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A hindrance or a help? The contribution of inspection to the quality of care in homes for older people
- Author:
- FURNESS Shelia
- Journal article citation:
- British Journal of Social Work, 39(3), April 2009, pp.488-505.
- Publisher:
- Oxford University Press
There has been no real attempt to explore the contribution and effectiveness of inspection as a catalyst for change and improving service provision. In England the Government is currently reviewing the way that one regulatory body, the Commission for Social Care Inspection (CSCI), operates and carries out its inspection functions in relation to care homes for older people. This article reports on a study carried out in 2004 that asked managers of care homes for older people about their views and experiences of inspection and ways to improve the process. The findings endorse inspection as a necessary intervention. Managers identified that the main purposes of inspection were: to ensure the well-being of residents; to achieve or comply with standards; to check that the home was running properly and to act as a double check against the homes own audits. The two most useful aspects of inspection were as a means of providing feedback and as support and guidance to managers. The expertise of the inspector needs to be better deployed to drive up standards of care and maximise their influence to promote an improvement in services and innovation in practice.
Risky business
- Author:
- COCKBURN Barbara
- Journal article citation:
- Care and Health Magazine, 3.05.05, 2005, pp.18-21.
- Publisher:
- Care and Health
As he stands down as head of the Social Care Association, Dick Cough explains to the author that a change in attitude from senior managers in residential care is desperately needed.
Social care managers and care workers’ understandings of personalisation in older people’s services
- Authors:
- STEVENS Martin, et al
- Journal article citation:
- Working with Older People, 23(1), 2019, pp.37-45.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the impact of personalisation policy on the providers of social care services in England, mainly to older people, within the context of austerity and different conceptions of personalisation. Design/methodology/approach: The paper draws on part of a longitudinal study of the care workforce, which involved 188 interviews with managers and staff, undertaken in two rounds. Findings: Four themes were identified: changing understandings and awareness of personalisation; adapting services to fit new requirements; differences in contracting; and the impact on business viability. Research limitations/implications: The paper reflects a second look at the data focussing on a particular theme, which was not the focus of the research study. Furthermore, the data were gathered from self-selecting participants working in services in four contrasting areas, rather than a representative sample. Practical implications: The research raises questions about the impact of a commercial model of “personalised care”, involving personal budgets (PBs) and spot contracts, on the stability of social care markets. Without a pluralistic, well-funded and vibrant social care market, it is hard to increase the consumer choice of services from a range of possible providers and, therefore, fulfil the government’s purposes for personalisation, particularly in a context of falling revenues from local authorities. Originality/value: The research presents an analysis of interviews with care providers and care workers mainly working with older people. Their views on personalisation have not often been considered in contrast to the sizeable literature on PBs recipients and social workers. (Edited publisher abstract)
Care home manager attitudes to balancing risk and autonomy for residents with dementia
- Authors:
- EVANS Elizabeth A., et al
- Journal article citation:
- Aging and Mental Health, 22(2), 2018, pp.261-269.
- Publisher:
- Taylor and Francis
Objective: To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Method: Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. Results: There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents’ dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. Conclusion: There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers. (Publisher abstract)
Developing inclusive care homes for older people who identify as lesbian, gay, bisexual and trans (LGBT)
- Authors:
- WILLIS Paul, et al
- Publisher:
- University of Bristol. Policy Bristol
- Publication year:
- 2017
- Pagination:
- 2
- Place of publication:
- Bristol
Briefly reports on an action research project which worked with a large care home provider and six care homes in England to increase awareness amongst staff about sexual and gender diversity and social inclusion. The research took a co-productive approach by recruiting eight volunteer LGBT Community Advisors (CAs) who engaged in sensitive, and sometimes personally challenging conversations with staff and managers. The evaluation found evidence of improved awareness by managers and staff during and after the three month intervention. The briefing highlights key implications for policy in relation to developing inclusive care homes. (Edited publisher abstract)
How do handovers happen? A study of handover-at-shift changeovers in care homes for older people
- Authors:
- NORRIE Caroline, et al
- Publisher:
- King's College London. Social Care Workforce Research Unit
- Publication year:
- 2017
- Pagination:
- 33
- Place of publication:
- London
Based on interviews and observations with staff in five care homes in England, this research, funded by the Abbeyfield Research Foundation, investigates the content, purpose and effectiveness of the handover of information about older residents exchanged between care staff coming off and coming on duty. It also looks at what seems to be the most important things to take into account when organising shift changeovers in care homes. The research carried out observations of 12 handovers and interviews with 30 members of staff. Descriptions of handover practices are reported under the areas of: timing and duration; who hands over to whom, and who participates; location; and content. The research identified he importance that all staff groups placed on the handover. Care assistants emphasised handovers as crucial preparation for going on duty and ensuring the safety of residents. Managers and nurses also reported their importance for team-building, staff management and staff education. Key elements of a successful handover reported included: clear communication; being able to hear and lack of distractions; punctuality of staff; transparent and readily available written records opportunity to ask questions; and respecting the confidentiality and dignity of residents. Although practices varied across care homes, the researchers suggest that residents’ wellbeing is consistently a primary concern for many frontline staff and their immediate managers. (Edited publisher abstract)
CMHTs for older people: team managers’ views surveyed
- Authors:
- ABENDSTERN Michele, et al
- Journal article citation:
- Journal of Integrated Care, 22(5/6), 2014, pp.209-219.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to identify features of community mental health teams (CMHTs) for older people valued by their managers, and those they would most like to change. Design/methodology/approach: Content analysis was used to analyse “free text” responses to open questions from a national survey about CMHTs’ organisational structures and processes. Responses were sorted into statements which were categorised into content areas and higher level dimensions. Findings: Free text information was provided by 376 teams (an 88 per cent response rate). Eight higher level dimensions were identified. One related specifically to integration with social care services, whilst several more included material about other aspects of intra-team integration (e.g. documentation and location). The largest proportion of statements related to staffing and teamwork. Statements about inter-personal and inter-professional issues were largely positive, whilst statements about resources, bureaucracy and integration with social care services typically detailed desired changes. Practical implications: Four key issues emerged comprising a high level of support from managers to develop integrated practices; a need to define the focus of CMHTs for older people and to be fully resourced; and the importance of a nurturing and supportive team environment. Originality/value: The methodology provides a bridge between qualitative and quantitative research, exploring the volume of statements on particular topics and their meaning. (Publisher abstract)
The impact of sexuality on the assessment of care needs and the delivery of care to older lesbians living in residential care homes in Bradford and Calderdale: a research project by Labrys Trust
- Authors:
- WALKER Rosemary, et al
- Publisher:
- Labrys Trust
- Publication year:
- 2013
- Pagination:
- 61
- Place of publication:
- Bradford
This study presents the findings of a fifteen-month research project exploring the attitudes and current practices to the assessment of the care needs and the delivery of care to older lesbians in care homes in Bradford and Calderdale. The methods used were a literature review, questionnaires to care home managers and care staff, followed by interviews with care managers and care staff. A total of six managers and 15 staff questionnaires were returned. The literature survey identified care needs which may be specific to older lesbians and different from the needs of their heterosexual counterparts. The survey found a poor understanding of the differences that set older lesbians apart from their heterosexual counterparts, and no awareness that this may impact on the assessment of care needs. As a result, older lesbians are likely to be disadvantaged in a system that can both fail to meet their needs and acknowledge their individual identity. The assessment of care needs did not facilitate the identification of sexual orientation and the delivery of care did not provide for the social and emotional wellbeing of an older lesbian in the care home system. The research was supported by funding from the NHS National End of Life Care Programme. (Edited publisher abstract)
Staff responses to age-related health changes in people with an intellectual disability in group homes
- Authors:
- WEBBER Ruth, BOWERS Barbara, MCKENZIE-GREEN Barbara
- Journal article citation:
- Disability and Society, 25(6), October 2010, pp.657-671.
- Publisher:
- Taylor and Francis
The purpose of this study was to explore how supervisors in group homes caring for people with intellectual disability responded to the development of age-related health changes in their residents. It examined how staff in Victoria, Australia, viewed age-related changes, how they decided when a resident should go to residential aged care, and how they supported people who stayed despite significant age-related health problems. Information from in-depth interviews with 10 group home supervisors working in the disability sector was analysed using dimensional analysis. The article discusses factors related to care including resident health characteristics, resources, skills and comfort level of supervisors, ability to navigate health and disability sector rules and regulations, and concern about impact on other residents. The findings from the study suggested that group home supervisors are the primary decision-makers about whether residents can remain in the group home or will be relocated to residential aged care, and that although supervisors consistently expressed the belief that, at some point, residents with serious health conditions may require more intensive or skilled care, there was less consistency in their views about the criteria determining when a resident can no longer be accommodated in the home.
Bringing assisted living services into congregate housing: housing directors' perspectives
- Authors:
- SHEEHAN Nancy W., OAKES Claudia E.
- Journal article citation:
- Journal of Aging and Social Policy, 18(1), 2006, pp.65-86.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
The purpose of this research is to explore the impact of an Assisted Living Services (ALS) program on directors of state-funded congregate housing in the United States. Using focus groups, the authors interviewed congregate housing directors about how adding the ALS program to their facilities impacted their management experiences. Four themes emerged from the analysis of the focus group data: (1) importance of assisted living services for promoting aging in place; (2) “costs” of offering ALS; (3) differences in how the ALS program was implemented; and (4) organizational issues emerging from the merger of housing and health-care models. The authors propose a number of policy issues that need to be addressed when services are added to existing housing.