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.

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.

scholarly journals 37 Factors Influencing Mealtime Care for People with Dementia Living in Care Homes: An Ethnographic Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
J Faraday ◽  
C Abley ◽  
C Exley ◽  
J Patterson
Keyword(s):  
Social Care ◽  
Hospital Admissions ◽  
Care Home ◽  
Good Practice ◽  
Ethnographic Study ◽  
Care Homes ◽  
Care Home Staff ◽  
Factors Influencing ◽  
People With Dementia ◽  
Health And Social Care

Abstract Introduction More and more people with dementia are living in care homes. Often they depend on care home staff for help with eating and drinking. It is essential that care home staff are able to provide good care at mealtimes. This study used ethnography to identify factors influencing mealtime care for this population. Methods Over twenty-five hours of mealtime observations were conducted in two UK care homes with diverse characteristics. Observations focused on interactions between care home staff and residents living with dementia. Twenty-two semi-structured interviews were carried out with care home staff, family carers, and visiting health and social care professionals, to explore mealtime care from their perspectives. The study used a constant comparison approach, so that data from early observations and interviews were explored in more depth subsequently. Results Five factors were identified which influenced mealtime care for people with dementia living in care homes. These were: environment (such as background music and building layout); kitchen and food (including connectivity between kitchen staff and others); staffing (for example: staff ratios and allocation); knowledge and support (including training, resources and supportive culture); and relationship with wider care team (such as family involvement, and the role of visiting health and social care professionals). Conclusions This study is part of a bigger project which will develop a staff training intervention to improve mealtime care for people with dementia living in care homes. The intervention will be informed by these findings, and by complementary evidence on good practice in mealtime care (from primary and secondary studies). It is anticipated that good mealtime care may improve quality of life for care home residents, and reduce hospital admissions.

scholarly journals Admiral Nurse Case Management within Enhanced Health in Care Homes

2021 ◽  
Vol 05 (02) ◽  
pp. 1-1
Author(s):  
Zena Aldridge ◽  
◽  
Karen Harrison Dening ◽  
◽  
◽  
...  
Keyword(s):  
Service Provision ◽  
Quality Care ◽  
Care Home ◽  
Care Homes ◽  
Care Home Staff ◽  
Nurse Case Management ◽  
Specialist Services ◽  
Health And Social Care ◽  
Improve Access

The United Kingdom’s (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 may require 24-hour care. Currently it is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it whilst residing in the care home. The provision of high-quality care for this population is a challenge with a lack of consistency in the provision of primary care and specialist services and a known gap in knowledge and skills. The NHS Long Term Plan aims to move care closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes (EHCH). However, such services need to be equipped with the correct skill mix to meet the needs of the care home population. Admiral Nurses are specialists in dementia care and are well placed to support the delivery of EHCH and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system. This paper discusses current gaps in service provision and how both the EHCH framework, and the inclusion of Admiral Nurses, might redress these and improve outcomes.

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 How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer–resident interactions

Dementia ◽  
2021 ◽  
pp. 147130122110020
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Fiona Beyer ◽  
Catherine Exley ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Admissions ◽  
Care Home ◽  
Good Practice ◽  
Oral Intake ◽  
Care Homes ◽  
Synthesis Process ◽  
Future Research ◽  
Care Home Staff ◽  
People With Dementia

People with dementia who live in care homes often depend on care home staff for help with eating and drinking. It is essential that care home staff have the skills and support they need to provide good care at mealtimes. Good mealtime care may improve quality of life for residents, and reduce hospital admissions. The aim of this systematic review was to identify good practice in mealtime care for people with dementia living in care homes, by focusing on carer-resident interactions at mealtimes. Robust systematic review methods were followed. Seven databases were searched: AgeLine, BNI, CENTRAL, CINAHL, MEDLINE, PsycINFO and Web of Science. Titles, abstracts, and full texts were screened independently by two reviewers, and study quality was assessed with Joanna Briggs Institute tools. Narrative synthesis was used to analyse quantitative and qualitative evidence in parallel. Data were interrogated to identify thematic categories of carer-resident interaction. The synthesis process was undertaken by one reviewer, and discussed throughout with other reviewers for cross-checking. After title/abstract and full-text screening, 18 studies were included. Some studies assessed mealtime care interventions, others investigated factors contributing to oral intake, whilst others explored the mealtime experience. The synthesis identified four categories of carer-resident interaction important to mealtime care: Social connection, Tailored care, Empowering the resident, and Responding to food refusal. Each of the categories has echoes in related literature, and provides promising directions for future research. They merit further consideration, as new interventions are developed to improve mealtime care for this population.

scholarly journals Testing for SARS-CoV-2 in care home staff and residents in English care homes: A service evaluation

2020 ◽  
Author(s):  
Emma Smith ◽  
Clare F Aldus ◽  
Julii Brainard ◽  
Sharon Dunham ◽  
Paul R Hunter ◽  
...  
Keyword(s):  
Care Home ◽  
Service Evaluation ◽  
Care Homes ◽  
Test Results ◽  
Testing Strategy ◽  
Home Team ◽  
Care Home Staff ◽  
Health And Social Care ◽  
Strategy Design ◽  
Nose And Throat

Background COVID-19 has especially affected care home residents. Aim To evaluate a nurse-led Enhanced Care Home Team (ECHT) enhanced SARS-CoV-2 testing strategy. Design and setting Service evaluation in care homes in Norfolk UK. Method Residents and staff received nose and throat swab tests (7 April to 29 June 2020). Resident test results were linked with symptoms on days 0-14 after test and mortality to 13 July 2020. Results Residents (n=518) in 44 homes and staff (n=340) in 10 care homes were tested. SARS-CoV-2 positivity was identified in 103 residents in 14 homes and 49 staff in seven homes. Of 103 SARS-CoV-2+ residents, just 38 had typical symptom(s) at time of test (new cough and/or fever). Amongst 54 residents who were completely asymptomatic when tested, 12 (22%) developed symptoms within 14 days. Compared to SARS-CoV-2 negative residents, SARS-CoV-2+ residents were more likely to exhibit typical symptoms (new cough (n=26, p=0.001); fever (n=24, p=<0.001)) or as generally-unwell (n=18, p=0.001). Of 38 resident deaths, 21 (55%) were initially attributed to SARS-CoV-2, all of whom tested SARS-CoV-2+. One death not initially attributed to SARS-CoV-2 also tested positive. Conclusion Testing identified asymptomatic and pre-symptomatic SARS-CoV-2+ residents and staff. Being generally-unwell was common amongst symptomatic residents and may indicate SARS-CoV-2 infection in older people in the absence of more typical symptoms. Where a resident appears generally unwell SARS-CoV-2-infection should be suspected. Protocols for testing involved integrated health and social care teams.

scholarly journals Immersive 360° videos in health and social care education: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carolyn Blair ◽  
Colm Walsh ◽  
Paul Best
Keyword(s):  
Learning Outcomes ◽  
Scoping Review ◽  
User Satisfaction ◽  
Social Care ◽  
Future Research ◽  
Learning Climate ◽  
Motivation To Learn ◽  
Care Education ◽  
Health And Social Care ◽  
Pedagogical Theory

Abstract Background Research on the pedagogical use of immersive 360° videos is a rapidly expanding area within health and social care education. Despite this interest, there is a paucity of empirical data on its application. Method A scoping review methodology framework was used to search for relevant articles published between 1970 and July 2021. Six databases were used to identify studies using immersive 360° videos for training and education purposes within health and social care: PubMed, Ovid Medline, Psych Info, Psych Articles, Cochrane Database and Embase. Research questions included: Is there any evidence that immersive 360° videos increase learning outcomes and motivation to learn in health and social care education? What are the key pedagogical concepts and theories that inform this area of research? What are the limitations of using immersive 360° videos within health and social education? The four dimensions contained within Keller’s ARCS model (attention, relevance, confidence and satisfaction) frame the results section. Results Fourteen studies met our inclusion criteria. Learning outcomes confirm that immersive 360° videos as a pedagogical tool: increases attention, has relevance in skill enhancement, confidence in usability and user satisfaction. In particular, immersive 360° videos has a positive effect on the user’s emotional response to the learning climate, which has a significant effect on users’ motivation to learn. There was a notable lack of pedagogical theory within the studies retrieved and a general lack of clarity on learning outcomes. Conclusion Studies examining the effectiveness of such interventions remains weak due to smaller sample sizes, lack of randomised control trials, and a gap in reporting intervention qualities and outcomes. Nevertheless, 360° immersive video is a viable alternative to VR and regular video, it is cost-effective, and although more robust research is necessary, learning outcomes are promising. Future directions Future research would do well to focus on interactivity and application of pedagogical theory within immersive 360° videos experiences. We argue that more and higher quality research studies, beyond the scope of medical education, are needed to explore the acceptability and effective implementation of this technology.

scholarly journals Patient and public involvement (PPI) in prisons: the involvement of people living in prison in the research process – a systematic scoping review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Samantha Treacy ◽  
Steven Martin ◽  
Nelum Samarutilake ◽  
Tine Van Bortel
Keyword(s):  
Systematic Review ◽  
Scoping Review ◽  
Public Involvement ◽  
Social Care ◽  
Positive Impact ◽  
Research Process ◽  
Evidence Base ◽  
Patient And Public Involvement ◽  
Care Research ◽  
Health And Social Care

Abstract Background Patient and Public Involvement (PPI) in health and social care research is increasingly prevalent and is promoted in policy as a means of improving the validity of research. This also applies to people living in prison and using social care services. Whilst evidence for the effectiveness of PPI was limited and reviews of its application in prisons were not found, the infancy of the evidence base and moral and ethical reasons for involvement mean that PPI continues to be advocated in the community and in prisons. Objectives To conduct a review of the literature regarding the involvement of people or persons living in prison (PLiP) in health and social care research focused on: (i) aims; (ii) types of involvement; (iii) evaluations and findings; (iv) barriers and solutions; and (v) feasibility of undertaking a systematic review. Methods A systematic scoping review was undertaken following Arksey and O’Malley’s (International Journal of Social Research Methodology 8: 19-32, 2005) five-stage framework. A comprehensive search was conducted involving ten electronic databases up until December 2020 using patient involvement and context related search terms. A review-specific spreadsheet was created following the PICO formula, and a narrative synthesis approach was taken to answer the research questions. PRISMA guidelines were followed in reporting. Results 39 papers were selected for inclusion in the review. The majority of these took a ‘participatory’ approach to prisoner involvement, which occurred at most stages during the research process except for more ‘higher’ level research operations (funding applications and project management), and only one study was led by PLiPs. Few studies involved an evaluation of the involvement of PLiP, and this was mostly PLiP or researcher reflections without formal or independent analysis, and largely reported a positive impact. Barriers to the involvement of PLiP coalesced around power differences and prison bureaucracy. Conclusion Given the very high risk of bias arising from the available ‘evaluations’, it was not possible to derive firm conclusions about the effectiveness of PLiP involvement in the research process. In addition, given the state of the evidence base, it was felt that a systematic review would not be feasible until more evaluations were undertaken using a range of methodologies to develop the field further.

scholarly journals Quality improvement through the paradigm of learning

2015 ◽  
Vol 16 (4) ◽  
pp. 195-207 ◽  
Author(s):  
Trish Hafford-Letchfield ◽  
Peter Lavender
Keyword(s):  
Quality Improvement ◽  
Older People ◽  
Social Care ◽  
Care Home ◽  
Care Homes ◽  
Project Staff ◽  
Content Type ◽  
Health And Social Care ◽  
Learning Interventions

Purpose – Achieving meaningful participation and co-production for older people in care requires radical approaches. The purpose of this paper is to explore an innovation where learning interventions were introduced into care settings and older people matched to community-based learning mentors to develop partnerships. The authors explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship-based approach to promote wellbeing. Design/methodology/approach – A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement. Findings – Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support. Originality/value – Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes.

Enjoying the front-line of dementia care: an integrative analysis of what care home staff report makes them happy at work

2014 ◽  
Vol 18 (4) ◽  
pp. 167-175 ◽  
Author(s):  
Jill Manthorpe
Keyword(s):  
Job Satisfaction ◽  
Social Care ◽  
Care Home ◽  
Dementia Care ◽  
Care Homes ◽  
Front Line ◽  
Content Type ◽  
Care Home Staff ◽  
People With Dementia

Purpose – High turnover of staff in the long-term dementia care sector contributes to poor quality care and lack of continuity of care in the UK and many other countries. The purpose of this paper is to explore the research evidence on what care assistants report they enjoy when working in front-line dementia care jobs in long-term care facilities. Design/methodology/approach – An integrative analysis was used to study research findings focusing on the front-line workforce in care homes. The literature review sought to capture key findings, including overviews of research, from studies from 1990 to mid-2014 that have considered the positive experiences of front-line care home staff working with people with dementia. Findings – There is a great deal of research investigating care home staff's job satisfaction. Much of this highlights the importance of personal, social and managerial relationships. Common themes continue to be reported. There is potential for work on improving care assistant experiences in care homes but also a need to address long-standing inequities affecting the care home sector. Research limitations/implications – Some studies are not precise about which staff groups they are investigating in studies about care homes and many concentrate on the problems staff report. Measures of job satisfaction vary. When exploring dementia-related care not all studies are clear if care home residents have dementia or not. Practical implications – Many studies have investigated the views of care assistants working with people with dementia in care homes that address happiness in their work, often reported as job or work satisfaction, and these should be consulted when developing dementia services or managing care homes. As with other parts of the social care workforce, employers and managers need to be aware of effective and acceptable workforce reforms and ways to reduce turnover. Originality/value – This review suggests the value of investigating positive aspects of care work with people with dementia living in care homes. Greater attention could be paid to job satisfaction in social care more widely.

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