scholarly journals An evaluation of a safety improvement intervention in care homes in England: a participatory qualitative study

2018 ◽  
Vol 111 (11) ◽  
pp. 414-421 ◽  
Author(s):  
Martin Marshall ◽  
Nadine Pfeifer ◽  
Debi de Silva ◽  
Li Wei ◽  
James Anderson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Care Home ◽  
Qualitative Evaluation ◽  
Care Homes ◽  
Care Home Staff ◽  
Safety Improvement ◽  
Preventable Harm ◽  
High Level ◽  
Willingness To Use ◽  
Improvement Intervention

Summary Objective A growing proportion of older people live in care homes and are at high risk of preventable harm. This study describes a participatory qualitative evaluation of a complex safety improvement intervention, comprising training, performance measurement and culture-change elements, on the safety of care provided for residents. Design A participatory qualitative study. Setting Ninety care homes in one geographical locality in southern England. Participants A purposeful sample of care home managers, front-line staff, residents, quality improvement facilitators and trainers, local government and health service commissioners, and an embedded researcher. Main outcome measures Changes in care home culture and work processes, assessed using documentary analysis, interviews, observations and surveys and analysed using a framework-based thematic approach. Results Participation in the programme appears to have led to changes in the value that staff place on resident safety and to changes in their working practices, in particular in relation to their desire to proactively manage resident risk and their willingness to use data to examine established practice. The results suggest that there is a high level of commitment among care home staff to address the problem of preventable harm. Mobilisation of this commitment appears to benefit from external facilitation and the introduction of new methods and tools. Conclusions An evidence-based approach to reducing preventable harm in care homes, comprising an intervention with both technical and social components, can lead to changes in staff priorities and practices which have the potential to improve outcomes for people who live in care homes.

scholarly journals The Contribution of Pharmacists and Pharmacy Technicians to Person-Centred Care within a Medicine’s Optimisation in Care Homes Service: A Qualitative Evaluation

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Sally Fowler Davis ◽  
Rachel Cholerton ◽  
Louise Freeman-Parry ◽  
Jo Tsoneva
Keyword(s):  
Care Home ◽  
Pharmacy Practice ◽  
Qualitative Evaluation ◽  
Care Homes ◽  
Framework Analysis ◽  
Medicines Management ◽  
Team Members ◽  
Care Home Staff ◽  
Management Interventions ◽  
Pharmacy Technicians

Pharmacists and pharmacy technicians seek to improve person-centred care. Improvements to systems for care homes seeks to reduce medicines waste and inefficiency, particularly through supporting care home staff, to enhance safer administration of medicines. A complex evaluation used qualitative design and utilised narrative enquiry, and team members and key stakeholders were interviewed. Framework analysis was used, aligning findings to a person-centred care framework for older people. The Medicines Optimisation in Care Homes (MOCH) team brokered improvement practices across care homes to enhance person-centred care. The framework analysis confirms that the team used ‘authentic attention’ in relation to the residents’ experiences and flexibility in relation to negotiating medication. The importance of transparency of processes and systems in medicines management is highlighted, alongside requirements for person-centred care to make explicit the reason for taking a medication, and the continuous discussion with a range of stakeholders about the continuing need for particular medications. The outcome of the evaluation includes insights into a new area of pharmacy practice in community, based on the skills, knowledge, and experience of pharmacists and pharmacy technicians working in the care home sector. Further study is needed into the efficacy and outcomes of medicines management interventions.

The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences

2021 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Chris Harvey ◽  
Simon Froggatt ◽  
Bryan Lightowler ◽  
Andrew Hodge
Keyword(s):  
Qualitative Study ◽  
Care Home ◽  
Community Services ◽  
Ambulance Service ◽  
Care Staff ◽  
Care Homes ◽  
Service Demand ◽  
Staff Members ◽  
Care Home Staff ◽  
Advanced Practitioner

Background/Aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences

2021 ◽  
Vol 23 (10) ◽  
pp. 1-8
Author(s):  
Chris Harvey ◽  
Simon Froggatt ◽  
Bryan Lightowler ◽  
Andrew Hodge
Keyword(s):  
Qualitative Study ◽  
Care Home ◽  
Community Services ◽  
Ambulance Service ◽  
Care Staff ◽  
Care Homes ◽  
Service Demand ◽  
Staff Members ◽  
Care Home Staff ◽  
Advanced Practitioner

Background/aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

scholarly journals Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation

2020 ◽  
Vol 70 (700) ◽  
pp. e793-e800
Author(s):  
Siân Russell ◽  
Rachel Stocker ◽  
Robert Oliver Barker ◽  
Jennifer Liddle ◽  
Joy Adamson ◽  
...  
Keyword(s):  
Early Warning ◽  
Care Home ◽  
Qualitative Evaluation ◽  
Acute Illness ◽  
Care Homes ◽  
Early Warning Score ◽  
Normalisation Process Theory ◽  
Home Setting ◽  
Care Home Staff ◽  
National Early Warning Score

BackgroundThe National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents’ vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England.AimTo identify challenges to implementation of NEWS in care homes.Design and settingQualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee.MethodInterviews were intended to capture people’s attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes.ResultsCare home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication.ConclusionThis evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.

scholarly journals Remembering the past, enhancing the present and sharing the future: a qualitative study of the impact of film screenings in care home communities

2020 ◽  
pp. 1-26
Author(s):  
Jenna P. Breckenridge ◽  
Thilo Kroll ◽  
Gavin Wylie ◽  
Ana Salzberg
Keyword(s):  
Qualitative Study ◽  
Care Home ◽  
Social Activity ◽  
Care Homes ◽  
Social Connection ◽  
Emotional Wellbeing ◽  
Care Home Staff ◽  
People With Dementia ◽  
The Rich ◽  
The Impact

Abstract Many care home residents lack opportunities for meaningful activity and social connection, resulting in poor physical and emotional wellbeing. Providing residents with varied activities and social opportunities can improve their quality of life. In this paper, we examine the potential for film to provide a meaningful, social activity. The limited existing research on film in care homes has predominantly examined the use of film clips and materials in stimulating reminiscence for people with dementia. In this paper, we adopt a broader, trans-disciplinary perspective of film, drawing on evidence from Film Studies that shared spectatorship has social and emotional benefits for the viewer. We offer the first qualitative study of care home residents’ social, emotional and embodied engagement with feature-length film and identify the key benefits of film in this setting. We ran social film screenings in two Scottish care homes over six weeks. Underpinned by psycho-cinematic theory, we collected and analysed observational data alongside interviews with care home staff and discussion groups with residents. Our findings identified three ways in which film screenings benefit residents and supports social connection: prompting reminiscence; enhancing residents’ experiences in the present; and creating a shared future and intergenerational connections. The paper offers useful insights into the rich potential for film to enhance the care home community, facilitate social connectivity and promote resident wellbeing.

scholarly journals Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Marshall ◽  
Adam Gordon ◽  
John R. F. Gladman ◽  
Simon Bishop
Keyword(s):  
Central Government ◽  
Resource Constraints ◽  
Care Delivery ◽  
Care Home ◽  
Third Sector ◽  
Care Homes ◽  
Framework Analysis ◽  
Local Networks ◽  
Care Home Staff ◽  
East Midlands

Abstract Background From late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed. Methods Ten managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals. Results Three key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care. Conclusions This study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.

scholarly journals Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Georgios Tsakos ◽  
Paul R. Brocklehurst ◽  
Sinead Watson ◽  
Anna Verey ◽  
Nia Goulden ◽  
...  
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Complex Intervention ◽  
Assessment Tool ◽  
Care Home ◽  
Care Homes ◽  
Routine Practice ◽  
Oral Health Promotion ◽  
Nice Guideline ◽  
Care Home Staff

Abstract Background Evidence for interventions promoting oral health amongst care home residents is weak. The National Institute for Health and Care Excellence (NICE) guideline NG48 aims to maintain and improve the oral health of care home residents. A co-design process that worked with residents and care home staff to understand how the NG48 guideline could be best implemented in practice has been undertaken to refine a complex intervention. The aim of this study is to assess the feasibility of the intervention to inform a future larger scale definitive trial. Methods This is a protocol for a pragmatic cluster randomised controlled trial with a 12-month follow-up that will be undertaken in 12 care homes across two sites (six in London, six in Northern Ireland). Care homes randomised to the intervention arm (n = 6) will receive the complex intervention based on the NG48 guideline, whilst care homes randomised to the control arm (n = 6) will continue with routine practice. The intervention will include a training package for care home staff to promote knowledge and skills in oral health promotion, the use of the Oral Health Assessment Tool on residents by trained care home staff, and a ‘support worker assisted’ daily tooth-brushing regime with toothpaste containing 1500 ppm fluoride. An average of ten residents, aged 65 years or over who have at least one natural tooth, will be recruited in each care home resulting in a recruited sample of 120 participants. Assessments will be undertaken at baseline, 6 months and 12 months, and will include a dental examination and questionnaires on general health and oral health administered by a research assistant. A parallel process evaluation involving semi-structured interviews will be undertaken to explore how the intervention could be embedded in standard practice. Rates of recruitment and retention, and intervention fidelity will also be recorded. A cost-consequence model will determine the relevance of different outcome measures in the decision-making context. Discussion The study will provide valuable information for trialists, policymakers, clinicians and care home staff on the feasibility and associated costs of oral health promotion in UK care homes. Trial registration ISRCTN10276613. Registered on 17th April 2020. http://www.isrctn.com/ISRCTN10276613.

scholarly journals Active residents in care homes: A holistic approach to promoting and encouraging meaningful activity for residents living in care homes: Innovative Practice

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1942-1947 ◽  
Author(s):  
Raymond Smith ◽  
Julia Wood ◽  
Fiona Jones ◽  
Liezl Anderson ◽  
Michael Hurley
Keyword(s):  
Residential Care ◽  
Systems Approach ◽  
Care Home ◽  
Family Members ◽  
Occupational Therapists ◽  
Holistic Approach ◽  
Care Homes ◽  
Care Home Staff ◽  
Meaningful Activity ◽  
Whole Systems

The active residents in care homes intervention aim to promote meaningful activity among care home residents. Residents, family members and staff from three residential care homes in South London are participating. It is a whole systems approach which involves formal and ‘on the floor’ training to empower care home staff to facilitate activity. Training is delivered by two occupational therapists, a physiotherapist and a rehabilitation assistant. This paper describes the active residents in care homes intervention, the evaluation methods and discusses some preliminary findings.

Urinary catheterization in care homes for older people: self-reported questionnaire audit of catheter management by care home staff

2006 ◽  
Vol 62 (1) ◽  
pp. 29-36 ◽  
Author(s):  
C.A.M. McNulty ◽  
J. Bowen ◽  
C. Foy ◽  
K. Gunn ◽  
E. Freeman ◽  
...  
Keyword(s):  
Older People ◽  
Care Home ◽  
Care Homes ◽  
Urinary Catheterization ◽  
Care Home Staff
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