Due to the high incidence of disability amongst their contemporaries, older people are likely to ... more Due to the high incidence of disability amongst their contemporaries, older people are likely to be involved in informal caring relationships. Due to the limited nature of post-retirement incomes, such carers are also likely to be relatively poor. In spite of this, little attention has been given to the role of older carers of disabled people or to the influence of poverty upon this role. In an attempt to redress this neglect, this paper will explore the way in which the ageing process serves to exacerbate the demands upon such carers, not only due to the increased incidence of disability experienced by older people, but also due to their decreased access to material resources, which would help to alleviate these demands.
The ‘Care Certificate’ was introduced in April 2015 as a new training programme that all new care... more The ‘Care Certificate’ was introduced in April 2015 as a new training programme that all new care workers (Health Care Assistants and Social Support Workers) should achieve before working unsupervised. This research aimed to evaluate the effectiveness of the Care Certificate in achieving an improved induction and training so that care workers are better-prepared to provide high quality care. We carried out a national telephone survey with 401 staff who have responsibility for the induction of care workers in care organisations. We also interviewed 68 care staff and 24 managers at 10 different care organisations to get a more detailed understanding of their experiences of the Care Certificate training. We found that the uptake of the Care Certificate has been good, and it is widely welcomed as providing a standardised approach to improving the care skills and confidence of those new to care. However, there is a proportion of smaller care organisations where the Care Certificate has n...
Background ‘Older People’s Shoes’ is a training intervention designed for healthcare assistants (... more Background ‘Older People’s Shoes’ is a training intervention designed for healthcare assistants (HCAs) to improve the relational care of older people in hospital. The intervention formed part of a broader evaluation, in this paper we describe its development from a learning design and methodological perspective. Methods Learning theory and an instructional design model were key components of the In-PREP (Input, Process, Review and Evaluation, Product) development methodology used in the design of the ‘Older People’s Shoes’ training intervention to improve the delivery of relational care by front-line hospital staff. An expert panel, current evidence, and pedagogical theory were used to co-design a training programme tailored to a challenging work environment and taking account of trainees’ diverse educational experience. Peer review and process evaluation were built into the development model. Results In-PREP provided a methodological scaffold for producing evidence-based, peer-revi...
Due to the high incidence of disability amongst their contemporaries, older people are likely to ... more Due to the high incidence of disability amongst their contemporaries, older people are likely to be involved in informal caring relationships. Due to the limited nature of post-retirement incomes, such carers are also likely to be relatively poor. In spite of this, little attention has been given to the role of older carers of disabled people or to the influence of poverty upon this role. It is therefore the purpose of this paper to help to redress this neglect by examining the influence of material circumstances on the role of older carers aged over sixty. With this aim in mind a sample of 34 older co-resident carers were asked a series of questions relating to their access to resources and their caring role.
The purpose of this study is to describe carers’ experience of the transition of their relative w... more The purpose of this study is to describe carers’ experience of the transition of their relative who has dementia to nursing home care. It is intended that this will provide evidence-based guidance for the development of initiatives to support carers. This aim is addressed by answering the following questions: 1. What are carers’ key influences in making the decision for their relative to move to a long stay setting? Who is involved in making this decision? 2. What are carers’ experiences of making the transition from caring for their relative at home to them being cared for in a long stay setting? 3. How has the family carer’s role changed as a result of their relative’s move to a long stay setting? 4. What types of roles do carers want to have? 5. How can carers be supported in these roles?
Objectives: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on... more Objectives: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on improved quality of life for people with dementia. This study compared the experience of people living with dementia and other mental health problems in extra care housing schemes that utilised EOP with schemes that employed an active control intervention. Method: Ten extra care housing schemes were cluster randomised to receive either the EOP intervention or an active control intervention for an 18-month period. Residents with dementia or other significant mental health problems (20-30 per scheme) were assessed on a number of outcome measures at baseline, six months, one year and 18 months. The primary outcome measure was quality of life. Self-reported depression was an important secondary outcome. Results: The EOP-participating residents rated their quality of life more positively over time (4.0 (SE 0.6) units; 14% p 5 0.001) than the active control (1.3 (SE 0.6) units; 4% p ¼ 0.003). There was also a significant group-time interaction for depressive symptoms (p ¼ 0.003). The EOP-participating residents reported a reduction of 25% at both six and 12 months and a 37% reduction at 18 months (all p's 5 0.001). EOP residents were less likely than residents in the active control sites to move to a care home or to be admitted to a hospital inpatient bed. They were more likely to be seen by a range of community health professionals. Conclusion: The EOP had a positive impact on the quality of life of people with dementia in well-staffed extra care housing schemes.
Good support at home for people with dementia and their carers is crucial to maintaining their qu... more Good support at home for people with dementia and their carers is crucial to maintaining their quality of life and helping them to remain in their own home. Person centred packages of care have been shown to be an effective means of providing this support. In this pilot study we aimed to improve quality of life of people living with dementia at (including at end of life) and their carers. This would be by using and evaluating, a bespoke, person centred music tool: Soundtrack to My Life (STML) with a dementia specialist home care team supporting people with dementia in their own homes. The STML tool is designed to draw together pieces of music representing significance in the life of a person with dementia, as part of a bespoke life history /biographical care plan. In using the tool, it was hoped that engagement of people with dementia by support staff would improve and that support staff would be encouraged to reflect on their practice, enhancing their interpersonal skills. The rese...
AIMS It was originally aimed to evaluate the impact of a personalised musical intervention on the... more AIMS It was originally aimed to evaluate the impact of a personalised musical intervention on the well-being of the clients of a specialist dementia home care service. This would have involved the compilation, by home care staff, of a music CD for each client. However, due to the failure of this intervention to be fully implemented, it subsequently became the goal of the research to establish the reasons for this. Overview of respondent interviews:
BACKGROUND: Front line care workers play a key role in health and social care provision for older... more BACKGROUND: Front line care workers play a key role in health and social care provision for older people and this has been reflected in training innovations aiming to improve the care provided by these workers. One recent training initiative has been the Care Certificate, which was fully launched in England in April 2015 and which aims to provide a consistent and transferable approach to this training. However, little is currently known about the patterns of implementation adopted by care organisations or about the perceptions of the Care Certificate held by care providers and by those in receipt of this care. AIMS: In order to address these issues and to optimise its impact, the implementation of the Care Certificate is being evaluated through an 18 month national study funded by the Department of Health Policy Research Programme. Project Reference Number PR-R14-0915-12004. METHODS: This study includes a telephone survey of care organisations in England as well as qualitative explo...
Purpose Drawing on the evaluation of a series of workshops in painting and drawing, this paper wi... more Purpose Drawing on the evaluation of a series of workshops in painting and drawing, this paper will assess the impact of attendance on the well-being of participants who had been identified as being at risk of developing mental health problems. Design/methodology/approach The evaluation was conducted by an independent researcher and consisted of interviews with group members at the beginning and the end of the project about their expectations and experiences. To complement this data, interviews were also carried out with group leaders and artists. Findings Workshop attendance helped to promote the mutual recovery and inclusion of participants while also enhancing the supportive capacities and social capital of their respective groups. These impacts were broad, sustained and mutually reinforcing, transcending the individual and the group to incorporate wider settings. Originality/value The importance of the these wider factors are often overlooked by traditional recovery models with ...
Although investment in staff development is a prerequisite for high-quality and innovative care, ... more Although investment in staff development is a prerequisite for high-quality and innovative care, the training needs of front line care staff involved in direct care have often been neglected, particularly within dementia care provision. The Care Certificate, which was fully launched in England in April 2015, has aimed to redress this neglect by providing a consistent and transferable approach to the training of the front line health and social care workforce. This article describes the early stages of an 18-month evaluation of the Care Certificate and its implementation funded by the Department of Health Policy Research Programme.
Due to the high incidence of disability amongst their contemporaries, older people are likely to ... more Due to the high incidence of disability amongst their contemporaries, older people are likely to be involved in informal caring relationships. Due to the limited nature of post-retirement incomes, such carers are also likely to be relatively poor. In spite of this, little attention has been given to the role of older carers of disabled people or to the influence of poverty upon this role. In an attempt to redress this neglect, this paper will explore the way in which the ageing process serves to exacerbate the demands upon such carers, not only due to the increased incidence of disability experienced by older people, but also due to their decreased access to material resources, which would help to alleviate these demands.
The ‘Care Certificate’ was introduced in April 2015 as a new training programme that all new care... more The ‘Care Certificate’ was introduced in April 2015 as a new training programme that all new care workers (Health Care Assistants and Social Support Workers) should achieve before working unsupervised. This research aimed to evaluate the effectiveness of the Care Certificate in achieving an improved induction and training so that care workers are better-prepared to provide high quality care. We carried out a national telephone survey with 401 staff who have responsibility for the induction of care workers in care organisations. We also interviewed 68 care staff and 24 managers at 10 different care organisations to get a more detailed understanding of their experiences of the Care Certificate training. We found that the uptake of the Care Certificate has been good, and it is widely welcomed as providing a standardised approach to improving the care skills and confidence of those new to care. However, there is a proportion of smaller care organisations where the Care Certificate has n...
Background ‘Older People’s Shoes’ is a training intervention designed for healthcare assistants (... more Background ‘Older People’s Shoes’ is a training intervention designed for healthcare assistants (HCAs) to improve the relational care of older people in hospital. The intervention formed part of a broader evaluation, in this paper we describe its development from a learning design and methodological perspective. Methods Learning theory and an instructional design model were key components of the In-PREP (Input, Process, Review and Evaluation, Product) development methodology used in the design of the ‘Older People’s Shoes’ training intervention to improve the delivery of relational care by front-line hospital staff. An expert panel, current evidence, and pedagogical theory were used to co-design a training programme tailored to a challenging work environment and taking account of trainees’ diverse educational experience. Peer review and process evaluation were built into the development model. Results In-PREP provided a methodological scaffold for producing evidence-based, peer-revi...
Due to the high incidence of disability amongst their contemporaries, older people are likely to ... more Due to the high incidence of disability amongst their contemporaries, older people are likely to be involved in informal caring relationships. Due to the limited nature of post-retirement incomes, such carers are also likely to be relatively poor. In spite of this, little attention has been given to the role of older carers of disabled people or to the influence of poverty upon this role. It is therefore the purpose of this paper to help to redress this neglect by examining the influence of material circumstances on the role of older carers aged over sixty. With this aim in mind a sample of 34 older co-resident carers were asked a series of questions relating to their access to resources and their caring role.
The purpose of this study is to describe carers’ experience of the transition of their relative w... more The purpose of this study is to describe carers’ experience of the transition of their relative who has dementia to nursing home care. It is intended that this will provide evidence-based guidance for the development of initiatives to support carers. This aim is addressed by answering the following questions: 1. What are carers’ key influences in making the decision for their relative to move to a long stay setting? Who is involved in making this decision? 2. What are carers’ experiences of making the transition from caring for their relative at home to them being cared for in a long stay setting? 3. How has the family carer’s role changed as a result of their relative’s move to a long stay setting? 4. What types of roles do carers want to have? 5. How can carers be supported in these roles?
Objectives: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on... more Objectives: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on improved quality of life for people with dementia. This study compared the experience of people living with dementia and other mental health problems in extra care housing schemes that utilised EOP with schemes that employed an active control intervention. Method: Ten extra care housing schemes were cluster randomised to receive either the EOP intervention or an active control intervention for an 18-month period. Residents with dementia or other significant mental health problems (20-30 per scheme) were assessed on a number of outcome measures at baseline, six months, one year and 18 months. The primary outcome measure was quality of life. Self-reported depression was an important secondary outcome. Results: The EOP-participating residents rated their quality of life more positively over time (4.0 (SE 0.6) units; 14% p 5 0.001) than the active control (1.3 (SE 0.6) units; 4% p ¼ 0.003). There was also a significant group-time interaction for depressive symptoms (p ¼ 0.003). The EOP-participating residents reported a reduction of 25% at both six and 12 months and a 37% reduction at 18 months (all p's 5 0.001). EOP residents were less likely than residents in the active control sites to move to a care home or to be admitted to a hospital inpatient bed. They were more likely to be seen by a range of community health professionals. Conclusion: The EOP had a positive impact on the quality of life of people with dementia in well-staffed extra care housing schemes.
Good support at home for people with dementia and their carers is crucial to maintaining their qu... more Good support at home for people with dementia and their carers is crucial to maintaining their quality of life and helping them to remain in their own home. Person centred packages of care have been shown to be an effective means of providing this support. In this pilot study we aimed to improve quality of life of people living with dementia at (including at end of life) and their carers. This would be by using and evaluating, a bespoke, person centred music tool: Soundtrack to My Life (STML) with a dementia specialist home care team supporting people with dementia in their own homes. The STML tool is designed to draw together pieces of music representing significance in the life of a person with dementia, as part of a bespoke life history /biographical care plan. In using the tool, it was hoped that engagement of people with dementia by support staff would improve and that support staff would be encouraged to reflect on their practice, enhancing their interpersonal skills. The rese...
AIMS It was originally aimed to evaluate the impact of a personalised musical intervention on the... more AIMS It was originally aimed to evaluate the impact of a personalised musical intervention on the well-being of the clients of a specialist dementia home care service. This would have involved the compilation, by home care staff, of a music CD for each client. However, due to the failure of this intervention to be fully implemented, it subsequently became the goal of the research to establish the reasons for this. Overview of respondent interviews:
BACKGROUND: Front line care workers play a key role in health and social care provision for older... more BACKGROUND: Front line care workers play a key role in health and social care provision for older people and this has been reflected in training innovations aiming to improve the care provided by these workers. One recent training initiative has been the Care Certificate, which was fully launched in England in April 2015 and which aims to provide a consistent and transferable approach to this training. However, little is currently known about the patterns of implementation adopted by care organisations or about the perceptions of the Care Certificate held by care providers and by those in receipt of this care. AIMS: In order to address these issues and to optimise its impact, the implementation of the Care Certificate is being evaluated through an 18 month national study funded by the Department of Health Policy Research Programme. Project Reference Number PR-R14-0915-12004. METHODS: This study includes a telephone survey of care organisations in England as well as qualitative explo...
Purpose Drawing on the evaluation of a series of workshops in painting and drawing, this paper wi... more Purpose Drawing on the evaluation of a series of workshops in painting and drawing, this paper will assess the impact of attendance on the well-being of participants who had been identified as being at risk of developing mental health problems. Design/methodology/approach The evaluation was conducted by an independent researcher and consisted of interviews with group members at the beginning and the end of the project about their expectations and experiences. To complement this data, interviews were also carried out with group leaders and artists. Findings Workshop attendance helped to promote the mutual recovery and inclusion of participants while also enhancing the supportive capacities and social capital of their respective groups. These impacts were broad, sustained and mutually reinforcing, transcending the individual and the group to incorporate wider settings. Originality/value The importance of the these wider factors are often overlooked by traditional recovery models with ...
Although investment in staff development is a prerequisite for high-quality and innovative care, ... more Although investment in staff development is a prerequisite for high-quality and innovative care, the training needs of front line care staff involved in direct care have often been neglected, particularly within dementia care provision. The Care Certificate, which was fully launched in England in April 2015, has aimed to redress this neglect by providing a consistent and transferable approach to the training of the front line health and social care workforce. This article describes the early stages of an 18-month evaluation of the Care Certificate and its implementation funded by the Department of Health Policy Research Programme.
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