ENRICHEnabling Research in Care Homes
Following the ENRICH model for Home Care?
Louise Marsh is a Research Associate and Health and Social Care practitioner. She has over 40 years experience in nursing and social work in the specialism of older people. Louise also established a registered Charity in 2005, the Evergreen Care Trust, supporting older and vulnerable adults with services and interventions through the voluntary and not for profit sector.
Health and Social care practitioner Louise Marsh looks at the ENRICH Enabling Research In Care Homes model and suggests that this could provide guidance and inspiration for a potential multi – Clinical Research Network CRN working party looking at establishing a similar research platform for home care providers.
Louise asks the following questions:
- How does Social Care research translate in both care home and home care forums?
- What are the challenges in embracing Social Care research?
- What might it take to authentically, broaden both Health and Social Care research through these sectors?
My role in Social Care research awareness and capacity building
I joined the University of Lincoln’s School of Health and Social Care as a Research Associate, a 12 month post funded by the Clinical Research Network East Midlands, to help build social care research awareness, activity and capacity within the region. I was first introduced to the Lincolnshire Enabling Research In Care Homes ENRICH network and forum in April of this year. I was very pleased to find a high energy, warm and welcoming team of research nurses and researchers, leading the way with health research in care homes. What was immediately evident to me was the positive relationship the researchers had built up over time with the care home managers. ENRICH has been operating nationally for over a decade and has been instrumental in building links with the care home sector and introducing home managers and practitioners to the many benefits of research engagement. ENRICH is an excellent model to follow.
What I have learnt so far
First lesson learned is that for research engagement to be effective, it is built on good working and trusting relationships between the research community and social care providers. Successful ENRICH forums demonstrate this well as care home managers and their teams actively engage with research projects presented in these forums.
Second lesson I have learned is that health research undertaken in social care settings, ie. care homes is often mistaken for social care research. Health and Social Care are closely linked, yet they are two very different services, with very different focuses. One is free at point of access while the other is subsidised heavily or completely funded by those who use it, both in care home and home care settings. Health is public, social care is private, commercial, corporate, charity or not for profit with a wide range of differing values underpinning service provision. Investment, working conditions, training and professional development, status and professional esteem are sadly, poles apart between health and social care agencies.
The Home Care Sector
My initial engagement with social care providers has been twofold, firstly, supporting the existing ENRICH efforts to build research capacity within the care home sector and secondly, engaging with home care providers, a relatively untapped provision for research.
Home care organisations deliver Care Quality Commission (CQC) regulated and non-regulated (low level supports like cleaning, shopping & laundry) services. These agencies provide the lion’s share of ‘care in the community’ via domiciliary (in people’s own homes) provision. This means they provide support and care to older or other vulnerable people who are frail, living with dementia, other chronic long-term conditions, as well as those struggling with poor mental health, learning and physical disabilities, and those in need of end-of-life care, their families, and carers.
Until the Covid-19 pandemic spotlight moved from care homes to the nation’s large scale domiciliary provision, home care barely warranted a mention, a fact not missed by the home care providers, workforce, and the users of these services.
Potential to develop a research platform for home care similar to care homes.
There is currently a small working party forming across Greater Manchester CRN and East midland Clinical Research Networks CRN’s who recognise the need for a similar model to ENRICH to provide a research platform for home care providers. There are many features that both care home and home care providers share in social care delivery, there is also a great deal which is vastly different and unique to the respective sectors. For example, care home staff arrive at the care home, and work a shift providing care and support as part of a team. Home care workers are out on the road working in individual homes, all areas, all weathers, all hours, and generally, all alone. This represents different circumstances with associated pressures, judgement calls, levels of skill and resilience.
We are at the beginning, a seed of an idea, but if the NIHR and CRNs are committed to social care research, then these organisations will need to consider with intent, what adjustments to the deeply embedded health lens, might need to be made to accommodate the very real and tangible differences, similarities and challenges these sectors face in delivering quality social care. What will it take to really embrace, support, and fund social care research? How might excellent practice and process and lessons learned through ENRICH help inform the development of a home care research platform and dramatically widen the research scope?
Research, Learning & Excellence Community (RELEC)
My main engagement focus has been with home care managers. To date, in Lincolnshire we have enlisted 15 willing to engage, home care provider organisations across the county into a group we have called RELEC. They are keen and eager to learn more about social care research, how evidence can be embedded into practice, how to engage with, relevant to their service, research opportunities, and crucially, how to influence the direction of future social care research, particularly, if this is the only meaningful way to drive essential change to a broken and dysfunctional system of care delivery.
In truth, in listening to care home managers, I hear similar yearnings and can’t help but wonder if they are given the opportunity to state what they would like research to focus on? what are the issues and concerns they have as busy, pressured registered care managers struggling in today’s social care climate to maintain aspirations of quality care and a happy work force to deliver it?
Further to this..
I have also endeavoured to engage with the Faith, Charity & Voluntary sectors who have expressed considerable interest in meeting with researchers who are now beginning to realise and recognise their immense contribution to social action, social justice, and social care provision.
There is further research scope for other vital groups like social workers and practitioners, the growing number of personal assistants providing what is normally regulated care by home care agencies, but are themselves unregulated, the army of informal and unpaid carers and essentially, the users of social care provision, their families, and carers. There is quite simply, a vast amount of social care provision across little known sectors, flying under the research radar.
A final lesson
Regardless of whether the sector is care home or home care, if research is not relevant to their service delivery, experience, challenges, and the desperate need to change things, there is little likelihood of anything beyond fleeting or temporary research engagement.
Contact details: Louise Marsh – Research Associate – School of Health & Social Care, University of Lincoln & CRN EM, Email: LMarsh@lincoln.ac.uk Telephone: 07913008125