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Losing time: developing mental health services for older people in Wales
- Author:
- AUDIT COMMISSION
- Publisher:
- Audit Commission
- Publication year:
- 2002
- Pagination:
- 42p.
- Place of publication:
- London
The quality of mental health services for older people in Wales varies greatly depending on where they live, and there are severe shortages of specialist care when they can no longer be supported at home. Carers are generally well supported but their needs should be assessed more consistently and staff in residential homes need better training. Report highlights over 30 examples of good practice, but says that this needs to be shared more widely. Calls for more partnership working between health and social care and the introduction of defined minimum standards.
National review of care homes for people living with dementia
- Author:
- CARE INSPECTORATE WALES
- Publisher:
- Care Inspectorate Wales
- Publication year:
- 2020
- Pagination:
- 29
- Place of publication:
- Llandudno Junction
This review looked at the care received by people living with dementia in care homes in Wales, and how they are supported in this important stage of their lives. It is based on inspection visits to 164 care homes and conversations with people living with dementia and their families about the care they received; and interviews with commissioners and providers of care home services. Main findings include: people living with dementia are cared for by staff who are warm, respectful, and provide care in line with personal plans; in a small proportion of homes, care is rushed; staff received dementia training but this did not always result in person-centred care; people’s well-being and care could be more effective with improvements to the environment in which they live; in general, families were very positive about the care, staffing and management in the care homes; people living with dementia had access to healthcare but frequently did not receive a timely diagnosis of their dementia; multi-disciplinary working could be improved, particularly hospital discharge practice; people’s medication had been reviewed in consultation with a GP or pharmacist in about 90% of care homes and there is monitoring of the effect of medication; providers said one in four people living with dementia are prescribed antipsychotic medication; people living with dementia were supported to access specialist mental health support; more effective admission and discharge from hospital would support care homes; a number of care homes embrace technology, developing links with communities and undertaking a range of creative activities that improved the well-being of people living with dementia; providers said that the key challenges facing care homes for people living with dementia are the retention of staff, the complexity of dementia and the impact on the home of people needing one-to-one care. Finance was a challenge consistently identified by providers. (Edited publisher abstract)
Putting care right: your guide to choosing a care home
- Author:
- ALZHEIMER'S SOCIETY
- Publisher:
- Alzheimer's Society
- Publication year:
- 2008
- Pagination:
- 23p.
- Place of publication:
- London
This guide features the essential issues to consider when deciding on a care home for a person with dementia. It lists questions families can put to care home staff and includes blank pages for notes on the places they visit. This guide raises the crucial questions everyone should ask about care homes. It will also help people to understand how to recognise quality care and help them to start demanding the high standards of care that people with dementia deserve. The charity’s survey found a third of people over 55 have experience of looking for care homes, but nationwide more than more than four out of ten people admit they would not know what to look for in a good care home. Skilled staff appear to be more important than a nicely decorated room when it comes to deciding on the quality of residential care. A choice of activities and access to outside space was also rated as important by more than 94 per cent of people.
Using survey data to measure changes in the quality of home care: analysis of the older people's user experience survey 2006
- Authors:
- MALLEY Juliette, NETTEN Ann, JONES Karen
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2007
- Pagination:
- 110p., bibliog.
- Place of publication:
- Canterbury
The development of the User experience Survey (UES) and the inclusion of the user’s perspective in the Performance Assessment Framework (PAF) were novel and important steps forward in the world of performance assessment and monitoring of social services. Commentators had previously criticised the lack of connectedness between the performance/quality and user involvement agendas and these developments represented real steps forward in meeting this goal. Analysis from the 2003 extension to the UES for older people has demonstrated that user experience measures can usefully discriminate between Local Authorities (LAs). While his new research raises some important questions, this type of approach is clearly an improvement on performance measurement based on processes and inputs. Fifty authorities took part with representation from all Government Office Regions and LA types. Analysis of responses to the compulsory questions and comparison with responses to these questions nationally revealed very similar proportions responding to each category. We can assume from these findings that the sample of authorities is broadly representative of the views of service users across England.
Quality in social care: achieving excellence in home care
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2014
- Pagination:
- 19 minutes 48 seconds
- Place of publication:
- London
Service users get together with a social care academic and a leader in the home care sector to discuss how excellence can be achieved in domiciliary care. We see examples of excellence in support offered to older people, people with learning disabilities and people with physical disabilities in their own homes. Much of the focus is on the relationship between staff members and the people they support because getting that right is fundamental to excellent care. This film has now been revised. This film was previously available under the title 'Defining excellence: excellence in domiciliary care '. (Edited publisher abstract)
Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services
- Authors:
- SIETTE Joyce, et al
- Journal article citation:
- BMJ Open, 11(11), 2021, Online only
- Publisher:
- BMJ Publishing Group
Background: Quality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults’, providers’ and policymakers’ needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services. Design Systematic review: Data sources MEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021. Eligibility criteria: Instruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics. Data extraction and synthesis: Two researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments. Results: 292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status. Conclusions: A comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users. (Edited publisher abstract)
Putting the ‘care’ in housing-with-care: integrated retirement communities: improving care quality and tackling the workforce crisis
- Author:
- ASSOCIATED RETIREMENT COMMUNITY OPERATORS
- Publisher:
- Associated Retirement Community Operators
- Publication year:
- 2021
- Pagination:
- 17
- Place of publication:
- London
This report analyses the quality, efficiency and benefits of social care provided by Integrated Retirement Community (IRC) operators in the UK. The report is based on an analysis of the Care Quality Commission (CQC) ratings of domiciliary care agencies run by Associated Retirement Community Operators (ARCO) members in IRCs; a survey of IRC operators; empirical data from the ExtraCare Charitable Trust; findings from a study on Covid-19 and IRC conducted by St Monica Trust; and a review of other relevant literature and research. The study found that care can be provided more effectively and efficiently in IRCs due to staff giving care to residents onsite and not needing to travel in between visits, and because many residents require less care after moving in due to health and wellbeing improvements. The report compares the care and support requirements of people living in IRC with those living in dispersed family homes, and calculates that, for a typical IRC with 200 people living there, 16 fewer care staff are needed than if the same levels of care were provided in the wider community – freeing up staff to provide care to those who need it elsewhere. Other findings include: IRCs deliver high quality and effective care and that the Covid-19 pandemic has shone a light on the way in which IRCs can keep residents safe and secure. Case studies include: Wixams Retirement Village (Extra Care Charitable Trust); Audley St Elphin’s Park, Derbyshire; Rangeford Villages. The report concludes with three main recommendations addressed to the UK government. (Edited publisher abstract)
Measuring safety in older adult care homes: a scoping review of the international literature
- Authors:
- RAND Stacey, et al
- Journal article citation:
- BMJ Open, 11(3), 2021, p.e043206. Online only
- Publisher:
- BMJ Publishing Group
Background: Safety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted. Objectives The aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes. Sources of evidence Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Eligibility criteria Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Charting methods Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. Results and conclusions Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. The findings indicate that there are a range of available safety measures used for quality monitoring and improvement in older adult care homes. These cover all five domains of safety in the SMMF. However, there are potential gaps. These include user experience, psychological harm related to the care home environment, abusive or neglectful care practice and the processes for integrated learning. Some of these gaps may relate to challenges and feasibility of measurement in the care home context. (Edited publisher abstract)
Quality indicators for community care for older people: a systematic review
- Authors:
- JOLING K.J., et al
- Journal article citation:
- PLoS ONE, 13(1), 2018, Online only
- Publisher:
- Plos Publications
- Place of publication:
- San Francisco, CA
Background: Health care systems that succeed in preventing long term care and hospital admissions of frail older people may substantially save on their public spending. The key might be found in high-quality care in the community. Quality Indicators (QIs) of a sufficient methodological level are a prerequisite to monitor, compare, and improve care quality. This systematic review identified existing QIs for community care for older people and assessed their methodological quality. Methods: Relevant studies were identified by searches in electronic reference databases and selected by two reviewers independently. Eligible publications described the development or application of QIs to assess the quality of community care for older people. Information about the QIs, the study sample, and specific setting was extracted. The methodological quality of the QI sets was assessed with the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. A score of 50% or higher on a domain was considered to indicate high methodological quality. Results: Searches resulted in 25 included articles, describing 17 QI sets with 567 QIs. Most indicators referred to care processes (80%) and measured clinical issues (63%), mainly about follow-up, monitoring, examinations and treatment. About two-third of the QIs focussed on specific disease groups. The methodological quality of the indicator sets varied considerably. The highest overall level was achieved on the domain ‘Additional evidence, formulation and usage’ (51%), followed by ‘Scientific evidence’ (39%) and ‘Stakeholder involvement’ (28%). Conclusion: A substantial number of QIs is available to assess the quality of community care for older people. However, generic QIs, measuring care outcomes and non-clinical aspects are relatively scarce and most QI sets do not meet standards of high methodological quality. This study can support policy makers and clinicians to navigate through a large number of QIs and select QIs for their purposes. (Publisher abstract)
The ARCO consumer code
- Author:
- ASSOCIATED RETIREMENT COMMUNITY OPERATORS
- Publisher:
- Associated Retirement Community Operators
- Publication year:
- 2017
- Pagination:
- 28
- Place of publication:
- London
Sets standards for the retirement community sector to help ensure providers offer a trusted and high quality service to those living in, and considering moving to, a retirement community. These provisions include requirements that operators of retirement communities are transparent in the way that they market and operate their communities and services, and that they ensure that customers receive information about fees and charges well before they decide to move in. They also include requirements to provide core levels of services to residents, and to treat customers in a professional, fair and non-discriminatory manner. (Edited publisher abstract)