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Recognition of the complexity facing residential care homes: a practitioner inquiry

Dudman, J., Meyer, J. ORCID: 0000-0001-5378-2761, Holman, C. and Moyle, W. (2018). Recognition of the complexity facing residential care homes: a practitioner inquiry. Primary Health Care Research and Development, doi: 10.1017/S1463423618000105

Abstract

Aim: To explore the experiences and challenges for residential care home staff when managing the healthcare needs of their residents, in particular those living with dementia.

Background: Increasing number of older people, with complex health and social care needs are living in residential care homes. Yet there is limited appreciation of why staff sometimes struggle to manage residents’ healthcare needs, or understanding of their working relationship with district nurses (DNs), whose responsibility it is to provide nursing support.

Methods: This PhD study, in a metropolitan area in the United Kingdom, was conducted by an experienced DN and involved three phases. This paper focuses on the first two phases. Phase 1 data included: semi-structured interviews (n=8), reflective field notes based on non-participant observation, documentary analysis of policies, procedures and assessment tools and other contextual data from one care home (case study site). The practitioner researcher reflected on the findings from the case study, in relation to her own knowledge and experience as a DN, focusing in particular on findings that were familiar, or which surprised. In Phase 2 she fed these findings back to other care homes (n=11) to check whether the findings from the single case study were unique or resonated with others. She gathered their feedback through semi-structured interviews with senior care staff (n=14). Data were analysed using thematic data analysis.

Findings: Findings highlight the complexity facing residential care homes: high levels of healthcare needs amongst residents, the demands of caring for residents living with dementia, variations in the knowledge and skill set of care staff, inequity in the level of healthcare support, the challenges of building a good relationship with DNs, and funding pressures facing care homes.

Implications: Any, or all of these factors can prevent care home staff from managing the healthcare needs of their residents.

Publication Type: Article
Additional Information: This article has been published in a revised form in Primary Health Care Research and Development https://dx.doi.org/10.1017/S1463423618000105. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © Cambridge University Press 2018.
Publisher Keywords: care home staff; district nurses; dementia; residential care homes
Subjects: R Medicine > RC Internal medicine
Departments: School of Health Sciences > Nursing
URI: http://openaccess.city.ac.uk/id/eprint/20157
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