Evidence Synthesis Team

Living, ageing and dying well in care homes

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Yesterday Jo and Noreen travelled to London for the launch of the NIHR Themed Review on Research with Care Homes. The event was held in one of the meeting rooms at the Wellcome Collection – a fabulous location with the added bonus of being able to steal a few moments with some of the inspiring and quirky exhibits en route – there is definitely something rather appealing about anywhere that describes itself as ‘a free destination for the incurably curious’.

 

The event kicked off with three scene setting and thought-provoking presentations from the perspective of policy and service (Martin Vernon, National Clinical Director for older people and integrated person-centred care, NHS England), care home providers (Sharon Blackburn, Policy and Communications Director, National Care Forum) and clinical staff in care homes (Dawne Garrett, Professional Lead for Older People and Dementia care, Royal College of Nursing). Did you know that every day there are more than twice as many people living in care homes in England and Wales than staying in hospitals?  And more people work in the care home sector than in the NHS? And whilst there is a growing focus on research to help care home residents live, age and die well this is still a fraction compared to the research that is performed in the hospital setting. Sharon outlined the huge diversity in care home provision, emphasised the need for building better understanding between health and social care professionals and the role of effective partnerships in providing excellent care.  Dawne highlighted the need for careful consideration of the most effective ways to communicate with care home owners, managers and staff; many working in care homes (and indeed in the NHS) are unable to access social media during their shifts and many will not have ready access to the internet.  Dissemination and communication methods that are commonplace within research communities may not be easily accessible in care homes.

 

We were then treated to a series of short presentations celebrating some of the research projects contained within the themed review – all of which have been funded by the NIHR or the Department of Health.  Clare Goodman (Professor of Health Care Research, University of Hertfordshire) began by congratulating the NIHR Dissemination Centre on their choice of photographs in the report – #NoMoreWrinklyHands – as this campaign points out older people are so much more than wrinkly hands but this is often how they are portrayed in the media. Clare discussed some of the current issues in care home research e.g. the lack of a minimum data set despite increasing sophistication and infrastructure, the need for intervention research to move the field beyond describing and exploring, a recognition that implementation is as challenging as testing the effectiveness of an intervention and the need for dementia expertise.

 

Tara Lamont (Deputy Director, NIHR Dissemination Centre) then explained how the themed review had been put together to provide an overview of recent research in the area, focusing on and celebrating research funded by the NIHR and the Department of Health.  The themed review contains a total of 44 studies and we were proud and excited that our work on mealtime interventions and gardens in care homes is included as well as a great new project we’re just beginning about the effects of animals on the health and well-being of care home residents.

 

Barbara Hanratty (Professor of Primary Care and Public Health, University of Newcastle) then talked about a project that is underway (due to complete mid 2018) to review evidence on new ways of working to promote health in care homes.  The review will focus on four areas – the use of technology, the workforce, communication and engagement between care homes and external bodies and the evaluation of changes in care and how care is received.

 

Next up was Martin Marshall (Professor of Health Improvement, University College London) who spoke about the challenges of evaluating complex interventions reflecting on the experience of carrying out a safety improvement programme with a linked participatory multi-method evaluation in care homes in the south east of England.

 

And finally Clive Ballard (Pro-Vice Chancellor, University of Exeter Medical School) spoke about the WHELD trial.  A factorial cluster-randomised controlled trial of an optimised person centred intervention to improve mental health and reduce anti-psychotic use amongst people with dementia living in care homes.

We spent the final part of the day in small groups discussing future steps for care home research. We understand that the summary messages from the discussion are going to be available in a blog post from the NIHR Dissemination Centre soon.  In the meantime, some of our take home messages were around i) the need for researchers to listen carefully to what care home owners, managers, staff and residents really want to know and how they want to know it, ii) to make efforts to mobilise voices that are not currently well heard e.g. those of health care assistants, residents and local communities and to work closely with care home managers (who are very busy people) and iii) the need to raise the status and profile of the care home sector and care home research.

We had a thoroughly enjoyable and stimulating afternoon and came away with much food for thought.  The themed review is freely available – take a look!  And spread the word.

 

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