Care Home Project Team

Sydenham, United Kingdom

Care Home Project Team

Sydenham, United Kingdom
SEARCH FILTERS
Time filter
Source Type

Kinley J.,Care Home Project Team | Stone L.,Care Home Project Team | Dewey M.,King's College London | Levy J.,Lancaster University | And 6 more authors.
Palliative Medicine | Year: 2014

Background: The provision of quality end-of-life care is increasingly on the national agenda in many countries. In the United Kingdom, the Gold Standards Framework for Care Homes programme has been promoted as a national framework for improving end-of-life care. While its implementation is recommended, there are no national guidelines for facilitators to follow to undertake this role.Aim: It was hypothesised that action learning alongside high facilitation when implementing the Gold Standards Framework for Care Homes programme will result in a reduced proportion of hospital deaths for residents and improvement in the care home staff ability to facilitate good end-of-life care.Design: A cluster randomised controlled trial where 24 nursing homes received high facilitation to enable them to implement the Gold Standards Framework for Care Homes programme. The managers of 12 nursing homes additionally took part in action learning sets. A third group (14 nursing homes) received the 'standard' Gold Standards Framework for Care Homes facilitation available in their locality.Setting/participants: In total, 38 nursing homes providing care for frail older people, their deceased residents and their nurse managers.Results: A greater proportion of residents died in those nursing homes receiving high facilitation and action learning but not significantly so. There was a significant association between the level of facilitation and nursing homes completing the Gold Standards Framework for Care Homes programme through to accreditation. Year-on-year change occurred across all outcome measures.Conclusion: There is a danger that without national guidelines, facilitation of the Gold Standards Framework for Care Homes programme will vary and consequently so will its implementation. The nurse manager of a care home must be actively engaged when implementing the Gold Standards Framework for Care Homes programme. © The Author(s) 2014.


Kinley J.,Care Home Project Team | Hockley J.,Care Home Project Team | Stone L.,Care Home Project Team | Dewey M.,King's College London | And 5 more authors.
Age and Ageing | Year: 2014

Objectives: to identify the care currently provided to residents dying in UK nursing care homes. Method: study participants were residents who had died within 38 nursing care homes in southeast England over a 3-year period. The nursing care homes had been recruited to take part in a cluster randomised controlled trial looking at different models of facilitation while implementing the Gold Standards Framework in Care Homes (GSFCH) programme. Two researchers examined the notes and daily records of all residents who died in each of these homes between the 1 June 2008 and the 31 May 2011. Results: a total of 2,444 residents died during the 3-year period. Fifty-six percent of these residents died within a year of admission. The support from specialist healthcare services to residents during their last 6 months of life was variable. Conclusions: nursing care homes have established links with some external healthcare providers. These links included the GP, palliative care nurses and physiotherapy. As dependency of resident increase with 56% residents dying within a year of admission these links need to be expanded. The provision of health care that meets the needs of future nursing care home residents needs to be 'proactively' obtained rather than left to chance. © The Author 2013.


PubMed | Lancaster University, Care Home Project Team and King's College London
Type: Journal Article | Journal: Palliative medicine | Year: 2014

The provision of quality end-of-life care is increasingly on the national agenda in many countries. In the United Kingdom, the Gold Standards Framework for Care Homes programme has been promoted as a national framework for improving end-of-life care. While its implementation is recommended, there are no national guidelines for facilitators to follow to undertake this role.It was hypothesised that action learning alongside high facilitation when implementing the Gold Standards Framework for Care Homes programme will result in a reduced proportion of hospital deaths for residents and improvement in the care home staff ability to facilitate good end-of-life care.A cluster randomised controlled trial where 24 nursing homes received high facilitation to enable them to implement the Gold Standards Framework for Care Homes programme. The managers of 12 nursing homes additionally took part in action learning sets. A third group (14 nursing homes) received the standard Gold Standards Framework for Care Homes facilitation available in their locality.In total, 38 nursing homes providing care for frail older people, their deceased residents and their nurse managers.A greater proportion of residents died in those nursing homes receiving high facilitation and action learning but not significantly so. There was a significant association between the level of facilitation and nursing homes completing the Gold Standards Framework for Care Homes programme through to accreditation. Year-on-year change occurred across all outcome measures.There is a danger that without national guidelines, facilitation of the Gold Standards Framework for Care Homes programme will vary and consequently so will its implementation. The nurse manager of a care home must be actively engaged when implementing the Gold Standards Framework for Care Homes programme.


Stacpoole M.,Care Home Project Team | Hockley J.,Care Home Project Team | Thompsell A.,South London and Maudsley NHS Foundation Trust | Simard J.,University of Western Sydney | Volicer L.,University of South Florida
International Journal of Geriatric Psychiatry | Year: 2015

Objective The objective of the study was to evaluate the effects of the Namaste Care programme on the behavioural symptoms of residents with advanced dementia in care homes and their pain management. Methods Six dementia care homes collaborated in an action research study - one withdrew. Inclusion criteria were a dementia diagnosis and a Bedford Alzheimer's Nursing Severity Scale score of >16. Primary research measures were the Neuropsychiatric Inventory - Nursing Homes (NPI-NH) and Doloplus-2 behavioural pain assessment scale for the elderly. Measures were recorded at baseline and at three 1-2 monthly intervals after Namaste Care started. Results Management disruption occurred across all care homes. The severity of behavioural symptoms, pain and occupational disruptiveness (NPI-NH) decreased in four care homes. Increased severity of behavioural symptoms in one care home was probably related to poor pain management, reflected in increased pain scores, and disrupted leadership. Comparison of NPI-NH scores showed that severity of behavioural symptoms and occupational disruptiveness were significantly lower after initiation of Namaste Care (n-=-34, p-<-0.001) and after the second interval (n-=-32, p-<-0.001 and p-=-0.003). However, comparison of these measures in the second and third intervals revealed that both were slightly increased in the third interval (n-=-24, p-<-0.001 and p-=-0.001). Conclusions Where there are strong leadership, adequate staffing, and good nursing and medical care, the Namaste Care programme can improve quality of life for people with advanced dementia in care homes by decreasing behavioural symptoms. Namaste is not a substitute for good clinical care Copyright © 2014 John Wiley & Sons, Ltd.


PubMed | University of South Florida, South London and Maudsley NHS Foundation Trust, Care Home Project Team and University of Western Sydney
Type: Journal Article | Journal: International journal of geriatric psychiatry | Year: 2015

The objective of the study was to evaluate the effects of the Namaste Care programme on the behavioural symptoms of residents with advanced dementia in care homes and their pain management.Six dementia care homes collaborated in an action research study-one withdrew. Inclusion criteria were a dementia diagnosis and a Bedford Alzheimers Nursing Severity Scale score of >16. Primary research measures were the Neuropsychiatric Inventory-Nursing Homes (NPI-NH) and Doloplus-2 behavioural pain assessment scale for the elderly. Measures were recorded at baseline and at three 1-2 monthly intervals after Namaste Care started.Management disruption occurred across all care homes. The severity of behavioural symptoms, pain and occupational disruptiveness (NPI-NH) decreased in four care homes. Increased severity of behavioural symptoms in one care home was probably related to poor pain management, reflected in increased pain scores, and disrupted leadership. Comparison of NPI-NH scores showed that severity of behavioural symptoms and occupational disruptiveness were significantly lower after initiation of Namaste Care (n = 34, p < 0.001) and after the second interval (n = 32, p < 0.001 and p = 0.003). However, comparison of these measures in the second and third intervals revealed that both were slightly increased in the third interval (n = 24, p < 0.001 and p = 0.001).Where there are strong leadership, adequate staffing, and good nursing and medical care, the Namaste Care programme can improve quality of life for people with advanced dementia in care homes by decreasing behavioural symptoms. Namaste is not a substitute for good clinical care.


PubMed | Care Home Project Team, Family Perception of Care Audit Project Lead and Family Perception of Care Audit Project Administrator
Type: Journal Article | Journal: International journal of palliative nursing | Year: 2016

This article aims to share the experience of a hospice in facilitating a multi-centre audit of end-of-life care in care homes, particularly noting the challenges and enablers of carrying out the audit.The audit was a retrospective multi-centre survey of bereaved relatives/next of kin of residents who died in the care home, using an anonymous, validated questionnaire: the Family Perception of Care Scale. Questionnaires were sent 3-months after bereavement. Returned questionnaires were analysed using SPSS and Excel. The care homes were in areas encompassing outer and inner city populations.The team identified eight challenges to the audit process, in particular, embedding procedures within the care homes, non-responses and developing action plans for improvement.Overall, the audit provided an indication of where improvements could be made and where care was already excellent, built confidence and increased expertise in the care-home staff.


Kinley J.,Care Home Project Team
Palliative medicine | Year: 2013

The number of older people in the UK is increasing. A significant proportion of end of life care for this population is currently provided and will increasingly be provided within nursing care homes. To identify the impact of implementing end of life care policy with regard to the use of the Gold Standards Framework in Care Homes programme, the Liverpool Care Pathway (or an Integrated Care Pathway) and educational/training interventions to support the provision of end of life care within nursing care homes within the UK. Systematic literature review of published literature and reports. An electronic search was undertaken of five databases-Medline, CINAHL, EMBASE, Web of Science and the Cochrane library and websites of government and palliative care organisations for papers and reports published between 2000 to June 2010. The reference lists of studies that were retrieved for the detailed evaluation were hand-searched for any additional relevant citations.. Only studies that included comparative outcome data were eligible for inclusion. Eight papers/reports, incorporating information from three studies were identified. Two studies reported on the implementation of the Gold Standards Framework in Care Homes programme and one the implementation of an Integrated Care Pathway for the last days of life. Improvements occurred in resident outcomes and in relation to staff recognising, managing and meeting residents needs for end of life care. The studies provided limited evidence on improved outcomes following the implementation of these interventions. Further research is needed, both within the UK and internationally, that measures the process and impact of implementing these initiatives.


Background: Nursing care homes are increasingly the place where frail older people die. However, training in end-of-life care is not statutory. Aims and objectives: To develop strategies to promote quality end-of-life care in nursing care homes. Design: Action research was used to work collaboratively with the managers and staff in two nursing care homes to develop end-of-life care. Methods: There were three overarching phases: an exploratory phase, feedback/planning of actions and a summative evaluation. Two main actions were inductively derived. One of the actions, reflective debriefing groups following a resident's death, is reported. Results: Ten reflective debriefing groups, led by the researcher (a specialist palliative care nurse), were undertaken. The groups facilitated learning at three different levels (being taught, developing understanding and critical thinking) and enabled staff to feel supported and valued. Implications for practice: The use of reflective debriefing groups is a useful mechanism to support experience-based learning about death/dying in care homes. © 2014 John Wiley & Sons Ltd.


PubMed | Care Home Project Team and University of Edinburgh
Type: Journal Article | Journal: International journal of palliative nursing | Year: 2016

The global population is changing with an increasing percentage of the oldest old, many of whom in the UK are looked after in care homes. Care homes now provide care for a fifth of the UK population who die each year. However, most nursing care homes are privately owned and not part of the NHS, which exposes staff to a lack of skills/knowledge in relation to end-of-life care.To implement the Gold Standards Framework in Care Homes Programme and audit outcomes within nursing care homes across five Clinical Commissioning Groups over a 7-year period using a research-based model of facilitation.The percentage of residents dying in nursing care homes increased from 57% to 79%, with improvement in other outcomes.A high facilitation model, including a sustainability initiative and ongoing audit, contributed to significant improvements when implementing the Programme. Reciprocity and trustworthiness underpin the success of this initiative.


PubMed | Care Home Project Team
Type: Journal Article | Journal: Age and ageing | Year: 2014

to identify the care currently provided to residents dying in U.K. nursing care homes.study participants were residents who had died within 38 nursing care homes in southeast England over a 3-year period. The nursing care homes had been recruited to take part in a cluster randomised controlled trial looking at different models of facilitation while implementing the Gold Standards Framework in Care Homes (GSFCH) programme. Two researchers examined the notes and daily records of all residents who died in each of these homes between the 1 June 2008 and the 31 May 2011.a total of 2,444 residents died during the 3-year period. Fifty-six percent of these residents died within a year of admission. The support from specialist healthcare services to residents during their last 6 months of life was variable.nursing care homes have established links with some external healthcare providers. These links included the GP, palliative care nurses and physiotherapy. As dependency of resident increase with 56% residents dying within a year of admission these links need to be expanded. The provision of health care that meets the needs of future nursing care home residents needs to be proactively obtained rather than left to chance.

Loading Care Home Project Team collaborators
Loading Care Home Project Team collaborators