From late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed.
Ten managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals.
Three key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care.
This study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.
By Anna Severwright, Another social care conference… the big names talking… and no one who draws on social care speaking at the main sessions. This is 2021 and still the conversations about social care, are happening without us, people with lived experience of social care (either themselves or as a family carer). Thankfully we have […]
Kimberly Bonvissuto, News – McKnight’s Senior Living
More than 85 independent living, assisted living and memory care leaders joined together at the International Council on Active Aging Forum in November. Together, they identified a philosophy and infrastructure of the “optimal community,” which offers lifestyle and services desired by current residents, with the quality-of-life features future residents will seek.
Five trends for senior living in 2021 to emerge:
Redefine the meaning of “community.”
Expand the built and unbuilt environment.
Integrate technology through all operations.
Emphasize wellness culture and lifestyle.
Strengthen workforce quality, growth and retention.
Research consistently shows that leaving care before a young person is ready for independence tends to lead to poor outcomes. “Readiness” is the ability of looked after young people and care leavers to care effectively for themselves, and it covers a range of important, developmental areas: secure, positive social & support networks (including biological and extended family, if appropriate); practical skills and knowledge; engagement in education, training or employment. In each of these the young person must demonstrate the ability to make healthy life decisions.
On this basis we need to accept that Looked After Children leave care too young…………
Yesterday, The Independent published an opinion piece written by Jo Brand about care workers. I like Jo and there were some sound points in the article. There was, however, the usual portrayal of care workers as doing hard, boring, unrewarding (on many levels) work with very little job satisfaction. I’m pretty sure that isn’t the case with Steven’s support team, but I worry that it might be. The basic evidence doesn’t support my anxiety. Of the team of five, the longest standing worker has been with Steven since 2005 (16 years) and the most recent addition to the team has been with us 8 years. If the job was that unbearable, would they want to stay so long? I know that their pay is significantly better than it was when they were employed by an agency, but would an extra £2.50 per hour compensate for a decade of daily drudgery?
The pandemic has shown how loneliness and isolation affects everyone, with many people living alone feeling more cut-off than ever. The need for alternative accommodation solutions within the community has never been greater, and Homeshare initiatives demonstrate the positive role of intergenerational living.
The COVID-19 pandemic has affected the physical, psychological, social and financial health of older persons. On this subject, the United Nations published a policy brief on the impact of COVID-19 on older persons in May 2020. In line with this, the purpose of this general review is to address three issues affecting older persons living in residential care facilities: protective measures implemented to block the virus’ entry, the types of mistreatment most frequently experienced and the necessity to promote and defend the rights of these persons.
The design of this study is based on input gathered since the end of April during meetings of the International Network for the Prevention of Elder Abuse (INPEA) and the results of a July survey of its members.
The survey results indicate variability in the implementation of protective measures in different countries and the significant presence of mistreatment and violation of the rights of older persons. Three major issues demand attention: ageism, systemic and managerial problems and the effects of implemented measures. All these prompt the INPEA to once again plea for the adoption of an international convention of human rights of older persons.
The extent to which individuals exercise control over the decision to move to a care home is recognised as an important determinant of their relocation experience.
Most studies report that care home environments can be restrictive, therefore making adjustment and adaptation more challenging.
There is a dearth of research on the extent to which residents can be facilitated to feel ‘at home’ in a care home environment
What this paper adds
Positive adaptation is connected to older peoples’ perceived quality of life, continued connection to home, family and community, and having opportunities to develop meaningful relationships with staff and other residents.
Facilitating difficult and caring conversations with individuals and their families is required to manage individual expectations of the move to promote a positive adaptation process.
Failure to engage early with these difficult conversations can negatively impact on the adaptation process over the course of the first year of life in a care home.
Older people do not always have existing social supports to cope with bereavement and loss in the care home which has a significant impact on their psychological well‐being.