword(s):

Health Care ◽

Scoping Review ◽

Health Professionals ◽

Educational Program ◽

Best Practice ◽

Intervention Studies ◽

Educational Interventions ◽

Learning Activities ◽

Inclusion Criteria ◽

Improving Health Care

BACKGROUND Health professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their dementia detection practices and management. OBJECTIVE The objective of this scoping review is to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs. METHODS We searched electronically published relevant articles with inclusion criteria; (1) intervention studies aimed at improving HPs practices concerning dementia care and (2) educational interventions focused on nurses and doctors’ knowledge, detection practice and management of dementia. Twenty-five articles fit the inclusion criteria. RESULTS Collaborative programs of practice based workshops, interactive learning activities with community and multi-faced educational program were the most effective. CONCLUSIONS HPs should be supported to improve their knowledge, tackle behavioural problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis. CLINICALTRIAL no applicable

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The ‘regulated death’: a documentary analysis of the regulation and inspection of dying and death in English care homes for older people

Ageing and Society ◽

10.1017/s0144686x06005460 ◽

2007 ◽

Vol 27 (2) ◽

pp. 233-247 ◽

Cited By ~ 9

Author(s):

KATHERINE FROGGATT

Keyword(s):

Older People ◽

Best Practice ◽

Quality Care ◽

Care Homes ◽

National Standard ◽

Good Death ◽

Term Care ◽

Documentary Analysis ◽

Death Event ◽

Inspection Process

In England, processes of regulation and inspection have been established to ensure that older people living in long-term care settings receive quality care. This paper describes how dying and death in care homes for older people is regulated and inspected. A documentary analysis was undertaken of the standard that addresses dying and death in the 2001 Care Homes for Older People: National Minimum Standards. Present in the standard is a ‘good death’ template drawn from constructions of best practice in palliative care. The way in which this national standard is enacted in the inspection process is described using a content analysis of the inspection reports from 226 care homes for older people. These present a narrow focus on dying and death, one that emphasises the older person's wishes and the degree of adherence to policies and procedures concerned with the dying and death event. A regulated death attenuates the ‘good death’ template and reflects both the inspection process and capabilities of the residents of care homes. If the regulation and inspection process is to integrate dying with living, a broader conception and regime of inspection is required. Only then will end-of-life care be provided that meets the diverse needs of older people who live in care homes.

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