The experience of living in a nursing home Literature review and summary of key issues raised with the Patient and Client Council Complaints Service

June 2018

Contents 1. Overview .............................................................................................................. 1 2. Introduction .......................................................................................................... 2 2.1 Definition of ‘nursing home’ ........................................................................... 2 2.2 The current provision of nursing home beds in Northern Ireland................... 3 2.3 DHSSPS Care Standards for Nursing Homes (2015) ................................... 3 2.4 Regulation and Quality Improvement Authority (RQIA) and Nursing Home Inspection Programme ............................................................................................ 5 3. What we did ......................................................................................................... 7 4. What we found ..................................................................................................... 8 4.1 A review of published literature ..................................................................... 8 4.1.1 Dignity and respect ................................................................................. 8 4.1.2 Quality of life ......................................................................................... 11 4.1.3 Personal care ....................................................................................... 14 4.1.4 Healthcare ............................................................................................ 16 4.1.5 Food and nutrition ................................................................................. 18 4.1.6 Safeguarding from abuse ..................................................................... 19 4.1.7 Making decisions about care ................................................................ 20 4.2 Review of PCC Complaints Support Service data....................................... 22 4.2.1 Clients of the PCC Complaints Support Service ................................... 23 4.2.2 Profile of residents in nursing home cases ........................................... 24 4.2.3 Complaint cases by Trust area ............................................................. 25 4.2.4 Nature of issue/concern ........................................................................ 25 4.2.5 Complaints processes in nursing home cases...................................... 30 4.2.6 Outcomes for clients ............................................................................. 31 5. Points of learning from complaints ..................................................................... 33 5.1 Termination of contract ............................................................................... 33 5.2 Facilitating people to raise issues/concerns ................................................ 34 5.3 Openness and transparency in dealing within issues and concerns ........... 36 5.4 Management of expectations ...................................................................... 37 5.5 Dealing with the complexity of next of kin issues ........................................ 37 5.6 Complaints are not representative of everyone’s experience ...................... 38 6. Conclusion ......................................................................................................... 39 References ............................................................................................................... 41

1. Overview Care delivered in nursing homes is a significant and essential part of care for the frail and elderly in our society. Many people report positive experiences of care, however, there are aspects of nursing home care that people are worried about and there is evidence of these concerns in our work at the Patient and Client Council (PCC). Issues identified through PCC work include concerns about staffi