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Quality of life outcomes for residents and quality ratings of care homes: is there a relationship?
- Authors:
- NETTEN Ann, et al
- Journal article citation:
- Age and Ageing, 41(4), 2012, pp.512-517.
- Publisher:
- Oxford University Press
Background: Quality ratings of care homes are used by decision makers in the absence of direct information about outcomes. However, there is little evidence about the relationship between regulators' ratings of homes and residents' quality of life outcomes. Objectives: To capture social care-related quality of life (SCRQoL) outcomes for residents and investigate the relationship between outcomes and regulator quality ratings of homes. Methods: Data were collected for 366 residents of 83 English care homes for older people inspected during 2008. Outcomes were measured using the Adult Social Care Outcomes Toolkit (ASCOT). Multivariate multilevel modelling was used to investigate the relationship between quality of life outcomes and star ratings of homes, controlling for resident and home characteristics. Results: Care homes were delivering substantial gains in SCRQoL, but were more successful in delivering ‘basic’ (e.g. personal cleanliness) than higher-order domains (e.g. social participation). Outcomes were associated with quality ratings of residential homes but not of nursing homes. Conclusions: The approach to providing quality ratings by the regulator in England is currently under review. Future quality indicators need to demonstrate their relationship with quality of life outcomes if they are to be a reliable guide to commissioners and private individuals purchasing care. (Publisher abstract)
Managing the care home closure process: care manager's experiences and views
- Authors:
- WILLIAMS Jacquette, NETTEN Ann, WARE Patricia
- Journal article citation:
- British Journal of Social Work, 37(5), July 2007, pp.909-924.
- Publisher:
- Oxford University Press
This paper reports case study research that set out to identify what care managers do during independent care home closures. Little research has focused on the way in which care homes for older people are closed in England, or what those involved think about the process. This paper reports the activities and views of care managers directly involved in helping older people relocate from care homes that were closed by their owners. During such closures, residents and their families have no choice but to move, usually to a deadline, and with little control over the process. Care managers have a responsibility to help arrange alternative care for those current residents who are publicly funded, and to offer information and support to those funding their own care (the ‘self-funded’). Closure related activities could involve considerable staff time. Care management arrangements, including the organization of teams and provision of needs assessments, varied across authorities. The care managers described drawing on emotional counselling and inter-personal skills, as well as practitioner knowledge and experience, particularly when offering support and advice about finding appropriate new homes. Tensions between aims, constraints on their actions and views of good practice are identified.
English local authority powers, responsibilities and guidelines for managing the care home closure process
- Authors:
- WILLIAMS Jacquette, NETTEN Ann
- Journal article citation:
- British Journal of Social Work, 35(6), September 2005, pp.921-936.
- Publisher:
- Oxford University Press
In England, the majority of older people living in care homes are publicly funded and the majority of publicly funded places are purchased from the independent sector. While the sector is subject to regulation, there is currently no statutory guidance aimed specifically at how care home closures are managed. This article reviews the powers and responsibilities of councils and the rights of residents during care home closures, before describing the prevalence and content of existing council guidelines. Just over a third of councils in England responded to inquiries and, of these, two-thirds reported having guidelines. This suggests that a considerable proportion of councils have no guidelines in place. Existing guidelines also varied. Differences included approaches to allocating responsibilities and providing help, and assessment to self-funding residents. The large number of arrangements and activities described suggest that some sort of plan or guidance is warranted to support the task of front line care managers. At the national level, the variation found in the guidelines combined with the lack of national guidance specific to closures suggests that clarification of councils’ legal responsibilities and powers during a care home closure is needed.
Guidelines for the closure of care homes for older people: prevalence and content of local government protocols
- Authors:
- WILLIAMS Jaquetta, NETTEN Ann
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2003
- Pagination:
- 38p.
- Place of publication:
- Canterbury
The rise in the number of care home closures in recent years has raised concerns about the way in which residents and their relatives and carers are being affected by such relocation and the way in which it is managed. Currently there is no statutory guidance in England aimed specifically at the way in which care homes close.. This paper presents a review of local government guidelines and protocols for the closure of care homes for older people. The objectives of the study were to identify the prevalence of written guidelines and the nature of existing principles and recommendations for good practice. Thirty-three documents were analysed to identify their purpose and scope, the ways in which roles and responsibilities were defined and allocated, and suggestions and recommendations for good practice.
The cost implications of the changing population and characteristics of care homes
- Authors:
- DARTON Robin, NETTEN Ann, FORDER Julien
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.236-243.
- Publisher:
- Wiley
A survey of care homes for older people was conducted in 21 local authorities in England in 1996. A complete response was obtained for 618 homes (75%) and 11,900 residents. Findings were compared with surveys conducted in 1986 and 1988. Dependency was significantly related to prices, primarily due to the differential payments to nursing and residential homes. Home characteristics were also related to price, the proportion of single rooms having the largest impact. However, prices were most sensitive to local wage rates, particularly in residential homes. Compared with previous surveys levels of dependency had increased, particularly in voluntary residential homes and nursing homes. Independent homes were more likely to be purpose built, and a higher proportion of beds were in single rooms, although only 30% of private residential, dual registered and nursing homes achieved the proposed level of 80% of beds in single rooms. Staffing ratios appeared to have increased, but price rises were modest, particularly for nursing homes.
Closures of care homes for older people; February 2002
- Authors:
- NETTEN Ann, DARTON Robin, WILLIAMS Jaquetta
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2002
- Pagination:
- 4p.
- Place of publication:
- Canterbury
Summarises research commissioned from the Department of Health investigating the causes processes and consequences of the increased number of closures of care homes for older people. The research aims to identify the rates of closures, the types of homes that are closing, and the circumstances that lead up to closure.
Residential or nursing home care? The appropriateness of placement decisions
- Authors:
- NETTEN Ann, et al
- Journal article citation:
- Ageing and Society, 21(1), January 2001, pp.3-23.
- Publisher:
- Cambridge University Press
Routinely-collected statistics show considerable variation between local authorities in Great Britain, in the proportions of supported residents placed in nursing and residential care. This raises the question of whether this is due to variations in demand supply or policy. Data were used from a national longitudinal survey of individuals admitted to publicly-funded residential and nursing home care. This article examines the pattern of admissions, the characteristics of people admitted and the relationship between these characteristics and admissions to residential and nursing home care.
Residential care for elderly people: an exploratory study in quality measurement
- Authors:
- SCHNEIDER Justine, MANN Anthony, NETTEN Ann
- Journal article citation:
- Mental Health Research Review, 4, April 1997, pp.12-15.
- Publisher:
- Personal Social Services Research Unit
Summarises the findings of a study to identify and test a number of possible measures of quality of care in residential homes. No definition of quality was adopted prior to the study, but the perspectives of residents, health and social care professionals, home staff, managers, and relatives were addressed. Goes on to put forward some policy implications drawn from the results of the survey.
The effect of design of residential homes in creating dependency among confused elderly residents: a study of elderly demented residents and their ability to find their way around homes for the elderly
- Author:
- NETTEN Ann
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 1987
- Pagination:
- 12p., tables, diags., bibliog.
- Place of publication:
- Canterbury
Reports on a study of 13 homes for the elderly which examined the effect of the environment on residents. It was noted that group homes provided a more favourable design, and 'meaningful points' could be seen as an aid to residents.
Measuring the outcomes of care homes: final report
- Authors:
- NETTEN Ann, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2010
- Pagination:
- 117p., bibliog.
- Place of publication:
- Canterbury
The authors report on a project which developed and tested an approach to measuring and monitoring outcomes of the care and support provided to residents of care homes for older people and people with learning disabilities. The research was part of the ‘Measuring Outcomes for Public Service Users’ (MOPSU) project, which was funded by the Treasury under the Invest to Save budget and led by the Office for National Statistics (ONS). The domains that comprise social care related quality of life (SCRQOL) formed the basis of the measures used in the study.