Doing ‘with’ rather than doing ‘to’ – working in partnership with care home staff

We spoke to Claire Goodman, Professor of Health Care Research at the University of Hertfordshire. Claire’s team is working on a number of research projects with care homes, and always aims to work in partnership with care home staff. In their most recent project, a care home manager was included as a co-applicant. This case study provides an overview of the benefits of a partnership approach and some tips on putting it into practice.

The benefits of partnership working

Shaping the research question

Working with care home staff identifies the research questions that are most relevant and important for them. Their priorities may not be the same as those of researchers, as Claire explained, “What seems to be an obvious research question to you may not be a priority from a care home perspective. You need to work with care homes when you’re developing your ideas, to get a feel for how they understand the world”. This will ultimately ensure that the research is more likely to benefit the end-users of the results.

Challenging researchers’ assumptions

The aim of care home research is often to improve care and to find ways to overcome the barriers to good practice. However, researchers can sometimes assume they know how to fix a problem without understanding the constraints on care home staff. Partnership working helps to keep the research grounded, as Claire described, “It helps you understand the different kinds of pressures on staff. We need to be very wary of assuming that care home staff don’t recognise a problem – there may be other explanations as to why the problem isn’t being addressed”.

Improving the research design

Care home staff can provide valuable insights to ensure that studies are easy to implement, which can make all the difference to whether a study is successful. In Claire’s experience, “You see beautifully designed trials not working, even though the evidence for the intervention is robust and the researchers are very good – it’s because there’s a problem with the process, which the staff might be able to help with.”

Creating co-ownership of the research

If care home staff feel like collaborators on a research project, they are more likely to help with overcoming practical problems such as when an outbreak of norovirus prevents site visits. When staff also feel a responsibility for the research going ahead, they are We spoke to Claire Goodman, Professor of Health Care Research at the University of Hertfordshire. Claire’s team is working on a number of research projects with care homes, and always aims to work in partnership with care home staff. In their most recent project, a care home manager was included as a co-applicant. This case study provides an overview of the benefits of a partnership approach and some tips on putting it into practice. more likely to help with finding practical solutions.

Ensuring clarity of roles and responsibilities

An effective partnership is based on honest communication as well as mutual trust and respect. When partnerships are working well it becomes much easier to clarify expectations and understand each other’s roles and responsibilities. In care home research this helps with:

• Explaining how confidentiality will be maintained

• Agreeing what will happen if the researchers observe any poor practice

• Discussing what to do when the research is not going well

• Managing staff expectations of the findings from the study and explaining the limits of the research

Putting it into practice

Claire’s advice is to “Think very hard about having care home managers or staff as part of your research team and definitely as part of your study advisory group – where we’ve done that, it’s helped us to avoid a few disasters”.

Partnership work needs to start at the very beginning of writing a research proposal so there is still room for people to have an influence. One way to do this is to set up a small discussion group. Another way is to join an existing meeting as Claire described, “We’ve gone to care home events where they’ve been bringing staff together for in-house training or for an annual conference and we’ve given them lunch. The staff draw strength from being with each other and you’re not then taking people away from their job… any means where you’re just letting people talk and you’re listening to them will work.”

It is also important for researchers to demonstrate they value the contributions from care-home staff, through financial rewards and ‘thank-you’s’. Claire’s team has done this in several ways:

• Offering a payment to every participating care home in return for support from one or two staff during data collection • Sending cakes when recruitment targets have been reached

• Writing newsletters to report on the progress of research

• Offering training and workshops for staff

• Holding a staff party at the end of a project

• Providing certificates for participation

• Giving staff vouchers as a thank-you for their time

From Claire’s perspective, “The thank-you’s are a statement of respect. It’s about recognising their contribution. Care home staff come under a lot of criticism and their expertise is not often recognised. We need to show we recognise they are experts in delivering a very important service.”

Key messages for care home researchers

• Working in partnership with care home staff will make your research more relevant and more grounded

• Ensure you speak to care home staff about your research ideas right from the beginning

• Practical advice from care home staff can make the difference between your study failing and succeeding

• You can consult staff formally in advisory groups or through informal discussions – be prepared to listen to their advice

• Remember to show your appreciation for their input and respect for their expertise

April 2015

For further information, contact:

Professor Claire Goodman

Email: c.goodman@herts.ac.uk