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A different ending: addressing inequalities in end of life care: people with dementia

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2016
Pagination:
4
Place of publication:
Newcastle upon Tyne

This document outlines the experience of people with dementia of barriers to good end of life care. The report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. The review supports existing evidence that there are a number of barriers that prevent people with dementia receiving good end of life care, including lack of identification and planning, unequal access to care, and poor quality of care. The Care Quality Commission encourages health professionals, including GPs, to facilitate early conversations with people with dementia and those who are important to them about their wishes and choices for end of life care, and help them to contribute to an advance care plan wherever possible; commissioners and providers to make sure that staff have the training and support they need to care for people with dementia who are approaching the end of life, and to understand and implement the requirements of the Mental Capacity Act 2005; and hospices to consider to what extent they are meeting the end of life care needs of people with dementia, and take action where required in line with our definition of good end of life care in hospice services. (Edited publisher abstract)

Book Full text available online for free

Stoke-on-Trent: local system review report: Health and Wellbeing Board

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2017
Pagination:
42
Place of publication:
Newcastle upon Tyne

One of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs. The reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This resulted in people finding it difficult to access GP appointments, older people being delayed in hospital, and needs and care packages in the community not being reviewed as regularly as they should be. The review also identifies areas for improvement. (Edited publisher abstract)

Book Full text available online for free

Bracknell Forest: local system review report: Health and Wellbeing Board

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2017
Pagination:
42
Place of publication:
Newcastle upon Tyne

One of 20 targeted local system reviews looking at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that the health and social care system in Bracknell Forest was working effectively with an integrated approach that was having positive outcomes for older people, with most older people receiving good quality health and social care services in a timely way. Reviewers found evidence of strong strategic leadership between Bracknell Forest Council, Bracknell and Ascot Clinical Commissioning Group and providers, with a well-established, collaborative approach to designing and delivering services. Bracknell Forest service priorities included helping older people avoid unnecessary admissions to hospital, offering older people support to stay well, and improving the capacity of homecare agencies and care homes to manage the recruitment challenges. As a result, there had been reductions the numbers of people remaining in hospital while they waited for their ongoing care to be arranged. Performance had improved and was better than comparator and national averages.The review also identifies areas for improvement. (Edited publisher abstract)

Book Full text available online for free

Halton: local system review report: Health and Wellbeing Board

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2017
Pagination:
35
Place of publication:
Newcastle upon Tyne

One of 20 targeted reviews of local authority areas looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that there was a strong commitment and a shared vision across the local authority and the clinical commissioning group (CCG) to serve the people of Halton well. There was a positive approach in Halton to maintain people’s health and wellbeing in their own homes, with services designed for older people to keep them socially included, active and able to manage their long term conditions. There was good support for carers including those supporting people living with dementia. Halton had also recently introduced new services introduced to avoid hospital admissions, including a rapid seven-day re-ablement service and a rapid clinical assessment team. Transformation projects for care homes and domiciliary care were underway so that people’s individual needs could be met in a timely way. This had led to a reduction in the numbers of delayed transfers of care and improvements in performance. The review also identifies areas for improvement (Edited publisher abstract)

Book Full text available online for free

A different ending: addressing inequalities in end of life care: lesbian, gay, bisexual or transgender people

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2016
Pagination:
4
Place of publication:
Newcastle upon Tyne

This document outlines the barriers to good end of life care experienced by lesbian, gay, bisexual or transgender people. The report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. Although LGBT people experience a higher incidence of life-limiting illness, their experience of care at the end of life has often been overlooked. Evidence shows that discrimination continues to have an adverse impact on people’s access, needs and experience of services. The review found limited evidence of services proactively engaging with LGBT people or specifically considering their needs, although LGBT people were represented in forums or consultations in some areas. LGBT people who took part in the review spoke about their fear of discrimination, which led to some older people hiding their sexual orientation or gender identity, while some same sex couples could feel inhibited and unable to comfort their partner physically in a hospital environment. LGBT people sometimes felt that staff made assumptions about their preferences so they were less able to make choices. They also felt that their partners were sometimes not involved in their care in the same way that a heterosexual partner would be. However, for some LGBT people end of life care they received was good. Some people felt respected, and sexual orientation or gender identity were not felt to be an issue. The Care Quality Commission encourages commissioners, providers and health and care staff to consider the needs of LGBT people in planning and delivering end of life care services; health and care staff to communicate openly and sensitively about sexual orientation and gender identity as a routine part of their delivering good quality, personalised end of life care; and commissioners and providers to collect data on sexual orientation and gender identity as part of an equalities approach to monitoring end of life care outcomes. (Edited publisher abstract)

Book Full text available online for free

A different ending: addressing inequalities in end of life care: older people

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2016
Pagination:
3
Place of publication:
Newcastle upon Tyne

Provides detailed information on older people’s experiences of end of life care. This report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. The review shows that older people’s experiences of end of life care are mixed, and the document focuses in particular on: staff attitudes; personalised care; and training and support for staff. The document sets out two key recommendations: commissioners and providers to develop systems to support care homes to care for people well at the end of life - to help reduce avoidable hospital admissions and to enable people to die where they choose; and commissioners and providers to make sure that staff who care for people who are likely to be approaching the end of life in any setting to have appropriate training and support to enable them to care for people approaching the end of life. (Edited publisher abstract)

Book Full text available online for free

Time to listen in care homes: dignity and nutrition inspection programme 2012

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2013
Pagination:
40
Place of publication:
Newcastle upon Tyne

Report of an inspection of 500 care homes, which were inspected on five standards: respecting and involving people who use services; meeting their nutritional needs; safeguarding them from abuse; staffing; and records. Almost two-thirds (316) of the homes inspected met all the standards checked. This meant that staff were respecting and involving people and that people’s nutritional needs were being met. To support this, homes had enough skilled and knowledgeable staff, they had taken steps to protect people from the risk of abuse, and they kept accurate records to support people’s care. However, people living in one in six of the care homes (80 homes) did not always have their privacy and dignity respected or were not involved in their own care. All the inspections were unannounced, each scheduled to include a mealtime. Excerpts from individual inspection reports illustrate what worked well and what needed to improve. (Original abstract)

Book Full text available online for free

Time to listen in care homes: dignity and nutrition inspection programme 2012: summary

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2013
Pagination:
5
Place of publication:
Newcastle upon Tyne

Report of an inspection of 500 care homes. Almost two-thirds (316) of the homes inspected met all the standards checked. This meant that staff were respecting and involving people and that people’s nutritional needs were being met. To support this, homes had enough skilled and knowledgeable staff, they had taken steps to protect people from the risk of abuse, and they kept accurate records to support people’s care. However, People living in one in six of the care homes (80 homes) did not always have their privacy and dignity respected or were not involved in their own care. (Edited publisher abstract)

Book Full text available online for free

Time to listen in NHS hospitals: dignity and nutrition inspection programme 2012

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2013
Pagination:
37
Place of publication:
Newcastle upon Tyne

Comparing the results of the 2011 dignity and nutrition review with these latest findings, the inspectors found that more hospitals were meeting people’s nutritional needs. However, fewer hospitals were treating patients with dignity and respect. 50 hospitals were inspected against five standards: respecting and involving people; meeting their nutritional needs; safeguarding them from abuse; staffing; and records. 33 hospitals were meeting all five standards. At the other end of the scale, three hospitals were meeting just two of the five standards, one hospital was meeting only one and one was not meeting any. (Original abstract)

Book Full text available online for free

Time to listen in NHS hospitals: dignity and nutrition inspection programme 2012: summary

Author:
CARE QUALITY COMMISSION
Publisher:
Care Quality Commission
Publication year:
2013
Pagination:
5
Place of publication:
Newcastle upon Tyne

This inspection report compares the results of the 2011 dignity and nutrition review with the 2012 findings. The main findings are that more hospitals are meeting people’s nutritional needs but there are fewer hospitals where patients are always treated with dignity and their privacy and independence respected. (Original abstract)

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