Managing dementia where there is challenging behaviour

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?

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

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

Let’s Talk – Piloting an educational drama in a care home

Caroline Norrie Dr Michelle CornesCaroline Norrie (left) and Michelle Cornes are, respectively, Research Fellow and Senior Research Fellow at the Social Care Workforce Research Unit. (666 words)

A Transformative Research Fund grant has been awarded to researchers from the Social Care Workforce Research Unit (SCWRU) at King’s College London to pilot an educational drama initiative in a care home in Cumbria. Care home staff, multi-agency colleagues (such as GPs and physiotherapists) and residents will hopefully volunteer to take part in a drama called Let’s Talk, which is designed to stimulate discussion about working relationships. As well as piloting the drama, three interprofessional, reflective ‘Community of Practice’ (CoP) meetings will be held which will act as a forum to discuss care home practices and ideas for change. Continue reading

Helping quality improvement in social care – listening to Registered Social Care Managers’ voices

Caroline Norrie Dr Michelle CornesCaroline Norrie (left) and Michelle Cornes are, respectively, Research Fellow and Senior Research Fellow at the Social Care Workforce Research Unit. (735 words)

Members of the Cumbria Registered Social Care Managers Network (CRSCMN) met recently to discuss what support is needed to help social care services make quality improvements in care homes and domiciliary care agencies.

Care home and home care managers were joined by a representative from Care Sector Alliance Cumbria who has responsibility for the recruitment and retention element of workforce development in this rural county. Michelle Cornes from the Social Care Workforce Research Unit (SCWRU) is Facilitator of the CRSCMN. SCWRU researcher Caroline Norrie, who has recently been working on two projects about adult safeguarding including whole-home investigations, also attended. Continue reading

Just do it!

John Burton John Burton has worked in social care since 1965 as a practitioner at all levels. His book, Leading Good Care, is just out from Jessica Kingsley Publishers. (1,342 words)

In Leading Good Care, I set out and recommend a positive and hopeful vision of social care. My subtitle—the task, heart and art of managing social care—is both realistic and idealistic. The task requires serious, disciplined, hands-on, and hard work. The heart signifies that this work is emotional and personal, and that care is a human relationship. And the art of managing care engages your skills, your imagination, your culture and creativity. Continue reading

View from the Frozen North

Last July we heard from the Cumbria Registered Social Care Managers’ Network (What can the city banks learn from social care?). At their most recent meeting, Network members discussed issues associated with providing care closer to home. (732 words)

Tim Farron, MP for Westmorland and Lonsdale, braved icy conditions to attend the Cumbria Registered Social Care Managers’ Network on Friday 16 January 2015. The aim of the meeting was to explore from social care mangers’ perspectives some of the challenges of delivering care closer to home. Given the pressures currently facing the hospital acute sector and especially Accident and Emergency Departments, discussions of care closer to home are especially topical as it explores how community health and social care staff can work together to keep people out of hospital where appropriate or to help them come home earlier. Continue reading

What do we know about managers of care homes?

Katharine OrellanaKatharine Orellana is a Research Training Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. Katharine’s Care Home Managers: a scoping review of evidence is published today by NIHR School for Social Care Research. (589 words)

We have a tendency to put care home managers at the back of our minds until a crisis hits the headlines. On such sad occasions, there is suddenly a lot of interest in them.

In England, around 460,000 adults live in 17,350 care homes that have a staff body of around 560,000. Care homes are hugely varied in many ways. They range from small, family businesses to large national and multinational chains offering anything from 1 – 215 beds. Homes may cater for more than one group of people, but they all provide accommodation and personal care. Just over a quarter of them also offer nursing, and these account for about half of all places in care homes as they tend to be larger operations. Staff must support residents with increasingly complex needs. Continue reading