scholarly journals Attracting, recruiting and retaining nurses and care workers working in care homes: the need for a nuanced understanding informed by evidence and theory

2020 ◽  
Author(s):  
Reena Devi ◽  
Claire Goodman ◽  
Sonia Dalkin ◽  
Angela Bate ◽  
Judy Wright ◽  
...  
Keyword(s):  
Care Home ◽  
Age Groups ◽  
Geographical Location ◽  
Care Homes ◽  
Complex Needs ◽  
Staffing Levels ◽  
Care Workers ◽  
Nuanced Understanding ◽  
Supportive Management ◽  
Training Opportunities

Abstract The care home sector relies on nurses and care workers to deliver care to residents living with frailty and complex needs. However, attracting, recruiting and retaining staff is one of the biggest challenges facing this sector. There is evidence available that describes factors that influence staff decisions to join and/or remain in the care home workforce, for example, individual rewards (such as feeling valued at work or training opportunities), relationships with colleagues and residents, supportive management or working arrangements (including flexible hours). However, it is less clear how different strategies are informed by evidence to improve recruitment and retention. Care homes are heterogeneous in terms of their size, staffing levels and mix, staff age groups, geographical location and working conditions. What matters to different members of the care home workforce will vary across nurses and care workers of different ages and levels of qualification or experience. Recognising this diversity is key: understanding how to attract, recruit and retain staff needs to discriminate and offer solutions that address this diversity. This important area of practice does not lend itself to a ‘one-approach-fits-all’ solution. This commentary provides a brief overview of known workforce challenges for the care home sector and argues for studies that use empirical evidence to test different theories of what might work for different staff, how and why, and in different circumstances.

scholarly journals An exploration of hydration practices in Maltese residential care homes for older people

2021 ◽  
Vol 23 (11) ◽  
pp. 1-12
Author(s):  
Francesca Micallef ◽  
Marisa Vella ◽  
Alan Sciberras Narmaniya ◽  
Glenda Cook ◽  
Juliana Thompson
Keyword(s):  
Older People ◽  
Residential Care ◽  
Care Home ◽  
Good Health ◽  
Care Homes ◽  
Complex Needs ◽  
Increased Risk ◽  
Adequate Hydration ◽  
Axial Coding ◽  
Sugary Beverages

Background/aims The integral relationship between adequate hydration and good health is widely recognised. Older people with complex needs and frailty can struggle to maintain adequate hydration, with residents in care home settings being at an increased risk of dehydration. The aim of this study was to explore current hydration practices in residential care homes in Malta. Methods An exploratory qualitative approach was adopted to explore staff's views and approaches in supporting residents' hydration. Data was collected via semi-structured, individual and small group interviews with staff from two care homes from the central and southern region of Malta. A process of open coding, followed by axial coding, was used to analyse the data. Peer debriefing was performed throughout, until agreement was reached among the research team about the final themes and sub-themes. Results Three themes emerged from the data: culture of promoting fluid intake; challenges in supporting older people to achieve optimum hydration; hydration practices and approaches. Conclusions A hydration promotion culture was demonstrated through various practices adopted in the care homes. The strong focus on water intake, in response to concerns about consuming sugary beverages, has implications for the promotion of a person-centred approach to hydration care. Inconsistencies in monitoring of fluids and daily recommended targets highlights the importance of policies or guidelines to guide hydration practice. Challenges related to refusal of fluids and language barriers among non-native staff were evident and justify further research is this area.

scholarly journals The Development of a Digital Dysphagia Guide with Care Homes: Co-Production and Evaluation of a Nutrition Support Tool

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 48
Author(s):  
Susan Pownall ◽  
Elizabeth Barnett ◽  
Julie Skilbeck ◽  
Angel Jimenez-Aranda ◽  
Sally Fowler-Davis
Keyword(s):  
Care Home ◽  
Well Being ◽  
Care Homes ◽  
Nutrition Support ◽  
Consensus Method ◽  
Support Tool ◽  
Care Workers ◽  
Good Nutrition ◽  
Poor Outcomes ◽  
Home Workers

Good nutrition is a recognised outcome in the health and well-being of older care home residents and dysphagia is a known risk factor associated with under nutrition and poor outcomes. The study co-produced a digital Dysphagia Guide with Care Homes using a consensus method with interviews and focus groups to prioritise the need for information and explore acceptability of an educational tool for care home workers. Evaluation of use, acceptability of design, and content of the guide were completed via remote monitoring. The workforce prioritised the need for training as well as the knowledge and skills in relation to planning resident-centred care and advice on textured diets. The technology was a means of offering ‘bite-size’ learning to enhance planning for nutrition across the whole organisation including managers, kitchen staff, and care workers. The Guide to Dysphagia was produced on a tablet and piloted in four care homes over 12 weeks, by 57 staff. Integrated analytics allowed user activity to be monitored. Findings showed that 73% of respondents reported the guide helped them in their job. Additionally, 88% of respondents stated they would recommend the guide to other staff, with 90% reporting it was easy to use. Engagement with staff and managers in four homes resulted in a co-designed, dysphagia guide.

Care workers’ abusive behavior to residents in care homes: a qualitative study of types of abuse, barriers, and facilitators to good care and development of an instrument for reporting of abuse anonymously

2013 ◽  
Vol 25 (5) ◽  
pp. 733-741 ◽  
Author(s):  
Claudia Cooper ◽  
Briony Dow ◽  
Susan Hay ◽  
Deborah Livingston ◽  
Gill Livingston
Keyword(s):  
Challenging Behavior ◽  
Elder Abuse ◽  
Care Home ◽  
Field Testing ◽  
Care Homes ◽  
Abusive Behavior ◽  
Care Workers ◽  
Risk Of Falls ◽  
Qualitative Focus Groups ◽  
Home Workers

ABSTRACTBackground: Elder abuse in care homes is probably common but inherently difficult to detect. We developed the first questionnaire to ask care home workers to report abuse anonymously.Method: We held qualitative focus groups with 36 care workers from four London care homes, asking about abuse they had witnessed or perpetrated.Results: The participants reported that situations with potentially abusive consequences were a common occurrence, but deliberate abuse was rare. Residents waited too long for personal care, or were denied care they needed to ensure they had enough to eat, were moved safely, or were not emotionally neglected. Some care workers acted in potentially abusive ways because they did not know of a better strategy or understand the resident's illness; care workers made threats to coerce residents to accept care, or restrained them; a resident at high risk of falls was required to walk as care workers thought otherwise he would forget the skill. Most care workers said that they would be willing to report abuse anonymously. Care workers were sent the newly developed Care Home Conflict Scale to comment on but not to complete and to report whether it was acceptable and relevant to them. Several completed it and reported abusive behavior.Conclusion: Lack of resources, especially care worker time and knowledge about managing challenging behavior and dementia were judged to underlie much of the abuse described. We describe the first instrument designed to measure abuse by care home workers anonymously; field-testing is the logical next step.

scholarly journals The “Cameos of Care Homes” project – care home staff’s Vanguard involvement and reflections

2019 ◽  
Vol 23 (2) ◽  
pp. 107-115
Author(s):  
Jess Harris ◽  
Jill Manthorpe
Keyword(s):  
Design Methodology ◽  
Research Output ◽  
Care Home ◽  
Care Homes ◽  
Content Type ◽  
Care Home Staff ◽  
Learning Cultures ◽  
Care Workers ◽  
The Impact ◽  
Practical Implications

Purpose The Cameos of Care Homes project is an opportunity to use the medium of film to showcase the experiences and reflections of frontline care home staff whose employers participated in the National Health Service (NHS) England Vanguard programme. Reflecting on their involvement in one of the Enhanced Health in Care Homes Vanguards, 12 staff describe, in front of the camera, the impact on themselves and their colleagues, on their care for their older residents, and on the wider culture of the care home. The paper aims to discuss this initiative. Design/methodology/approach The paper reports the experiences of care home staff that were purposefully recorded on film about their participation in a care home Vanguard. The recruitment of the care homes and staff is described, as are the development of interview questions and approaches needed when filming is considered as a research method. Findings Participating care home staff reported that their involvement in the Vanguard programme had improved knowledge, confidence, morale, communication skills and the homes’ learning cultures. They were enthusiastic about reporting their experiences on film. Examples were given of proactive early support from local NHS staff leading to improvements in care, thereby reducing demand on the NHS. However, participation was resource intensive for care homes. Care home staff hoped the support that accompanied the Vanguard programme would continue but were uncertain to what degree this would happen once the Vanguard programme ceased. Research limitations/implications The interviews were undertaken with a self-selecting group of care home staff from two care homes operating in one of the six Vanguard sites in England. By their very nature, interviews for a public film cannot provide anonymity. Practical implications Researchers seeking the views of care home staff may wish to consider filming interviews and presenting the film as a research output that is engaging and informative for care home and wider audiences. Originality/value The paper presents an analysis of filmed interviews with care home managers and care workers working with older people. Their views on the Vanguard initiative have not been widely considered, in contrast to the sizeable literature relating to NHS activity and expenditure.

scholarly journals 101 Avoiding Burnout of the Care Home Workforce During the COVID-19 Pandemic and Beyond: Sharing National Learning and Local Initiatives

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Johnston ◽  
C Malcolm ◽  
L Rambabu ◽  
J Hockley ◽  
S D Shenkin
Keyword(s):  
Case Studies ◽  
Online Survey ◽  
Care Home ◽  
Care Homes ◽  
Rapid Review ◽  
Staff Retention ◽  
Complex Needs ◽  
Health And Social Care ◽  
Wide Range ◽  
Home Workers

Abstract Introduction COVID-19 in care homes has heightened the risk of staff burnout, undermining already problematic staff retention and low morale. There has been an associated proliferation of resources and online initiatives to support frontline workers, however, few of these are directly targeted at the care home workforce. Care home workers are highly skilled in caring for people with complex needs, but have very variable levels of formal training, and just over half of care homes in Scotland include registered nurses. This project will rapidly collate existing resources and identify, direct from care home workers, their best practice, initiatives, and resources used to support resilience and retention during this pandemic and moving forward. Methods 1) Rapid review of care home specific evidence and resources (including published research and social media); 2) Online survey of Enabling Research in Care Homes (ENRICH) members across Scotland (n = 55); 3) Case studies within six care homes to identify what is working well and what is not in terms of promoting resilience and emotional support. Results The rapid review has identified a wide range of resources directed at supporting staff working in care homes; the survey and case studies will provide data on the key learning and resources that have supported staff, and outline the challenges identified. There are many resources available but staff do not access these. The role of the care home manager is key. Key conclusions This comprehensive review of resources and initiatives will make a valuable contribution to policy and practice designed to reduce burnout and foster retention not just in care homes but more widely across health and social care.

scholarly journals What makes a good handover in a care home for older people?

2019 ◽  
Vol 23 (3) ◽  
pp. 167-176
Author(s):  
Jo Moriarty ◽  
Caroline Norrie ◽  
Jill Manthorpe ◽  
Valerie Lipman ◽  
Rekha Elaswarapu
Keyword(s):  
Care Home ◽  
Care Homes ◽  
Care Plan ◽  
Handheld Devices ◽  
Small Scale ◽  
Content Type ◽  
Care Home Staff ◽  
Care Workers ◽  
Good Contrast ◽  
Practical Implications

Purpose The purpose of this paper is to investigate the content, purpose and effectiveness of the handover of information between care home staff beginning and completing a shift. Design/methodology/approach This was an exploratory study drawing on ethnographic methods. A total of 27 interviews with a range of care home staff, including managers, registered nurses, senior care workers and care workers were undertaken in five care homes selected to give a good contrast in terms of size, ownership, shift patterns and type of handover. Findings Most handovers were short – lasting 15 min or so – and were held in the office or secluded area in which staff could talk privately. They lasted longer in one home in which the incoming and outgoing shifts physically visited each resident’s room and the communal spaces. Staff felt that handovers were important for the efficient running of the home as well as to alert everyone to changes in a resident’s health or important events, such as a hospital appointment. In one home, handheld devices enabled staff to follow a resident’s care plan and update what was happening in real time. Research limitations/implications This was a small scale study based on data from a limited number of care homes. Practical implications The increasing popularity of 12 h shifts means that many homes only hold two short handovers early in the morning and in the evening when the night staff arrive. There appears to be a trend to reduce the number of staff paid to attend handover. Despite this, handovers remain an important component of the routine of a care home. The information contained in handover relates to the running of the care home, as well as residents’ wellbeing, suggesting that, while their content overlaps with written records in the home, they are not superfluous. Originality/value Although the literature on handovers in hospitals is extensive, this appears to be the first published study of handover practices in care homes.

scholarly journals Memories, identity and homeliness: the social construction of mealtimes in residential care homes in South Wales

2013 ◽  
Vol 34 (5) ◽  
pp. 753-789 ◽  
Author(s):  
SUSAN PHILPIN ◽  
JOY MERRELL ◽  
JOANNE WARRING ◽  
DEBRA HOBBY ◽  
VIC GREGORY
Keyword(s):  
Residential Care ◽  
Temporal Structure ◽  
Care Home ◽  
Geographical Location ◽  
Care Homes ◽  
Staff Members ◽  
Individual Interviews ◽  
South Wales ◽  
Food And Drink ◽  
Informal Carers

ABSTRACTMealtimes in residential care homes are fundamentally social occasions, providing temporal structure to the day and opportunities for conversation and companionship. Food and drink are imbued with social meanings and used to express and create relationships between people. There is a dearth of research exploring care home residents' mealtime experiences in the United Kingdom. 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.

Commissioning social care for older people: influencing the quality of direct care

2013 ◽  
Vol 34 (6) ◽  
pp. 930-950 ◽  
Author(s):  
HELEN CHESTER ◽  
JANE HUGHES ◽  
DAVID CHALLIS
Keyword(s):  
Older People ◽  
Quality Care ◽  
Care Home ◽  
Secondary Data ◽  
Standard Of Care ◽  
Direct Care ◽  
Recruitment And Retention ◽  
Complex Needs ◽  
Care Workers ◽  
Care For Older People

ABSTRACTThe delivery of personalised support to vulnerable older people is largely contingent on those staff who provide direct care. These care workers play an invaluable role in supporting vulnerable older people that may have increasingly complex needs either at home or in care homes. Internationally, concern has been raised both about the recruitment and retention of care workers; and their skills and competencies because of their importance in the delivery of quality care services. Using both primary and secondary data, this paper explores commissioning and contracting arrangements for domiciliary care and care home provision in England and their influence on the recruitment and retention of staff in these services. The implications of the findings are discussed in the context of two factors which influence continuity of care, a proxy for quality services for older people: training opportunities for staff and factors affecting the supply of labour from which direct carers are traditionally recruited. It is suggested that some of the drivers of quality in the provision of care may not be susceptible to the influence of commissioners and providers. Nevertheless, training may aid the recruitment and retention of care workers and provide one way in which they can promote a higher standard of care for older people.

scholarly journals Alcohol in long-term care homes: A qualitative investigation with residents, relatives, care workers and managers

2021 ◽  
pp. 145507252110181
Author(s):  
Jakob Emiliussen ◽  
Søren Engelsen ◽  
Regina Christiansen ◽  
Anette Søgaard Nielsen ◽  
Søren Harnow Klausen
Keyword(s):  
Alcohol Use ◽  
Interpretative Phenomenological Analysis ◽  
Care Home ◽  
Care Homes ◽  
Structured Interviews ◽  
Term Care ◽  
Care Workers ◽  
Symbolic Value

Introduction: Western societies are aging rapidly, and habitual use of alcohol is changing among older adults. Hence, care facilities are facing novel challenges regarding alcohol use. This pioneering qualitative study seeks to investigate the role of alcohol in care homes, as seen from the perspectives of residents, care workers, relatives, and institution management simultaneously. Method: Five residents, four care workers, three relatives, and two care home managers participated in semi-structured interviews lasting 60 minutes maximum. An interpretative phenomenological analysis framework were utilised for the analysis. Results: It seems that there is a positive attitude towards the use of alcohol in care homes across the four groups of participants. They find that the use of alcohol is presently low among the residents. Importantly there appears to be an important symbolic value in the rituals surrounding alcohol which is upheld by all four groups. Conclusion: While experiences between the four groups seem to converge regarding the use of alcohol, there are still some important differences. Importantly, we suggest that these unique views be utilised in developing methods for handling alcohol use in care homes in the future.

The experiences of Indian migrant care home staff working with people with dementia: a pilot study exploring cultural perspectives

2016 ◽  
Vol 20 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Brandon Ow Yong ◽  
Jill Manthorpe
Keyword(s):  
Pilot Study ◽  
Social Care ◽  
Care Home ◽  
Care Homes ◽  
Term Care ◽  
Content Type ◽  
People With Dementia ◽  
Care Workers ◽  
The Social ◽  
The Uk

Purpose – Little is known about migrant Indian care workers working in long-term care facilities for people with dementia in England and the purpose of this paper is to remedy this lack of information in the light of political interest in immigration to the UK and continued staff shortages in parts of the social care sector. Design/methodology/approach – This pilot study investigated the experiences of workplace acculturation among 12 migrant Indian care workers who were employed in English care homes. Qualitative face-to-face interviews were conducted in 2013. Analysis of the interviews was conducted using principles of interpretative phenomenological analysis. Findings – Following analysis five themes emerged along an acculturation timeline. First, during the first six months of their employment, the migrant care workers recalled feeling vulnerable, seemingly marked by a sense of insecurity and an overwhelming state of cognitive burden within an unfamiliar cultural context. Second, simultaneously, the migrants felt perturbed about their new role as direct care workers. Third, few had been able to draw on their networks of friends and relatives to build up knowledge of their new work environments before starting care home employment. Fourth, two years into the work, although they reported feeling better adapted, psychological and socio-cultural adjustments were still thought to be needed. Fifth, most participants retained their ambition to be recognised as a qualified nurse in the UK and to pursue a nursing career outside the social care sector. Research limitations/implications – This is a pilot study in which 12 migrant Indian care home workers were interviewed. Further interviews might provide a greater range of views and experiences. The care homes that participated in this research were in the London region where staff shortages are common in dementia services such as care homes. Practical implications – The findings suggest a need for employers and human resource managers to respond to the specific needs of Indian and other migrants working with older people who are resident in care homes. Such responses should reflect the timeline of their acculturation and employers need also to acknowledge and address aspirations to move on to NHS work. Originality/value – This study is unique to the best of the authors’ knowledge in addressing Indian care workers specifically as a substantial part of the migrant care workforce in the UK. It offers information about their perceptions and suggests practical human response and managerial initiatives.

Sign in / Sign up

Export Citation Format

Share Document