The Dunhill Medical Trust has joined with the Alzheimer’s Society to co fund three projects that explore ways in which researchers can work collaboratively with care homes. Those living and working in care homes will be put in the driving seat alongside researchers to share decision making and ownership of the research and findings. Exploring novel ways to do this will help make sure that the research addresses relevant and current challenges in practical and accessible ways and leads to practical and scalable solutions to improve care.
The universities of Exeter, Lincoln and Worcester have been awarded funding to explore different models. In all three projects, researchers will be based within care homes, working with staff and residents to design and carry out research, known as a ‘researcher in residence model’. This will ensure the research is grounded in the day to day realities of caring for people with dementia.
The challenge of care home research during a pandemic
Due to COVID-19 research in care homes has had to cease. For the CHARM project they saw this as just another challenge to overcome and worked with their care homes on a contingency plan to allow the project to continue for as long as possible. Although the project has now had to halt until October they have written a blog of their experiences which can be read here.
The Care-Home Action Researcher-in-residence Model (CHARM)
CHARM is based at the University of Worcester and involves partnership with four care-home providers active locally. The team involved in CHARM ground their approach in the observation that previous approaches to engaging care homes in research have often run into difficulties with engagement, data collection, and poor adherence to interventions. They see these difficulties as arising because of two things: lack of consideration of resources needed and of the capacity of care homes to support research processes; and a failure to engage in true collaboration that leaves staff feeling researched ‘on’ rather than ‘with’ and neglects meaningful resident and family engagement.
To identify how research could be done without running into these problems, the researchers held a workshop for care-home providers and researchers that identified preferences. Those involved in the workshop decided that these preferences could best be addressed through a researcher-in-residence model based in action research.
The model being tested in the CHARM project has three central components: (a) three professional researchers will facilitate research in four care homes, one each from the four provider partners involved in the project over a twelve-month period; (b) these researchers will act as researchers-in-residence and spend time in each care home as a way of promoting the development of strong collaborative relationships with those living and working there; (c) explicitly identified lead roles among the professional researchers and co-researchers as a way of establishing a stable, ongoing action-researcher-in-residence team.
The Lincolnshire Project
The Lincolnshire Project is a partnership between the University of Lincoln and Tanglewood Care Homes Group. Like CHARM, this project involves using action research to embed people living and working in care homes in the development, design, and delivery of a programme of work. As a result of prior consultation, those involved have agreed the project will centre on a broad area of need: transitions into, within, and out of care homes.
Experience and research both indicate that care-home transitions can be disruptive and distressing; can heighten the risks of depression, agitation, frailty, and falls; and can be a source of concern and stress for caregivers. When somebody’s transition from a hospital to a care home is badly planned or communicated it can lead to unnecessary distress or disorientation for the person involved and for loved ones and can also mean that care-home professionals lack the information they need to provide good quality care. Improvements in the transition process can be hard to achieve.
The remit of the group will be to use real-life transition experiences to identify areas of good practice, impacts they want to achieve and potential interventions. Members of the group will receive introductory training on research and research methods and examples of how research has previously been used to improve care for people with dementia. Lines of inquiry might include the development of practical resources such as ‘emergency welcome packs’ for emergency arrivals; toolkits or training resources to support staff; changes to handover documents; additional occupational therapy support and advice or challenging existing practice and implementing process improvements within the transition pathway.
The Exeter Care Homes and Knowledge Collaboration (ExCHANGE)
ExCHANGE is a collaboration between organisations in Devon and the South-West Peninsula concerned with the care and happiness of care home residents: the University of Exeter; the National Institute for Health Research Applied Research Collaboration for the South-West Peninsula (PenARC); the South West Academic Health Science Network (SW AHSN); and the Devon Care Kite Mark (DCKM), a group of over 50 independent care providers committed to improving the lives of those living and working in care homes through a programme of continual review and improvement.
The ExCHANGE team plans to use three complementary methods to achieve their aims:
- Making Sense of Evidence workshops will use a model successfully used in PenARC with a range of groups including local authorities, patients and members of the public, police officers and staff, and Alzheimer’s Society employees. The workshops are intended to provide people living and working in care homes with the knowledge, skills, and confidence to understand and engage with research and research evidence. The team will also organise two Making Sense of Care Homes workshops intended primarily for researchers.
- Project Generation Forums forums are to establish local priorities for a care-home centred research agenda and will be based on similar processes used locally in the past. They will enable co-design of research projects between care-home staff and residents, community stakeholders (including family members of residents), and researchers that is flexible and responsive to the needs and expertise of the groups involved.
- Knowledge Brokers are similar to researchers-in-residence but may involve situating practitioners in research settings as well as vice versa. The aim of using them is to span or bridge the gap between research and practice communities by supporting the exchange of knowledge and values.
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