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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)
Living life with dementia: local Age UK and Age Concern contributions to quality outcomes for people living with dementia and their carers
- Author:
- CHANNA Harvinder
- Publisher:
- Age UK
- Publication year:
- 2011
- Pagination:
- 36p.
- Place of publication:
- London
The National Dementia Strategy (NDS) has, as a key priority, the improvement of outcomes for people living with dementia and their carers. Nine quality outcome statements are proposed which capture what people living with dementia and their carers aspire to. This guide describes a range of services for people with dementia and their carers which demonstrate some of the ways that local Age UKs and Age Concerns are contributing towards achieving these quality outcomes. The services are divided into different categories representing the NDS quality outcomes. Quotes from the service users are provided to bring to life the ways in which policy can be translated into action to make a difference to the lives of people living with dementia and their carers. The aim is to provide commissioners with ideas for support and services that contribute to the key NDS quality outcomes.
Standards of care in day hospitals and day centres: a comparison of services for older people with dementia
- Authors:
- REILLY Siobham, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(5), May 2006, pp.460-468.
- Publisher:
- Wiley
Current policy in England emphasises the importance of caring for highly dependent older people for as long as possible at home. It is therefore crucial that day care services are effective and widely available. This study aimed to compare the type and standard of care provided for older people with dementia in day centre and day hospital settings. A cross-sectional postal survey design was employed. Representatives from three-quarters of identified specialist day care services for older people with dementia in the North West of England provided information on a range of indicators including: basic structural features; delivery of care; service content; and quality measures. The results found day hospitals tended to have more day care places and a greater number of attendees, but lower occupancy rates than day centres. Day hospitals reported higher standards of care in relation to systematic assessment and care planning, promotion of rehabilitation, carer involvement and individualised provision of care. They were also more likely to employ building design features to encourage independence and choice for people with dementia. A higher proportion of day centres provided services exclusively to older people with dementia and a greater proportion of staff in day centres had undergone specific training in caring for people with dementia. Day centres were also more likely to have effective transport arrangements in place. It is concluded that the standards developed for the study were sufficiently reliable to allow for an acceptable estimate of quality. Day centres and day hospitals appeared to perform two distinct, but complementary functions. These results provide key material for shaping the provision of day care for older people with dementia, especially given the absence of national standards in this area.
Hearing what users say: the importance of training for high quality management in dementia care
- Authors:
- PARKER Jonathan, et al
- Journal article citation:
- Managing Community Care, 9(6), December 2001, pp.28-33.
- Publisher:
- Pavilion
This article explores the importance of seeking the views of service users with dementia. This is fundamental to raising quality standards in the management of dementia care, and demands commitment to on-going high quality training for social care staff. Examines contemporary research and policy developments in this context.
DCM and engagement combined to audit care quality
- Author:
- BROOKER Dawn
- Journal article citation:
- Journal of Dementia Care, 7(3), May 1999, pp.33-36.
- Publisher:
- Hawker
Discusses how combining the methodologies of Dementia Care Mapping DCM and Engagement can provide a reliable indicator of quality of care, useful in inspection of services, and research.
Improving services for older people: staff development in dementia care
- Author:
- FRASER Mary
- Publisher:
- Stanley Thornes
- Publication year:
- 1999
- Pagination:
- 134p.
- Place of publication:
- Cheltenham
Examines the role of staff education and training for carers working with people with dementia in the context of the business of running a care home. Demonstrates how effective education programmes can significantly enhance the quality of care provided for residents and, by adding to the quality of the overall care package delivered, can also contribute to good business practice. Based on practical work conducted in care homes, provides guidelines for the implementation of life long learning strategies which will be of benefit to staff, residents and employers.
EACH: clearing the channels of information for Europe
- Author:
- MEULENBERGS Leen
- Journal article citation:
- Journal of Dementia Care, 5(5), September 1997, pp.26-28.
- Publisher:
- Hawker
The European Alzheimer Clearing House (EACH) aims to become an information exchange for good practice in all aspects of dementia care throughout Europe. Describes its current projects and priorities.
The patient experience in community mental health services for older people: a concept mapping approach to support the development of a new quality measure
- Authors:
- WILBERFORCE Mark, et al
- Journal article citation:
- BMC Health Services Research, 18(461), 2018, Online only
- Publisher:
- BioMed Central Ltd
Background: The patient experience is a crucial part of the measurement of service quality. However, instruments to evaluate experiential quality in the community mental health care of older adults are lacking. Before designing a new instrument, clarity is needed about what is to be measured, and how care experiences are articulated by patients. The study aimed to construct a framework to describe older patients’ experience of community mental health and social care. Methods: Concept mapping blends structured qualitative data collection with quantitative analysis in a mixed method approach. Five activities were undertaken. Patients first identified sentences describing the care experience; a card-sort exercise then grouped these thematically; multidimensional analysis portrayed these data in a map of clusters; interpretation was by patient advisers; finally a new questionnaire was designed. The research involved 22 older people with mental health problems and 29 mental health practitioners, from one region of England. Results: Sixty-seven statements were identified that described the care experience. Analysis of card sort data revealed seven clusters, which were interpreted by patient advisers to the study as: personal qualities and relationships; communication problems; feeling powerless; in-and-out care; bureaucracy; focus on life, not just mental health; and continuity of care. These themes and the component statements were used as a foundation for later work, developing a new measure of the care experience in mental health services for older people. Conclusions: Concept mapping has many strengths as an empirical and participant-driven means for underpinning new measurement instruments. A group of older people identified 67 candidate statements that could act as questionnaire items grouped within seven themes. Future research will establish the psychometric properties of the new measure. (Edited publisher abstract)
Digging deep: how organisational culture affects care home residents' experiences
- Author:
- KILLET Anne
- Journal article citation:
- Ageing and Society, 36(1), 2016, pp.160-188.
- Publisher:
- Cambridge University Press
Organisational culture of institutions providing care for older people is increasingly recognised as influential in the quality of care provided. There is little research, however, that specifically examines the processes of care home culture and how these may be associated with quality of care. This paper draws from an empirical study carried out in the United Kingdom (UK) investigating the relationship between care home culture and residents' experience of care. Eleven UK care homes were included in an in-depth comparative case study design using extensive observation and interviews. The analysis indicates how organisational cultures of care homes impact on the quality of care residents receive. Seven inter-related cultural elements were of key importance to quality of care. Applying Schein's conceptualisation of organisational culture, paper examines the dynamic relationship between these elements to show how organisational culture is locally produced and shifting. It is found that a particular organisational culture in a care home cannot be achieved simply by importing a set of organisational values or the ‘right’ leader or staff. Rather, it is necessary to find ways of resolving the everyday demands of practice in ways that are consistent with espoused values. It is through this everyday practice that assumptions continuously evolve, either consistent with or divergent from, espoused values. Implications for policy makers, providers and practitioners are discussed. (Edited publisher abstract)
The NHS atlas of variation in healthcare: reducing unwarranted variation to increase value and improve quality
- Author:
- NATIONAL HEALTH SERVICE. Right Care
- Publisher:
- Public Health England
- Publication year:
- 2015
- Pagination:
- 277
- Place of publication:
- London
This publication uses maps to show the variation in health care for a variety of conditions across England and Wales. The maps are accompanied by commentary on the background context, scale of variation and options for action. Conditions covered include: care of mothers, babies, and children and young people; mental health problems; dementia; care of older people; end of life care; and learning disabilities. Twenty one of the indicators are also presented by local authority area. The Atlas also highlights the work being done by Right to Care to support anyone wanting to reduce unwarranted variation of health care provision within their locality or between their locality and other areas of the country. (Edited publisher abstract)