Handovers in care homes for older people – their type, timing and usefulness. Findings from a scoping review

Abstract

There is a considerable body of literature on the importance of effective shift handovers in hospitals and other health-care settings but less is known about the transfer of information between staff starting and completing stints of paid work in care homes. In the first of two articles considering this under-explored topic, we report findings from a scoping review examining what is known about shift-to-shift handovers in care homes for older people and their equivalents. It is based on systematic searches of electronic databases of English-language journals on ageing and internet searches for material published between January 2005 and October 2016. Guidance from the regulatory body for health and social care in England, the Care Quality Commission, highlights the importance of handovers in care homes but the degree to which they are embedded into care home routines appears to be variable, influenced by factors such as workplace culture, shift patterns and the extent to which they involve all those on duty or just those with professional qualifications. Staffing shortages and whether or not members of staff are paid for their time attending handovers appear to be further constraints on their use. We conclude that there is considerable scope for further research in this field to identify and develop good practice.

What makes a good handover in a care home for older people?

“…(Researcher note from Douglas Hall) Some researchers have reported that the exclusion of care workers from handovers can be used to reinforce status between senior staff, which might include senior care workers, and direct care workers (Moriarty et al, 2019). The care homes participating in this study emphasised that -even if there was a two-stage handover in which the more senior staff 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 (Manager, The Chestnuts)…”

“…Given that care homes provide 24 hour support involving different shifts of staff, it is surprising that so little research has examined what happens during change of shift handovers in care homes (Moriarty et al, 2019). A few studies have referred tangentially to handovers as one of the many activities in which care home staff are involved (Kerr et al, 2008;Bennett et al, 2015;Killett et al, 2016).…”

Older care home residents’ and their relatives’ knowledge, understanding and views of shift handovers: an exploratory, focused-ethnographic qualitative study using interviews and observations

“…Several studies undertaken in clinical settings have identified handover of information between ‘outgoing’ and ‘incoming’ shifts as a key element influencing outcomes, patient safety and satisfaction 4–6. There is considerable research on nurse handovers in hospitals7 and a small, but growing, body of research about patient perspectives of or involvement in handovers, for example, 6 8–12. Little attention has been paid, though, to handovers in residential care settings, with or without nursing, which is surprising given the overlap between care home residents and hospital patients in terms of their support needs.…”

“…Little attention has been paid, though, to handovers in residential care settings, with or without nursing, which is surprising given the overlap between care home residents and hospital patients in terms of their support needs. As in 24 hours clinical settings, at least two changes of shift occur daily in every care home 7. Handovers—whether between nurses, care workers, nurses and care workers, with or without the involvement of senior managers—may be an important element in ensuring good, consistent quality of care for residents although the CQC does not specifically monitor their quality.…”

Quality of Life in Older Adult Care Homes: Comparing Office Hours with Out-of-Office Hours

“…Compared with hospital settings, very little is known about the outcomes nor experience outside of office hours of older people living in care homes. For example, despite their importance, the change over from day to night staff in care homes has been, unlike equivalent change overs in hospital settings, the focus of little research (Moriarty et al, 2017). Like hospitals, care homes, both with and without nursing care, support their residents twenty-four hours a day, seven days a week.…”