Needs, characteristics and experiences from minority ethnic adults with learning disabilities and minority ethnic older people living in care homes across England: an exploratory mixed methods study

As the United Kingdom (UK) becomes increasingly ethnically and culturally diverse, acknowledgement of needs, characteristics and experiences of minority ethnic community care services will become an increasing priority. This exploratory mixed method study investigates needs, characteristics and experiences of minority ethnic adults with learning disabilities and minority ethnic older people living within care homes across England. This thesis explores empirical findings obtained from two sources. First, quantitative findings ascertained from 173 care homes in England recruited from the Measuring Outcomes Public Service Users (MOPSU) study conducted in 2006-2010. Questionnaires enabled opportunities to explore characteristics of care homes, care home staff and care home service users. Questionnaires and quantitative observations from the MOPSU study enabled exploration of sensitivity to cultural needs for culturally diverse groups. Second, focus groups supplemented MOPSU findings by qualitatively exploring cultural needs and experiences of care homes for South Asian and African-Caribbean older people and their relatives. This thesis draws from Carnaby (2007) layers of influence model which stipulates various factors impacting service users lived experiences. This thesis adds to the layers of influence model by splitting factors into three levels, namely, micro or individual factors, meso or service level factors and micro or societal level factors. Findings on needs, characteristics and experiences of care homes with specific reference to minority ethnic populations were mapped onto micro, meso and macro factors. This thesis also draws upon universalism, which involves acknowledging the significance of cultural factors within phenomena including social care outcomes. Furthermore, multiculturalism was inherent throughout this thesis, namely, recognizing diversity and heterogeneity amongst groups and striving for equitable harmonious living, regardless of background. Questionnaire findings from the MOPSU study revealed differences between adults with learning disabilities and older people with care home services, care home staff and care home service users. Additional findings reported some differences between minority ethnic care home service users and white ethnic service users in terms of characteristics of care homes, care home staff along with service user differences with physical, social and cognitive characteristics. Higher levels of depression were also found between south Asian adults with learning disabilities in comparison with other minority ethnic adults with learning disabilities. Definitions and experiences of sensitivity to cultural needs reported from focus groups illuminated the importance of cultural factors in conceptualizing social care outcomes and experiences of care homes. Focus groups revealed considerable unmet cultural needs for minority ethnic populations within mainstream care homes as opposed to specialist care homes supporting minority ethnic service users. Observational findings on sensitivity to cultural needs reported from the MOPSU study revealed evidence of sensitivity to cultural needs and evidence of unmet cultural needs particularly, within mainstream care homes. Whilst this research is exploratory in nature and has only begun to address the many issues that are important in supporting minority ethnic adults with learning disabilities and minority ethnic older people living in care homes. But, the questions addressed and findings on needs, characteristics and experiences of care homes for minority ethnic adults with learning disabilities and minority ethnic older people are important for striving towards equitable service delivery as well as long term outcomes of good quality of life and wellbeing for all service users regardless of background.