Provides detailed information on older people’s experiences of end of life care. This report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. The review shows that older people’s experiences of end of life care are mixed, and the document focuses in particular on: staff attitudes; personalised care; and training and support for staff. The document sets out two key recommendations: commissioners and providers to develop systems to support care homes to care for people well at the end of life - to help reduce avoidable hospital admissions and to enable people to die where they choose; and commissioners and providers to make sure that staff who care for people who are likely to be approaching the end of life in any setting to have appropriate training and support to enable them to care for people approaching the end of life.
(Edited publisher abstract)
Provides detailed information on older people’s experiences of end of life care. This report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. The review shows that older people’s experiences of end of life care are mixed, and the document focuses in particular on: staff attitudes; personalised care; and training and support for staff. The document sets out two key recommendations: commissioners and providers to develop systems to support care homes to care for people well at the end of life - to help reduce avoidable hospital admissions and to enable people to die where they choose; and commissioners and providers to make sure that staff who care for people who are likely to be approaching the end of life in any setting to have appropriate training and support to enable them to care for people approaching the end of life.
(Edited publisher abstract)
Subject terms:
user views, older people, end of life care, personalisation, person-centred care, staff-user relationships;
This report details the findings from the visits to twenty four NHS wards providing acute assessment for older people with functional mental illness in Scotland and contains recommendations to improve patient care. Functional mental illness includes common conditions such as depression and anxiety, and rarer conditions such as schizophrenia, delusional disorder, bipolar affective disorder and obsessional compulsive disorder. The care of 128 individuals was reviewed, and attempts were made to hear their views where possible, including the views of 15 unpaid carers – most often family member or close friends. The review found that just about a quarter of care plans were felt to have a good amount of individualised and personalised content, with just over half having some individualised person centred content. The rest had non-individualised generic content. The majority of patients were able to give information about staff availability and felt staff were easily available and approachable. Nearly all patients were being reviewed at least weekly by their psychiatrist, with the remainder being reviewed every fortnight but there was considerable variation in levels of input from clinical psychologists in different wards. Only about half of patients said they had access to advocacy, half were either unaware of, or did not have access to, advocacy. Detained patients were more likely to be aware of advocacy.
(Edited publisher abstract)
This report details the findings from the visits to twenty four NHS wards providing acute assessment for older people with functional mental illness in Scotland and contains recommendations to improve patient care. Functional mental illness includes common conditions such as depression and anxiety, and rarer conditions such as schizophrenia, delusional disorder, bipolar affective disorder and obsessional compulsive disorder. The care of 128 individuals was reviewed, and attempts were made to hear their views where possible, including the views of 15 unpaid carers – most often family member or close friends. The review found that just about a quarter of care plans were felt to have a good amount of individualised and personalised content, with just over half having some individualised person centred content. The rest had non-individualised generic content. The majority of patients were able to give information about staff availability and felt staff were easily available and approachable. Nearly all patients were being reviewed at least weekly by their psychiatrist, with the remainder being reviewed every fortnight but there was considerable variation in levels of input from clinical psychologists in different wards. Only about half of patients said they had access to advocacy, half were either unaware of, or did not have access to, advocacy. Detained patients were more likely to be aware of advocacy.
(Edited publisher abstract)
Subject terms:
mental health care, mental health services, inspection, user views, performance evaluation, care plans, person-centred care, staff-user relationships, older people, assessment;
This review explores how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity. The results are based on an analysis from the inspections of 81 care homes in 9 primary care trust areas during January and February 2011. The inspection teams interviewed managers, residents and staff, observed care provided to residents, and examined case files. The findings are discussed against 4 themes: involvement and information; personalised care, treatment and support; safeguarding and safety; and suitability of staffing. Among the findings were that 77% of care plans considered the views of the resident, and that 96% of care homes identified the changing health care needs of residents through informal or responsive monitoring. However, the review also showed that: 25% of residents did not feel they were offered a choice of male or female staff to help them use the toilet; 44% of care homes indicated they received routine visits from GPs; 30% of nursing homes did not have a 'do not attempt resuscitation' policy (and, of those that did, just 37% of staff had received training on it); 35% of homes reported they sometimes had problems getting medicines to residents on time; and 10% of care homes said they paid for their GP surgeries to visit.
This review explores how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity. The results are based on an analysis from the inspections of 81 care homes in 9 primary care trust areas during January and February 2011. The inspection teams interviewed managers, residents and staff, observed care provided to residents, and examined case files. The findings are discussed against 4 themes: involvement and information; personalised care, treatment and support; safeguarding and safety; and suitability of staffing. Among the findings were that 77% of care plans considered the views of the resident, and that 96% of care homes identified the changing health care needs of residents through informal or responsive monitoring. However, the review also showed that: 25% of residents did not feel they were offered a choice of male or female staff to help them use the toilet; 44% of care homes indicated they received routine visits from GPs; 30% of nursing homes did not have a 'do not attempt resuscitation' policy (and, of those that did, just 37% of staff had received training on it); 35% of homes reported they sometimes had problems getting medicines to residents on time; and 10% of care homes said they paid for their GP surgeries to visit.
Subject terms:
learning disabilities, older people, person-centred care, access to services, adult social care, care homes, care planning, dignity, general practitioners, health care;
This report brings together key findings from 20 local system reviews to explore how health and social care services work together to support and care for older people England. The reviews found examples of health and care organisations working well together, but also found ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people. The report presents the findings across the following areas: older people’s experiences of moving between health and care services; barriers and enablers to providing timely and high quality care; factors enabling system working, including leadership; and the sustainability of services, including workforce and supply of services. Key findings include that although organisations intended to work together, they also prioritised their own goals over the shared responsibility to provide person centred care. They also often failed to share information and planned their workforce in isolation to other services. The report's recommendations include for more effective joined-up planning and commissioning; a joint framework for measuring the performance of how agencies collectively deliver improved outcomes for older people; the development of joint workforce plans; and better regulation and oversight of local health and care systems.
(Edited publisher abstract)
This report brings together key findings from 20 local system reviews to explore how health and social care services work together to support and care for older people England. The reviews found examples of health and care organisations working well together, but also found ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people. The report presents the findings across the following areas: older people’s experiences of moving between health and care services; barriers and enablers to providing timely and high quality care; factors enabling system working, including leadership; and the sustainability of services, including workforce and supply of services. Key findings include that although organisations intended to work together, they also prioritised their own goals over the shared responsibility to provide person centred care. They also often failed to share information and planned their workforce in isolation to other services. The report's recommendations include for more effective joined-up planning and commissioning; a joint framework for measuring the performance of how agencies collectively deliver improved outcomes for older people; the development of joint workforce plans; and better regulation and oversight of local health and care systems.
(Edited publisher abstract)
Subject terms:
older people, integrated care, interagency cooperation, health care, adult social care, person-centred care, commissioning, hospital discharge, hospital admission, prevention, community care, wellbeing, delayed discharge;
The report is one of 20 local area reports produced as part of the local system reviews programme and will be followed by a national report for government that brings together key findings from across the 20 local system reviews. The local system review considered system performance along a number of ‘pressure points’ on a typical pathway of care with a focus on older people aged over 65. It also focussed on the interface between social care, general medical practice, acute and community health services, and on delayed transfers of care from acute hospital settings. The review found that there was a commitment to be an integrated system but the structure was not in place to enable integration to happen effectively. While system leaders and managerial staff were visible and engaged there needed to be more emphasis on building trust and developing a collaborative approach to system integration. It was not clear how frontline staff could contribute to and influence integrated service design and delivery. Frontline staff expressed frustration at the pace of change and the barriers to integration including the inability to share detailed information across the system. Feedback from people and carers stated that navigation of the health and social care system was challenging. Analysis of Adult Social Care Outcomes Framework (ASCOF) data showed that there was an increasing proportion of older people living in Coventry who said it was difficult to find the social care information and support they needed. It was not evident that system-wide multidisciplinary team working for effective outcomes was in place. There were emerging examples of good practice around prevention but more work needed to be done to become a truly integrated system.
(Edited publisher abstract)
The report is one of 20 local area reports produced as part of the local system reviews programme and will be followed by a national report for government that brings together key findings from across the 20 local system reviews. The local system review considered system performance along a number of ‘pressure points’ on a typical pathway of care with a focus on older people aged over 65. It also focussed on the interface between social care, general medical practice, acute and community health services, and on delayed transfers of care from acute hospital settings. The review found that there was a commitment to be an integrated system but the structure was not in place to enable integration to happen effectively. While system leaders and managerial staff were visible and engaged there needed to be more emphasis on building trust and developing a collaborative approach to system integration. It was not clear how frontline staff could contribute to and influence integrated service design and delivery. Frontline staff expressed frustration at the pace of change and the barriers to integration including the inability to share detailed information across the system. Feedback from people and carers stated that navigation of the health and social care system was challenging. Analysis of Adult Social Care Outcomes Framework (ASCOF) data showed that there was an increasing proportion of older people living in Coventry who said it was difficult to find the social care information and support they needed. It was not evident that system-wide multidisciplinary team working for effective outcomes was in place. There were emerging examples of good practice around prevention but more work needed to be done to become a truly integrated system.
(Edited publisher abstract)
Subject terms:
integrated care, quality improvement, place-based approach, older people, interagency cooperation, multidisciplinary teams, adult social care, health care, commissioning, delayed discharge, leadership, person-centred care, social prescribing, information sharing;
This local system review of Plymouth is one of 20 targeted reports to examine how older people move through the health and social care system, with a focus on the interfaces between services. It focuses on three key areas: maintaining the wellbeing of a person in their usual place of residence; crisis management; and step down, return to usual place of residence and/ or admission to a new place of residence. As well as analysis of local data, the review sought feedback from system leaders, people delivering care, and people who use services, their families and carers to examine whether services were: safe, effective, caring, responsive, and well led. The review found there was a shared ambition among system leaders for the integration of service delivery in Plymouth and a clear framework for interagency collaboration. It also found examples of staff working in an integrated way. However the experience of people receiving health and social care services was varied, with some negative experiences of discharge from hospital and missed opportunities to better utilise voluntary and community sector services in terms of maintaining people at home and avoiding hospital admission. Suggested areas for improvement include: more attention to commissioning for prevention and early intervention to improve sub optimal performance and the need for organisational development work to break down any organisational barriers and ensure there is a shared understanding among staff of their role in achieving integration at an operation level.
(Edited publisher abstract)
This local system review of Plymouth is one of 20 targeted reports to examine how older people move through the health and social care system, with a focus on the interfaces between services. It focuses on three key areas: maintaining the wellbeing of a person in their usual place of residence; crisis management; and step down, return to usual place of residence and/ or admission to a new place of residence. As well as analysis of local data, the review sought feedback from system leaders, people delivering care, and people who use services, their families and carers to examine whether services were: safe, effective, caring, responsive, and well led. The review found there was a shared ambition among system leaders for the integration of service delivery in Plymouth and a clear framework for interagency collaboration. It also found examples of staff working in an integrated way. However the experience of people receiving health and social care services was varied, with some negative experiences of discharge from hospital and missed opportunities to better utilise voluntary and community sector services in terms of maintaining people at home and avoiding hospital admission. Suggested areas for improvement include: more attention to commissioning for prevention and early intervention to improve sub optimal performance and the need for organisational development work to break down any organisational barriers and ensure there is a shared understanding among staff of their role in achieving integration at an operation level.
(Edited publisher abstract)
Subject terms:
older people, integrated care, interagency cooperation, prevention, delayed discharge, leadership, multidisciplinary services, commissioning, person-centred care, hospitals, health care, adult social care;
Thematic report presenting the findings of focused inspections to examine how the quality of care in care homes meets the Standards of Care for Dementia in Scotland. The standards were developed with the key principles of helping people with dementia and their carers to understand and protect their rights, indicate to care providers what is expected of them and improve the quality of dementia care homes. This report draws on the inspections 145 care homes, including the perspectives of residents, relatives and staff. It includes examples of effective practice and also highlights areas for improvement. Overall, the inspections found that the majority of care homes contribute to meeting the standards of care assessed, with over half of care homes delivering good quality care. However, the report also identifies the potential for improvements to ensure that quality of life for people with dementia is not limited. Other areas identified as in need of improvement include: access to independent advocacy, opportunities for people living with dementia to be active and engaged, up to date and accurate persona care plans, and for an enablement approach and integration of the care home within the community to be adopted more widely across care homes.
(Edited publisher abstract)
Thematic report presenting the findings of focused inspections to examine how the quality of care in care homes meets the Standards of Care for Dementia in Scotland. The standards were developed with the key principles of helping people with dementia and their carers to understand and protect their rights, indicate to care providers what is expected of them and improve the quality of dementia care homes. This report draws on the inspections 145 care homes, including the perspectives of residents, relatives and staff. It includes examples of effective practice and also highlights areas for improvement. Overall, the inspections found that the majority of care homes contribute to meeting the standards of care assessed, with over half of care homes delivering good quality care. However, the report also identifies the potential for improvements to ensure that quality of life for people with dementia is not limited. Other areas identified as in need of improvement include: access to independent advocacy, opportunities for people living with dementia to be active and engaged, up to date and accurate persona care plans, and for an enablement approach and integration of the care home within the community to be adopted more widely across care homes.
(Edited publisher abstract)
Subject terms:
care homes, dementia, older people, quality of life, quality assurance, performance evaluation, person-centred care, rights, standards, advocacy, inspection;