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The Enhanced Health in Care Homes Framework study (The EHCH Study)

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The Enhanced Health in Care Homes Framework study (The EHCH Study)

Dr Gary Hodge is a Registered Mental Health Nurse and Research Fellow at the University of Plymouth, School of Nursing and Midwifery.

In this blog, Gary introduces the ongoing EHCH Study, which continues to recruit care homes in a two regions of South West England.

People living in care homes should expect the same level of support as if they were living in their own home. This can only be achieved through collaborative working between statutory health and social care providers, the voluntary, community and social enterprise (VCSE) sector, and care home partners. The EHCH model includes seven care elements, which move away from traditional reactive models of care delivery towards proactive care is centred on the needs of individual residents, their families, and care home staff. Such care can only be achieved through a whole-system, collaborative approach.

Dr Gary Hodge is a Registered Mental Health Nurse and Research Fellow at the University of Plymouth, School of Nursing and Midwifery.

Tuesday 14th February 2023


More than 400,000 people are living in just over 17,000 care homes in the UK, with the majority of residents being older people (>65 years) who are often living with dementia, frailty, and end of life care needs. These individuals rely on care-home staff to provide the care and support that enables them to live their lives in the best way possible. Compared to other groups in society there has been little research within care homes. There has however been a growing awareness of the importance of this area.

The Enhanced Health in Care Homes Framework (EHCH) was introduced in 2016 (updated 2020) with a commitment for it to be rolled out nationally, which is embedded within England’s NHS Long-Term Plan. The EHCH framework’s principle aims are the delivery of high quality and personalised care, offering the right care in the right place, and ensuring the best care for people living in care homes.  Nevertheless, quality of personalised care in care homes, and ways of improving it, remains poorly understood. Previous research has been top-down and focused on ways to limit health-service use and reduce costs.  This study is important because there is little research into the experiences of residents, families and care professionals, and no research has yet looked at the EHCH as a whole, in a broad context rather than individual components.

What is the EHCH study?

The EHCH study uses a participatory case study design to collect data. It aims to explore the implementation of the EHCH framework across eight care homes in two regions of South West England. It is important to us that the study is collaborative and co-productive. Therefore, it has been developed with the participation and involvement of care home leads. The study is designed to give care home staff, families, and residents a stronger voice about the delivery of high quality personalised care supported by the Framework for Enhanced Health in Care Homes.

What does our study aim to achieve?

The primary aim of the study is to explore what works, what does not work, and what would support care homes to engage in the EHCH framework in a collaborative and sustainable way.

What does the study involve?

I am spending one day a week in each care home observing day-to-day care delivery and the care home culture in order to begin to understand the everyday world of care homes. I am also inviting people who live, work, and visit the care home to take part in semi-structured interviews to capture participants’ experiences of receiving and delivering care in a care home.  Care documents are also reviewed of residents who participate in the study. A stakeholder dissemination event will take place at the end of the study.

Where are we with the study?

Four care homes have already been recruited to the study, two of which completed the observation and interview phases in December 2022. The following two care homes joined the study in January 2023. We are hoping to recruit a further four care homes to the study, commencing between March and April 2023.

Want to know more or wish to take part in the study?

If you would like to know more about the study, or you are a care home that might be interested in taking part please feel free to contact me (via email initially)

I would be very happy to share our study information or visit you at your care home to talk further.

The study is funded by the Torbay Medical Research Fund and supported by PenARC.

Dr Susie Pearce is the Chief Investigator of the EHCH study.