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A further opinion on reimagining nursing homes
- Author:
- CASTLE Nicholas G.
- Journal article citation:
- Journal of Aging and Social Policy, 22(4), October 2010, pp.334-338.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
This commentary discusses an article by Robert L.Kane on reimagining long-term care (LTC) in the Journal of Aging and Social Policy, 22(4) 2010. The reimagining article examines ways in which the prominence of nursing homes in the LTC system could be diminished. Here the writer provides a further opinion on what could be done better within the current system using the current resources. He stresses that what is important is the provision of high quality LTC services for the elderly. Nursing homes are part of the range of possible solutions; they need to be improved and the quality raised but they are very diverse and new models are being developed. The author believes that they continue to have a place in LTC.
Approaches to improving quality in nursing and residential homes: recent developments in Australia and their relevance to the UK
- Authors:
- BARTLETT Helen, BOLDLY Duncan
- Journal article citation:
- Quality in Ageing, 2(3), September 2001, pp.3-14.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Concerns about quality and standards of care in the nursing and residential home sector have exercised policymakers, managers and practitioners in both Australia and the UK for some years. While Australia is a relatively young country, demographically speaking, it has in place a coherent 'aged care' policy. The UK on the other hand, with its rapidly ageing profile, has only recently made a serious policy commitment to the health and social care agenda for older people. Australia therefore has several years of experience to be shared with the UK when it come to policy and practice of quality improvement. In particular, there are valuable lessons to be learnt from Australia's national outcome standards and monitoring system for care homes, and it's more recent introduction of care homes accreditation system. Apart from identifying any issues associated with the implementation of such approaches to quality improvement, it is important to establish whether they have an impact on the quality of care and life of older residents. As the UK moves to implementing national minimum standards in 2002, lessons from Australia are timely and may help inform best practice and policy in long-term care in the future.
Measuring the quality of care for older people
- Authors:
- POTTER Jonathan, GEORGIOU Andrew, PEARSON Michael
- Publisher:
- Royal College of Physicians
- Publication year:
- 2000
- Pagination:
- 136p.,tables,diags.,bibliogs.
- Place of publication:
- London
Examines how to measure standards in health care for older people. Begins with a discussion of techniques for measuring quality. Moves on to discuss the national agenda for quality, with reference to the National Service Framework and the National Institute for Clinical Excellence. Then examines care studies of specific areas of health care, including stroke and incontinence, with critiques of their methodology. Concludes with recommendations for future practice.
Clearing the path for quality: benchmark standards
- Author:
- AVEBURY Kina
- Journal article citation:
- Registered Homes and Services, 2(12), April 1998, pp.162-163.
Describes how the Department of Health is financing and co-ordinating a new Advisory Group at the Centre for Policy on Ageing to submit a report to the DoH and the Welsh Office on benchmark standards in care homes. The intention is to provide revised clearer central guidance on the standards which care homes provide. Local and health authority inspection units will be given clearer and more specific guidelines about what regulators should expect in terms of fitness of persons, buildings, services and outcomes. This article reviews their task.
Lessons for regulating informal markets and implications for quality assurance: the case of migrant care workers in Austria
- Authors:
- SCHMIDT Andrea E., et al
- Journal article citation:
- Ageing and Society, 36(4), 2016, pp.741-763.
- Publisher:
- Cambridge University Press
The rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities. (Publisher abstract)
The view from within: "good" care from the perspective of care professionals: lessons from an explorative study
- Authors:
- SHULMANN Katharine, et al
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2016
- Pagination:
- 16
- Place of publication:
- Vienna
Policy briefing which focuses on care quality from the perspective of professionals working in the field of long term care in Austria. Specifically the briefing looks at what care professionals consider to be high quality care and how it should be defined; and what structural-, process- and outcome-related factors they believe affect outcomes. The study draws on interviews and workshops with representatives from various professional groups, as well as 24-hour carers and family carers, to identify themes and issues central to discussions of "good" care. The interviews and workshops identified a number of factors for the provision of high quality care: the continued development of a distinct long term care identity, rather than a separate identity of health/social care; working conditions; relationships, including between care professionals and users, and between professionals and informal carers; the way that care services are financed and structured, which has a strong influence on the delivery of care, interaction and cooperation; and the importance of multidisciplinary care teams. The authors propose recommendations to directly and indirectly improve quality of care through action at the macro, organisational, and individual levels. (Edited publisher abstract)
The quality of death: ranking end-of-life care across the world
- Author:
- ECONOMIST INTELLIGENCE UNIT
- Publisher:
- Economist Intelligence Unit
- Publication year:
- 2010
- Pagination:
- 39p.
- Place of publication:
- London
Increasing longevity and ageing populations mean demand for end-of-life care is likely to rise sharply. Despite this, few nations, including rich ones with cutting-edge healthcare systems, incorporate palliative care strategies into their overall healthcare policy. The aim of this report is to highlight the parts of the world and areas of practice where most progress is being made and to assess where more work still needs to be done when it comes to improving the accessibility to and quality of end-of-life care globally. The report is based on 2 areas of research: the Economist Intelligence Unit’s ‘Quality of Death Index’, which ranks 40 countries in terms of the quality and availability of end-of-life care; and in-depth interviews with over 20 experts from across the world. The findings show that the UK has led the way in terms of its hospice care network and statutory involvement in end-of-life care, and ranks top of 40 countries measured in the Index. Funding is not the only barrier to the accessibility and quality of end-of-life care; other factors such as cultural taboos, lack of understanding, and the futile use of life-preserving medical technologies also hamper progress. Drug availability is the most important practical issue. Across the world an estimated 5 billion people lack access to opioids. High-level policy recognition and support is crucial to improve the quality of end-of-life care.
Health and social care of older people: could policy generalise good practice?
- Author:
- CURRIE Colin T.
- Journal article citation:
- Journal of Integrated Care, 18(6), December 2010, pp.19-26.
- Publisher:
- Emerald
This article considers the traditional separation of health and social care in relation to the care of older people, arguing that this separation has increasingly unacceptable consequences for the quality and cost-effectiveness of the care provided. With the ageing of the UK population, the care of older people has become the central challenge of both the health and social care systems, yet they have in general failed to establish means to work together. The article discusses evidence to support the view that more integrated care - delivered jointly, promptly and flexibly to meet the changing clinical and dependency needs of frailer older people at home - can minimise unnecessary use of more costly and less preferable care elsewhere, and thus reduce the overall costs of late-life care while improving its quality. This paper considers the background to the widely prevailing culture of separatism, presents quantitative evidence of the current postcode lottery in care, describes examples of current good practice, considers some options on functional and structural integration, and speculates on policy that might deliver better and more cost-effective care for an ageing population at a time of impending stringency in the funding of public services. In particular, the success of two primary care trusts, Torbay and the Isle of Wight, in integrating health and social care services for older people is discussed.
Reforming long-term care in Portugal: dealing with the multidimensional character of quality
- Author:
- SANTANA Silvina
- Journal article citation:
- Social Policy and Administration, 44(4), August 2010, pp.512-528.
- Publisher:
- Wiley
This article provides an overview of the informal and institutional setting of long-term care in Portugal and focuses on service quality, discussing it alongside broader problems related to the organisation of long-term care in the country. It analyses the main providers, discussing structural, organisational, quality and financing aspects of a very complex situation that is currently evolving at a very fast pace, in adapting to Portuguese society’s new needs in the social care network and the recent introduction of what is designated as a third level of care, the National Network of Long-term Integrated Care (Rede Nacional de Cuidados Continuados Integrados – RNCCI). It presents the results of the first self-assessments these bodies have made of the quality and suitability of services provided from the users’ point of view. The results of a survey conducted by the Eurobarometer between 25 May and 30 June 2007 on the attitudes, needs and expectations of Portuguese citizens regarding long-term care and care of the elderly are discussed. The article concludes that the information and data available are insufficient to support any deep analysis of the situation and field action, and sets some lines for future work in this area.
The long-term view
- Author:
- MARSHALL Mary
- Journal article citation:
- Professional Social Work, October 1998, p.8.
- Publisher:
- British Association of Social Workers
The author, social work representative on the Royal Commission on Long Term Care for the elderly, urges the profession to make its voice heard.