ENRICHEnabling Research in Care Homes
This month, Foothold (IET Benevolent fund) are delighted to be joined by BPS chartered psychologist and dementia care researcher Dr Kellyn Lee for 2 special webinars.
If you’re currently caring for someone with dementia, these expert webinars will help you cope with the extraordinary challenges dementia can bring, whilst improving the wellbeing of the people you care for.
May 19th 12:00 – 13:00
PART 1: Understanding the importance of everyday objects in dementia care – Material Citizenship
May 20th 12:00 – 13:00
PART 2: Supporting the wellbeing of families of people with dementia through the We Care – Dementia Care programme
Find out more in Dr Kellyn’s brand-new blog
To book your place on one or both of these free webinars click here
Researchers from The London School of Hygiene and Tropical Medicine and The London School of Economics discuss whether the UK Government Really did throw a protective ring around care homes during the Covid-19 Pandemic.
The objectives of the study were to: “examine COVID-19 policies for care homes in England and to describe providers’ experiences of those policies in May and June 2020.”
The methods they used were: “Mixed methods including policy analysis and an anonymous online survey of English care home providers, recruited using webinars and WhatsApp groups about their experiences of funding, testing, PPE, isolation and staffing until the end of May and early June 2020.”
Their findings are: “Although social care policies in England have aligned with those advised by the World Health Organization, they were arguably delayed and were not implemented effectively. Testing had taken place in 70% of care homes surveyed but only 36% of residents had been tested, of whom 16% were positive. Managers were unable to effectively implement isolation policies and reported that workforce and funding support did not always reach them. Guidance changed frequently and was conflicting and could not always be implemented, for example when personal protection equipment was extremely expensive and difficult to source.”
For full details of this paper click here
The London School of Hygiene and Tropical Medicine, GB
, The London School of Economics, GB
The London School of Hygiene and Tropical Medicine, GB
“Margaret Butterworth Care Home Forum is a forum for discussion and learning focused on dementia care in communal settings such as nursing homes, care homes and extra care housing. There will be 3 webinars over the course of 2022. The first webinar on 23 March 2022, from 2.00-4.00 will focus on the theme ‘Visiting in care homes during Covid-19’.
Two speakers will discuss this topic:
Josie Dixon, Assistant Professorial Research Fellow, Care Policy and Evaluation Centre, London School of Economics and Political Science, will discuss the study Visit-id: a study of care home visiting arrangements during Covid-19
Dr Kathleen Lane, PI of UCAIRE study, University of East Anglia, will talk about the study titled “We can’t visit and see what’s going on for her… it’s like having paper-bags over our heads”: experiences of infection-control measures on family and friends of care-home residents during Covid-19
We will have plenty of time for questions and discussions. Once you have registered on Eventbrite, you will receive the Zoom-link a few days before the webinar.”
To register click here
The programme will include:
- International overviews of the impacts of the pandemic on Long-Term Care systems, a discussion of lessons learnt and the policy reforms that are needed to strengthen Long-Term Care systems all over the world.
- Findings from research projects on Long-Term Care and COVID-19
Details of the programme will be shared as we have them; for now, please email Adelina Comas-Herrera at email@example.com if you would like to present.”
The workshop is free to attend with pre-registration. Click here to register
“The MARQUE programme includes a range of techniques to help staff get to know residents’ interests, address their agitation, and improve communication. In the original study, researchers introduced the programme into 10 care homes.
In this study, researchers revisited 6 of the same care homes. They asked staff to look back at action plans they had drawn up two years earlier. The study found that all homes had continued with at least one intervention. Staff members felt their working lives and the culture of the home had improved as a result. Themes that emerged from interviews with staff were: improved communication, more respect for junior colleagues, and an increased willingness to try new strategies. They saw benefits both for themselves and for residents.
However, only one home was still using its full action plan. That may be because members of staff who were trained in MARQUE techniques had left.
Many interventions have been designed to improve dementia care. But long-term assessments are rare. Most studies look at the effects of an intervention within a year. That may not be long enough to embed improvements in a care home’s culture.
This is a small study, but it suggests the MARQUE programme could be rolled out more widely.”
To read more click here
Funding: This research was co-funded by the NIHR and the Economic and Social Research Council (ESRC). The two year follow study was funded by the NIHR ARC North Thames
“This cross NIHR ARC event brings together practitioners from health and social care and all those interested in learning from the pandemic to support older people and staff living and working in care homes.
The webinar starts with a presentation of a completed study looking at visiting in care homes and how these findings can inform future practice. It then showcases three studies. One recently completed that compared the evidence on what needs to be in place for effective online consultations with the experience of health and social care staff during the pandemic, one with emerging findings and one, just starting.
The final session is a discussion between participants and speakers to share learning, support cross organisation working and enable researchers and practitioners to discuss what works for residents and staff.”
Research projects being discussed are:
- Care home visits during the pandemic: The impact of testing and vaccination and the effects on all involved – Clarissa Giebel, University of Liverpool. NIHR ARC North West Coast
- Videoconferencing and online technology for communication between care homes and health and social care practitioners – Krystal Warmoth, University of Hertfordshire. NIHR ARC East of England
- Identifying approaches, barriers and facilitators to visiting in care homes during the COVID-19 pandemic – Claire Surr, Leeds Beckett University. NIHR ARC Yorkshire and Humber
- Visit-id: a study of care home visiting arrangements during Covid-19 – Josie Dixon- London School of Economics and Political Science. NIHR ARC North Thames
To register click on Eventbrite
Keeping care home residents safe
Mais House is a small care home in coastal Bexhill for residents with a military service connection. This case study explores how the homes nursing team maintained a COVID-safe and COVID-free environment for all staff, residents and visiting family members throughout the first wave of the pandemic – despite community rates of COVID-19 staying high within its local area during this time.
Key learnings from a nurse-led COVID-safe and COVID-free care home environment:
· Building the capacity of the core nursing and support team has been vital to resident outcomes and staff wellbeing.
· Training and support to develop skills across the nursing and support teams has underpinned the resilience of care in the home, taking pressure off community services and reducing admissions.
· Leadership and support for the team to deliver the highest standard of care.
To read more click here
“New research by the Health Foundation shows that the amount of hospital care received by those living in care homes in England rapidly declined in the first three months of the pandemic in 2020 and was substantially lower than in the same period in 2019.
The research, which is due to be peer reviewed, provides the first comprehensive and national analysis of all hospital care provided to care home residents during the first wave of the pandemic.
It appears to substantiate concerns that care home residents (including those in nursing homes and residential care) may have faced barriers to accessing hospital treatment as the NHS rapidly reorganised to free up hospital capacity to care for critically ill COVID-19 patients.”
If you would like to read more click on this link
“An evidence-based programme for care home residents living with dementia improved their quality of life and reduced agitation and other symptoms of dementia. A major study across the UK found that the Well-being and Health for People Living with Dementia (WHELD) programme was effective and cost less to deliver than usual care.
The WHELD programme supports care home staff to deliver patient-centred interventions for residents with dementia. It seeks to reduce reliance on antipsychotic drugs and uses social interaction, personalised activities and exercise to improve care.
Most person-centred interventions used in care homes are not based on scientific evidence. WHELD was tested in a large clinical trial, which showed that it improved quality of life for people with dementia. The programme also reduced agitation and the overall burden of neuropsychiatric symptoms such as depression or aggression. A reduction in the number of hospital and GP visits made the approach less expensive to deliver than usual care.
What’s the issue?
A third of people with dementia in the UK (288,000) live in care homes. Those in care homes tend to have more severe dementia than those living in the community. Agitation and a range of other behavioural and psychological symptoms make it challenging to care for these people.
Person-centred care is the gold standard of care for people with dementia. Yet previous research has found that many care home residents have as little as two minutes of social interaction each day. There is currently no effective, evidence-based intervention to help staff care for these patients without using drugs.
In the first stages of this programme, researchers reviewed 40 studies on psychosocial interventions for people with dementia in care homes. These studies supported the use of person-centred approaches such as reminiscence therapy, in which photographs or other mementoes are used to help someone recall life events and memories. Walking, seated exercise, circle dance or other pleasant activities of the person’s choice were also found to help.
The researchers then looked at training manuals for person-centred care in dementia. Only four out of 170 manuals described interventions with proven benefits.
The team developed the first version of the WHELD programme based on the most practical and effective therapies. It combined person-centred care, management of agitation and non-drug approaches. A first randomised controlled trial tested this version of WHELD in 16 care homes over a period of nine months. It found that reviews of antipsychotic medication halved the use of these drugs. This increased the behavioural and psychological symptoms of dementia unless the medication review was combined with personalised activities. The combination of review plus social interaction significantly improved quality of life and reduced the risk of dying among people with dementia by 30%. Exercise reduced symptoms of agitation.”
For more details on this programme click here
New research carried out by Dr Eva Cyhlarova, Dr Michael Clark and Professor Martin Knapp from the Care Policy and Evaluation Centre at the LSE identify key barriers highlighting the variation and changing nature of the social care sector in England, with many providers lacking capacity for research participation.
“The Review explored challenges in recruiting organisations and individuals for adult social care research and identified possible strategies to address them from the perspective of social care. Some of the recommendations set out by the Review – such as investment in research capacity-building and providing research support costs to organisations – may help.
Challenges for researchers included the need to adjust recruitment strategies because of the variation among provider organisations and as a result of the rapidly changing nature of care delivery in England. Interviewees also identified a lack of understanding of research benefit and organisations’ gatekeeping arrangements as common difficulties.
The seventeen senior social care researchers interviewed about their experiences also recommended: ensuring effective involvement throughout studies; building partnerships with individuals, groups and organisations; and offering financial and other incentives to organisations for their participation. Using a variety of recruitment strategies and offering a range of participation routes were also suggested.
The Review recognised the growing investment in recent years in developing capacity in adult social care research and highlighted the need for further investment if the sector is to respond to the rising need for robust research evidence to help improve policy, practice and outcomes.
Professor Martin Knapp, Director of NIHR SSCR, said:
Recruitment into research studies can be very difficult, and social care researchers have often struggled. In this Review we have tried to identify the main challenges, and what solutions other researchers have suggested. It is now important for research funders and researchers to explore these recommendations to support adult social care research. It would be great to hear from organisations and individuals on their experiences of recruitment (or not) into studies.”
For access to the full report click here