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As rates of dementia rise, there is an increased demand for specialist accommodation for people with dementia. Watergate Court in Gateshead is an extra care facility that provides care and accommodation for residents with different levels of dementia within a wider community of older people. To ensure high-quality, cost-efficient care for these residents, an effective method of assessing their care needs was required. The Watergate Tool was developed to assess the level of care provision that the residents with dementia needed. The authors found that when the Watergate Tool was used regularly within the context of an effective multidisciplinary team, it contributed to consistent care provision assessments, ensuring that the residents with dementia received the care that they needed.

Background/aimsThe integral relationship between adequate hydration and good health is widely recognised. Older people with complex needs and frailty can struggle to maintain adequate hydration, with residents in care home settings being at an increased risk of dehydration. The aim of this study was to explore current hydration practices in residential care homes in Malta.MethodsAn exploratory qualitative approach was adopted to explore staff's views and approaches in supporting residents' hydration. Data was collected via semi-structured, individual and small group interviews with staff from two care homes from the central and southern region of Malta. A process of open coding, followed by axial coding, was used to analyse the data. Peer debriefing was performed throughout, until agreement was reached among the research team about the final themes and sub-themes.ResultsThree themes emerged from the data: culture of promoting fluid intake; challenges in supporting older people to achieve optimum hydration; hydration practices and approaches.ConclusionsA hydration promotion culture was demonstrated through various practices adopted in the care homes. The strong focus on water intake, in response to concerns about consuming sugary beverages, has implications for the promotion of a person-centred approach to hydration care. Inconsistencies in monitoring of fluids and daily recommended targets highlights the importance of policies or guidelines to guide hydration practice. Challenges related to refusal of fluids and language barriers among non-native staff were evident and justify further research is this area.

Background:Sepsis is a common condition, with an estimated 30 million cases worldwide each year, resulting in 6 million sepsis-related deaths. Some 60% of all sepsis events and 80% of sepsis-associated deaths occur in the older population. This is because the ageing process, and the presence of multiple comorbidities, make many older people vulnerable to developing, and dying from, sepsis. However, serious illness and death from sepsis can be avoided if the signs and symptoms are identified quickly, and interventions started early.Methods:This article explains current research and guidelines with regard to the causes, recognition, treatment and prevention of sepsis in the older population, and considers the role of care home staff in supporting effective care of residents as risk of developing sepsis.Conclusions:Care home staff are well-positioned to recognise sepsis and contribute to treatment, as their in-depth knowledge of residents makes it easier for them to identify changes in residents' behaviours and health status, which may indicate sepsis. By taking steps to ensure the risk of developing infections is reduced, care home staff can make a valuable contribution to the prevention of sepsis.

Due to the complex needs in the older care home population, it is essential to develop the right workforce. Juliana Thompson et al explore the development of a workforce competency framework that cuts across professional, organisational and sector boundaries.

Care home placements in the UK can leave student nurses under-equipped for the care home nurse role. In this article, Juliana Thompson et al describe how student placements at Northumbria University were influenced by placements in the US

Moving from active rehabilitation to a care or nursing home can be demoralising for residents. Juliana Thompson and Glenda Cook suggest ideas that can support their abilities and aspirations