Providing nursing support within residential care homes

This study examines a joint NHS-Local Authority initiative providing a dedicated nursing and physiotherapy team to three residential care homes in Bath and North East Somerset. The initiative aims to meet the nursing needs of residents where they live and to train care home staff in basic nursing. * Hospital admissions and nursing home transfers were prevented. Care home staff and managers preferred residents to be able to stay in their home when they were ill, as did residents themselves. * Enhancing health-orientated education and training of care home staff was challenging at first but relationships improved, and the confidence and professionalism of care staff grew. * Residents’ nursing needs cannot simply be equated with their level of dependency. For example, a resident with dementia can be functionally independent yet have major, often un-communicated health needs. * The early detection of illness and resulting opportunity for early intervention was a major part of the team’s work. Residents were likely to benefit from improved quality of life. * Overall, estimates of costs and savings ranged from a 'worst case' scenario of £2.70 extra to a more likely scenario of £36.90 saved per resident per week. Savings were mainly in reduced use of NHS services, while the Primary Care Trust and Adult Social Services both funded the intervention, highlighting the need for partnership working to sustain funding. * The researchers conclude that any increase in cost should be measured against the benefits of promoting long-term quality of life, quality of care and providing a firm foundation for future workforce development

The Future of Robots in a Super-Aged Society

It is estimated that the world population aged 65+ will triple from 6.9% to 20% by 2050 [1]. Across the world, different countries are at various stages in this super-ageing journey. Japan is the most rapidly ageing society with 28.2% now in this age group; in contrast, emerging economies such as India have some of the world’s youngest populations (6.1% aged 65+) [2]. The creation of super-aged societies will be without parallel in human history. While people may be living longer, it is also important to consider their Quality of Life (QoL), whether these additional years are ‘healthy life years’ [3].&nbsp;</p

Models for providing improved care in residential care homes: a thematic literature review

This Annotated Bibliography is one output from a review of the available research evidence to support improved care in residential care homes as the needs of older people intensify. Key findings The review identified extremely little published evidence on residential care homes; the research base is almost exclusively related to provision of care in nursing homes. Much of this research is from the US or other non-UK sources. Although it could be argued that some findings are generalisable to the UK residential care context, a systematic process is required to identify which. The literature often makes no distinction between nursing and residential homes; use of generic terms such as ‘care home’ should be avoided. There is considerable international debate in the quality improvement literature about the relationship between quality of care and quality of life in nursing and residential homes. Measures of social care, as well as clinical care, are needed. The centrality of the resident’s voice in measuring quality of life must be recognised. Ethnic minority residents are almost entirely absent from the quality improvement literature. Some clinical areas, internationally identified as key in terms of quality e.g. palliative care, are absent in the general nursing and residential home quality improvement literature. Others such as mental health (dementia and depression), diabetes, and nutrition are present but not fully integrated. Considerable evidence points to a need for better management of medication in nursing homes. Pharmacist medication reviews have shown a positive effect in nursing homes. It is unclear how this evidence might relate to residential care. There is evidence that medical cover for nursing and residential care home residents is suboptimal. Care could be restructured to give a greater scope for proactive and preventive interventions. General practitioners' workload in care homes may be considered against quality-of-care measures. There is US literature on the relationship between nurse staffing and nursing care home quality, with quality measured through clinical-based outcomes for residents and organisational outcomes. Conclusions are difficult to draw however due to inconsistencies in the evidencebase. Hospital admission and early discharge to nursing homes research may not be generalisable to residential care. The quality of inter-institutional transfers and ensuring patient safety across settings is important. To date research has not considered transfer from residential to nursing home care. The literature on district nurse and therapist roles in care homes includes very little research on residential care. Partnership working between district nurses and care home staff appears largely to occur by default at present. There is even less research evidence on therapist input to care homes. Set against the context outlined above, the international literature provides evidence of a number of approaches to care improvement, primarily in nursing homes. These include little discussion of cost-effectiveness other than in telecare. Research is needed in the UK on care improvement in residential homes