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Powerpoint about the current state of care homes, about the evolution of My Home Life as a movement and our leadership course.

Powerpoint about the current state of care homes, about the evolution of My Home Life as a movement and our leadership course.

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  • 18,000 care homesTypically -
  • 0.9% for ages 65-74, 4.3% for 75-84 year olds and 20.7% if 85 and over. Women residents tend to be older, at an average age of 85.6 years, compared to 83.2 for men (Office o). Two thirds of older people living in care homes experience some level of cognitive impairment and75% of them are classified as being severely disabled. It is also estimated that up to 40% of residents experience depression. Depression is estimated to affect up to 40% of older people who live in care homes and it often goes unrecognised (Audit Commission 2000. Audit Commission (2000) Forget Me Not: Mental Health Services for Older People. Audit Commission, London. Two Thirds of older people living in care homes experience some level of cognitive impairment. Bebbington A, Darton R and Netten A (2001) Care homes for older people. Volume 2. Admissions, needs and outcomes. PSSRU. Canterburyf Fair Trading 2005). 75% classified as being severely disabled (OFT 2005)
  • UK Residential care for the Elderly Market Development Report 2.5% reduction in LA fees this yearBased upon: ! Unit Costs of Health and Social Care 2010 compiled by Lesley Curtis is free online (http://www.pssru.ac.uk/uc/uc.htm#contents) and is a  respectable referencing source too. There is also a whole section on care for older people: http://www.pssru.ac.uk/pdf/uc/uc2010/uc2010_s01.pdf  SERVICEEstimated Weekly cost*NotesHospice£2,600 Care home –children£2,408 Elderly impatient ward bed for a week£2,051 Long-stay mental hospital£1,505 High dependency care home (younger people)£1,345 Care home – learning disabilities£922  Residential care home (young people)£748 Residential rehab – drug & alcohol use£628 Nursing Home (older people)£494*Amount paid for by PSSResidential Home (older people)£446*Amount paid for by PSS
  • Netten et al (2001) found that two thirds of homes in their survey had staff with NVQs or BTEC awards, with many other members of staff working towards such qualifications. Another survey by the CPA (2001) of 1200 independent sector and local authority homes found that at least 20% of all care assistants had some form of additional training qualification (TAKEN FROM DUDMAN –MHL Lit Review)Skills for Care survey reveals happy but unappreciated social care workforceby Shirley Ayres - May 25, 2008 The first ever survey of more than 750,000  care workers across England found that whlst 90% of staff are happy in their work less than half believe their work is appreciated by the general public.The survey of 500 care workers carried out by Skills for Care found only 39% felt their work was appreciated and many felt that there was little understanding of the value of their hard work.
  • Commissioning, health and safety, chemical regulations, medicatiion guidelines, health and safetyREAD FAIRY STORY
  • 40 years ago – door handles placed out of reach, manual restraint common place – strapped in,Now, not so, more engaged, some amazing care homes supporting residents who have been forgotten by other models of care,Care homes advocating and championing for residents
  • Laing and BuissonIncreasingly important roleIncreased demand - 40,000 beds in next ten years and 82% increase by 2030 (John Bond,University of Newcastle)G
  • 0.9% for ages 65-74, 4.3% for 75-84 year olds and 20.7% if 85 and over. Women residents tend to be older, at an average age of 85.6 years, compared to 83.2 for men (Office o). Two thirds of older people living in care homes experience some level of cognitive impairment and75% of them are classified as being severely disabled. It is also estimated that up to 40% of residents experience depression. Depression is estimated to affect up to 40% of older people who live in care homes and it often goes unrecognised (Audit Commission 2000. Audit Commission (2000) Forget Me Not: Mental Health Services for Older People. Audit Commission, London. Two Thirds of older people living in care homes experience some level of cognitive impairment. Bebbington A, Darton R and Netten A (2001) Care homes for older people. Volume 2. Admissions, needs and outcomes. PSSRU. Canterburyf Fair Trading 2005). 75% classified as being severely disabled (OFT 2005)
  • Laing and BuissonIncreasingly important roleIncreased demand - 40,000 beds in next ten years and 82% increase by 2030 (John Bond,University of Newcastle)G

Transcript

  • 1. Promoting Quality of Life in Care HomesMy Home Life: Wiltshire Professor Julienne Meyer
  • 2. Promoting Quality of Life in Care Homes So...what do we think about care homes?•Scandals?•Poor quality?•Money-grabbing?•Undesirable?•Less relevant?•In decline?
  • 3. Promoting Quality of Life in Care HomesNumber of care homes (CQC, 2010)
  • 4. Promoting Quality of Life in Care Homes Older people in care homes• 400,000 older people• Average age 85 years• 66% Cognitive impairment• 40% depression• 75% classified “severely disabled” (OFT 2005)• Massive increase in dependency levels• Generally unable to remain in the community
  • 5. Promoting Quality of Life in Care Homes Funding• £446 state fee for care homes (older people)• Hospital bed = £2,051• Children’s home = £2,408• Care home (LD) = £748• 28% third party top-up• Saving the NHS £billions
  • 6. Promoting Quality of Life in Care Homes Workforce• ½ million employed in care homes• Care-assistants £6.56 per hour• Lack of funding for training• Paid less than those looking after our rubbish• 66% NVQ2• 39% feel unappreciated by public (Skills for Care)
  • 7. Promoting Quality of Life in Care Homes Unsupported, isolated, mistrusted•4 changes in regulation in 10years•“Feeding the system ratherthan feeding residents!”•High levels of personalstress
  • 8. Promoting Quality of Life in Care Homes Quality?•On-going improvementsover the past decade (CSCI)•Steady improvementsaround risk-taking,voice,choice & control•If supported, care homescan deliver remarkableoutcomes!
  • 9. Promoting Quality of Life in Care Homes The future...•Vital part of care spectrum•Demand increasing (40,000beds needed in next ten years)•Greater specialism•Reducing pressure on NHS•A sector that is emerging ashaving the potential to deliverquality for our frailest citizensin community and in carehomes
  • 10. Promoting Quality of Life in Care Homes Older people in care homes• 400,000 older people• Average age 85 years• 66% Cognitive impairment• 40% depression• 75% classified “severely disabled” (OFT 2005)• Massive increase in dependency levels• Generally unable to remain in the community
  • 11. Promoting Quality of Life in Care Homes The future...•Vital part of care spectrum•Demand increasing (40,000beds needed in next ten years)•Greater specialism•Reducing pressure on NHS•A sector that is emerging ashaving the potential to deliverquality for our frailest citizensin community and in carehomes
  • 12. Promoting Quality of Life in Care Homes My Home Life Programme UKPromoting quality oflife for those living,dying, visiting andworking in carehomes for olderpeople.
  • 13. Promoting Quality of Life in Care Homes SupportAge UK, City University, Joseph Rowntree & Dementia UK Other key organisations: Relatives & Residents Association National Care Forum English Community Care Association National Care Association Registered Nursing Home Association Care Forum Wales Scottish Care Independent Health & Care Providers National Care Home R&D Forum
  • 14. Promoting Quality of Life in Care Homes Phases of My Home LifePhase One: Vision(2005-7 – HtA)Phase 2: Dissemination(2007-9 – BUPA)Phase 3: Implementation(2009-12 – JRF, DH, LA,City Bridge etc)
  • 15. Promoting Quality of Life in Care Homes MHL VisionPersonalisation1. Maintaining identity2. Sharing decision-making3. Creating communityNavigation4. Managing transitions5. Improving health & healthcare6. Supporting good end-of-lifeTransformation7. Keeping workforce fit for purpose8. Promoting a positive culture
  • 16. Promoting Quality of Life in Care Homes Relationship-centred careSecurity: to feel safeBelonging: to feel part of thingsContinuity: to experience links and connectionsPurpose: to have a goal(s) to aspire toAchievement: to make progress towards these goalsSignificance: to feel that you matter as a personPositive relationships within the home and across the community of practice
  • 17. Promoting Quality of Life in Care Homes The value of the vision• Evidence of what customers (residents) want• Articulates the expertise of the sector• A framework for identifying evidence of good practice for self-regulation• Accentuating positive (disassociating from bad press)• Evidence base to inform commissioning and regulation• Driven forward by the care home sector itself
  • 18. Promoting Quality of Life in Care HomesActivities •Synthesising evidence •Empowering leaders •Developing resources •Creating networks •Supporting change •Maintain momentum
  • 19. Promoting Quality of Life in Care Homes Best Practice• She‟d been very poorly for a couple of days, and in the middle of the night the staff came and woke me up and said “We think Betty hasn‟t got long. Do you want to come and say goodbye to her?” So I put my dressing-grown on and went down the corridor and they left me with her. I climbed on the bed next to her and put my arms around her and told her what a good friend she had been to me. She died in my arms‟.
  • 20. Promoting Quality of Life in Care Homes My Home Life Spirit•Building uponenergy, enthusiasm and bestpractice out there•Collaborating, sharing, realising a vision for change
  • 21. Promoting Quality of Life in Care Homes Aims of MHL Wiltshire•Provide learning experience for asmall number of care home managers(Leadership and Support)•Identify and reduce the barriers toQoL across the wider system(Community Development)Celebrate and share good practiceacross care homes•To create a movement in Wiltshirewhich celebrates positive practice
  • 22. Promoting Quality of Life in Care Homes Leadership: 4 day course• Open to all deputies and managers of care homes• 4 day intensive training: reflective practice, stress management, change management, evidence based and relationship-centred practice• Safe, confidential support on your personal journey of improvement
  • 23. Promoting Quality of Life in Care Homes Support: 12 months Action LearningSafe environment to learn from each other (share)Allow time to focus on a real issue in depth (reflect)Learn how to listen and question (non-judgemental)Consider how the issue can be resolved (link to action)Commitment to feedback and learn (process and outcomes)Key questions include: What is happening? What should be happening? What is stopping it happening? What can be done to make it happen?
  • 24. Promoting Quality of Life in Care Homes Community Development strand• Identify what care homes want to work on with local authorities• Identify what local authorities want to work on with care homes• Run appreciative inquiry workshop to help resolve a shared issue of concern• Leave care homes and local authorities working in better partnership
  • 25. Promoting Quality of Life in Care Homes
  • 26. Promoting Quality of Life in Care Homes What managers say….“We‟ve all got the same kind of problemscropping up, it‟s great to know you‟re not aloneand when we talk through the problems, thesolutions become clearer.”“It‟s been really helpful for my personaldevelopment as well as beneficial to thehome….it‟s giving me the confidence to stand upfor doing things right, it‟s very motivating.”
  • 27. Promoting Quality of Life in Care Homes What are the benefits?„It‟s like turning on a light bulb, suddenly things becomeclear‟•Managers tell us they are changing hugely•They are engaging with their staff differently•They are engaging rather than avoiding the emotion ofrelatives•They are avoiding being caught up in the anxiety andstress caused by external demands•They feel part of a wider movement for change!
  • 28. Promoting Quality of Life in Care Homes Contact DetailsMy Home Life Programmehttp://www.myhomelife.org.ukProf Julienne Meyer, Exec DirectorTom Owen, DirectorCity University LondonAdult Years DivisionSchool of Health SciencesNorthampton SquareEC1V 0HBLondon,United KingdomTel: +44 (0)20 7040 5776Fax: +44 (0)20 7040 5529Email: mhl@city.ac.uk