Health services research, care homes, end of life care Not Applicable
Conditions
Interventions
This is an Implementation Science study which will take an approach to care with an established research evidence-base (called 'Needs Rounds') and identify what adaptations need to be made to integrat
Sponsors
University of Stirling
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Stakeholders (for interviews in Phase 1 & 2): 1. Work for specialist palliative care or a care home in one of the six cases; or are a resident in one of the care homes; or are a relative of a care home resident in one of the six cases; or work in acute care impacted by hospitalised care home residents 2. Willing to provide informed consent 3. Have capacity to provide their own consent to participate 4. Not engaged in any current safeguarding investigations Care homes: 1. Located near to the specialist palliative care team 2. Provide care to residents who have high clinical nursing/medical needs 3. Willing to sign a memorandum of understanding with the research team, outlining provision of hospitalisation data, facilitate access to staff for interviews, and engagement in Needs Rounds 4. A range of sizes (focusing primarily on larger care homes, following CQC data indicating lower quality in larger facilities), sole traders and large corporate provider, and with a range of funding models (NHS/social care and self-funded residents) Residents: 1. Resident in a collaborating care home in one of the six case study locations 2. An anticipated life-expectancy <6 months, or a deteriorating condition where they are at risk from dying without an adequate care plan in place 3. Experiencing sub-optimal bio-psycho-social symptoms Relatives completing 'family perceptions of care' questionnaire 1. Relative of a resident who was discussed in Needs Rounds 2. Able to provide their own informed consent Interviewees (PPI evaluation) 1. Co-investigator or staff at one of the case study sites 2. Able to provide their own informed consent
Exclusion criteria
Exclusion criteria: Does not meet inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Characteristics of effectiveness regarding 'What works for whom, under what circumstances, with the UK Model of Needs Rounds' assessed through qualitative interviews with key stakeholders (residents, relatives, care home staff, specialist palliative care staff, and acute care staff) during the 12 month intervention | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Rate of hospitalization (in days) measured at baseline for 4 months and for the final 4 months of the intervention 2. Staff capability of all staff attending Needs Rounds measured using Staff capability of adopting a palliative approach (CAPA) gathered prospectively throughout the 12 months of implementation 3. Quality of Death and Dying measured using the quality of death and dying index (QODDI), gathered prospectively on all deceased residents throughout the 12 months of implementation 4. Family perceptions of care measured using the Canadian Health Care Evaluation Project (CANHELP) lite, gathered prospectively on families of residents discussed during the 12 month intervention | — |
Countries
England, Scotland, United Kingdom
Outcome results
None listed