Improving the quality of care in care homes by care home staff
Award Number
15/144/51Programme
Health and Social Care Delivery ResearchStatus / Stage
CompletedDates
2 July 2017 -1 July 2020
Duration (calculated)
02 years 11 monthsFunder(s)
NIHRFunding Amount
£664,371.67Funder/Grant study page
NIHRContracted Centre
University of SussexPrincipal Investigator
Professor Jackie CassellPI Contact
J.Cassell@bsms.ac.ukPI ORCID
0000-0003-0777-0385WHO Catergories
Models across the continuum of careTools and methodologies for interventions
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 175 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | 15/144/51 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20170702 |
| End Date | 20200701 |
| Duration (calculated) | 02 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | University of Sussex |
| Funding Amount | £664,371.67 |
Abstract
Over 300,000 older people in England live in care homes due to significant long-term health problems. Many have cognitive impairment. In England, the Care Quality Commission (CQC) regulates care homes to ensure appropriate quality of care. There are, nonetheless, concerns about the quality of some homes, and questions about what ‘quality’ means, and how to measure it. The new Care Act stresses that care services should improve people’s ‘wellbeing’ – their quality of life (QoL) and health. Care home staff have a critical bearing on quality. Issues of pay, training, status, terms and conditions are likely to influence quality. Where staff are specifically trained to focus on the outcomes of care on QoL, this should have a positive effect on quality, as should situations where staff work closely with unpaid carers and volunteers. Aims: 1. Develop new health outcome measures for pain and anxiety/depression that can be used with care home residents unable to communicate their QoL 2. Explore the correlation between CQC’s ratings of the home and indicators of residents’ QoL 3. Assess how much staff mix and employment conditions of the care workforce matter for quality: especially staff turnover rates, training provision, different contracts, pay rates. 4. Evaluate (pragmatically) two measures for improving care home quality: a. By training staff to focus on resident quality of life or ‘outcomes-focused care planning’ (OFCP); b. By encouraging staff and care homes to draw on help from local communities e.g. unpaid carers, volunteers, through ‘community engagement’ (CE). Methods: WP1. Conceptual development of two domains (pain and anxiety/depression) and a scoping review of existing measures, with a particular focus on tools that already incorporate observational methods. Focus groups with care home (as selected in WP3) will explore the face and construct validity of the items. WP3 will also provide data to test the reliability and validity of these domains. WP2. Econometric analysis of secondary data to investigate the relationship between CQC quality ratings and workforce characteristics, training provision and community engagement. Care home quality data for all homes for older people (c. 10,000) in England are available from the regulator. Data on staff characteristics and conditions are from the National Minimum Dataset for Social Care, which includes a sample of over 6,000 care homes for older people/dementia, employing about 250,000 staff. WP3. Evaluation of OFCP and CE approaches using data from 20 intervention and 20 matched comparison homes. A filtering survey will be used to identify the sample. After matching, we will assess whether those in intervention homes have better QoL, measuring this using tools from WP1. We will also investigate the relationship between home CQC quality rating and resident QoL. WP4. Case studies and participatory action research will be conducted in 6 homes selected from the WP3 sample to explore how OFCP and CE are implemented and developed, and on how they can have an impact on outcomes. Impact: The project should help care homes, commissioners and regulators understand the impact of workforce policy, training and community engagement, and so improve the quality of care. We will produce academic papers of the results/methods, along with reports and guides for those whose work concerns care homes. Literature for residents and carers will also be produced.
Aims
This research aims to: 1. Develop new health outcome measures for pain and anxiety or depression that can be used with care home residents unable to say how they feel because of dementia or very poor health. 2. Explore how closely CQC quality ratings relate to residents’ quality of life. 3. Assess how much staff qualifications (e.g. number of registered nurses) and employment conditions matter for care quality. 4. Assess two ways that quality might be improved: a. By training staff to focus on resident quality of life (called ‘outcomes-focused care planning’ or OFCP); b. By encouraging staff and care homes to draw on help from local communities, e.g. unpaid carers, volunteers and other resources (called ‘community engagement’).