The construction of a meaningful life depends upon satisfying ‘fundamental human needs’. These are broadly categorised as: physical, social and self-actualisation needs that every human experiences. Some fundamental human needs satisfiers, such as ‘home’, are synergic, addressing more than one need. For an older person, the move to a care home compromises their ontological security (through disruption of identification with place and control over environment) that one's own ‘home’ provides. This paper explores the complex issues surrounding the residential status of care home residents in terms of fundamental human needs. The methodology utilised was hermeneutic phenomenology. Eight older residents participated in the study, and each resident was interviewed up to eight times over a period of six months. Narrative analysis was used to interpret how participants viewed their experiences and environment. Five themes emerged from the narratives that collectively demonstrate that residents wanted their residential status to involve ‘living with care’ rather than ‘existing in care’. The five themes were: ‘caring for oneself/being cared for’; ‘being in control/losing control’; ‘relating to others/putting up with others’; ‘active choosers and users of space/occupying space’ and ‘engaging in meaningful activity/lacking meaningful activity’. This study indicates that if care homes are to achieve synergic qualities so residents are able to regard care homes as ‘home’, then care home staff may need to be more focused on recognising, acknowledging and supporting residents' aspirations regarding their future lives, and their status as residents.

Background: The increasingly complex nature of care home residents' health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England. Study Aims: To explore the views and experiences of practitioners, social care officers, and carers involved in the enhanced health care in care home programme, in order to develop understanding of the service delivery model and associated workforce needs for the provision of health care to older residents. Methods: A qualitative constructivist methodology was adopted. The study had two stages. Stage 1 explored the experiences of the programme enhanced healthcare workforce through group, dyad, and individual interviews with 45 participants. Stage 2 involved two workshops with 28 participants to develop Stage 1 findings (data were collected during February-March 2016). Thematic and content analysis were applied. Findings: The enhanced healthcare programme provides a whole system approach to the delivery of proactive and responsive care for nursing home residents. The service model enables information exchange across organizational and professional boundaries that support effective decision making and problem solving. Clinical Relevance: Understanding of the processes and outcomes of a model of integrated health care between public and independent sector care home services for older people.

Health- and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health- and social care initiatives.

Aim:To scope and explore hydration practices in care homes.Background: Older residents do not regularly consume adequate fluids to support health. Achieving this is difficult with residents who have coexisting health, sensory and functional problems, as well as challenging hydration habits.Design: This project used a sequential exploratory mixed method design to scope and explore existing hydration practices.Methods: Data were collected via two stages. First was a survey of hydration practices. Twenty-nine responses were received from 81 care homes (response rate: 35.8%). Second was the exploration of practitioners' experiences and perceptions of hydration practice via semi-structured interviews (54 staff: 43 interviews). Descriptive statistics summarised the survey findings. Open coding and thematic analysis were applied to the qualitative data, and details of the methods are reported in adherence to COREQ criteria.

Experiences and views of nursing home nurses in England regarding occupational role and statusThe aim of this paper was to explore nursing home nurses' perceptions of what influences their occupational status. A hermeneutic phenomenological approach was taken, during which 13 nurses from 7 nursing homes for older people located in England were each interviewed up to 5 times using an episodic interview technique. Findings suggested that economic policies regarding funding longterm care, and perceptions of the nature of work undertaken in nursing homes, may together negatively impact the occupational status of nurses working in these settings. This reduced occupational status is proposed as a factor which shapes nurses' perception of this role. Low occupational status may also impact on these nurses' ability to enact the role. Finally, the paper documents how nursing home nurses may attempt to manage issues of status in order to retain occupational esteem.