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Improving oral health for adults in care homes
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2016
- Pagination:
- 4
- Place of publication:
- London
This quick guide, developed for care home managers and their staff, explains how to achieve good oral health for people who live in care homes. Based on the NICE guideline on oral health for adults in care homes, it covers: how poor oral health can affect people’s ability to eat, speak and socialise normally; how to carry out an oral health assessment; the knowledge and skills care staff need to know to support residents maintain good oral health; and what the Care Quality Commission expects from care homes. The guide includes an oral health assessment tool and provides links to further information. (Edited publisher abstract)
Managing risk, minimising restraint
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2009
- Pagination:
- 6
- Place of publication:
- London
- Edition:
- Updated 2021
This briefing examines the use of restraint in care homes and approaches to minimise its use. It presents some of the learning from a review of the literature on the use of restraint in care homes for older people and an exploration of practice. The briefing looks at what might constitute restraint, whether restraint is ever right, the links between risk and restraint and developing knowledge and skills. Key messages include: many different actions can constitute restraint, ranging from physically holding someone to unintentionally leaving their walking frame out of reach; understanding what restraint is, and the occasions on which it is acceptable, is the first step towards minimising its use – the Mental Capacity Act (2005) provides some clear guidance; using a five-step framework will help with making informed decisions in situations where the use of restraint is being considered – observe, do some detective work, consider the options, implement the plan, monitor and review the plan; supporting residents to take positive risks helps increase their wellbeing as well as reducing reliance on restraint to maintain their safety; talking openly about restraint with residents, relatives and staff will help promote good practice; using the physical environment to promote a sense of wellbeing can help avoid some of the situations that result in the use of restraint; care staff need opportunities to develop their skills and knowledge, and to share learning about how to respond to the challenges they face. [Published: October 2009; Updated April 2021] (Edited publisher abstract)
Developing a minimum data set for older adult care homes in the UK: exploring the concept and defining early core principles
- Authors:
- BURTON Jennifer Kirsty, et al
- Journal article citation:
- Lancet Healthy Longevity, 3(3), 2022, pp.e186-e193.
- Publisher:
- Elsevier
Reforms to social care in response to the COVID-19 pandemic, in the UK and internationally, place data at the heart of proposed innovations and solutions. The principles are not well established of what constitutes core, or minimum, data to support care home residents. Often, what is included privileges data on resident health over day-to-day care priorities and quality of life. This Personal View argues for evidence-based principles on which to base the development of a UK minimum data set (MDS) for care homes. Co-produced work involving care home staff and older people working with stakeholders is required to define and agree the format, content, structure, and operationalisation of the MDS. Implementation decisions will determine the success of the MDS, affecting aspects including data quality, completeness, and usability. Care home staff who collect the data need to benefit from the MDS and see value in their contribution, and residents must derive benefit from data collection and synthesis. (Edited publisher abstract)
Perceptions and experiences of residents and relatives of emergencies in care homes: a systematic review and metasynthesis of qualitative research
- Authors:
- CURTIS Ffion, et al
- Journal article citation:
- Age and Ageing, 50(6), 2021, pp.1925-1934.
- Publisher:
- Oxford University Press
Background: the perceptions and experiences of care home residents and their families are important for understanding and improving the quality of emergency care. Methods: we conducted a systematic review and metasynthesis to understand the perceptions and experiences of care home residents and their family members who experienced medical emergencies in a care home setting. The review protocol was registered in PROSPERO (CRD42020167018). We searched five electronic databases, MEDLINE, CINAHL, PubMed, Cochrane Library and PsycINFO, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of studies included in this review. Results: of the 6,140 references retrieved, 10 studies from four countries (Australia, Canada, UK and USA) were included in the review and metasynthesis. All the included studies were assessed as being of good quality. Through an iterative approach, we developed six analytical themes: (i) infrastructure and process requirements in care homes to prevent and address emergencies; (ii) the decision to transfer to hospital; (iii) experiences of transfer and hospitalisation for older patients; (iv) good communication is vital for desirable outcomes; (v) legal, regulatory and ethical concerns and (vi) trusting relationships enabled residents to feel safe. Conclusions: the emergency care experience for care home residents can be enhanced by ensuring resources, staff capacity and processes for high quality care and trusting relationships between staff, patients and relatives, underpinned by good communication and attention to ethical practice. (Edited publisher abstract)
Care home census for adults in Scotland: figures for 2007-2017 (as at 31 March)
- Author:
- ISD SCOTLAND
- Publisher:
- ISD Scotland
- Publication year:
- 2018
- Pagination:
- 35
- Place of publication:
- Glasgow
This release presents data from the Scottish Care Home Census for adults which takes place on 31 March each year. The care home census form consists of two parts: the first part asks for aggregated data at care home level; the second part of the census form asks for information on individual Long Stay residents only, such as gender, age and health characteristics e.g. dementia. Main points for all adult care homes include: there were 1,142 adult care homes on 31 March 2017, a decrease of 21% compared to 31 March 2007 (1,451); there were 40,926 registered care home places available on 31 March 2017, which is 4% fewer than were available in 2007 (42,653); on 31 March 2017, there were 35,989 adults in care homes, which is 5% lower than in 2007 (37,702); on 31 March 2017, 91% (32,691 out of 35,989) of all care home residents (i.e. long stay, short stay and respite residents) were in Older people care homes. With respect to older people care homes: at 31 March 2017, there were 31,223 long stay residents in care homes for older people, a decrease of 4% compared to 31 March 2007 (32,482); in the same time period, the number of short stay/respite residents in care homes for older people increased by 96% (1,468 compared to 750); the percentage of long stay residents living with dementia (either medically or nonmedically diagnosed) in a care home for older people increased from 54% at 31 March 2007 to 62% at 31 March 2017. (Edited publisher abstract)
Rising from the COVID-19 crisis: policy responses in the long-term care sector
- Author:
- ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2021
- Pagination:
- 13
- Place of publication:
- Paris
This brief looks at mortality rates in care homes, as well as the policy responses undertaken during the Covid-19 pandemic. The brief assesses the emergency preparedness of the sector and highlights the lessons learned, including policies to reduce isolation, testing strategies, care workforce and co-ordination with the health care sector. Key messages include: the long-term care (LTC) sector was generally ill-prepared to tackle a health emergency – deaths in the sector account for 40% of total COVID-19 deaths; most OECD countries banned visitors to LTC facilities and reduced group activities especially during the early months of the outbreak – such restrictions of visitors and group activities had a toll on resident’s well-being; access to testing and personal protective equipment (PPE) in the initial phases of the pandemic was not sufficiently prioritised in the sector; correct identification of symptoms among residents in care homes and staff was limited due to lack of initial knowledge on screening, insufficient access to health professionals and testing availability; high population density in LTC facilities has often been associated with worse outcomes; a higher LTC staffing rate was strongly associated with lower infection and LTC death rates across countries in early 2020; only seven OECD countries generated guidelines for better integration of care services with hospitals and only six improved access to palliative care; going forward, improving LTC preparedness requires an assessment of preparedness at the level of LTC facilities with detailed knowledge of human and material resources and regular actualisation of protocols for different scenarios. In addition, enhancing LTC response to emergencies requires co-ordination channels between public health authorities and the social sector, but also adequate follow-up mechanisms on the strategies undertaken with standardised data on infections and characteristics of facilities and residents. (Edited publisher abstract)
An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial)
- Authors:
- FORSTER Anne, et al
- Journal article citation:
- Age and Ageing, 50(6), 2021, pp.2063-2078.
- Publisher:
- Oxford University Press
Background: Care home (CH) residents are mainly inactive, leading to increased dependency and low mood. Strategies to improve activity are required. Design and setting: Cluster randomised controlled feasibility trial with embedded process and health economic evaluations. Twelve residential CHs in Yorkshire, United Kingdom, were randomised to the MoveMore intervention plus usual care (UC) (n = 5) or UC only (n = 7). Participants: Permanent residents aged ≥65 years. Intervention: MoveMore: a whole home intervention involving all CH staff designed to encourage and support increase in movement of residents. Objectives and measurements: Feasibility objectives relating to recruitment, intervention delivery, data collection and follow-up and safety concerns informed the feasibility of progression to a definitive trial. Data collection at baseline, 3, 6 and 9 months included: participants’ physical function and mobility, perceived health, mood, quality of life, cognitive impairment questionnaires; accelerometry; safety data; intervention implementation. Results: 300 residents were screened; 153 were registered (62 MoveMore; 91 UC). Average cluster size: MoveMore: 12.4 CHs; UC: 13.0 CHs. There were no CH/resident withdrawals. Forty (26.1%) participants were unavailable for follow-up: 28 died (12 MoveMore; 16 UC); 12 moved from the CH. Staff informant/proxy data collection for participants was >80%; data collection from participants was <75%; at 9 months, 65.6% of residents provided valid accelerometer data; two CHs fully, two partially and one failed to implement the intervention. There were no safety concerns. Conclusions: Recruiting CHs and residents was feasible. Intervention implementation and data collection methods need refinement before a definitive trial. There were no safety concerns. (Edited publisher abstract)
Home care market dynamics in England
- Author:
- ALLAN Stephen
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2021
- Pagination:
- 71
- Place of publication:
- Canterbury
This report analyses the extent of the home care market in England, examining the market at a national, regional, local authority (LA) and small area level. Further, the report quantitatively analyses the drivers of supply at small area level and the factors which determined the likelihood of closure of a home care provider. Using data on the number of providers in England for 2014-2018, we found that nationally there was a 15.6% rise in the number of providers, from 7,852 to 9,079. Despite this large level of growth, there was still a lot of turnover of firms. Regionally, the differences in growth of home care supply were stark: East of England, East Midlands, West Midlands and London had very strong growth of over 20%, whilst other regions had limited (South West), no (North West) or even negative (North East) growth. The average LA had 60 providers of home care in 2018, an increase of eight providers from 2014. Growth of home care provision was stronger in LAs with higher supply. Thirty-five LAs, mainly in the North West and North East, had a fall in the number of home care providers and nineteen LAs had a very high growth rate in providers of more than 43.4%. This study also tested and confirmed the following hypotheses, which were developed from theoretical models of supply and probability of closure: 1) that the bigger the market the more the number of firms; 2) that the higher the costs the fewer the number of firms; 3) the higher the quality of a provider the lower the likelihood of closure; and 4) the greater the level of home care competition faced by a provider the greater the likelihood of closure. (Edited publisher abstract)
Hidden lives and deaths: the last months of life of people with intellectual disabilities living in long-term, generic care settings in the UK
- Authors:
- TODD Stuart, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(6), 2021, pp.1489-1498.
- Publisher:
- Wiley
Rationale: This paper concerns mortality and needs for end-of-life care in a population of adults with ID living in generic care homes. Methods: Various sampling strategies were used to identify a difficult to find a population of people with ID in generic care homes. Demographic and health data were obtained for 132 people with ID. This included the Surprise Question. At T2, 12 months later, data were obtained on the survival of this sample. Findings: The average age was 68.6 years, and the majority were women (55.3%). Their health was typically rated as good or better. Responses to the Surprise Question indicated that 23.3% respondents might need EoLC. At T2, 18.0% of this population had died. The average of death was 72.2 years. The majority died within the care setting (62.9%). Implications: The implications for end-of-life care and mortality research are discussed. (Edited publisher abstract)
The experience of animal therapy in residential aged care in New Zealand: a narrative analysis
- Authors:
- WONG Gemma, BREHENY Mary
- Journal article citation:
- Ageing and Society, 41(11), 2021, pp.2641-2659.
- Publisher:
- Cambridge University Press
Animal therapy has been shown to have both physiological and psychological benefits for older people, including improvements in outlook and social interaction. Volunteer-led animal visitation programmes are common within residential aged care facilities in New Zealand. Visits by animals and handlers are intended to improve the quality of life of people in residential care. Very little research has been conducted on the informal animal visitation programmes typical in care facilities in New Zealand. This project examined the experience of animal therapy in two residential aged care homes that receive animal visits from an animal welfare organisation. In-depth interviews were conducted with seven older people about their experiences of the programme and analysed using narrative analysis. Three overarching narratives were identified: animal therapy as a fleeting pleasure, residential care as a sad environment, and identity outside residential care as highly valued. Older people in residential care do value animal therapy, but it is narrated as a fleeting pleasure, rather than having a long-lasting or far-reaching impact on the daily experience of residential care. In some ways, the structure of the animal therapy programme may underscore the challenges to everyday autonomy and identity experienced in residential aged care. These findings can be used to develop animal visiting programmes which recognise the importance of a valued social identity in later life. (Edited publisher abstract)