Improving health and care in physically unwell care home residents
Care home staff can access different NHS services to support a physically unwell care home resident. This study explores care home staff views and experiences of community-based alternatives to hospital for physically unwell residents. The study will make recommendations on how to support care homes to use community-based alternatives and to prevent hospital admissions.
Part of our Improving Health and Social Care research theme
Care homes need to meet increasingly complex needs of their ageing residents. Different NHS services are available to support physically unwell care home resident, such as calling the GP or 999. Often physically unwell residents are admitted to hospital, but this can lead to deterioration in the health of the resident and is costly. Community-based alternatives (e.g. Virtual Wards) have been shown to have positive patient outcomes and reduce NHS costs. It is unclear what care pathways are used by care home staff and in particular how much experience care homes have in using community-based alternatives. This study will assess how care home staff view and access community-based alternatives to hospital when a resident is physically unwell.
We are conducted a mixed methods study including an online survey and interviews. A short online survey will be sent to staff working in a care home in Buckinghamshire, Oxfordshire and Berkshire. This intends to gain insight into staff views and experiences of different types of NHS support, in particularly community-based alternatives to hospital. Interviews will conducted with approximately 30 staff to gain more in depth to understanding of how they view and use these community-based alternatives and how they can be better supported to deliver high quality care to their physically unwell residents.
How we are involving patients and the public
A PPI group has formed as part of the ARC theme on Improving Health and Social Care. They receive regular project updates and can provide feedback on any aspect of the study.
As the study involves care home staff, we have consulted with care home managers on the content of the survey and the interview questions. Their feedback is being used to improve the survey and interview questions.
How we are planning to implement the research outputs
We have formed relationships with care home managers and providers, the Oxford AHSN, and Oxford University Hospitals NHS Foundation Trust. We have met with our key partners to discuss the project and to seek their feedback (e.g. care home managers are commenting on the survey we are developing and have advised us on the interview questions). The findings of the study will be disseminated to our key partners and we will support them to implement our findings.
Project Lead
Team Members
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Sara McKelvie
NIHR Clinical Lecturer in Gen Practice
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Ray Fitzpatrick
Emeritus Professor of Public Health and Primary Care
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Partners on this project
Project end date
2025
Aims
- To explore to what extent community-based alternatives to hospital are used by care home staff when a resident physically deteriorates
- To understand staff experiences (positive and negative) about NHS support offered to physically deteriorating care home residents
- To explore what, if any, further support is needed by care home staff to enable them to use community-based alternatives to hospital
Deliverables
- Identify facilitators and barriers to care home staff using community-based alternatives to hospital
- Outline the support needed by care home staff to use community-based alternatives to hospital
- Dissemination of findings, including scientific publications, conference presentations, and sharing a summary of the research findings with participating care homes and key partners (such as the AHSN)
Expected Impact
Evidence shows that community-based alternatives to hospital are positive for patient outcomes and for reducing hospital costs. This study will:
- Improve understanding of how care homes support their physically deteriorating residents;
- Identify how well NHS services, including community-based alternatives to hospital, support care homes in the care for their physically unwell residents;
- Make recommendations on how to address barriers to using community-based alternatives, thus enabling care home residents to receive hospital type treatment in their familiar environment and to reduce hospital admissions.