Supporting quality improvement in care homes for older people: the contribution of primary care nurses

Abstract

This paper discusses how health and social care can work together collaboratively to improve the quality of care for older people resident in care homes, using Essence of Care benchmarking as an example. There is an increasing interest in how care is provided in care homes, including its impact on quality-of-life and end-of-life care. Care standards and government policy have emphasized the need for primary care to work more closely with care home staff. The available evidence on older people's health care needs, and how primary health care and nursing work in care homes was evaluated. Case studies and descriptive reports on Essence of Care benchmarking were also used to identify the facilitators and barriers to using it as a means to improve the quality of care for older people in care homes. The key issues relate to the differences in the working cultures of health and social care, and the complex health care needs of older people living in care homes that do not have onsite nursing support. Structured tools such as benchmarking can potentially be used to improve the quality of care for older people in care homes, but care home staff need adequate support to adapt this approach to their working environment. Primary care nurses need to be more proactive in the way that they work with older people in care homes. Structured tools such as benchmarking can help them to recognize the range and complexity of resident's health needs, and work with care home staff in ways that acknowledge their expertise and improve the overall care of older people in these settings.