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Factors associated with higher quality assessment tools in care homes
- Authors:
- WORDEN Angela, CHALLIS David
- Journal article citation:
- Journal of Care Services Management, 2(1), October 2007, pp.79-91.
- Publisher:
- Taylor and Francis
This paper investigates the relationship between the quality of assessment tools used in care homes and the different characteristics of care homes in part of North-West England. Using both single variable comparisons and multivariate analyses there were several home characteristics associated with the use of higher-quality assessment tools. Higher-quality assessment process were associated with homes being larger, part of a group or chain, provision of staff training and run by non-for-profit organisation or local authority. Poorer quality of assessment was associated with inspection reports indicating lower standards of management and staffing and generally poorer quality of the home. The findings raise the question as to whether government initiatives to improve assessment of older people should be extended to care homes, with a need to focus on certain types of home where assessment is less likely to be well developed.
Assessing care home quality using routine regulatory information
- Authors:
- WORDEN Angela, CHALLIS David
- Journal article citation:
- Quality in Ageing, 7(3), September 2006, pp.33-44.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Quality is an essential criterion by which care homes for older people are judged. However, the measurement of quality is both challenging and potentially costly. This article examines the potential of using routinely generated data from inspection processes as quality indicators. Eight key areas are identified: leadership, activity, meals services, health, staffing, size of homes, environment and quality of life. It indicates that generation of such information is possible, providing material that may be used in research and also for more general guidance.
Assessment in continuing care homes: towards a national standard instrument
- Authors:
- CHALLIS David, CARPENTER Iain, TRASKE Karen
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 1996
- Pagination:
- 94p.,tables,bibliog.
- Place of publication:
- Canterbury
Report from a study examining the role of assessment in continuing care homes for older people, including a review of relevant care systems, procedures and documents in the UK and elsewhere. Assessment of quality in residential settings currently focuses on standards measuring regime, staff quality and casemix using aggregated home level information, but there is very little individual care plan or resident focus to quality assurance. Concludes that what is needed is a single instrument, the Minimum Data Set/Resident Assessment Instrument developed in the United States, to measure all the aspects of care home life.
The development of a national standard assessment instrument for use in continuing care homes
- Authors:
- CHALLIS David, et al
- Journal article citation:
- Care Plan, 5(3), March 1999, pp.19-21.
- Publisher:
- Positive Publications/ Anglia Polytechnic University, Faculty of Health and Social Work
This study examines the possibility of developing a standard assessment instrument for residents in care homes, which could assess individual care needs, assist in constructing care plans and help to cost the level of care provided. Staff used a modified American Minimum Data Set/Resident Assessment Instrument in the pilot study. This showed that the MDS/RAI has the potential to be used in continuing care homes in the UK.
The development of a national standard assessment instrument for use in continuing care homes
- Authors:
- CHALLIS David, et al
- Journal article citation:
- Working with Older People, 3(2), April 1999, pp.24-26.
- Publisher:
- Emerald
Following a focused training programme in eight homes, staff using a modified American Minimum Data Set/Resident Assessment Instrument carried out 125 assessments. The pilot study found that the MDS/RAI has potential to be used in continuing care homes in the UK. Reports on a study to examine the possibility of developing a standard assessment instrument for residents in care homes, which could assess individual care needs, assist in constructing care plans and provide appropriate information to permit costing the level of care provided.
The potential impact of changes in public funding for residential and nursing-home care in the United Kingdom: the Residential Allowance
- Authors:
- CLARKSON Paul, HUGHES Jane, CHALLIS David
- Journal article citation:
- Ageing and Society, 25(2), March 2005, pp.159-180.
- Publisher:
- Cambridge University Press
The pursuit of independence and avoidance of unnecessary care-home admissions are key elements of British government policy for the care of older people. The present government's objective to maintain independence has been compromised by the ‘Residential Allowance’ which, as a component of social security payable to residents in independent-sector homes, could be seen as an incentive to place people in care-homes rather than seek care-at-home. In order to remove this incentive, the government proposed to abolish the allowance and instead transfer resources by a grant to local authorities. This was intended to promote independence by making available funds with which social services departments could support domiciliary care. This paper examines the potential impact of the proposal from the perspective of front line practitioners and managers. Calculations of the proposal's likely effects in five authorities were made from a simulation of their usual decision-making processes. The results, applied to the national picture, showed only a marginal effect of the change upon admissions to care homes. The potential effect of the change in diverting admissions from care homes was seen to be hampered by organisational influences which vary between authorities.
Recruitment and retention of a social care workforce for older people
- Authors:
- HUGHES Jane, CHESTER Helen, CHALLIS David
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2009
- Pagination:
- 165p., bibliog.
- Place of publication:
- Manchester
This report describes the findings from the first of a three phase research project to identify factors within local authority commissioning, contracting and care management arrangements which influence the recruitment and retention of staff in domiciliary services and care homes. The first chapter outlines the policy context shaping commissioning and contracting arrangements and presents the findings of a selective literature review. Following chapters describe the methodology of the study, which included a postal survey was sent to local authorities with social services responsibilities. Ninety two of a total of 149 were returned. The findings describe the current arrangements and present the findings from the national survey. A typology of local authority and commissioning arrangements for older peoples services are then presented. Includes extensive tables and figures. The study was funded by the Department of Health under the Social Care Workforce Research Initiative.
Public funding for residential and nursing home care: projection of the potential impact of proposals to change the residential allowance in services for older people
- Authors:
- CLARKSON Paul, HUGHES Jane, CHALLIS David
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.211-216.
- Publisher:
- Wiley
This article investigates the potential effects of a policy change in the funding of UK residential care. The White Paper "Modernising Social Services " outlined plans to change the distribution of the Residential Allowance (RA), payable in support of residents in independent residential or nursing home care, from a component of income support paid direct to establishments to a grant to local authorities. This change was intended to remove the incentive in accessing independent residential care more favourably than local authority care. A further objective was to encourage local authorities to use the grant to support home-based alternatives to residential care. The policy rests on a model in which price signals dictate the choice of care for an older person. By, in effect, raising the price of independent residential and nursing home care, the policy provides an incentive for authorities to seek alternatives to institutional care. The study indicated that wider organisational factors other than price are likely to play a greater role in deciding whether an older person is admitted to care. Changes in public funding alone do not reflect the complexities involved in decision-making concerning the residential placement of older people.
Policy, organisation and practice of specialist old age psychiatry in England
- Authors:
- CHALLIS David, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(11), November 2002, pp.1018-1026.
- Publisher:
- Wiley
The aim of this article is to describe and compare service arrangements in old age psychiatry across England according to three broad domains: levels of professional autonomy; degree of community orientation (delivery of and links with community services) and degree of integration between health and social care provision. The findings indicate that there is marked variation in the deployment and use of professional staff in old age psychiatry, ranging from open access to multidisciplinary assessment to services only accessible by clinician referral. Patterns of linkage with primary care are likewise variable with only half of services providing the types of support recommended by the Audit Commission. Community orientation was evident to a considerable extent in support to care homes and assessment practices. Links between health and social care appeared strongest in terms of liaison and training. There was less evidence of more formal integration through shared management of staff or for links with intensive home support for those with dementia.