ENRICHEnabling Research in Care Homes
ENRICH support for research
Adam Smith, Programme Manager, Office of the NIHR National Director for Dementia Research
The ENRICH initiative has been running for several years, the overall aim has been to improve the support provided to researchers wishing to work with care homes, improve care homes access, influence and involvement in research and address issues with care home residents being underrepresented in research and in clinical trials.
As the programme lead, I regularly receive emails and calls from researchers, particularly PhD students and early career researchers asking what support is available, or for particular advice on a specific aspect of setting up a study involving care home residents.
I am writing this blog to share my top 5 tips / pieces of advice for researchers who are new to working with care homes and residents:
1. Identifying care homes to work with ASAP –
It will take much longer than you might expect, so allow much longer than anticipated to identify initial participants. To help, you should start to identify care homes, or a care home group as early as possible even before you apply for funding, as funders may be looking for assurances that you have prepared. You might also want to look beyond your immediate area / community. Some of the best recruiting studies started by saying they only wanted local homes, but were forced to look further afield when recruitment was tough, so anticipate and plan this from the start. The ENRICH website can also provide information on which local care homes might be engaged – http://enrich.nihr.ac.uk/participants
2. Make sure the research fits the environment –
Care homes are busy places, the staff may be stretched, English may not be the staff’s first language, and there may not be internet access or computers for email. When you are planning how your study will be delivered, these simple environmental factors can be important. Make sure you have visited a care home, talk to staff about your study and check if it is deliverable e.g. If your study requires staff to be trained on a new process, can they spare the time to be trained? Will you capture night and day shifts? Are you using data capture forms that are simple and easy to understand? How will you get your hands on this data?
3. Is your study interesting to the staff and residents? –
I have spoken to lots of care home managers over the years. Many are very supportive of research, and of finding and researching better ways to care for and help residents. They also have lots of ideas of their own. It is important to check that your study is interesting, and highlight any benefits of taking part for the staff and residents. Given all the pressures on care homes, your study has to be something that they agree is valuable e.g. preventing falls, reducing prescribing errors, identifying swallowing difficulties.
4. Governance, insurance, permissions, red tape –
Conducting a research study in a care home or non-NHS setting is different, but it isn’t complicated. Like all studies, you need ethics, permission and a good protocol. The pages on the ENRICH website should help provide some guidance, you can also look to the Health Research Authority, or approach your local Research Design Service.
5. Reach out and listen –
All four of my first tips could be summed up into ‘good public and patient involvement’ at both the design and delivery stages of the study. Don’t fall into the trap of assuming that care home residents are beyond being able to provide input. Residents have lots of differing reasons for moving to nursing and residential homes, and it is important to talk to residents and get their input. It is also important to feedback to these same people, both during the study and after completion. It may seem obvious, but it is worth stressing this point; and funders will also want to see that this is being done. You should also take a look at other similar research that is or has taken place, and reach out to colleagues to find out about their experiences. For example, there is a regular group of researchers who connect on twitter using #demphd.
Finally, I wanted to draw your attention to a few pages on our website, and a link to another website that I think are essential reading:
You can also get in touch with us via email at firstname.lastname@example.org if you need help, advice or support in finding care homes to participate in your study, or even if you need help getting some care home staff or resident input.
Alternatively, to discuss opportunities for research and support in your area, please contact your Local Research Network.