Article 19.04.2022

Researchers publish guidance for complex projects in care homes

ARC EoE researchers have investigated factors that influence how well research is applied in care homes, using their findings and recommendations to develop guidance for future projects.

Care homes are complex settings for putting research into practice and many factors can disrupt studies and reduce their value for residents, staff, researchers and funders, to improve care and services.

Research projects with care homes often involve trialling complex interventions such as measures to reduce hospital admissions or improve participation in activities. There are multiple components and relationships both within and outside the care home that need to work well for these interventions to be successful.

The national Developing resources And minimum data set for Care Home Adoption (DACHA) study is supported by ARC EoE under the Ageing and Multi-morbidity Theme, to ensure research makes a difference for care homes. The study team are investigating how data can support research, service development and innovation in these settings. They aim to pull evidence and data together in one resource for managers, health professionals and researchers to help improve services and share best practice. 

DACHA study lead and ARC EoE researcher Dr Guy Peryer said: “We undertook a systematic review of 33 process evaluations of complex intervention trials conducted in care homes internationally, to find out why so many report neutral findings. Our analysis highlights key considerations for care home staff and researchers when collaborating on research trials, to improve and maintain positive working relationships. These include assessing how taking part in research will impact staff workload, prioritising staff involvement in research and change processes - and maintaining their interest and engagement throughout a study, as well as considering how workplace factors like staff turnover and care home management changes can impact on study delivery. 

“Researchers planning and undertaking research with care homes need a sensitive appreciation of the complex care home context. Applying research is most effective when an intervention is co-created and co-produced, with agreed purpose and adequate resources to incorporate within existing routines and care practices.”
 

Dr Guy Peryer, DACHA study lead and ARC EoE researcher

The findings from ‘Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis’ have now been published in the international journal Age and Ageing, available to read online here.

A guidance leaflet has been produced with findings from the review to help staff in care homes and to support care home research projects. The leaflet is available to download online here.

Key findings:

  1. Research teams need to assess how their research will have an impact on the work practices of staff in care homes.
  2. Factors such as high staff turnover, changes in care home management, and limited resources often lead to changes from how the research project was originally designed to take place.
  3. Maintaining care home staff engagement over the lifetime of the study and avoiding the drift in staff interest should be taken seriously by researchers.
  4. Researchers must prioritise involvement of staff in the process of intervention and change.

The NIHR-funded DACHA study is a four-year project which started in November 2019, led by the University of Hertfordshire, and delivered in collaboration with seven ARCs, nine universities, the National Care Forum, The Health Foundation, and the Alzheimer’s Society Research Network.