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A teaching nursing home

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VOL: 96, ISSUE: 48, PAGE NO: 43

Clifford Upex is chief executive of The Guideposts Trust Teaching Nursing Home

The Guideposts Trust Teaching Nursing Home was developed to provide accommodation for people who are mentally, and possibly physically, frail, and suffering from dementia. It was opened by HRH Princess Alexandra in May 2000.

The Guideposts Trust Teaching Nursing Home was developed to provide accommodation for people who are mentally, and possibly physically, frail, and suffering from dementia. It was opened by HRH Princess Alexandra in May 2000.

The home has a centre which is equipped to provide 24-hour continuing care, teaching for nurses, doctors and a wide range of other health care professionals, as well as research into the practical problems experienced by residents.

The character of the home
The special character and purpose of the home derives from its commitment to provide domestic contentment for older people with severe disabilities, both physical and mental, while providing facilities for interdisciplinary education and research.

The style of teaching, learning and research used in the home is one that recognises the residents as active contributors to the training of health and social work professionals. The interest and creativity of residents and their relatives is actively encouraged.

The care offered in the home is centred on detailed individual care plans and takes account of the particular needs and wishes of each resident. Relatives and carers are invited to share in the care planning, especially in making decisions about the management of incidental illnesses or the onset of a terminal phase of care.

The building
The ground floor accommodation has 30 en suite bedrooms divided into two groups of seven bedrooms and two groups of eight bedrooms. Each small group has its own lounge/dining room and bathroom.

The accommodation surrounds a courtyard with a landscaped garden and conservatories where residents can sit and meet families and friends. The courtyard is bordered by a covered walkway. There are also meeting rooms, as well as a room for occupational therapy and physiotherapy.

A reception area divides the nursing home from the offices and teaching centre. In this part of the building there are two offices, a library, a conference room and a series of seminar/meeting rooms.

The teaching
The home creates opportunities for training and experience for everybody likely to be involved in the provision of continuing care for older people with severe mental or physical disabilities - professional or non-professional.

Teaching occurs during day-to-day care of the residents and in courses which take place in the teaching centre. Teaching also takes place outside the home; members of the teaching staff attend other nursing homes and residential settings in the private, charitable and statutory sectors.

The most important group of learners are staff working in nursing homes. They include nurses - generally trained but rarely with postregistration specialist training - and untrained care staff. Because of the shortage of these staff and the cost of cover for staff released from their duties to attend training programmes, only outreach teaching in their own establishments can meet the training needs of this group.

Senior staff in other homes are also encouraged to come and learn within the teaching nursing home. Future GPs and consultants with responsibilities for older people need to:

- Understand and be expert in the support of residents in continuing care;

- Comprehend what being a nursing home resident is like;

- Have an idea of the psychiatric, medical and general management problems which can arise when caring for nursing home residents.

This experience can best be gained by being personally responsible for medical aspects of care in a home and working with the other staff involved. The teaching home offers doctors in training an opportunity to gain such experience.

A wide range of health care workers have the opportunity to benefit from the project and undertake programmes for:

The home encourages undergraduates and postregistration health care professionals to gain experience through practice visits and occasional study weeks. The schools of health care studies, occupational therapy and social sciences at Oxford Brookes University advise on these and assist in their organisation.

The kind of people for whom short courses would be appropriate include: social workers; residential or nursing home staff; health and social services managers; theology students; psychologists; speech therapists; nutritionists; community care assistants and voluntary workers.

Four different levels of participation in the work of the nursing home are offered to learners:

Training in basic nursing skills is also offered to informal carers nursing older people in their own homes.

Research
Research at the home simply means asking critical questions such as:

- What are the best ways of looking after people with the disabilities that brought them into nursing care?

- How can their enjoyment of life be best assured in the face of problems that require them to be in 24-hour care?

- What skills need to be developed among the staff who care for them in order to attain these goals?

The research is less concerned with larger issues, such as the causes of diseases, and more concerned with everyday problems, for example how to help with a person's continence or communication difficulties.

It is important to do this in the least intrusive and most supportive manner possible, taking into consideration the dignity and independence of that particular person.

It is expected that a variety of research studies will be under way in the home at any given time. The outcomes of such research will be published and disseminated.

The Guideposts Trust is a registered charity and has been involved in caring for people with mental health problems since 1972. The teaching nursing home is believed to be the first project of its kind in the UK.

- For more information on courses and other aspects of the Guideposts Trust, telephone 01865 760 075

How should general nurses and nursing home nurses work more closely together? See next week's NT

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