Healthcare framework for adults living in care homes: equality impact assessment

Healthcare framework for adults living in care homes: My Health - My Care - My Home Equality Impact Assessment

Title of Policy

My Health - My Care - My Home: A healthcare framework for adults living in care homes

Summary of aims and desired outcomes of Policy

The framework seeks to examine how the health and care of people living in care homes should be optimised, supported, and delivered. It will aim to enhance the health of people living within a care home, improving the way we assess, monitor and respond to enduring and changing health and care needs through working with health and care professionals, health and social care partnerships and care home providers. It will set out recommendations for how professionals, services and systems can work effectively and to enable the provision of seamless, personalised care at all times.

This framework has the potential to contribute to the following National Outcomes :

• Health – we are healthy and active
• Communities - we live in communities that are inclusive, empowered, resilient and safe
• Human Rights – we respect, protect and fulfil human rights and live free from discrimination
• Education – we are well educated, skilled and able to contribute to society

Directorate: Division: team

Directorate for Social Care and National Care Service Development; Adult Social Care Oversight and Assurance Support Division; Quality and Improvement Team

Executive summary

The healthcare framework for adults living in care homes examines how the health and healthcare of people living in care homes should be optimised supported and delivered. It will also enhance the assessment, monitoring and response to the forever changing health and healthcare needs of people who live in care homes.

The framework will set out recommendations for how professionals, services and systems can work effectively to support our aims by building on existing good approach models, and setting out key principles and recommendations. This EQIA is designed to support the development of the framework and considers the potential impacts of the framework across the range of protected characteristics.

Following publication of the framework, we will embark on a further period of engagement and collaboration with key stakeholders from across the sector to effectively implement the principles of realistic medicine into everyday practice in the delivery of care in homes, and to deliver the recommendations outlined in the framework. This work will contribute to the ongoing review and monitoring of this EQIA and any new evidence identified will be reflected in subsequent versions.

Background

Excellence in the provision of health and social care is a right for all our people. People living in care homes have increasingly complex health needs. Their requirements go beyond physical health, and include social, psychological and spiritual care needs, and they have a right to have their needs met in a person-centred, holistic, consistent and co-ordinated way. Care should be outcome focused as set out in the Health and Social Care Standards.

The purpose of this work is to develop a healthcare framework for adults living in care homes in Scotland that is:

• Person-centred, holistic and rights focused
• Relationship based, inclusive and collaborative
• Proactive
• Responsive to needs 24/7
• Accessible, Seamless and Flexible
• Equitable
• Safe and Effective
• Committed to quality improvement and shared learning

The framework will seek to examine how the health and care of people living in care homes should be optimised, supported, and delivered. It will also aim to enhance the health of people living within a care home, improving the way we assess, monitor and respond to enduring and changing health and care needs through working with health and care professionals, health and social care partnerships and care home providers.

It will set out recommendations for how professionals, services and systems can work effectively to support our aims by building on existing good approach models, and setting out key principles and recommendations for the following core elements of care:

• a nurturing environment
• the multi-disciplinary team (MDT)
• prevention
• anticipatory care, supporting self-management, and early intervention
• urgent and emergency care
• palliative and end of life care

These core elements are underpinned by both 'a sustainable and skilled workforce' and effective use of 'data, digital and technology'.

The Scope of the EQIA

This EQIA is designed to support the development of the framework document. The framework is most likely to have an impact on the people living within adult care homes in Scotland and their families, but it is also likely to affect the care home team and the wider multi-disciplinary team. This EQIA assesses and highlights any direct or indirect impact of the framework on people living and working in adult care homes with protected characteristics under the Equality Act 2010 (Age, Disability, Sex, Pregnancy and Maternity, Gender Re-Assignment, Sexual Orientation, Race, and Religion or Belief).

A variety of sources were used to gather evidence to compile this EQIA, including data from the Care Home Census for Adults in Scotland, and care home workforce data available on the Scottish Social Services Council's website.

Key Findings

In general, positive impacts were identified. The framework applies to all adults living in care homes in Scotland and the aim of the framework, and the purpose of its recommendations is to ensure that everyone living in a care home has the right to the same care as others living in the community.

The framework promotes the development of personal care plans, encouraging conversations with the person and those close to them, to ensure that what matters to the individual is taken into account and that the health and social care and support is tailored to the needs of the individual. It supports everyone's right to live according to their beliefs and fulfil their emotional, psychological and spiritual needs, and the personal plan would take into account any specific need in relation to any of the protected characteristics and be adapted accordingly.

The framework should have a positive effect as it is about encouraging those living in care homes to have the opportunity to live their best life possible, with meaningful activities, and supporting them to maintain links within their local community which enables cognitive stimulation, mobility, independence and communication.

Communication between the person living in the care home and their families, the care home workforce, and the wider multi-disciplinary team is promoted throughout the framework. This will help raise the level of understanding between the individual's needs, which will in turn foster good relations between people across the range of protected characteristics.

While the framework is likely to have some impact on the care home workforce and wider multi-disciplinary team, it does not address issues directly in relation to the range of protected characteristics. However, recommendations are being made within the framework to ensure that all staff, regardless of any protected characteristic, receive the relevant training, education and support to give them the right skills to carry out their roles, and promoting communication to ensure people have equity of care.

The EQIA identified that there is a recognised lack of data gathering and analysis about people with certain protected characteristics who access social care, including care homes. Also, the reliability and availability of data relating to those who live in care homes and care home staff makes data collection difficult.

Recommendations and Conclusion

Recommendations are made within the framework that will look to improve future data sharing and collection. We acknowledge this is unlikely to assist with the development of this framework, however it may help with implementation and future data-gathering exercises.

In conclusion, the evidence collected over the course of the EQIA process has shown that the healthcare framework for adults living in care homes is likely to have an overall positive impact across the range of protected characteristics.

Relevant stakeholders were engaged with during the development of the framework, and engagement will continue during the implementation of the recommendations within the framework. The EQIA process will be ongoing, and all relevant data and evidence will be analysed and reviewed against any equality impacts, and the associated documents will be kept up to date with any new evidence.