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

Staff respondents also highlighted their educational needs; they suggested thattraining was important in order to give informed care. Some staff respondentshighlighted the difficulties of participating in educational opportunities; low staffinglevels and lack of availability were cited as the major issues. Nursing staff identifieda need for clinical updating and for courses which focused on the needs of olderpeople. One staff respondent in a senior managerial position described how shehad set up an educational network with other facilities in order to maximiseeducational opportunities for staff. Care attendants also discussed their educationalneeds. In some facilities care attendants who had undertaken the health careassistant course highlighted the difference this had made to their capacity to carefor residents. They were concerned, however, that they had not been able to takeup a new role on return from the course. In the focus groups, participants alsoraised the issue of the health care assistant training course. They were extremelypositive about this course and felt that it had really made a difference to client care.Many, however, had also experienced difficulties in implementing the new rolewithin their facilities.8.5 Physical Environment161The issue of physical environment was raised by a number of respondents (Table8.3). Staff and resident respondents and relatives highlighted the importance ofhomely environments which were structured to give residents a choice of their ownroom if desired. For some resident respondents, the lack of a private room was areal problem, particularly in public facilities. Communal facilities were much morea feature of public facilities than private ones. Residents found life in a communalward difficult and highlighted issues of privacy and the lack of choice in listeningto the television or radio. Relatives also shared this concern. It was evident fromresident interviews that the quality of the physical environment made a differenceto resident quality of life. Poor physical facilities meant that some residents, mainlyin public facilities, spent substantial time each day by their bed.It was also evident from observation within the study sites that living in a communalward impacted on the capacity of a resident to exercise choice about the time theygot up in the morning. The general noise of others getting up was likely to disturball residents in a ward which made later waking impossible. An additional problemhighlighted by a number of resident respondents within a few public care study