Unscheduled social care at night
Research type
Research Study
Full title
Exploring unscheduled care at night: the Night Owls project
IRAS ID
273097
Contact name
Diane Seddon
Contact email
Sponsor organisation
Bangor University
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
This Masters by Research project will explore a Local Authority Night Owls service which provides social care support overnight to people in their own homes. The research will focus on older adults (65 years +) who use this Local Authority service for unscheduled social care support.
The project's objectives are to analyse anonymised, routinely collected Local Authority Night Owls service and socio-demographic data to gain intelligence about the types of people using the Night Owls service and what types of support the Night Owls service is providing. We will then seek feedback from older adults who have used the Local Authority Night Owls service for unscheduled social care support in the last three months. We will also seek feedback from their family members, friends and neighbours. In these interviews we will explore how they experience the Night Owls service and how it has contributed towards the achievement of personal wellbeing outcomes. Based on the findings of these interviews we will design an evaluation/ feedback questionnaire for the Night Owls service. We will pilot this questionnaire over a one month period with older adults receiving unscheduled Night Owls visits to ensure it is useable and acceptable to people using the Local Authority Night Owls service.
Summary of Results
Why the research is important Care at home is becoming a national priority for many countries as a result of the growth in the global population of older adults. The number of adults who need social care at home, also known as domiciliary care, has risen as a result of more people living longer with more complex needs. Research has focused on daytime domiciliary care services, but little is currently known about the types of care and support available to older adults (aged 65 years and above) needing care at home overnight. A literature review conducted as part of the study identified that domiciliary night care staff can play an important role in meeting the overnight care and support needs of older adults who wish to be cared for at home. However, the review found gaps in knowledge about the impacts and outcomes of overnight care at home services.
This Masters by Research project, funded by European Social Funds (ESF) as part of a Knowledge Economy Skills Scholarship (KESS2), explored a local authority-provided service in North Wales, the Night Owls, which provides overnight social care and support to people in their own homes. Findings demonstrated that the Night Owls contributed to the achievement of older adults’ and unpaid carers’ personal wellbeing outcomes.
What the researchers did
Analysis of anonymised, routinely collected service and socio-demographic data identified the types of people using the Night Owls service and the types of support the Night Owls provided over a five-month period. Semi-structured interviews elicited the views of older adults and their unpaid carers on their experience of receiving unscheduled overnight care. Analysis of interview data and existing research on care and support at home informed the development of a pilot questionnaire. A short voluntary survey was included to ascertain how user-friendly the questionnaire was and to gain feedback about whether the approach would be useful for the service to collect data in the future.What the researchers found
The Night Owls provided support to mostly older adults living with frailty and adults at the end of life between April 2022 and August 2022 (n=3081). Care and support needs included providing assistance with toileting/continence, providing personal care, helping an older adult to bed, re-positioning, carrying out safety checks and providing reassurance, attending to a confused older adult, and attending to a health concern or discomfort. Older adults who had experienced a fall at home but had not sustained a serious injury were also provided with care and support (n=45). The majority of falls (n=24) were successfully resolved by the Night Owls, emergency services were called on 10 occasions, and data was unavailable for 11 visits. The Night Owls’ mean response time to people who had experienced a fall at home was 36 minutes and the mean call length was 45 minutes.Older adults, aged between 81 and 95 years (n=4), and their unpaid carers (n=3) were interviewed between September 2022 and December 2022. Analysis of interview data provided evidence of the positive impact and effect the overnight service had on participants’ wellbeing and led to the development of five major themes: meeting the wellbeing needs of older adults at night; supporting unpaid carers; supporting autonomy; providing individualised support; and barriers to accessing overnight care and support at home. The Night Owls played an important role in helping older adults realise their night-time biopsychosocial wellbeing needs. This was done through promoting older adults’ dignity; through contributing to improving health outcomes by providing a timely response to older adults who had experienced a fall at home; and through reducing feelings of night-time vulnerability and anxiety by being a source of companionship, comfort, and reassurance.
The overnight service supported the caring relationship by helping family carers to have uninterrupted sleep at night which in turn helped them build resilience to enable them to continue being able to provide care. Older adults valued that the Night Owls were able to support their preference for being cared for at home and deliver care which met their individual support and language needs. Participants felt that navigating the care system was challenging and that a lack of knowledge and awareness about the service were potential barriers to others with similar needs being able to access overnight care and support at home.
The questionnaire was distributed by Night Owls staff to older adults who received unscheduled care and support during a one-month period between 6th February and 6th March, 2023. The low number completed (n=1) suggests a questionnaire may not be the optimal way of capturing feedback from this population. However, positive responses identified that the individual’s expectations of the service matched the resulting care, that the care and support delivered was person-centred, and that nothing could have been done differently to improve the care and support received.
Why the research is important
The study has contributed to the knowledge and understanding of older adults’ and unpaid carers’ overnight care and support needs at home and demonstrates the benefits of having access to a dedicated overnight service. Future research should explore the potential of overnight domiciliary care services to alleviate pressure on emergency services, to delay care home admissions, and to reduce hospital admissions. Further research which includes the perspectives of unpaid carers and other family members is needed about how to build trusting, person-centred relationships between older adults and overnight domiciliary care workers.REC name
South Central - Oxford C Research Ethics Committee
REC reference
19/SC/0539
Date of REC Opinion
16 Oct 2019
REC opinion
Favourable Opinion