Exploring and Understanding the lived experience in CAre homes for older people of Infection risk and transmission during the COVID-19 pandemic: a mixed-methods study to inform what we can learn for future infectious disease outbREaks (UCAIRE)
Summary
UCAIRE is exploring how residents in older people’s care homes, their family/friends and care-home staff experience coping with preventing the spread and transmission of SARS-CoV-2 (the virus that causes COVID-19). Findings will inform the development of guidelines and support in managing future outbreaks of infectious diseases in care homes and in providing support to those living, visiting and working in care homes.
Background
Usual safety measures in care homes for older people have not fully controlled the spread of the highly infectious virus that causes COVID-19, so care homes added more safety measures. These include restricting visitors and changing how care is given. But we do not know how residents, families/ friends of residents and staff have coped with measures to prevent the virus spreading and if these met their needs.
Our study starts with an online survey open to staff in any job role. It asks about working during COVID-19 and challenges to how staff coped trying to prevent the spread of infection. Survey results will show us the different ways staff manage infection risk in care homes and how they feel about that. Next we will interview residents, family/friends and staff to learn how they experienced coping with COVID-19. We will ask them for details of how infection-control worked for them in daily life. Their views will help us understand the impact on them of the steps taken to limit the spread of infection. Interviews for staff and family/friends are online or on the telephone to remove infection risk. Research Nurses will recruit residents and arrange interviews if UCAIRE researchers cannot enter care homes because of lockdown restrictions.
We will analyse information from the surveys and interviews, combine the results and write a report on what we have learned. We will share findings with organisations in social care and use social media to raise awareness of the outcomes. We aim for UCAIRE to add to findings on the best and most relevant steps and support that help residents, families and staff to cope with measures that control the spread of infectious diseases. UCAIRE will also find out how responses to infection-control measures can support the actual needs of those who live, visit and work in care homes.
Project aims
UCAIRE uses two methods – an online survey; qualitative interviews – to achieve three main objectives:
- Carry out an online survey of staff who work in any job role in a care home. The online survey will find out staff’s general views and specific concerns on the spread of COVID-19 within care homes for older people.
- Hold qualitative interviews with care-home residents, family/friends of residents and care-home staff. Interviews will give us detailed information on how individuals experience infection-control measures and reducing the risk of infection during the pandemic.
Combine the findings from the online survey with those from the interviews to gain full understandings of the experience of infection-control and risk and the needs of those living and working in care homes. The results will be used to develop guidelines tailored for specific users: care-home residents; family/friends of residents; care-home staff.
Project activity
UCAIRE is a one-year study. It will end on 31 May 2022.
Online survey for care-home staff: on-going until 30 November 2021.
Interviews for staff, for family/friends of residents and for care-home residents:
- we have obtained ethical approval for the online survey and interviews with family/friends and staff
- we are submitting a separate application to obtain ethical approval to recruit and interview care-home residents
- interviews will continue until early February 2022
Analysis of data (this will be on-going from time interviews begin).
Stakeholder workshop in spring 2022 to obtain feedback on draft resources and how to tailor them for (i) care-home residents, (ii) family/friends of residents and (iii) care-home staff.
Produce tailored resources.
Submit final report to funder and two papers to peer-reviewed journals.
Anticipated and potential impact
Anticipated outputs
- final report to funder and a short version for the funder’s website
- plain English summary for care-home residents, for family/friends and for care-home staff
- two papers to be submitted to peer-reviewed journals in long-term care (one on the survey results; another on the interview findings)
- seminars for NIHR SSCR and the LTC-COVID network
Potential impact
N.B., UCAIRE is not an NHS-based study so we cannot claim potential impact in the NHS. However, we aim to have an impact in the care-home sector.
- Workshop or forum in spring 2022: a co-produced event for those supporting, involved with and interested in older people’s care homes (e.g., practitioners, commissioners, carers, residents) to share learnings on the needs of staff, residents and family/friends in coping with infectious disease outbreaks. At this workshop we will also obtain feedback on tailoring the draft outputs in the most appropriate way for different stakeholder groups
- Propose a symposium at the British Society of Gerontology’s annual conference to be held at UWE, Bristol, in July 2022
- Through links with ARC EoE’s IIRP theme, engage with stakeholders in a “Population in Focus” area to help implement findings into practice
- Practitioners and carers on UCAIRE will support outreach and impact (e.g., a regional care-home provider will disseminate findings at network- and care-home levels and post on their website and social-media channels)
Carers and practitioners on the UCAIRE team will share findings with their networks. These actions will help to increase the impact of the study. We hope our findings will help to improve social-care practice.
Next steps
Online survey for care-home staff: on-going until 30 November 2021.
Interviews for staff, for family/friends of residents – on-going.
Obtain ethical approval to recruit and interview care-home residents – IRAS application to be submitted.
Recent activity
Online survey for care-home staff
- opened in August 2021
- on-going until 30 November 2021
Interviewing staff and family/friends of care-home residents:
- commenced in late September (4 interviews to date)
- on-going activities
Transcribing of interview data is under way
Recruitment activities are on-going
Related projects
UCAIRE team-members Kathleen Lane and Diane Bunn are also conducting a one-year study funded by Burdett Trust for Nursing: UndersTanding the distinct challenges for Nurses in Care Homes: LeaRnIng from COVID-19 to support resiliencE and mental well-being (THRIVE). Diane is the PI; Kathleen is one of the Co-Applicants. THRIVE will end on 31 January 2022.
UCAIRE team-members Lane, Bunn and Brainard conducted a short study, November 2020-January 2021, on care-home staff’s experience of infection-control measures, findings from which have been published in Bunn et al. (2021), The Lived Experience of Implementing Infection Control Measures in Care Homes during two waves of the COVID-19 Pandemic. A mixed-methods study. doi: https://doi.org/10.1101/2021.07.08.21260181
Who is involved
PI Dr Kathleen Lane, UEA
Researchers and institutions
Dr Julii Brainard, UEA
Dr Diane Bunn, UEA
Ms Julie Houghton, Carer/PPI
Dr Anne Killett, UEA
Professor Sarah O’Brien, Newcastle
Ms Suzanne Mumford, Care UK
Ms Laura Watts, UEA
Corresponding researcher, organisation (email)
Dr Kathleen Lane, University of East Anglia (UEA)