Category Archives: Residential care

A focus on dementia: ongoing research at the Unit

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As part of Dementia Action Week, Unit researchers Olivia Luijnenburg, Fauzia Knight and Kritika Samsi highlight some of our ongoing work in dementia care research in different settings and topic areas: homecare, care homes, support for carers, community work, reducing inequalities in dementia care and methodological work. (775 words)

Homecare

Our homecare work has led to some novel online guides and resources. Colleagues have produced visual and academic outputs on what the role of Dementia Champions in the homecare sector entails. We have also helped to develop dedicated websites for people living with dementia and those who support them: Forward with dementia is an online guide for people living with dementia and carers to support them after a dementia diagnosis; DemCon 2 (currently under evaluation by homecare workers) is a web-based toilet-use and continence care intervention for homecare workers supporting people living at home with dementia. This project builds on two previous studies to co-design guidance for family carers and health professionals in this context. DemCon 2 will also develop further practical guidance about continence care for use by people living with dementia themselves.

We are also part of the Alzheimer’s Society funded GRACE (Goal diRected, Accessible, & Evidence-based Care for Families affected by dementia), which is a new way to support family carers and people living with dementia, through a manualised intervention using goal setting. We are also contributing to PALLDEM-Homecare, Continue reading →

Building research capacity in social care research to improve care for older people in care homes

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Filipa MaiaThe NIHR-funded SHARE programme aims to build social practitioners’ skills and knowledge, to use research to inform and improve services in the workplace. The SHARE programme is a collaboration between Kingston University and King’s College London working closely with NIHR ARC South London and the NIHR Policy Research Unit in Health and Social Care Workforce. Filipa Maia, one of the people who have been awarded funding to take part in the programme, writes here about her experience of the SHARE programme and how her research could improve care for older people in care homes. Filipa is an education, research and engagement officer at Nightingale Hammerson, a care home provider. (1,249 words)

Please tell us a bit about your background and why you applied for the funding?

I moved to London in July 2021, shortly after completing a Master’s degree in Sociology at Nova University of Lisbon. I majored in English and Spanish studies, before my Master’s in Women’s Studies. By mixing my passions for literature and theatre, I wrote my thesis, “Women’s views of their own bodies: a study on representations of the female body in feminist theatre.” During that process, I discovered how much I like writing about people, their stories, their work and their motivations. Sociology felt like a good choice, a way to understand people more deeply in society and create space for their experiences to be explored and shared.

When I arrived in London, I stepped into the world of care by chance and found an entirely new way to connect with people. My first role was as a therapy assistant at Nightingale Hammerson, where I spent hours alongside residents and observed healthcare professionals of all kinds (physiotherapists, occupational therapists, healthcare assistants, registered nurses) all working with one shared goal of giving residents the best possible quality of life. Continue reading →

Exploring the effects of the rise of living costs on small to medium sized care home providers and care professionals

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Head and shoulders of a person

Dr Caroline Emmer De Albuquerque Green, Post-Doctoral Fellow at the ARC South London, introduces a new study. Caroline works within the NIHR Applied Research Collaboration South London: Social Care Theme at HSCWRU.

 

“Our work is to care for the most vulnerable in society and after the pandemic… [the costs of living crisis] is more reason why providers will be closing homes” (A small care home provider)

The United Kingdom (UK) is currently experiencing the steepest rise of inflation in the past 30 years. Consumer prices in February 2022 were 6.2% higher compared to the previous year. The Bank of England estimates that inflation may rise to 9% in 2022 (Francis-Devine et al. 2022 Rising cost of living in the UK – House of Commons Library (parliament.uk)). For people living in the UK, this means increased costs of living, including fuel, energy and food prices. This is also the case for care homes and people working in them, which next to the rise of living costs are still facing Covid-19 related restrictions, staff shortages as well as further rises in operational costs and taxes. Continue reading →

The Gallery of Spiritualities – welcome to a new exhibition in a care home

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olivia luijnenburgOlivia Luijnenburg is a Research Associate in King’s College London’s NIHR Policy Research Unit in Health and Social Care Workforce. (460 words)

What is ‘spirituality’ in care? How can care home staff attend to residents’ spiritual needs? For my PhD project, I had the task of finding answers to such questions. When thinking about spirituality and spiritual needs, many people’s minds immediately go to religion and religious needs. However, what about care home residents who do not practice a religion or are not part of a religious community? We know that spiritual wellbeing is found through a sense of community, connection, nature, or the arts, which can but does not have to be of a religious nature. Surprisingly, the spiritual needs of older people in residential care have often been overlooked.

To address the lack of knowledge around spirituality in care and illuminate the intangibility of what spiritual needs might look like, I collected ‘artefacts’ from care home residents before talking with them. These could be an object, a space, a song, a person, or anything else that represented a sense of joy, peace, safety, or fond memories for the person. The ‘artefacts’ functioned as a conversation starter, as well as a stimulant to the imagination of what ‘spirituality’ might mean to the participant. They were photographed and collected in a ‘Gallery of Spiritualities’. Continue reading →

Cleaning, catering and housekeeping staff in care homes: shining a light on their contributions during Covid

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Kritika Samsi and Caroline Norrie, Research Fellows at the Policy Research Unit in Health and Social Care Workforce, introduce a new study at the Unit. (329 words)

Kritika Samsi

Kritika Samsi

Caroline Norrie

Caroline Norrie

Housekeeping staff in care homes – cleaners, those working in kitchens, laundries, maintenance – are often forgotten but are the backbone of many care homes. What happened to them during the coronavirus pandemic is the subject of a new research study. Researchers at the NIHR Health and Social Care Workforce Research Unit at King’s College London (KCL) have received NIHR Policy Research Programme funding to investigate the experiences and challenges of these care home workers during COVID-19.

Housekeeping and catering staff have been crucial during the coronavirus crisis given their role in infection control, food preparation, and help with social distancing. But they tend to be overlooked. What they have done and the challenges they faced during the crisis are often hidden. Many are women with families, work part-time, and on shifts, and often are from migrant or minority ethnic backgrounds. We know they are not well paid. Some sadly died from the virus. We want to find out whether and to what extent these workers were prepared and supported in their roles during the pandemic. This will help meet a gap in knowledge – how to better support this staff group work to prevent coronavirus, help those with it, and with service recovery. Continue reading →

Toolkit for reflection on human rights in the context of social care

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Caroline Green is Post-Doctoral Fellow at the Policy Research Unit in Health and Social Care Workforce, King’s College London. (709 words)

During the COVID-19 pandemic, the importance of human rights for people needing care and support in care homes or at home, their carers, families and friends became evident. Care home residents, especially people with dementia, were one of the groups who were and still are most severely affected by the virus, with thousands of deaths from a COVID-19 infection not only in England but many countries around the world. The need to protect people requiring care and support and to balance infection control – thus the basic rights to health and life – with the right to a private and family life and to social participation was but one of many examples of a human rights issue that we as a society had to face during this pandemic. Conversations around these topics are often difficult.

Human rights as enshrined in international and national law, notably the Human Rights Act, are directly relevant to people requiring care and support, service providers and care workers. Not only is every human being entitled to have his or her rights respected, protected and implemented but the English legal and regulatory system for care providers also makes them directly relevant in care settings. However, human rights are more than a legal concept. They are also a moral concept, which can help to build a social care system and determine the way care is provided. Human rights in social care is therefore a broad topic, with many different ways of approaching it in conversations, training and research. Continue reading →

Cameos of Care Homes: stories from social care Vanguards

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Jess Harris is Research Fellow at the Social Care Workforce Research Unit, King’s College London. She led the Cameos of Care Homes project. (616 words)

Six ‘Vanguard’ areas across England have been developing approaches to enable care homes to better support the increasingly complex health needs of their residents. These six, focusing on ‘Enhanced Health in Care Homes’, were among 50 Vanguard pilot areas (2015 to 2018) tasked with developing models of care that can be sustained and replicated across England, helping the health and social care system tackle financial pressures and rising demands.

A recent National Audit Office (NAO) report has examined the Vanguards’ impact so far, in terms of value for money, and concluded: ‘there are early signs of a positive impact on emergency admissions’. However, at this early stage it cautions that ‘the longterm impact and sustainability of Vanguards is still not proven’. (page 47)

Staff members taking part in ‘Cameos of Care Homes’

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Managing dementia where there is challenging behaviour

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Esme Moniz-Cook and Jill Manthorpe summarise the findings from a study on the management of dementia. (609 words)

  • Help for family carers supporting people with dementia who are distressed is much needed but services struggle to provide effective responses
  • Both families and care home staff need more support to help them to care for people with dementia – especially when the ‘going gets tough’

Bookshelf_NBK447072-page-001The findings from a large research study on the Management of Dementia with clinically significant challenging behaviour at home and in care homes led by the University of Hull and Humber NHS FT are published today (11 August 2017). The research was funded by the National Institute for Health Research (NIHR), Programme Grants for Applied Research (PGfAR). The study examined the records of over 5,300 older people and their families who were referred for specialist help to NHS mental health services across England. Nearly two thirds (61%) of those with dementia and distressing behaviour had a mild dementia rather than severe dementia. Practitioners did not always recognise that people at this stage were experiencing problems such as agitation, aggression and distress; and over a six month period, they did not manage to reduce the difficulties faced by these families. Families bore most of the care costs, and many were untouched by the evidence, guidelines and scope that services should provide them with timely individually-tailored effective responses to their challenging circumstances. Continue reading →

Researching in care homes – what was learnt from a study of handovers?

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Caroline NorrieCaroline Norrie is Research Fellow at the Social Care Workforce Research Unit, King’s College London (330 words)

What can researchers of care services learn from our recent handover study?  We asked ourselves this question and discussed this at the annual conference of the British Society of Gerontology held in Swansea last week (pictured below is the new beach side campus) at the start of July. Our paper summarised the findings of our unique exploration into handovers in care homes and then we paused to ask what could be relevant to other researchers studying care home practice and systems. Continue reading →

Let’s Talk – Care Homes and Delayed Discharge

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Bev EvansNorman CrumpBev Evans and Norman Crump, both of Lancaster University Management School, report from a recent meeting where participants discussed the transition from hospital to care home. (913 words)

According to the National Audit Office (2016), between 2013 and 2015, official delayed transfers of care rose 31 per cent and in 2015 accounted for 1.15 million bed days – 85 per cent of patients occupying these beds were aged over 65. Since 2010, waits for beds in nursing homes increased by 63 per cent. Across Morecambe Bay University Hospitals NHS Foundation Trust (MBUHT) waiting for a care home place can be a significant cause of delay.

In early October, Cumbria Registered Social Care Managers’ Network, Kendal Integrated Care Community (ICC) and MBUHT convened a special ‘Let’s Talk’ discussion group which brought together local care home managers, social workers, hospital discharge coordinators, ward staff and nurse practitioners from the community. The aim of the meeting was to explore how the transition from hospital to a care home could be improved. ‘Let’s Talk’ is a specially facilitated session delivered by King’s College London, Lancaster University, Dignity in Dementia and the South Lakes Registered Social Care Managers Network. Meetings are designed to enable participants to see issues from each other’s perspectives and to afford time to critically reflect on a particular ‘wicked issue’. Continue reading →