Concern at night care for elderly

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A study of care in residential homes has indicated standards may be much lower at night than during the day.

Edinburgh-based researchers raised questions about the level of training given to night-shift carers and a lack of routine inspections.

The research, commissioned by the Joseph Rowntree Foundation, found that care workers felt isolated and anxious.

The study said minor changes could make a big difference and called for care homes to be inspected at night.

The research was carried out by a team at the Centre for Research on Families and Relationships (CRFR), which has its main base at the University of Edinburgh.

Their report - Supporting older people in care homes at night - is said to be the first study of its kind to highlight the night-time care experiences of residents, relatives and staff.

Less training

It also reflects the views of care commissioners, who are responsible for inspecting homes in Scotland.

Researchers said that although residential care homes provide a round-the-clock service, little is known about what happens at night.

The study, carried out at three care homes in Scotland, pinpointed good and bad practice, as well as ways to make changes.

The report found that unacceptable levels of noise and light disturbed residents during the night, while people with dementia often struggled in their surroundings.

It found that night staff got less training than day staff, and little or no training on dementia, pain management or nutrition.

To improve the quality of night-time care, it is essential that night-time staff are supported, trained and valued Dr Heather Wilkinson Co-author

The study also said that routine and indiscriminate over-checking for things such as breathing, falls and incontinence, led to the unnecessary disturbance of residents.

It found that managers in the care homes studied were not involved enough in night-time work and supervision.

Dependence on unknown agency and bank staff increased the workload on regular staff and jeopardised the quality of care for residents, the report's authors found.

Co-author Dr Heather Wilkinson, a co-director of CRFR, said small changes by staff, such as not turning on bright lights and assigning people to manage individual night-time care plans, could have a big impact.

She said: "Despite supporting 400,000 elderly people 24 hours a day, residential care and nursing homes are seldom inspected during the night, usually only if there has been a complaint.

"We found that night-time inspections were carried out with less rigour than day-time inspections."

Dr Wilkinson added that more must be done to ensure staff are equipped to cope with the demands of a night time shift.

"We found that night staff missed out on relevant training; felt isolated and anxious due to lack of management and supervision; and had their workloads increased by having to instruct and supervise agency staff," she said.

"To improve the quality of night-time care, it is essential that night-time staff are supported, trained and valued."