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

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2.4 Regulatory StructuresThere are no regulations governing care within public long-stay settings in Ireland.The private and voluntary nursing home sector in Ireland is subject to regulationsthrough the Nursing Homes (Care and Welfare) Regulations, 1993, which weremade under Section 6 of the Health (Nursing Homes) Act, 1990. The regulationscover the following areas:Standards of care – nursing homes must provide ‘suitable and sufficient careto maintain the person’s welfare and well-being’. This is achieved by ensuringa high standard of nursing care and medical care by a medical practitioner ofthe resident’s choice.Welfare and well-being – a wide range of suitable activities for the residentmust be provided along with facilities for occupation and recreation. Theresident must be able to carry out personal affairs in private and to exercisechoice as long as it does not infringe on the rights of other residents.The nursing home must provide adequate arrangements to allow religiousobservance by residents. Residents must also be kept informed of currentaffairs and local and community news and events.Contract of care – a contract of care outlining details of the services to beprovided and the fees to be charged should be provided to the resident bythe nursing home within two months of the person’s admission to the home.Personal possessions – residents must have sufficient space for personalpossessions. Provision must be made for the safe-keeping of personalpossessions.Discharge – a nursing home proprietor must give a resident 14 days notice priorto discharging that resident.Staffing – the person in charge of a nursing home must be a nurse with at leastthree years experience, unless the proprietor is a medical practitioner. A nursemust be on duty at all times. Staff must be adequate in number and sufficientlytrained. Training facilities for staff may be provided by health boards.Accommodation and facilities – suitable and sufficient accommodation mustbe provided. The number of residents in the nursing home must not exceedthe number for which the nursing home is registered. Standards regardingsleeping, living and dining areas, lighting and heating, and facilities andequipment are provided. A visitor’s reception area and a staff office must beprovided. Doorways and corridors must be wide enough to accommodatewheelchairs, walking aids and access ramps where appropriate. There must bea separate kitchen with suitable cooking facilities, equipment and tableware.45
46Design – the design of the nursing home must protect residents from the riskof accidents. Floors must have a safe covering. Handrails must be provided onboth sides of staircases and in circulation areas, and grab rails must be providedin bath, shower and toilet areas. If residents use more than two floors, a liftmust be provided if the health board in question deems it necessary.Hygiene – the nursing home must be kept in a clean and hygienic conditionand adequate sanitary facilities provided. Food must be stored in hygienicconditions.Sanitary facilities – there must be sufficient piped hot and cold water andwash-hand basins provided in each bedroom. There must also be a sufficientnumber of toilets, commodes, baths and showers. An adequate numberof toilets should have wheelchair access. Bed linen, disposable sheets andincontinence sheets should be in sufficient supply and changed as frequentlyas required. Adequate arrangements for the disposal of such items must bein place.Nutrition – suitable, nutritious and varied food must be served in a sufficientamount bearing in mind dietary requirements of residents. Fresh drinking watermust also be available on every floor of the nursing home.Information – a brochure with information about the nursing home mustbe provided outlining issues such as the admissions policy, accommodationprovided and special facilities and services.Records – adequate records concerning information on residents and staffshould be kept in a confidential and safe manner.Death and dying – upon the death of a dependent person the nursing homeproprietor must inform the medical officer of health for the area in which thenursing home is located not later than 48 hours after the death.Inspections – inspections of nursing homes should be made at least every sixmonths. Inspectors are permitted to conduct interviews in private with personsin the home, including staff, and to examine any resident believed to be inreceipt of substandard care. Inspections may also be carried out in premisesbelieved to be nursing homes but which are not registered as such.Complaints – any nursing home resident or a person acting on his or her behalfmay make a complaint in writing to the health board concerning any matterpertinent to the nursing home in general or the maintenance, care, welfare andwell-being of a resident. The CEO of the health board will then assign an officerto investigate the nursing home in question.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland
Page 1 and 2: ImprovingQuality of Lifefor Older P
Page 3: National Council on Ageing and Olde
Page 6 and 7: Authors’ AcknowledgementsThe rese
Page 8 and 9: ContentsCouncil Comments and Recomm
Page 10: 6.7 Meaningful Occupation 1296.8 Ch
Page 14 and 15: CouncilComments andRecommendations
Page 16 and 17: Quality of Life DomainsThe research
Page 18 and 19: Meaningful ActivitiesThe research n
Page 20 and 21: the research revealed that, in gene
Page 22 and 23: The Council accepts that the cultur
Page 24 and 25: this regard. The Council believes t
Page 26 and 27: ExecutiveSummary
Page 28 and 29: MethodologyA mixed method research
Page 30 and 31: Long-Stay Facility Survey FindingsT
Page 32 and 33: Residents were most positive about
Page 34 and 35: Chapter OneIntroduction
Page 36 and 37: There is no single definition descr
Page 38 and 39: This chapter provides justification
Page 40 and 41: Chapter TwoQuality of Careand Quali
Page 42 and 43: 2.2 Separating Quality of Care and
Page 44 and 45: 2.3 Policy for Long-Stay Care in Ir
Page 48 and 49: Medical preparations - medication s
Page 50 and 51: inspections are mainly concerned wi
Page 52 and 53: often not designed to meet the spec
Page 54 and 55: Residents who did not want to be in
Page 56 and 57: Human resources management standard
Page 58 and 59: The Mid-West Standards for Resident
Page 60 and 61: process and outcomes of the service
Page 62 and 63: 2.9 ConclusionQuality of life for o
Page 64 and 65: Chapter ThreeThe Interpretationand
Page 66 and 67: The difficulty of defining such an
Page 68 and 69: Implicit definitions use the broad
Page 70 and 71: Human needs may also provide part o
Page 72 and 73: successfully complete a self-report
Page 74 and 75: In relation to older people specifi
Page 76 and 77: The results of this particular stud
Page 78 and 79: The design of a residential care se
Page 80 and 81: Chapter FourMethodology
Page 82 and 83: each method used at the same point
Page 84 and 85: 4.3.3 Data AnalysisThe transcripts
Page 86 and 87: Table 4.2: Distribution of question
Page 88 and 89: 4.4.4 Quantitative Data AnalysisThe
Page 90 and 91: Anonymity and confidentiality are i
Page 92 and 93: from stakeholders who attended the
Page 94 and 95: 4.7 Ethical ClearanceEthical cleara
Page 96 and 97:
Chapter FiveQuality of Lifein Long-
Page 98 and 99:
All participants reported that ther
Page 100 and 101:
Staffing and skill mix: comments fr
Page 102 and 103:
Recruiting and retaining staff: com
Page 104 and 105:
Impact of physical environment on r
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5.6.2 Social EnvironmentParticipant
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They believed that this problem was
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Participants also discussed at leng
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Chapter SixQuality of Lifein Long-S
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Table 6.1: Type of facilityN %Priva
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Figure 6.2: Age profile of long-sta
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Figure 6.5 shows the percentages of
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Figure 6.7: Long-stay residents’
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In private and voluntary facilities
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Table 6.6: Ratio of RNs on the even
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Staff turnover investigates the num
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Table 6.10: Therapeutic and other s
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sector and 50 per cent in the volun
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Table 6.13: Number of facilities in
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stay units also allow ambulant, men
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The majority of private and volunta
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Table 6.17: Call bell facilities by
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Chapter SevenDescription ofStudy Si
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others were open and residents’ b
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7.2.2 StaffingRegistered nurses and
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Some residents were able to leave t
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the day by their bed. In addition,
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equired full assistance with dressi
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Chapter EightCare Environmentand Et
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8.2 Promoting AutonomyThis category
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Table 8.1: Involvement of residents
Page 158 and 159:
Table 8.2: Maintaining independence
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Focus group participants reported t
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Staff respondents also highlighted
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Therefore, the practice of rosterin
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8.7 ConclusionThis chapter presente
Page 168 and 169:
Chapter NinePersonal Identity
Page 170 and 171:
Table 9.1: Identity and personalise
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The real meI’m there in a photogr
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how important it was that residents
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Table 9.5: Freedom and constraintsA
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9.5 PrivacyThe degree of privacy en
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9.6 Self-RespectAcknowledging resid
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9.7 ConclusionsThe findings suggest
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Chapter TenConnectedness,Social Rel
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10.2 Connectedness, Involvement and
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A concrete example of the priority
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Cultural differencesnot an issueI f
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esidents but reserved the title of
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Table 10.3: Relationships among res
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it feel more like visiting somebody
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Near home(I) was living up the road
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Chapter ElevenActivitiesand Therapi
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had a special activities/therapies
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11.3 Therapeutic ActivityThis categ
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A few facilities had incorporated o
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Some facilities organised special t
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For residents, what appeared to be
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Chapter TwelveConclusions andRecomm
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The prevalence of quality deficits
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attitude to their institutionalisat
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higher the proportion of care given
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was that they had a choice. In some
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The physical environment in some fa
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activities need to be dynamic and r
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Older people in residential care mu
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choice regarding the gender of a ca
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Residents and their families should
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References
Page 234 and 235:
Birren, J.E. and Dieckmann, L., 199
Page 236 and 237:
Collin, C., Wade, D.T., Davies, S.,
Page 238 and 239:
Hubbard, G., Downs, M.G. and Tester
Page 240 and 241:
McCormack, B., 2003. ‘A conceptua
Page 242 and 243:
Redfern, S., Hannan, S., Norman, I.
Page 244 and 245:
Appendices
Page 246 and 247:
Profile of your long-stay facility1
Page 248 and 249:
6a. Are there any reasons why you w
Page 250 and 251:
Staff resources10. How many whole-t
Page 252 and 253:
Services and facilities17. Are any
Page 254 and 255:
Care process24a. Can long-stay resi
Page 256 and 257:
32b. If Yes, when can residents smo
Page 258 and 259:
38a. Was this facility purpose-buil
Page 260 and 261:
45. Are any of the following provid
Page 262 and 263:
General atmosphereComment on the ge
Page 264 and 265:
DomainFeeling caredfor/feelingsecur
Page 266 and 267:
DomainFeeling caredfor/feelingsecur
Page 268 and 269:
DomainGeneralCue question/promptsHa
Page 270 and 271:
DomainCompanionship/relationshipCon
Page 272 and 273:
DomainRelationship tofamily/friends
Page 274 and 275:
Terms ofReference
Page 276 and 277:
c) providing information and advice
Page 278:
National Council on Ageingand Older
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