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Addressing the nutritional needs of older people in residential care homes
- Authors:
- MERRELL Joy, et al
- Journal article citation:
- Health and Social Care in the Community, 20(2), March 2012, pp.208-215.
- Publisher:
- Wiley
Malnutrition in older people is a significant and continuing problem. The aim of this qualitative study was to explore the factors that influence the nutritional care provided to residents in 2 different types of residential care homes. There is concern that national guidelines regarding the nutritional care of older people in residential care homes are not always implemented. One of the homes had communal dining rooms, and the other had 8 bedded units with their own kitchen and dining facilities. The sample of 45 participants comprised 19 staff (managers, care and catering staff), 16 residents and 10 residents’ relatives. Data were collected using semi-structured interviews, focus groups, observation and documentary review. This paper focuses on the findings relating to how the staff assessed and addressed residents’ nutritional needs. In both care homes, staff strove to be responsive to residents’ dietary preferences, working in partnership with residents and their families to provide nutritious food in a homely environment. Neither home conducted nutritional screening to identify those at risk of malnutrition, but relied on ad hoc observation and monitoring. The staff’s knowledge of special dietary needs was limited. A need for further training for care home staff regarding the importance of nutrition in maintaining health in older people and the use of nutritional screening was identified.
Relational practice as the key to ensuring quality care for frail older people: discharge planning as a case example
- Authors:
- WILLIAMS Sion, NOLAN Mike, KEADY John
- Journal article citation:
- Quality in Ageing, 10(3), September 2009, pp.45-55.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Discharging frail older people from acute hospital settings has been an issue of concern for over 40 years and recent studies suggest that enduring problems remain. This paper explores the experiences of discharge from three different units: an acute surgical ward, an acute medical ward and a specialist ward for older people. Based on extensive data from interviews with older people, their family carers and ward-based staff, a grounded theory of the discharge experience is presented. This suggests that the quality of discharge hinges largely on whether the focus of efforts is on ‘pace’ (the desire to discharge older people as rapidly as possible) or ‘complexity’ (where due account is taken of the complex interaction of medical and wider social issues). When pace is the focus, ‘pushing’ and ‘fixing’ are the main processes driving discharge. However, when attention is given to complexity, far more subtle processes of ‘informing’ and ‘brokering’ are in evidence. These latter processes are conceived of as forms of ‘relational practice’ and it is argued that such practices lie at the heart of high quality care for older people.
cARTrefu: creating artists in residents. A national arts in care homes participatory and mentoring programme. Evaluation report 2015-2017
- Authors:
- ALGAR-SKAIFE K., CAULFIELD M., WOODS B.
- Publisher:
- Bangor University
- Publication year:
- 2017
- Pagination:
- 98
- Place of publication:
- Bangor
An evaluation of the cARTrefu project, which aimed to increase opportunities for care home residents and staff to participate in the arts and to develop mentor artists to deliver sessions for older people in care homes across Wales. The evaluation report provides information on the impact of cARTrefu, the mentoring process, provides tips for delivering an art residency, and identifies challenges and recommendations for future projects. The results of the evaluation found that involvement in a cARTrefu art residency had: significantly improved the well-being of care home residents; significantly improved the attitudes of care staff and artist practitioners towards residents, especially those with dementia; and significantly improved the confidence of care staff to lead sessions in the home. cARTrefu also influenced the likelihood of care staff to engage in creative and cultural activities both outside of work and with residents. (Edited publisher abstract)
Working for a shared common purpose: experiences of health and social care integration in Wales
- Authors:
- UNIVERSITY OF SOUTH WALES. Welsh Institute for Health and Social Care, LLEWELLYN Mark, et al
- Publisher:
- UNISON Cymu/Wales
- Publication year:
- 2018
- Pagination:
- 76
- Place of publication:
- Cardiff
This report, commissioned by the trade union UNISON and conducted by researchers at the Welsh Institute for Health and Social Care, looks at the current experience of the integration of health and social care integration in Wales. It provides insights from three case study locations working to achieve the integration of services for older people in Monmouthshire, Bridgend and Anglesey, conducting interviews with front-line workers and strategic leaders. The report also provides information on the legislative and policy context in Wales and summarises findings from a short literature review. It identifies a number of factors which enable excellence in integrated care. These include: that care should be focused on the needs of the individual; strong and clear leadership; involvement and empowerment of care staff; support and training for care workers; view integration as an opportunity to improve services rather than a cost saving venture. It also highlights the role of trade unions in supporting staff through change and acting as joint leaders of the integration agenda. A list of examples of integration in Wales are included in the appendices. (Edited publisher abstract)
‘Everyday advocates’ for inclusive care? Perspectives on enhancing the provision of long-term care services for older lesbian, gay and bisexual adults in Wales
- Authors:
- WILLIS Paul, et al
- Journal article citation:
- British Journal of Social Work, 47(2), 2017, pp.409-426.
- Publisher:
- Oxford University Press
This paper centres on a neglected area of social work with older people - the social inclusion of older lesbian, gay and bisexual (LGB) adults in long-term care environments. The translation of equality law into the delivery of adult care services is a challenging endeavour for organisations, even more so in the morally contested terrain of sexual well-being. This report presents findings from a mixed-methods study into the provision of long-term care for older adults who identify as lesbian, gay and bisexual (LGB). Herein we present findings from a survey of care workers and managers (n = 121) and from focus groups with equality and LGB stakeholder representatives (n = 20) in Wales. Focusing on the current knowledge and understanding of staff, the authors suggest that affirmative beliefs and practices with sexual minorities are evident amongst care workers and managers; however, the inclusion of LGB residents needs to be advanced systemically at structural, cultural and individual levels of provision. There is a need for enhancing awareness of the legacy of enduring discrimination for older LGB people, for cultural acceptance in care environments of older people's sexual desires and relationships, and for a more explicit implementation of equality legislation. Social workers in adult care can advance this agenda. (Edited publisher abstract)
Meeting the health needs of older people with intellectual disabilities: exploring the experiences of residential social care staff
- Authors:
- NORTHWAY Ruth, HOLLAND-HART Daniella, JENKINS Robert
- Journal article citation:
- Health and Social Care in the Community, 25(3), 2017, pp.923-931.
- Publisher:
- Wiley
Older people with intellectual disabilities often experience high levels of health needs and multiple morbidities but they may be supported by residential care staff with little or no previous experience of identifying and meeting health needs. Little is known regarding how they undertake this health-related role and this exploratory study seeks to address this gap. A purposive sample of 14 managers of supported living accommodation in Wales were interviewed in 2014 to determine their experiences of supporting tenants in relation to age-related health needs. The semi-structured interviews were transcribed and thematically analysed. Three of the emerging themes are reported in this paper: meeting health needs, the consequences of ageing and relationships. Findings indicate that residential care staff support older people with intellectual disabilities with complex and multiple health needs: they monitor health status, support access to healthcare, provide additional support arising from changing health needs and advocate for tenants in the context of healthcare. However, their role is often not understood by healthcare professionals. The importance of staff having a long-term relationship with those they support was identified as being important to identifying any health-related changes. The need to develop effective relationships with healthcare staff was also noted. It is concluded that there is a need for better understanding among health staff of the role of residential social care workers and for further research regarding health-related communication. (Publisher abstract)
The homecare deficit: a report on the funding of older people's homecare across the United Kingdom
- Author:
- UNITED KINGDOM HOMECARE ASSOCIATION
- Publisher:
- United Kingdom Homecare Association
- Publication year:
- 2015
- Pagination:
- 56
- Place of publication:
- Wallington
Using data obtained under freedom of information legislation, this report provides a snapshot of the prices paid for older people's homecare by councils in Great Britain and the Health and Social Care Trusts in Northern Ireland during a sample week in September 2014. Visual and numerical data are included to make comparisons at a national, regional and local authority level. The report provides information on the average price councils paid for homecare for older people; the numbers of councils paying their local providers sufficient to comply with the National Minimum wage (including careworkers' travel time); and those paying a UK or London Living Wage. It also highlights the risks associated with under-funded care such as poorer terms and conditions, insufficient training for the workforce, resulting in problems in retaining good quality care workers. (Edited publisher abstract)
Memories, identity and homeliness: the social construction of mealtimes in residential care homes in South Wales
- Authors:
- PHILPIN Susan, et al
- Journal article citation:
- Ageing and Society, 34(5), 2014, pp.753-789.
- Publisher:
- Cambridge University Press
Mealtimes in residential care homes are fundamentally social occasions, providing structure to the day and opportunities for conversation and companionship. This paper reports on particular findings from a qualitative study which investigated factors influencing nutritional care provided to residents in two different types of residential care settings in South Wales, UK. Data were generated through focus group interviews with relevant staff members (N = 15), individual interviews with managers (N = 4) and residents (N = 16) of the care homes and their informal carers (N = 10), observation of food preparation and mealtimes throughout the day, and analysis of appropriate documents. Data were analysed using thematic analysis. This paper's focus is on the ways in which care home residents' experiences and understandings of mealtimes were influenced by various environmental factors, such as the home's geographical location, physical lay-out and ambience. Moreover, the shared meaning of mealtimes for residents, informal carers and staff was constructed from each group's socio-cultural background, family experiences and memories, and was integral to residents' sense of normality, community and identity (Edited publisher abstract)
Research prioritisation project: how can we best provide sustainable care and support to help older people live happier and more fulfilling lives?
- Author:
- JAMES LIND ALLIANCE
- Publisher:
- Social Care Wales
- Publication year:
- 2021
- Pagination:
- 12
- Place of publication:
- Cardiff
This document outlines the research priorities identified from a project to find out what people over 65 thought were the important questions they wanted answers to. This study was developed by Health and Care Research Wales and Social Care Wales, in association with the James Lind Alliance. Almost 400 older people, carers and social care practitioners were asked, "how can we best provide sustainable care and support to help older people live happier and more fulfilling lives?" Members of the public and social care professionals were invited to take part in surveys and workshops to have their say on the priorities. The members of the public were identified and supported to be involved by the Health and Care Research Wales Support Centre public involvement team. The priorities were found to cover these 10 themes: effectiveness of early help; prevention of carer stress and burnout; joint working to meet the needs of older people; personalisation and involvement in decision making; provision of support for people with complex needs; funding sustainability; barriers to accessing services; staff terms and conditions of employment; maintaining quality care; and reducing social isolation and loneliness via home and community care. (Edited publisher abstract)
Swimming upstream: the provision of inclusive care to older lesbian, gay and bisexual (LGB) adults in residential and nursing environments in Wales
- Authors:
- WILLIS Paul, et al
- Journal article citation:
- Ageing and Society, 36(2), 2016, pp.282-306.
- Publisher:
- Cambridge University Press
This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. This paper presents qualitative evidence from research into the provision of care environments in Wales. It discusses the findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. The authors argues that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. The paper then discusses how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argues against the separation of care and sexual orientation in practice. (Edited publisher abstract)