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

It was evident across all data sets that the number of nursing staff from overseashas grown significantly. Many staff commented on the crucial role these staff hadin maintaining services for older people. The findings of this study would suggestthat some facilities have been more successful than others in facilitating integrationof staff from overseas. These facilities had invested heavily in induction and supportand reported that they were able to retain care staff from overseas for a numberof years. Other facilities reported difficulty in recruitment and retention, leading toconcern about an impending skills crisis within their services. The survey revealedthat there were little overall differences in staff turnover across facility types.However, there were very significant differences in the range of staff turnoveracross facilities with one facility reporting 24 staff leaving in the last six months.218Focus group participants reported that overseas nurses were difficult to retain, asthey were attracted to higher pay differentials in the public sector and perceivedwork within the acute sector as having more potential career opportunities forthem. Focus group participants, particularly in Dublin, reported that up to 85 percent of their registered nurses were from overseas. They were very appreciativeof being able to recruit these nurses as covering the service would have beenimpossible without them, but they also highlighted the need to review salarylevels, support and training.Interview and focus group data revealed that the age profile of staff workingwith older people was different to that of those working in acute services. Theyreported that nurses working with older people were older and many were nearingretirement. Many nurses, therefore, trained some time ago and this may besignificant in relation to continuing education needs. In addition, if many staffworking in long-stay care are near to retirement as reported, succession planningfor long-stay care services is vital.12.5 Physical Environment and Ethos of CareObservation within study sites revealed that a resident’s capacity to make choicesabout their day varied across facilities. Staff and resident interviews and survey dataalso revealed significant differences in the capacity of residents to exercise choice.On the whole, residents were more likely to have choice about the time they gotup or went back to bed if they lived in a private rather than public facility. However,overall, the survey found that the more dependent someone was, the less likely itImproving Quality of Life for Older People in Long-Stay Care Settings in Ireland