Article 07.10.2020

Norfolk care homes to benefit from £1.2 million UEA project

Researchers at UEA will be part of a £1.2 million government-funded project to improve care in residential homes, which were hard-hit by the Covid-19 crisis.

They will help develop an online staff training platform to improve and personalise care, which will be rolled out to almost 1,500 care homes nationwide – including every care home in Norfolk.

The project is led by the University of Exeter and King’s College London and involves researchers from UEA’s Norwich Medical School and the London School of Economics, with funding from the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI).

The team previously developed an Improving Wellbeing and Health for People with Dementia (WHELD) programme – one of the very few staff training programmes that is proven to improve lives for people with dementia in care homes.

Research has shown that the WHELD programme improved quality of life and mental health, and reduced the use of harmful sedative drugs.

Now, the staff training programme will be adapted to the needs presented by the Covid-19 crisis, and a digital version of the programme will be provided to care homes nationwide with support provided virtually.

Old Age Psychiatrist Prof Chris Fox, from UEA’s Norwich Medical School, is a front line clinician and an intervention advisor on the original WHELD programme. He said: “Many of the 400,000 people living in care homes in the UK have dementia, mental health or neuropsychiatric symptoms, and a number of physical illnesses.

“They are at particularly high risk of developing severe Covid-19, and providing support is challenging for care staff who are facing a difficult, distressing and isolated work environment.

“It is very important that care staff are supported, because they are going through a difficult time in trying to provide care in hugely challenging circumstances.

“This funding will allow us to adapt the WHELD training programme into a digital format that can be used during the Covid-19 pandemic – to support mental health and primary care services to deliver better care for residents.”

The project is hosted by the Frailty Research Group which is part of UEA Health and Social Care Partners (UEAHSCP).

Prof Clive Ballard, Dean and Pro-Vice Chancellor of the University of Exeter Medical School, said: “Care home residents are among the frailest in society, and are at particularly high risk of dying from Covid-19. I’m delighted that this funding will help us to adapt the programme to a Covid-19 world, and roll it out swiftly, to provide the best possible support to residents and staff.”

The platform aims to bring together conversations and resources to share stories and solutions to the challenges care homes face. Short, digestible and practical digital resources and tools that are easily accessible and supported by a network of WHELD coaches will create a community that allows us to stay connected and supported at a distance. 

The first step will be to develop specific adaptations to the programme in light of the Covid-19 crisis, such as peer networking and solution sharing. They will combine with the core elements of WHELD, focussing on person-centred care which involves the resident in decision-making, personalised activities that are tailored to the residents’ interests, and reducing unnecessary sedative medications, known to increase risk of falls and death.

Within four weeks, the programme will be made available to 160 care homes. The team will evaluate outcomes relating to staff mental health and attitudes, and residents’ quality of life, their attainment of care goals, and use of sedative medications. Building on the findings, the team will evaluate efficacy and cost-effectiveness in 1.280 care homes, before making the programme "implementation ready" for national care home roll-out.

Professor Dag Aarsland, Chair of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said: “The Covid-19 related social distancing has made it particularly challenging for care home residents with dementia. They might not be able to see their families and loved ones, and may see staff in full PPE gear, which might be frightening, without fully understanding the reasons behind these changes.

“This is expected to lead to increased emotional stress including anxiety, depression and night-time problems, which again will lead to poorer physical health and well-being for care home residents. This project will address these challenges and help to improve the quality of life for people living with dementia in care homes, helping families and carers adapt to these challenging times better."

Joanne McDermid, of the University of Exeter, who coordinates WHELD, said: “For me, this study is all about building connections and the importance of community, which are especially vital in a time of isolation and social distancing.

“It's about creating more opportunities for meaningful engagement and interaction both with people living with dementia in care homes as well as for care staff seeking peer to peer connection across the care home sector. Being able to share what you've learned with other people makes for a much richer experience.”

Miguel Vasconcelos Da Silva  RN, Dementia Theme Manager, Department of Old Age Psychiatry, King’s College London, said: “Since the setup of the Care Home Research Network (CHRN), a community of care homes across England that are working with us to support research into dementia, it has provided a key structure facilitating and enabling research with care home members. The CHRN was key in enabling and supporting the development and delivery of the WHELD programme. The programme was very well received by the care homes, helping them deliver person centred care for their residents.

“It’s great to see the WHELD programme continuing to develop and excel in providing the much-needed support for care homes during this difficult time. I hope the WHELD programme will be welcomed by the care homes, particularly in the current challenging times, and with limited support and help available."