Enabling older people to engage effectively with community social care: developing a theory of change for specialist mental health support worker activities
Award Number
NIHR200046Programme
Research for Patient BenefitStatus / Stage
CompletedDates
2 September 2019 -31 December 2022
Duration (calculated)
03 years 03 monthsFunder(s)
NIHRFunding Amount
£216,662.00Funder/Grant study page
NIHRContracted Centre
Humber Teaching NHS Foundation TrustContracted Centre Webpage
Principal Investigator
Dr Mark WilberforcePI Contact
mark.wilberforce@york.ac.ukPI ORCID
0000-0001-6977-4483WHO Catergories
Methodologies and approaches for risk reduction researchModels across the continuum of care
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 190 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR200046 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20190902 |
| End Date | 20221231 |
| Duration (calculated) | 03 years 03 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Humber Teaching NHS Foundation Trust |
| Contracted Centre Webpage | |
| Funding Amount | £216,662.00 |
Abstract
As the number of older people with social care needs grows, so will the number who have problems engaging with care services for reasons linked to mental health problems or cognitive impairment. These engagement problems manifest in different ways. People may withdraw or avoid care workers, may display extreme apathy, or otherwise there may be assertive actions such as shouting or physical acts to repel care. Often this leads to a collapse of care arrangements, and a referral to secondary community mental health teams. The applicants’ prior research highlighted the potentially vital role of specialist mental health support workers in helping engagement with social care. However, in common with assistant-grade staff across the care system, their activities lack an evidence-base. Without this understanding, practice varies locally without converging on "what works". The research aims to develop a theory of change for mental health support worker activities to improve the engagement of older people with their social care. This will define key active components of their work and associated mechanisms of change, as well as understanding the important facilitators and barriers that influence outcomes. The end-point will be a handbook describing the theory of change in a practice-accessible format, with illustrative case-studies drawn from the research. Methods A three-stage research design is proposed. Stage 1 comprises a scoping review, which will synthesise existing (theoretical and empirical) literature that offers insight into engagement problems with community care. The synthesis will be interpreted by an expert workshop to interactively develop an outline, formative theory of change. This will propose how improved engagement can be achieved, and through what steps, and what change is required between each. Stage 2 comprises qualitative interviews and focus groups in four areas of England. In-depth interviews with 10-12 informal carers and social care providers will examine how engagement difficulties arise, and their perceptions of how support workers are able to assist. A further 22-24 interviews with support workers in mental health teams will examine their activities, focusing on key aspects of the outline theory of change identified at Stage 1. Finally, two focus groups with mental health professionals will examine wider facilitators and barriers to support worker outcomes. Stage 3 will design and develop a handbook for support workers. This will be a learning resource detailing how support workers can help older people to engage with social care, using illustrative practice examples and prompting for reflection on their own skills and capability. A consultation group with support workers will consider how practice change could be implemented in the long-term, such as through a training intervention in a future research project. Anticipated Impact and Dissemination The handbook will be complemented with targeted dissemination activity, through Skills for Care platform (‘Learn from Others’), outputs in the British Journal for Healthcare Assistants and a presentation at a support worker-focused annual conference, amongst others. Longer-term impact activity will be oriented to new research seeking to embed learning in practice, such as through a novel training intervention.
Aims
The research aims to develop a theory of change for mental health support worker activities to improve the engagement of older people with their social care.