Supporting people in Care Homes at Night

1. Supporting people in Care Homes at Night Diana Kerr, Heather Wilkinson , Colm Cunningham

7. Findings from Phase one • Care Commissioners only inspect at night if there is cause for concern or a compliant. • Little management involvement • ‘What if’ Anxiety • Unacceptable levels of ‘Checking’ • Unacceptable levels of noise and light • Little knowledge amongst night staff about dementia, nutrition or continence • Training given not night time specific • Problems with lack of English • Problems with gender balance

8. Phase two • Development of Action plans • Implemented after negotiation with managers and staff.

9. Interventions • Raising awareness • Increase management involvement • Reduction in ‘checking’ • Intro night key worker system and care plans • Reduction in noise and light levels • Put in some person centred, night time specific , practice based training on dementia and management of incontinence

10. Resulted in • Reduction in inappropriate/harmful interventions • More appropriate interventions • Reduction in Challenging behaviour. • Improved sleep • Improved mornings • Less stress

11. Policy Implications • All policy documents concerned with the provision of residential and nursing care for older people must specifically address night time issues as appropriate and not assume that general statement in relation to care will encompass night time. • Regulatory bodies need to give equal weight to the regulation and inspection of night as well as day provision. • Audit tools in relation to all areas of care and in particular in relation to nutrition, continence and dementia must specifically address night time requirements. • SVQ and other training accessed by night staff must address aspects of care that are night specific. • Qualification levels must apply equally and specifically to night staff and not be biased towards day staff.