Staffing Levels

[father ted]

I am sure this question must have been asked before but thought I would ask.

Is there a minimum requirement for staffing levels. The staff to residents ratio?

When Mum went into the home the floor she was on was not full and also the residents that were there were more self sufficient than those there now. Recently they have had two admissions who are mobile and go around waking up other clients that are asleep or sitting next to them and touching them or playing with their hair/clothing. This results in the residents that are usually quite content to respond and become irritated and shout. There are I think are about 15 residents with 3 staff but if one goes off for lunch then it its only 2 though sometimes cover is provided from somewhere else but not always and if a resident needs help in their room it leaves one person less.
It didn't seem an issue before but with the new people it has become so. My Mum is quite entertained by it for now but I am concerned it will eventually irritate her too and cause problems.

 

[father ted]

Also, in all truth it has unsettled me. Up until now I have not doubted my decision for Mum to be there as I could no longer care for her and yet she needed far more input than carers visits during the day. But today I did feel sorry to see her there, even though she doesn't complain.

 

[love.dad.but..]

Others may know but don't think there is as such but a setting has to show that they have adequate staffing levels to keep residents safe and their needs met etc. When dad was in his NH the staff ratio was...32 residents ..daytime 6 carers 2 nurses 2 activity staff...nights 3 carers 1 nurse. However while that seems reasonable on face value there were many times when I felt even that was not enough because often for personal care etc the carers worked 2 to 1 resident double handed care and that was pretty much every resident every morning. In any setting as different residents come and go the balance can quickly shift if even just 2 residents are agitated or disruptive and often in a dementia setting it is more than that with unique individual challenges....dad was one of those sadly.

 

[nitram]

Others may know but don't think there is as such but a setting has to show that they have adequate staffing levels to keep residents safe and their needs met etc.

Agreed, in spite of searching the best I can find is 'adequate'.

It's difficult to legislate an overall minimum staff (at what skill level?):resident (at what needs level?) ratio.

 

[Sirena]

I don't think there is a minimum ratio. I'd say the ratio at my mother's care home is similar to yours, but there are about 40 residents so there are more carers, which means less of a problem if one has to disappear. There are usually 4 carers in the lounge (with the majority of the residents) and then another 3 or 4 elsewhere in the building. Numbers aren't the only issue though, staff need to be deployed in the right way and have the right experience.

As your mother doesn't seem worried by it, I would wait and see what happens, the new residents might settle down. And if they don't, they may be moved on.

 

[Elle3]

My dad was in a Dementia unit for residents with challenging behaviour, there was only a max of 18 residents, the ratio there was 3 residents to one carer and 1 nurse, but sometimes more. His previous care Dementia Care home was 5 to 1.

 

[elvismad]

My mum is one of those that wanders into others rooms. Sadly this does upset some of the other residents, some understand, but I 'get' that it is an invasion of their space. Obviously mum does not mean any harm. The reality is there is never enough staff as the dynamics of the care situation within a home is constantly changing. We are working with mums care home to try to source Social Services funding for 1 to 1 for mum for a few hours at the weekend (when staffing levels always seem to be less) in a bid to reduce the number of falls. We are at 16 at last count - 3 of which have required the attention of paramedics - head wound, broken nose etc.

 

[tryingmybest]

Apologies for speaking out loud, and I don't want to upset anyone, but I find it unbelievable that so few carers can cope with so many residents. It must be an absolutely impossible situation in all these places. It's hard enough caring for just my Mum here with me at home, 1-2-1, yet people try to tell me it would be better for her to be in a care home!

 

[Helly68]

tryingmybest I think staffing number vary and although there may be less staff in evidence some times than we might like, other staff are doing laundry, cooking, medications etc so the person above who said it is how they are deployed, is right.

I think care home staffing can work (and I wont say I haven't seen shifts with tow few staff, but not often) because, in my view, there is a routine, it is easier to do some things at scale (laundry), staff work shifts and have breaks (which many home carers never do) and have training and experience - though this varies.
I don't always think individuals get the same level of care as they might have got one to one at home, but I know that I am neither physically or mentally cut out to be a carer. I have the greatest respect for those who do this.

 

[father ted]

Thanks for all your responses.

In all the care homes I have visited I have never considered them staffed adequately. A new resident can change the dynamics of it all. One lady where my Mum is calls out all the time and the others tell her to shut up but when her relatives visit or a member of staff sits with her and she gets attention she is completely contained and content. This could be done by a volunteer too but I realise that the paperwork and responsibility of having volunteers in could be off putting to some care homes. Also difficult to recruit people I should imagine.

Interestingly there was someone from the RCN on the radio this morning talking about staffing levels in hospitals- the guidelines being that they have to be adequate ( in terms of numbers and qualifications for the care and medical needs of the patients) and that this was causing a problem in many hospitals. She said that 'guidelines' are too conservative and always err toward an understaffed situation rather than the other way round. There was a movement to change it.

 

[Jaded'n'faded]

I agree with others. Sometimes the staffing levels are fine but a couple of 'high need' residents can make a big difference. Obviously carers have to respond to those most in need but that can mean the 'quiet ones' get less than their fair share of care and attention at times.

The man in the room next to mum's shouts out constantly: 'Help! Get Off Me! **** Off!' etc, etc. It's very distressing to listen to. His cries for help are often in vain as no one comes, but - I'm hoping - the staff know when he actually needs something and when he's just calling out randomly. (And they do check on everyone regularly.) But I would hate to think that was my mum, calling out in obvious distress and nobody coming.

Mum just says: That's my neighbour - he's always singing...

 

[Sirena]

I've honestly never thought there were too few staff in my mother's care home. There is a relaxed atmosphere and the residents seem content. During the day most of the residents seem to be downstairs in the main lounge, or in the quiet lounge. Very few stay in their rooms - I have never seen my mother in her room! - although they could if they wanted to. I always go up (alone) to check her room every visit, and all is peaceful. Obviously I have no idea what it's like during the night though, as I'm not there.

I suspect if a PWD was very challenging they would not accept them, but there are a few high-needs/more challenging residents who always seem to be managed well. I think the quality of the carers is as important as the number.