Care homes

What national policy and guidance says

The treatment of people who have had a stroke who live in care homes has 12 mentions in the National Stroke Strategy, which stresses the importance of equity of service for individuals whether they are returning to their own home or going into a care home. The involvement of care homes is particularly important in the delivery of National Stroke Strategy quality markers 11 (end of life care), 12 (seamless transfer of care), 13 (long term care and support), 14 (assessment and review), 15 (participation in community life) and in 18 (leadership and skills).

The National Audit Office identified in 2010 that more work needed to be done so that care home staff understand:

• the needs of someone who has had a stroke
• how to manage them
• the signs of a stroke
• stroke should be treated as a medical emergency

The Care Quality Commission stroke review highlighted concerns over how well staff in care homes understand and respond to stroke, and recommended that commissioners, adult social services and providers of services should work together to:

‘ensure services understand and adapt to people’s individual needs and circumstances, including people in care homes.’

Within each of the Profession Specific Concise Guidelines from the Royal College of Physicians (RCP), it is stated that:

• All patients in nursing homes, care homes and residential homes should be able to receive assessment and treatment from specialist rehabilitation services
• All staff in nursing homes, care homes and residential homes should be familiar with the common clinical features of stroke and the optimal management of common impairments and activity limitations

Resources

Nursing Concise Guide for Stroke 2008
Nutrition and Dietetics Concise Guide for Stroke 2008
Physiotherapy Concise Guide for Stroke 2008
Psychology Concise Guide for Stroke 2008
Speech and Language Therapy Concise Guide for Stroke 2008
Occupational Therapy Concise Guide for Stroke 2008

The Department of Health has issued guidance on the NHS Standard Contract for Care Home Services 2011/12 on the one-year interim contract to be used when contracting for NHS funded care home services.

Measuring progress: indicators for care homes, a handbook published by the European Centre for Social Welfare Policy and Research, contains a set of 94 selected result-oriented indicators that has been developed for care homes to measure and manage quality improvements.

Quest for Quality - An Inquiry into the Quality of Healthcare Support for Older People in Care Homes: A Call for Leadership, Partnership and Improvement produced by the British Geriatrics Society in June 2011 – looks at the evidence and makes recommendations for working in care homes.

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