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

Therefore, the practice of rostering most nursing staff in the morning and minimumnursing staff in the evening was discarded and new staff rotas implementedto enable residents to get up and go back to bed at their desired time. In somefacilities, mealtimes were staggered and activities were at different times of theday to meet residents’ preferences.In some facilities, both public and private, resident and staff respondentscommented on the caring ethos and how this shaped care within the facility.In some facilities this ethos was based on resident inclusion in decision-making,maximising resident capacity, facilitating choice and keeping residents involved.The manager’s role in shaping this ethos was commented on by staff and residents.One manager described the difficult and challenging path of implementing a newethos of care and the time, commitment and support needed to see it through.Another manager described how the ethos pervaded all aspects of managementof the facility. She described how this ethos involved caring for staff and investingin training and induction so that the best care could be delivered for residents.In other facilities, again both public and private, care was described as routinisedand focused on tasks. In these facilities care was perceived as focusing mostlyon the physical aspects. Some staff were concerned that the social and emotionalneeds of residents were not being met. In some of these facilities, it was evidentthat there was a real desire to change care practices but that many constrainingfactors had held back the pace of change (Table 8.4). In these facilities staffexpressed the need for change in the routine of care and their frustration that littleprogress had been made. In other facilities the focus on routine had become soembedded, staff could not see how it could change. They explained that currentstaffing levels and resources made change impossible. A few staff respondentsquestioned the commitment of some staff to change and suggested that a fewstaff were not motivated to care for older people.163