Wygram Nursing Home

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Wygram Nursing Home, OSV 0000756, 31 July 2018

Wygram Nursing Home, OSV 0000756, 31 July 2018

The centre is a purpose built three storey construction that opened in 2015 and is located in Wexford town. The centre is registered to accommodate 71 residents. Residential accommodation is provided across three floors and consists of the following: The ground floor has 10 single ensuite bedrooms and one twin ensuite bedroom. The first floor has 25 single ensuite bedrooms and three twin ensuite bedrooms. The second floor contains 24 single ensuite bedrooms and two twin ensuite bedrooms. There are two passenger lifts to each floor. Each of the three floors had a central core area which was fitted out with couches and armchairs and there is also a communal day room on the second floor. There is one dining room on the ground floor that is large enough to accommodate all residents. The dining room has dividers that can be pushed back so the room can be used for a number of functions at the same time, for example activities. The main kitchen area is adjacent to the dining room. There are two smaller galley style kitchens on both the first and second floors. A number of bedrooms on the first and second floors have balcony areas which residents can also access. There is also a community resource building on site known as Davitt House which is a focal point for social, educational and religious activities. The provider is a limited company called Wygram Nursing Home Limited. The centre provides care and support for both female and male adults over the age of 18 years requiring long-term, respite or convalescent care with low, medium, high and maximum dependency levels. The range of needs include the general care of the older person, residents with dementia and or a cognitive impairment and residents with intellectual disabilities. The centres stated aim is to meet the needs of residents by providing them with the highest level of person centered care in an environment that is safe, friendly and homely. Pre-admission assessments are completed to assess a potential resident's needs and whenever possible residents will be involved in the decision to live in the centre. The centre currently employs approximately 87 staff and there is 24-hour care and support provided by registered nursing and healthcare assistant staff with the support of housekeeping, catering, administration, laundry and maintenance staff.

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Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

The person in charge had not changed since the time of the last inspection. She provided a good standard of governance and clinical leadership to the staff team in all aspects of care delivery. She was suitably qualified as a registered nurse and had the authority accountability and responsibility for the provision of the service. The inspector found that she was well informed about residents and person centred in her approach. There was a clearly defined management structure which identified the lines of authority and accountability in the centre. The person in charge works on a full time basis and is supported by an assistant director of nursing. The assistant director of nursing assumes responsibility of the designated centre in the absence of the person in charge.

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Wygram Nursing Home, OSV 0000756, 01 August 2017

Wygram Nursing Home, OSV 0000756, 01 August 2017

The inspector formed the judgement through observation, speaking with staff and review of documentation that there was an adequate complement of nursing and care staff with the required skills and experience to meet the assessed needs of residents taking account of the purpose and size of the designated centre. Staff who spoke with the inspector said that there was sufficient staff on duty day and night. Residents who spoke with inspectors did not raise any concerns with staffing levels. Staff numbers were on duty as outlined on the roster.

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Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

There were policies in place to protect residents from being harmed or suffering abuse. All staff had received training on the prevention, detection and reporting of abuse. Prior to the inspection the Authority had been notified of two issues of potential financial abuse. Inspectors reviewed documentation in relation to these issues and were satisfied that they had been managed in accordance with the centre’s policy on the protection of residents from abuse. Inspectors spoke with residents, some of whom said that they felt safe in the centre and “it was like a home from home”.

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Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

Wygram Nursing Home, Davitt Road, Wexford Town, Wexford

management of another centre. There were four members on the board of the Wygram Nursing Home limited with the provider nominee being the director of operations. As director of operations he had been part of the design team and project management team during the development of this centre. He now had specific responsibilities for clinical support services including maintenance, services and quality compliance. He also had responsibility for ensuring that all complaints were appropriately responded to.

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Factors associated with high job satisfaction among care workers in Swiss nursing homes – a cross sectional survey study

Factors associated with high job satisfaction among care workers in Swiss nursing homes – a cross sectional survey study

The greatest strength of this job satisfaction study among care workers in Swiss nursing homes was its extensive dataset–the product of a large representative nursing home sample and high response rates. Add- itionally, the strict focus on strong job satisfaction re- sponses allowed identification of the associations most relevant to the nursing home care workforce. However, the findings should be interpreted with caution in view of its limitations. First, as its cross-sectional design cap- tures care workers’ job satisfaction and associated fac- tors only at a single instant, no causal relationships can be inferred. Second, considering the complexity of a so- cially determined construct such as job satisfaction, the use of a single item to measure it might be disputable. Nevertheless, previous studies have successfully applied similar measures to job satisfaction, as well as to related workplace factors and perceptions [19, 26, 42]. Third, the selection of items examined in relation to job satis- faction was limited to those used in the SHURP study. Other potentially relevant factors, such as work-family conflict or the opportunity to provide person-centered care, were left unexamined. Finally, social desirability bias might have skewed the results towards the positive end, reflecting the workers’ desire to be members of a good workplace.

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End-of-life care communications and shared decision-making in Norwegian nursing homes - experiences and perspectives of patients and relatives

End-of-life care communications and shared decision-making in Norwegian nursing homes - experiences and perspectives of patients and relatives

According to the literature, the evidence regarding the benefit of discussing plans for end-of-life care with pa- tients is mixed [6]. On the one side, patients can find the process itself helpful, particularly when discussions focus on their goals, values and beliefs, rather than on specific interventions, which may help them feel ac- knowledged as individuals by the nursing home staff. There may also be other important benefits, including re- ceiving care that is aligned with their wishes [9, 42, 43], and improving documentation of the patient’s preferences [8]. Advance care planning is also thought to help families to prepare for the death of their loved one [44]. On the other side, there are some risks and barriers one has to keep in mind. Besides feelings of uneasiness, some patients may also feel that they do not have sufficient information to engage in such discussions, related to an uncertainty concerning their future illness and decline. Other barriers include the reluctance of family members and/or the staff to discuss end-of-life care, as well as time restraints for the staff [5, 11].

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Norwegian Nursing Home—A Care Facility or a Home?

Norwegian Nursing Home—A Care Facility or a Home?

Norwegian health authorities are aware of the risk that deficiencies in provision of municipal nursing and care services may occur. The Norwegian Board of Health Supervision has summarized the experience gained from supervision of municipal nursing and care services in all the counties in Norway [18]. Deviations from the regu- lations were identified in 80 per cent of the 373 supervision visits. Regulatory deficiencies were mainly related to inadequate help with basic needs, inadequate administrative procedures when allocating services, and inade- quate routines for internal control. The Norwegian Board of Health Supervision also questions whether there is enough staff with the necessary competencies to meet the needs of the residents. A new supervision visit was arranged in 2010, and for institutional care the deviations from the regulations were found in different areas; there was a lack of knowledge, practice and routines to detect undernourished older persons, and thus to prevent and treat under nourishment. In addition, supervision found that residents in nursing homes were not given the correct treatment regarding rehabilitation, and that the residents freedom of movement were violated (through locked door) as a collective restriction, something that is against the regulations [19]. A recently published re- port from The Norwegian Board of Health Supervision [20] about compulsory health care in nursing homes concludes that: “The breaches of the regulations that we detected indicate that there is a great risk that service provision is inadequate” (p. 9).

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State Variation in Posthospital Home Nursing for Commercially Insured Medically Complex Children

State Variation in Posthospital Home Nursing for Commercially Insured Medically Complex Children

In future work, researchers should evaluate potential drivers of the observed variation among states and over time regarding the provision of home nursing, including more direct regulatory and market-based mechanisms and, potentially, more complex policy mechanisms. For example, the relative size of the home nursing labor supply in any given state may be directly due to the restrictiveness of that state’s scope-of-practice regulations or due to the local prevailing differential of wages between home and hospital nursing. 22 At the level of policy, levels of home nursing among commercially insured children might be driven by Medicaid policies but, potentially, in divergent directions. On the one hand, more expansive Medicaid coverage policies regarding home nursing might increase the pool of available home nurses in an area, allowing for improved access to home nursing among both Medicaid- insured and commercially insured

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Patterns of multimorbidity in an ageing population of people with an intellectual disability: Results from the intellectual disability supplement to the Irish longitudinal study on ageing (IDS TILDA)

Patterns of multimorbidity in an ageing population of people with an intellectual disability: Results from the intellectual disability supplement to the Irish longitudinal study on ageing (IDS TILDA)

Background: Undesirable outcomes in late life are often a result of declines in social engagement and inadequate nutritional intake. To target these two issues simultaneously, we present the RelAte project, a relationship-based mealtime intervention study. Previous research has shown that similar interventions can benefit the physical [1] and social [2] wellbeing of older nursing home residents. We aim to deliver our intervention to community-dwelling, independent older adults. Methods: 100 individuals who are identified as being at risk of social isolation will be recruited to the study. 50 participants will be randomised to the treatment group, and 50 to the control group. Peer volunteers will also be recruited and trained to deliver the mealtime intervention in the homes of the intervention group participants, once weekly for 8 weeks. Psychological, cognitive, and health-related metrics will be assessed at baseline, post-intervention and at two follow-up points to investigate whether an intervention of this type can be seen to have a statistically significant impact on quality of life and psychosocial wellbeing in socially isolated older adults. Another area of interest to the researchers is the impact of the intervention on the peer volunteers; this will be inves- tigated also using relevant psychometric assessments post-intervention. Results: We report relevant guiding principles from the literature. These principles include person-centred care, relevant nutritional guidelines for the clinical population, and prior research on rela- tionship-based interventions. Our goals include the successful enhancement of the quality of life of socially isolated older adults, by providing them with two combined services within their own home. We outline our plans to deploy the RelAte intervention in the homes of 50 individuals in the community.

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Adjustment of nursing home quality indicators

Adjustment of nursing home quality indicators

Finally, it is important to note that some limitations of QI scoring in first and second generation frameworks remain in our proposed third generation framework. Par- ticularly, the third generation framework does not directly address the problem of low base rates (rare events). More work is needed to address this issue. One approach would be to accumulate observations over a long period of time. Typically nursing home QIs are scored quarterly, but longer periods may allow the accu- mulation of more events and lead to more stable esti- mates. The cost of such an approach is the greater time lag may not capture current quality or care practices at a given facility. A better approach may be to limit consider- ation of viable QIs to those that do not have a low base rate.

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Dermatological and musculoskeletal disorders of nursing home workers in Australia, Japan, South Korea and Taiwan

Dermatological and musculoskeletal disorders of nursing home workers in Australia, Japan, South Korea and Taiwan

The main factor contributing to MSD among aged care staff is probably the manual handling of patients who require assistance for all their daily activities of living. More than half the employees surveyed during this study were involved in regular manual handling tasks, with moving patients being their most frequent, strenuous activity (undertaken by 58.2% of all staff). This category included many tasks such as manually transferring residents between their beds, wheelchairs, bath and any activities directly related to physical patient handling. Nevertheless, previous studies have indicated a much higher rate of patient moving tasks among American (70.0%) 27 and Japanese (66.2%) HCW. 1 Nursing home studies in Australia and Taiwan on the other hand have reported lower rates of patient moving tasks (37.9 and 56.0% respectively). 22,23 In Japan, Ando et al 1 reported the percentage of their staff undertaking strenuous manual tasks to be higher than ours (changing the patient’s bed: 87.1 vs. 41.8% and washing the patient: 79.3 vs. 44.0%). Conversely, a lower proportion of their Japanese workers were involved in changing the patient’s clothes when compared to the current study (43.7 vs. 50.5%). It is possible the differing rates of manual handling tasks documented during previous studies relate to the finer targeting of only those employees involved in regular patient contact. On the other hand, the present research targeted all staff within the study facility regardless of their expected patient contact frequency; a factor which may have reduced the overall MSD prevalence to a certain extent. The existence of various load-reduction strategies such as mechanical aids and lifting techniques might also have varied between our research group and those within other studies.

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The Ombudsman's nursing home casebook

The Ombudsman's nursing home casebook

The Ombudsman formed the view that the refusal by the HSE to grant assistance under the Nursing Homes Support Scheme was at odds with the medical evidence on record. In particular, the evidence recorded that the man needed full-time supportive care and that he had lived in nursing homes previously under the “Winter Beds Initiative”. His family helped to care for him at home at other times of the year. His application also followed several admissions to hospital in the previous months. In addition, it was clear from the application form for the Scheme that, while the man expressed a preference for staying at home, he also indicated that he was willing to stay in the nursing home for a few months.

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Long-term Care in Estonia. ENEPRI Research Report No. 75, 15 June 2010

Long-term Care in Estonia. ENEPRI Research Report No. 75, 15 June 2010

Reforms in the healthcare system are closely linked to the social welfare system. However, the health care and social welfare systems are relatively separate from each other, which cause problems in terms of the transfer of people between the different systems. The accessibility and quality of long-term care services is limited, due to the fact that the welfare and healthcare systems are financed from different sources - from the state budget and through the Estonian Health Insurance Fund (EHIF), respectively. Many social care home residents also need long-term care, but the amount of care provided is constrained by limited municipal budget resources. As the target group for long-term care and welfare services largely overlaps, integration and better coordination of services are required to respond more effectively to the varying needs of elderly and chronically ill people.

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Personalisation briefing: Implications for nursing homes

Personalisation briefing: Implications for nursing homes

Personalised care in a nursing home is enhanced by collaborative ways of working. This should include identifiable contacts to which referral can be made such as: opticians, audiologists, chiropodists, dentists, general practitioners, nutritionists, specialist practitioners for end of life care, continence services, falls coordinators, infection control specialists, dementia care and the whole range of available health condition specialists.

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Dermatological and musculoskeletal disorders of nursing home workers in Australia, Japan, South Korea and Taiwan

Dermatological and musculoskeletal disorders of nursing home workers in Australia, Japan, South Korea and Taiwan

Although skin disease and musculoskeletal disorders are believed to be common among nursing home workers, to date there have been no coordinated international studies of these occupational issues. Therefore, it was considered appropriate to conduct one of the first cross-cultural investigations of occupational dermatology and ergonomic complaints among nursing home workers in Australia, Japan, South Korea and Taiwan using a standardised methodology.

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Adjustment of nursing home quality indicators

Adjustment of nursing home quality indicators

Finally, it is important to note that some limitations of QI scoring in first and second generation frameworks remain in our proposed third generation framework. Par- ticularly, the third generation framework does not directly address the problem of low base rates (rare events). More work is needed to address this issue. One approach would be to accumulate observations over a long period of time. Typically nursing home QIs are scored quarterly, but longer periods may allow the accu- mulation of more events and lead to more stable esti- mates. The cost of such an approach is the greater time lag may not capture current quality or care practices at a given facility. A better approach may be to limit consider- ation of viable QIs to those that do not have a low base rate.

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(In )formal caregivers’ and general practitioners’ views on hospitalizations of people with dementia   an exploratory qualitative interview study

(In )formal caregivers’ and general practitioners’ views on hospitalizations of people with dementia an exploratory qualitative interview study

reported insufficient communication about medication, medication education for caregivers (concerning dosage, indication, administration with other medications, rec- ognition of side effects and therapeutic outcomes) would be helpful. This has also been suggested by Campbell and colleagues [25]. Regular drug reviews with the par- ticipation of the (in-)formal caregivers and the persons with dementia might be even more necessary for people with dementia than for the general population. This is also demanded by existing guidelines [26] and viewed as an indicator of the quality of care [27]. The interviewed (in-)formal caregiver took over responsibility for the health and medical care of people with dementia. Other studies also state (in-)formal caregivers serve as surro- gates for medical decision making among patients with dementia [24], act as care coordinators, and as informa- tion sources and front-line communicators [17]. In triads composed of practitioners, people with dementia and in- formal caregivers interaction shifts over time. Communi- cation with the caregiver increases while communication with the patient decreases [28]. This was also true in our study. The person with dementia is often marginalized in communication and no longer takes part in his/her own care decisions [28], e.g. in our study, the perceived necessity of a hospitalization was never reported to be discussed with the person with dementia. Nevertheless many informal caregivers do not know enough about available help/services [29] and do not get sufficient symptom management advice [30]. This increased need for information is a long known fact [16, 31, 32]. Creat- ing possibilities for the reimbursement of conversations between GPs, informal caregivers and people with dementia (about medications, side-effect-monitoring and health care strategies) could potentially diminish this problem. In addition, a regular exchange between ambu- latory care providers and GPs, as well as, between nurs- ing home caregivers and GPs should be fostered, as suggested by our interviewees and van den Bussche and colleagues [33]. This need for the interconnectedness of medical, nursing and further treatment and support is accepted on paper, but not yet realized in actual care in Germany [34].

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Gaming the system to care for patients: a focused ethnography in Norwegian public home care

Gaming the system to care for patients: a focused ethnography in Norwegian public home care

Providing nursing care in a contemporary context Nursing is a profession that is historically based on moral obligations towards the suffering human being. High-quality nursing depends on nurse-patient relationships (NPRs), which many consider fundamental to nursing [42–44] and which have health-enhancing potential [45]. Patients view NPRs as a way to develop meaning in their daily life in home care [46]. Caring sciences promote NPRs as es- sential, advocating that all caring is formed in relation- ships and stating the aim of relieving suffering and enhancing patients’ health and wellbeing [44, 47]. Even though healthcare personnel are obligated by law to pro- vide professionally sound and compassionate services, less than 40% of community nurses report having enough time to safeguard patients’ needs for caring, social contact, and companionship [15]. Being unable to fulfill these obliga- tions can cause stress, frustration, guilt, and loss of pride in giving good care [48]. Formalized and task-oriented ser- vices can lead to nurses’ professional judgement being overlooked in the healthcare organization, and NPRs, car- ing and individualized care may suffer as a result.

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The treatment of hypertension in care home residents: a systematic review of observational studies

The treatment of hypertension in care home residents: a systematic review of observational studies

unexpected, as most guidance no longer recommends them for the treatment of hypertension and favors the use of calcium channel blockers. This could be an example of a treatment lag in this po- pulation, or that other factors, such as heart failure, are acting as confounders. However, treatment rates for hypertension in care home populations were higher than in noncare home hypertensive populations (70% vs 63%), 27 which does not support the hypothesis that the treatment of this long-term condition is overlooked in care home residents.

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