Key Findings

Care home professionals provide specialist care to support people living with diverse and often complex needs, practicing with a clear focus on the need to personalise care to the individual. Staff can make (and have made) a positive contribution to resident care, local and national decision-making when they are actively involved in planning, policy-making and research.

Accessible summary

We identified a gap in the evidence around the understanding of care home staff experiences during the COVID-19 pandemic in Scotland. So we planned a study where we interviewed care home staff about managing COVID-19 outbreaks in their homes to learn lessons for the future.

Using a range of networks to share invitations including Scottish Care, ENRICH Scotland and existing connections, we recruited 34 staff working in a range of roles to take part. We interviewed them, recorded what they told us and studied their responses looking for patterns and areas of similarity and differences.

We found that care homes had different experiences during outbreaks depending on the size, timing of the outbreak and resident group they supported.  The national response to the COVID-19 pandemic resulted in fundamental change to care home relationships. Staff responded by adaptation in uncertainty. However, they were challenged by emerging inequalities influencing residents’ care. There were tensions between staff experience and evolving external approaches to regulation and oversight. All this change resulted in psychological impacts on staff. However, there was also widespread evidence of compassionate leadership and teamwork in their responses. Effective sources of support were underpinned by respectful relationships and continuity, tailored to the specifics of the care home service.

Our findings are relevant beyond the pandemic and we continue to seek opportunities to share them and use them to positively influence the support provided to people living in care homes and the professionals who care for them.

We have produced a short video summary of our findings.

• Contact for more information: jenni.burton@glasgow.ac.uk
• Read the full article

Key Findings

Focus group and interview key findings include the need for better training and resources with regards to implementing infection control policies around laundry including a stratified risk tool for the assessment of different textiles in care homes and how they should be processed.

Accessible summary

The aim of this study is to determine the current infection control policies and practices utilised by care/nursing homes in the laundry of patient associated textiles, barriers to implementing such policies and attitudes towards laundering.

Using surveys, interviews and focus groups, qualitative and quantitative responses were collated to evaluate current practices in UK care/nursing homes. The surveys targeted two specific care home levels: one survey for management and another for healthcare workers who work in care/nursing home settings, enabling a range of opinions about current infection control policies with regards to laundry to be collated. A laundry management working group was formed via the Infection Prevention Society Care Home Special Interest Group, and a second survey, which included additional questions focusing on Infection Prevention and Control was also distributed. Individuals from independent organisations took part in interviews and a focus group which discussed current infection control policies in place and any barriers care/nursing homes are facing with regards to implementing such policies.

Surveys were taken by a total of 1,062 respondents. Survey 1 was taken by 901 respondents (The managers’ survey was taken by 495 respondents and the Healthcare workers’ survey by 406 respondents). Survey 2 was taken by 161 respondents (The managers’ survey was taken by 104 respondents, and the care workers’ survey was taken by 57 respondents). Results from survey 1 found that under half of 355 healthcare workers believed that bed linen (49.30% (175)), personal laundry (45.48% (161)) and staff uniforms (43.71% (153)) is always processed well in their on-premise laundry sites. Over half of the 316 healthcare managers state their staff receive formal laundry training; however, 86.74% (229) of healthcare workers stated they would like to receive further training. Healthcare workers (85.77% (229)) and managers (90.75% (275)) stated they would like more support with running on-premise laundries in their settings.

Results from survey 2 found that the majority of care workers (91% - 31) and managers (87% - 53) stated that their laundry equipment is commercial. The majority of care workers (84% - 21) and managers (87% -53) stated that they have a dirty to clean flow in the laundry room, leaving approx. 25% of care homes surveyed not having this critical workflow. In addition, 100% (80) respondents use red water-soluble bags for soiled and/or infected linen, full water soluble bags are stored in a solid lidded container/non-soluble plastic bag according to 68% (17) of care workers and 67% (55) of managers. Furthermore, 56% (14) care workers and 56% (30) managers do not have a manual sluice facility/sluicing basin situated in the laundry room and 100% (25) of care workers and 91% (49) of managers reported that they have a designated area for the storage of clean linen which is separate to used linen within their settings.

The results have highlighted the barriers to the implementation of infection prevention laundry policies in the diverse care home setting, with the most evident finding being that the care home sector requires more support, education and training for the effective management of on-premise laundering.

• Contact for more information: klaird@dmu.ac.uk

Key Findings

Adaptive Interaction provides an effective and meaningful form of connection for people with very advanced dementia, their families and professional caregivers. Training in the approach provides carers and families with the confidence to engage in an alternative form of communication and to look more closely for signs of interaction in the person they care for.

Accessible summary

Our work involves helping families and carers to communicate people with very advanced dementia who no longer use speech to communicate and who don't understand the speech of others. This approach, called 'Adaptive Interaction' involves using the non-verbal 'language' of each individual to communicate with them, thereby allowing meaningful interaction in the absence of speech. Our current work is ongoing, as such the article attached provides the findings of one of our previous studies.

• Contact for more information: mpe2@st-andrews.ac.uk
• Read the full article

Accessible summary

When someone with a condition that affects their memory or understanding is unable to decide about taking part in a research study, their families may be asked to decide on their behalf. However, some family members do not know what the person’s wishes and preferences about research would be, and some find it difficult to decide.

Advance research planning is a process for people to express their wishes about being involved in research studies in the future. It might help families make decisions about research. It has already been introduced in some other countries. We wanted to know whether advance research planning is acceptable and feasible in the UK.

We invited a wide group of people (members of the public including people living with capacity-affecting conditions, family members, researchers, clinicians, and other professionals) to complete an online questionnaire. We asked what they thought about the idea of advance research planning, what the barriers might be, and what could help support it. The survey was open November 2022 - March 2023

A total of 327 people completed the survey. Participants were very supportive of introducing advance research planning in the UK. They identified a number of challenges, including how people will know about it, who should be involved, and how will their preferences be kept up to date. Participants suggested strategies to help raise awareness and improve uptake.

• Contact for more information: ShepherdVL1@cardiff.ac.uk
• Read the full article