Enhanced Care Home Outcomes: A Qualitative Study (ECHO)

April 3, 2017 updated by: Oxford Health NHS Foundation Trust

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.

Study Overview

Status

Completed

Conditions

Detailed Description

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.

Study Type

Observational

Enrollment (Actual)

19

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United Kingdom
    • Oxfordshire
      • Oxford, Oxfordshire, United Kingdom, OX37JX
        • Department of psychological services, Fulbrook centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Staff and relatives of service users

Description

Inclusion Criteria:

  • Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
  • Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
  • GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
  • Service user representatives from Age UK carer groups
  • Note: * Sampling GPs, care staff and relatives through the top 10% of care homes referring to and using services of the care home support service will ensure that they have adequate awareness of the care home support team to contribute to the focus group discussion.

Exclusion Criteria:

  • Not fluent in English

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Care home staff
Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service
NHS staff
GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service
Service user representatives
Service or carers of an older person with dementia attending and Age UK carers group
Relatives of residents
Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Themes derived from a thematic analysis of staffs attitudes to the implementation an integrated care home in-reach team.
Time Frame: 1.5 hour focus group
1.5 hour focus group

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Oxford Health NHS Foundation Trust

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2016

Primary Completion (Actual)

August 1, 2016

Study Completion (Actual)

August 1, 2016

Study Registration Dates

First Submitted

February 24, 2016

First Submitted That Met QC Criteria

March 8, 2016

First Posted (Estimate)

March 9, 2016

Study Record Updates

Last Update Posted (Actual)

April 4, 2017

Last Update Submitted That Met QC Criteria

April 3, 2017

Last Verified

April 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • 1163

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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