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

7.2.2 StaffingRegistered nurses and care assistants provided care for residents. The ratioof registered nurses to care assistants varied across facilities and shift times.At worst, the ratio was 1:4, at best 1:3. Where ratios of care assistants werehighest, the registered nurse(s) focused on specific tasks such as administeringmedication and activities such as wound dressings rather than direct care.Consequently, care assistants were responsible for most of the fundamentalcare of residents. In some facilities the ratio of registered nurses to care assistantsleft little capacity for supervision of care assistants’ work.7.2.3 Life in the FacilityIn all facilities residents generally appeared to be able to choose the time theygot up or went back to bed. While there was usually a routine shaped around mealtimes residents did have some choices about their day. The range of choices wasgreater in some facilities than others. One facility staggered lunch times to facilitateresident preferences for late or early lunch. In another, the routine of the day wasmuch more fixed with little resident choice. In some facilities residents appearedto have a good rapport with staff who seemed to know them well.143Most facilities had a range of activities for residents including painting, card games,music, Sonas and bingo. One facility had a tai chi class for residents and staff andtheir own transport system which helped to facilitate resident outings. In anotherfacility the only activity offered was singing.7.2.4 Resident Profile/DependencyThe majority of residents living in these facilities were between 75 and 94years old. One facility, however, had a unit for younger people with disabilities,which meant that 40 per cent of their residents were under the age of 65.Most residents living in these facilities were categorised as high or maximumdependency. Many residents needed help with some activities of daily living,but there were a significant number of residents who were mobile without thehelp of staff. A few residents were independently mobile enough to be ableto leave the facility on their own. In all facilities there were some residents whoqualified for subvention from the HSE. In one facility over half of the beds hadbeen allocated for public patients but not all of these beds were utilised.