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Outcomes-based care planning in older adult care homes

2022 Conference Presentation

9 September 2022

Outcomes-based care planning in older adult care homes

Nick Smith , University of Kent , United Kingdom

Jonathan Taylor, University of Oxford
Madalina Toma, University of Kent
Ray Fitzpatrick, University of Oxford
Hugh McLeod, University of Bristol
Ann-Marie Towers, University of Kent
Julien Forder, University of Kent


Background: Care planning and reviews are an important part of supporting people with care needs. In England, local authorities are responsible for working with individuals and others to produce a care plan. For provider organisations such as care homes, care planning and reviews are central to ensuring that the ongoing care they provide meets residents' needs. Guidance from CQC requires care providers to ensure that the planning, reviewing and provision of care involves the genuine involvement of the person being supported or their representatives.

This presentation outlines an ARC national priority study on developing outcomes-based care planning in older adult care homes. This work builds on the initial international piloting of an outcomes-based care planning approach which utilises the Adult Social Care Outcome Toolkit (ASCOT) as the basis for care planning conversations in older adult care homes, but also explores the use of other outcomes measures the ICECAP capability measures.

Objectives: The overall aim of this ARC national priority work is to inform the development of outcomes-based approaches towards care planning in older adult care homes. More specifically, this work aims to:

Identify and learn from existing care planning approaches in older adult care home settings.

Explore approaches to implementing changes in routine practice in older adult care homes.

Understand the perspectives of the older adult care home sector on outcomes-based care planning.

Methods: The ARC national priority study on outcomes-based care planning in older adult care homes involves three different activities:

A scoping review of care planning in older adult care home settings.

A scoping review of the factors which act as barriers or facilitators to the implementation of interventions in older adult care homes which change routine practice with the aim of improving quality of life.

A consultation exercise with those who work with or in older adult care homes focusing on care planning.

Results: Emerging findings from the first scoping review indicate that (a) most care planning that takes place in older adult care homes is concerned with end-of-life care, and that (b) the ability to conduct meaningful care planning is often hampered by a lack of knowledge and confidence.

Preliminary consultations with three care home providers in Australia, Sweden and England, respectively, who have already begun to implement outcome-based care planning, highlight that even when there is organisational motivation to implement new care planning approaches and organisations are involved in co-producing its implementation, workforce-capacity remains a significant barrier to wider roll-out.

Conclusions: Care planning that focuses on residents' quality of life outcomes and wellbeing is in its infancy in care homes for older adults. There is an international appetite to pilot such approaches and feedback from early adopters in Australia and Sweden indicate it is well received by family members, residents and staff. Nonetheless, implementation of new approaches to assessment and care planning takes time and a better understanding of the barriers to implementation are required.