Staff Attitude Clinical Trial
Official title:
Enhanced Care Home Outcomes (ECHO): An Evaluation of the Experiences of Staff and Stakeholders Working With an Integrated Care Home Support Service (CHSS)
This qualitative study uses focus group methodology and purposive sampling with the aim of obtaining views of Care Home Support Service staff and other stakeholders about their experiences of a redesigned National Health Service (NHS) Care Home Support Service. Individual stakeholder focus groups will be conducted with General Practitioners (GP), care home staff, relatives of residents in care homes, service-user representatives (Total N=32, across 4 focus groups). This study forms part of a larger evaluation of the CHSS service; service improvement workshops will be conducted with Oxford Health NHS Care Home Support Service, Community Nursing and Community Mental Health staff that are working in the 102 participating homes. Each participant who consents will take part in a focus group to explore their experiences of a redesigned NHS care home support service. Participants will be involved in the study for up to six months from gaining informed consent until last contact with the research team when a summary of the research will be sent. The data will be analysed using thematic analysis and applied with the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.
There are currently 800 000 people in the United Kingdom (UK) living with dementia and this
is predicted to grow to 1 million people by 2021. Studies suggest that 250 000 of people
with dementia reside in care homes. Reports such as the National Dementia Strategy and
subsequent government initiatives, such as the Dementia Challenge and the Prime Minister's
Challenge on Dementia 2020 have helped the nation focus on provision of services for people
with dementia. Further, our media remind us that the quality of care being delivered in care
homes needs significant improvement. With an ageing population effective, safe, good quality
care for our older people is paramount.
A high proportion of people in care homes have dementia and many have co-existing physical
health problems and/or additional mental health needs. An integrated Care Home Support
Service (CHSS) delivers care and treatment of both physical and mental health problems at an
early stage of development. This integrated service combines two approaches which have been
shown to be effective in randomised control trials and open studies in a stepped care model.
Evidence suggests it is feasible to implement some elements of such approaches into a
specialist mental health NHS context. However, no widespread implementation of this combined
approach had been undertaken in an NHS context until the integration of this Care Home
Support Service.
Evaluating the implementation of health care initiatives is crucial in determining their
impact and sustainability in a routine NHS setting. This qualitative evaluation is part of a
broader evaluation of the service. Focus groups and service improvement workshops will be
conducted with NHS staff and other stakeholders. The data will be analysed using thematic
analysis and applied to the RE-AIM framework to:
- Provide valuable information from NHS staff and stakeholders regarding the impact and
sustainability of this model.
- Explore key factors to consider when integrating physical and mental health services.
- Increase understanding of the potential barriers and facilitators of integrating
evidence-based practice into a routine NHS setting.
On completion of the research the findings of the study will be disseminated to research
participants and health professionals to support learning and best practice both locally and
nationally.
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