Exploring the cultural sensitivities of UK care home services to the older Nigerian residents

Amuji, Ifeoma (2021) Exploring the cultural sensitivities of UK care home services to the older Nigerian residents. Doctoral thesis, Northumbria University.

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Abstract

Background: The older black Nigerian population in the UK has increased during the 20th century due to a combination of longevity and migration. As a result, the issue of preparedness of care home services to meet the needs of frail, ill and disabled individuals from a minority ethnic population is increasingly important.
Quality service provision includes acknowledging ethnic diversity, thus ensuring culturally- appropriate care for all older people, regardless of ethnic minority status. Few studies have investigated cultural sensitivity in care homes and also no study has been carried out in relation to cultural sensitivity to older Nigerians. This study aimed to explore the cultural sensitivity of English care home services to older Nigerian immigrants and examine practices and approaches within care home services to address the individual needs of residents and their families, and how those practices and approaches influenced the provision of culturally-sensitive care.

Methods: This study explored the sensitivities and barriers of using care home services by Nigerian older people through a constructionist framework. Four care homes and 19 participants took part in the study. Among these participants 7 were residents and 12 were care staff or managers. Two interviews were conducted. The first interview involved the use of semi- structured interviews for both the residents and staff, and focus group interviews with care staff and their manager, to investigate and gain in-depth understanding and insight on the cultural sensitivity of care home services to older Nigerians. The second interviews involved the use of semi-structured telephone interviews as a follow up to get more in-depth understanding on unanticipated responses and obtain nuanced answers which were not explored when the initial responses were received.

Findings: This study has provided a more nuanced understanding about culturally-sensitive practice in the care home. Findings revealed that some care homes were more culturally sensitive than others. It was revealed that these care homes were practicing under the synergistic and participatory stage of cultural awareness. Under the synergistic stage of cultural awareness, most of the staff were aware of the cultural differences amongst themselves and the residents, and they embraced this and chose the best way to provide for their cultural needs. This was either their way or that of the resident. Under the synergistic stage they sourced ideas from families, fellow staff and social workers. Some of the ideas were cooperative working, ongoing assessment, integrating with families, and extension of their roles. They used ideas and insight from staff of a similar background to the resident in core areas such as dietary needs, resulting in staff working part-time in the kitchen to make ethnic food for the residents due to a lack of skills from their chef to prepare diverse cultural cuisine. To keep residents happy and active, some care homes incorporated celebration of significant dates such as each resident’s independent day. Initiation of culturally-appropriate greetings were used as a mark of respect as well as an avenue to create trust in order to facilitate assessment of culturally-appropriate needs. Meanwhile, the participatory stage, which some of the care staff fell into, showed how they worked together with people of different cultures (care staff) to create a culture of shared meanings through teamwork and meetings. From the resident’s perspective, it was found that their daily lives involved getting by and surviving or living passively, but they acknowledged that staff are commendable in some aspects of their everyday life. Also, some residents were reticent in disclosing their needs to staff, as they assumed that the staff are already aware. As a result, some of the care staff worked hard in finding out these needs. However, all care homes had some work to do in being culturally sensitive.

Conclusion: The research showed that services needed to improve to meet the key cultural needs of their diverse residents. Findings in this study revealed that care home staff might be culturally aware, but not culturally sensitive, and as such are not culturally competent. Research focused on cultural sensitivity in care homes is still at an early stage of development and therefore requires further elaboration. This study is however beneficial to understanding the needs of older Nigerians living in care homes and offers an insight into the existence of diverse needs for people from other ethnic minorities.

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