Co-producing the implementation of falls management in care homes
Research type
Research Study
Full title
Co-producing a novel model and outcomes framework for the implementation of falls management in care homes settings
IRAS ID
313841
Contact name
Katie Robinson
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
1 years, 3 months, 28 days
Research summary
Summary of Research
Falls in care homes are common among older adults living in care homes. A proactive approach to identify and modify falls risks is recommended to reduce the chance of a resident falling. However, in practice this can be difficult to achieve and requires joined up working across health and social care organisations in a local area (now known as an integrated care system or ICS). A recent review of literature recommended that future research into falls management approaches should focus on the organisational systems of care homes.
A programme of research has begun which aims to develop a new of working with staff and organisations to support the delivery of falls management in care homes. This work follows an implementation science approach and is guided by the Consolidated Framework for Implementation Research. The first stage of the programme was to identify the important parts to include in a falls management approach and how to evaluate if the implementation of the approach is successful. This was done by reviewing literature and asking experts for their opinions. The second stage will explore the contextual issues relating to staff and organisational systems involved in falls management in care homes. This will be explored through non-participant observations and semi-structured interviews with care home staff and residents.
The next stage (which is this research) is to work together with residents, staff and organisations to develop a new model for implementing falls management in care homes and a framework for evaluating if implementing the model was successful. This will be done by a series of workshops. This stage will also evaluate the process of people and organisations working together to produce the new model, known as the co-production process. This will be explored through non-participant observations of the workshops and a group reflection meeting or one-to-one interviews.Summary of Results
Why we did the study:
Many residents of care homes are at high risk of falling. These falls can lead to significant injuries, reduce confidence and worsen quality of life. Training care home staff to be proactive in identifying falls risks and developing actions is best practice. Delivering this best practice across the complex organisation of care homes is challenging. We worked together with care home, NHS and local authority staff to develop a model to deliver best practice falls management. We also wanted to learn about how we can work together to develop the model using an approach called co-production.What we did:
There were two parts to the work:
1. Developing and delivering the model
Sixteen stakeholders (care home residents and relatives, care home staff and NHS and local authority staff) participated in 18 co-production workshops over 12 months. The model was then delivered in care homes in Nottinghamshire, and 14 care home staff were interviewed to explore their views on how well the model worked.2. Learning about the co-production process
Co-production workshops were observed to explore interactions between participants. Nine stakeholders participated in reflection meetings to share their experiences of the process.
A study collaborator group including clinicians, care home staff, care home policy managers and resident PPIE advisors supported this study. Study collaborators and co-production participants have been acknowledged or involved in writing publications.
What we found:
1. Developing and delivering the model
A shared learning model that emphasises a collaborative approach to learning about falls was co-produced. The model includes providing information for resident and relatives, offering a bespoke package for each care home and providing on-going support. Key outcomes for determining success of the model included improving the confidence and competence of care home staff in managing falls. The elements of bespoke and on-going support were delivered across care homes by an NHS falls specialist.
Care homes valued the specialist skills and knowledge provided and considered this supported open and honest conversations that promoted a learning culture. The ease of access and timelines of the support was considered important. Staff felt their confidence and communication about falls had improved.
2. Learning about how well the co-production process worked
All participants reflected that the co-production process had been positive and had supported further learning. There were however challenges around managing reputational concerns and the fatigue to participants when taking part in workshops. The dynamics within the workshops changed over time as relationships developed. Reflections highlighted the importance of being flexible and supporting participants to feel safe and confident when sharing their views.REC name
Social Care REC
REC reference
22/IEC08/0015
Date of REC Opinion
17 Jun 2022
REC opinion
Favourable Opinion