Improving Quality of Life for Older People in Long-Stay Care ...

Staffing and skill mix: comments from focus group participantsI know in the public sector, we would be staffed historically. You know, if you hadfive staff nurses on a shift twenty years ago, you still have five, but the patientshave got much more dependent and they’re coming in much more ill into thehospital and we would find that, in all of the areas, that’s a major problem.Staffing is historical; it’s nothing to do with the dependency of patients. (FG3D)I have 39 frail, elderly people, some with dementia, in a welfare home, with oneregistered nurse on a duty at any given time! (FG1D)Well, in the private sector … whereas I would say that other nursing homes havethe walking wounded and the semi-retired I would have people that would be veryphysically highly dependent. The majority of my 59 residents have dementia andthat has an implication for staffing but staffing was determined historically withinthe group, that’s how it was. (FG3D)Where I work happens to be where we have the right number of staff. When wechanged to long-stay, the staffing levels remained at the same level as they werein the acute facility. (FG1D)Oddly enough, in the private nursing home sector, because we’re inspected soregularly, our staffing levels have changed. … Because of the numerous inspectionsour staffing levels have increased because the health board recommend that weneed more staff. (FG3D)The only requirement in terms of staffing within a private nursing home is that theyhave one trained nurse on at any time, and that may have been fine when theystarted off, when they were starting off with 15 beds, but the majority of our nursinghomes now have 50 and 60 beds. … I feel that the nursing staff levels within privatenursing homes are set far too low. (FGDO)Well, I would believe that sometimes we’re top heavy with nurses and we’d seeareas with only one type of staff, where I would prefer to have two care attendantsrather than having one nurse, and economically that would work. I think there areother hospitals, I would hasten to add, that don’t have enough registered nurses. (FGC)995.4 Recruiting and Retaining StaffMany participants reported difficulties in recruiting and retaining staff within servicesfor older people. They suggested that this was because of the increased opportunitiesavailable to registered nurses elsewhere in the health services. They perceived thatgerontological nursing was not the first preference of younger nurses. This had twoeffects: firstly, some services had to recruit high numbers of overseas nurses; andsecondly, investing in staff appeared less worthwhile if they were in post for a shorttime only. This was a particular problem for many of the private nursing homes whosuggested that the nurses they recruited to their facilities saw working in a privatenursing home a stepping stone to moving to working in the public and acute sector.