addressing sensory loss in registered care homes

Rhif elusen gof. 226227Reg charity no. 226227

Addressing sensory loss in registered care homes

Ansley Workman

Head of Independent Living

RNIB Cymru


The numbers

Registered Care Homes - Wales• Approx 64,000 people• Approx 740 RCHs- older people

Providers• 75 per cent private• 14 per cent voluntary • 11 per cent statutory


The numbers

Living with significant sight loss• 1 in 7 over 65

• 1 in 5 over 75

• 1 in 2 over 90


Estimated prevalence• As many as over of half of older residents in

care homes (RNIB 2010)Why? • Higher likelihood of people with a VI being

admitted

• Difficulty in accessing eye care services

• Residents co-morbidity - eye care interventions are overlooked or though unnecessary


Future projections

Future projections• 23% of population will be over 65 by 2034• 5% of population will be over 85 by 2035

24 hour care• 82% increase for people over 80 over the

next 20 years


Dementia and sight loss• At least two thirds of people living in care homes

• Different forms of dementia can also affect sight not limited to loss of visual field or acuity but linked to difficulties in carrying out practical activities

• Individuals may not be cognisant over their own health or social care needs.

• Low levels of awareness and understanding of how to respond to residents with dementia and their specific health and social care needs


Current practice

• No National Standards for sight checking in care homes

• Therefore not on the “radar”

• Ad hoc relationships with local or specialised domiciliary optometrists

• Cost = strong incentive to avoid over - testing


Partnership approach

• RNIB Cymru, Action on Hearing Loss Cymru, Sense Cymru

Is sensory loss

• Recognised

• Identified

• Addressed in Care Plans and practice


Why intervene

• Best possible sight

• Complications or increases severity due to non

diagnosis of eye conditions

• Associated health risks inc falls, depression, reduced

quality of life

• Improvements in managing other conditions such as dementia


Key issues and barriers

• Lack of awareness

• Lack of priority given to eye

• Eye health overlooked as a health indicator

• Limits in delivery of training


Who else?

• Care and Social Services inspectorate Wales

• Care Council for Wales

• My Home Life Cymru

• Care Forum Wales


Care Standards and Social Services Inspectorate Wales (CSSIW)

• Outcomes not standards

• Thematic

• Benchmarking

• Inspectors – training and observational tools


Care Council for Wales

• Regulator for the social care profession in Wales


My Home Life Cymru

• Regional and National Networking Days

• Conference

• Steering Group

• Publications


My Home Life Cymru

Bulletin for Care home staff – QualityOf Life for Residents with sight loss • Recognising sight loss

• Engaging with residents

• Creating the right environment

• Top ten10 tips


Care Forum Wales

• Representative body for 500+ care homes and independent care sector organisations across Wales

• Helping members to deliver high quality services and dignity in care for the elderly and others in need of social care


Latest research

Recommendations

• National awareness campaign

• The Care Quality Commission should incorporate eye health indicators into their assessment criteria for care homes and across the general health system.


Latest research

Recommendations• Care Home providers should be encouraged

to add eye health and sight loss testing to their key performance indicators

• Further research should be conducted to explore the impact of the General Ophthalmic Services contract restrictions on domiciliary sight testing


Latest research

Recommendations

• More qualitative research is required within care homes to ensure barriers to good eye health practices for care home workers, managers and providers are understood.


Ambassador model

• To create visual awareness and impact of sight loss on everyday life

• Discuss best practice and impact of not recognising sight loss such as falls and not engaging

• Types of sight loss and impact

• Different residents and scenarios


Publications, guidance and toolkits

Sight Loss• Undetected sight loss in care homes: an evidence

review( International Longevity Centre – UK. Thomas Pocklington Trust)

• Seeing it from their side: A guide to recognising and supporting sight loss in your care home (RNIB)

• Seeing it from their side: Adapting older people’s services to support sight loss ( RNIB and AgeUK)



Sight Loss• RNIB Care Homes fall Prevention project: A review of

the literature (RNIB)

• Preventing sight loss in older people (Barriers and enablers to the uptake of regular sight tests (RNIB)

• My Home life: Quality of life for residents with sight loss: Supporting residents with sight loss (My Home Life Cymru / Thomas Pocklington Trust)



Dual Sensory Loss• The identification and assessment of the needs of older people

with combined hearing and sight loss in residential Homes (University of Birmingham for Bupa / Sense)

• Fill in the Gaps: A toolkit for professionals working with older people (Sense)

• Fill in the Gaps: A checklist for assessing older deaf people (Sense)

• Seeing Me: Guidance on sight and hearing difficulties for staff who care for older people (Sense)



Dual Sensory Loss• Seeing me: a checklist for identifying older people

with dual sensory loss (Sense )

• Older people who use BSL – preferences for residential care provision in Wales (University of Manchester)

• The good life: Guidance on helping older people with sight and hearing problems (Sense)



All of the above documents are available on the Social ServicesImprovement Agency (SSIA) website

http:ssia.wlga.gov.uk/index.cfm?articleid=7307

Or at the individual organisations’ websites• www.rnib.org.uk• www.sense.org.uk• www.pocklington-trust.org.uk• www.actionhearingloss.org.uk• www.myhomelife.org.uk



Other useful organisations

• www.ilcuk.org.uk

• www.vision2020.org.uk (Dementia and Sight Loss Interest Group)

• www.alzheimers.org.uk

addressing sensory loss in registered care homes

Documents