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

The interviews with residents, staff and relatives were gathered in 12 long-stay carestudy sites. This approach yielded a rich contextualised data set and was resourceefficient as it allowed a large number of residents and staff to be interviewed in thesame setting over a period of a few days.In all, 101 resident interviews were gathered with between eight and ten undertakenin each study site. The sample comprised of residents who were newly admitted,residents who had lived in the facility for longer than three months and residentswho had some cognitive impairment but were able to understand questions andrespond. Both male and female residents were included. Forty-eight interviewswere conducted with staff across facilities, four within each study site. Allcategories of staff were included: registered nurses, directors of nursing, healthcare assistants, care attendants, cooks, cleaning staff, physiotherapists andoccupational therapists. Interviews with relatives were conducted by phone;in all, 13 interviews were conducted with relatives who agreed to participate.28Focus Group FindingsThe findings from focus groups revealed that low staffing levels and inappropriateskill mix were considered to be major barriers to the provision of quality care.The relatively low ratios of registered nurses to care assistants in some privatenursing homes was also raised as an issue of concern. Participants also reportedthat it was increasingly difficult to recruit and retain staff. Participants consideredthe physical and social environment of the facility to be key determinants ofresidents’ quality of life. The major negative impacts on quality of life wereidentified as a lack of privacy and an institutionalised approach to care. A shift toindividualised and person-centred care was viewed as central to improving qualityof life and well-being of people in long-stay care. Focus group participants madea number of recommendations for change. Chief among these were the need forstronger regulation and legislation and an independent inspectorate for both publicand private facilities.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland