Better partnership between care homes and the NHS: Findings from the<i>My Home Life</i>programme

Owen, Tom; Meyer, Julienne; Bentley, Jane; Heath, Hazel; Goodman, Claire

doi:10.1179/csm.2008.3.1.96

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…A community dietician had, on her own initiative, developed close relationships with all four care homes on a one-by-one basis in a way that recognised care home staff’s contribution to service delivery. The County Council for this site had commissioned a leadership programme for all care home managers as part of a nationally recognised initiative supported by the third-sector [ 18 ]—this was the same programme undertaken by two care home managers at site 1.…”

Section: Resultsmentioning

confidence: 99%

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

et al. 2018

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Introductioncare home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use.Methodsa realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners.Resultscontext-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which ‘wraps around’ care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites.Conclusionactivities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.

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Section: Resultsmentioning

confidence: 99%

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

et al. 2018

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“…Other research has demonstrated the value of partnership approaches guided by AI and relationship-centred care to improving the quality of life for people in LTC settings. For example, My Home Life (MHL), a UK initiative aimed at promoting quality of life for individuals ‘living, dying, visiting and working in care homes’ ( Owen, Meyer, Bentley, Heath, & Goodman, 2008 , p. 96) found optimizing relationships between residents, family, staff and the wider community as well as facilitating shared decision-making concerning all aspects of home life to be crucial to promoting a positive culture within LTC ( Meyer & Owen, 2008 ). While MHL offers an exemplar of a culture change initiative within care settings, it has not focused on changing the culture of dementia care specifically.…”

Section: Discussionmentioning

confidence: 99%

Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance

et al. 2014

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Longstanding concerns about quality care provision, specifically in the area of long-term care, have prompted calls for changing the culture of care to reflect more client-driven and relationship-centred models. Despite an increase in culture change initiatives in both Canada and the United States, there is insufficient information about the theories and approaches that guide culture change. The purpose of this paper is to describe a culture change initiative currently underway in Canada, the Partnerships in Dementia Care Alliance, and the theoretical foundations informing our work. More specifically, we describe how the theoretical and philosophical underpinnings of the Alzheimer Disease and Related Dementias framework, the authentic partnership approach, participatory action research and Appreciative Inquiry have been integrated to guide a culture change process that encourages working collaboratively, thinking and doing differently and re-imagining new possibilities for changing the culture of dementia care.

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“…A consultation event that involved care home and health care representatives identified multiple examples of the NHS working with care homes to improve information exchange, palliative care, reduce falls, and unplanned admissions to hospital [12]. These interventions often involve the introduction of specialist health workers and teams or problem specific workers to achieve the desired outcomes [13,14].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of integrated working between care homes and health care services

Davies

Goodman

Bunn

et al. 2011

BMC Health Serv Res

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152

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BackgroundIn the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working.MethodsA systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis.ResultsSeventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration.ConclusionsDespite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes.

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Better partnership between care homes and the NHS: Findings from theMy Home Lifeprogramme

Cited by 10 publications

References 4 publications

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance

A systematic review of integrated working between care homes and health care services

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