Quality standard
Quality statement 4: Recognition of sensory impairment
Quality statement 4: Recognition of sensory impairment
Quality statement
Older people in care homes who have specific needs arising from sensory impairment have these recognised and recorded as part of their care plan.
Rationale
Mild but progressive sight and hearing losses are a common feature of ageing and may go unnoticed for some time, but can have a serious effect on a person's communication, confidence and independence. The recognition and recording of needs arising from sensory impairment by staff who are alert to the symptoms and signs and aware of the role of the GP in the route to referral can help to ensure early assessment and access to appropriate healthcare services. For older people in care homes this is essential to improve their quality of life and avoid isolation, which can have a detrimental effect on mental wellbeing.
Quality measures
Structure
Evidence of protocols to ensure that staff are trained to recognise specific needs arising from sensory impairment in older people, and record these needs as part of their care plan.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from staff training records.
Process
Proportion of older people in care homes who have had a sight test within the past 2 years.
Numerator – the number of people in the denominator who have had a sight test within the past 2 years.
Denominator – the number of older people in care homes.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by care professionals and provider organisations, for example from service user records.
What the quality statement means for different audiences
Organisations providing care ensure that staff are trained to be alert to specific needs arising from sensory impairment in older people in care homes and to record them in a care plan.
Social care, health and public health practitioners are alert to and recognise specific needs arising from sensory impairment in older people in care homes and record them in their care plan.
Local authorities and other commissioning services commission services from providers that can produce evidence of protocols for training staff to be alert to specific needs arising from sensory impairment in older people in care homes and to record them in a care plan.
Older people in care homes are cared for by staff who recognise needs that occur because of sight or hearing problems and record these as part of their care plan.
Source guidance
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GP services for older people: a guide for care home managers. Social Care Institute for Excellence (SCIE) guide 52 (2013), Managers' responsibilities and the NHS reforms: actions as a result of listening to residents and relatives, accurate, up-to-date recording; Workforce development, standards and regulation: developing trained, confident care workers
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Dignity in care. SCIE (2006, updated 2020), Information and communication
Definitions of terms used in this quality statement
Care homes
This refers to all care home settings, including residential and nursing accommodation, and includes people accessing day care and respite care. [Expert opinion]
Recognised
Recognised in this context relates to the recognition by staff working with older people in care homes of the needs arising from sensory impairment and the sharing of information with healthcare professionals, including GPs. Staff should be continually alert to new and existing needs. This should involve monitoring of existing impairments and recognition of new sensory impairments. This is likely to include ensuring regular sight and hearing checks are arranged, cleaning glasses, and changing hearing aid batteries, or referral to an appropriately trained professional. [SCIE's research briefing 21 on identification of deafblind dual sensory impairment in older people and expert opinion]
Regular sight test
Adults are normally advised to have a sight test every 2 years. However, in some circumstances, the ophthalmic practitioner may recommend more frequent sight tests, for example in people who:
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have diabetes
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are aged 40 or over and have a family history of glaucoma
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are aged 70 or over.
Sensory impairment
Sensory impairment most commonly refers to sight or hearing loss. It includes combined sight and hearing loss, which is frequently referred to as dual sensory impairment or deafblindness. [Adapted from Basic sensory impairment awareness (NHS Education for Scotland) and the Department of Health's guidance on deafblind people: guidance for local authorities]
Trained staff
This refers to staff who have been trained to recognise and record the symptoms and signs of sensory impairment when caring for older people. Staff should be aware that there are many different types of sight and hearing loss, with a large variation in the degree of impairment. Staff should also be competent in recognising when older people need a referral for assessment and management of the sensory impairment. [Expert opinion]
Equality and diversity considerations
Sensory impairment is common in older people. It is frequently perceived as an expected feature of ageing rather than as potentially disabling. It is important that sensory impairment is not considered as acceptable for older people in care homes. This may need to be emphasised during training to increase awareness and recognition of sensory impairments.
When looking for signs or symptoms of sensory impairment, be aware of any learning disabilities, acquired cognitive impairments, communication and language barriers, and cultural differences. Staff should ensure that they are aware of the needs and preferences of older people who are approaching the end of their life.
It is important that staff are aware that older people in care homes have the same right to access healthcare as people living independently in the community. This is stated in the NHS Constitution for England.