The Research Project

Plain English Summary

Aim and methods

This project brings together researchers from the University of Bedfordshire with the Care Quality Commission, which is the regulator of care homes in England. It aims to understand how people with alcohol and drug problems experience care in care homes and find ways to improve it.

It also aims to gather experts' opinions, including people with lived experience, to agree on the best ways to help. All the work will involve people with lived experience, their families, care workers, care home inspectors, and other health and social care professionals. We will use various methods such as interviews, focus groups, case studies, data analysis, and reviewing existing research to gather strong evidence. When we have assembled the evidence, we will convene groups of experts (including people with lived experience) to establish agreement about the recommendations.

Dissemination

The recommendations will form the basis for resources and guidance for key groups, including a guide for residents and families about what care they should expect. We will share our findings and guidance through care home organisations, social media, newspapers, radio, and presentations, building on our previous study's successful strategy.

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Scientific abstract

Research question

What is the best way to support People with Substance Dependence (PWSD) in care homes?

Background

The number of people with substance dependence (PWSD) who require support in a care home is increasing rapidly in the UK and other countries. Supporting PWSD in care homes presents complex practical, ethical and legal issues, yet very little is known how to support PWSD in this setting. Our previous research suggests that care homes are struggling to provide good care to this group, mostly because of a lack of knowledge and skills. There is evidence of avoidable harm, preventable hospital admission, delayed discharge from hospital and routine denial of admission to care homes. These findings are a concern for the Care Quality Commission (CQC) who will be our partners in this research.

Aim

The study has two aims (a) to understand how PSWD experience care and identify areas for improvement (b) create a circle of dialogue among experts (including experts-by-experience) to develop a consensus on best practice and competencies required to deliver high quality care.

Objectives

1. Explore how PWSD experience care, their support needs and which outcomes are important to them.
2. Identify the barriers/facilitators to achieving these outcomes.
3. Develop consensus on what good/innovative care looks like and the competencies care home workers require to achieve high quality care.

Methods

Five key stakeholder groups – PWSD, families/advocates, care workers, inspectors and other care professionals, will be included and involved at every stage. Stage 1: A hermeneutic systematic review of literature on different models of care and strategies to support PWSD in congregate living care settings. Stage 2: In-depth interviews/focus groups with a diverse sample of PWSD, family members, CQC inspectors, care home staff and other professionals. Case studies of homes providing good/innovative care. Analysis of existing CQC data. Stage 3: Informed by insight from Stages 1 and 2, an international online Delphi survey to develop consensus recommendations for best practice and the competencies required to deliver high quality care.

Timeline for delivery

27 months (April 2025 – July 2027)

Anticipated impact and dissemination

This study is likely to reduce inequalities in access to care, experience and outcomes for PWSD and lead to cost savings, for example, a reduction in preventable hospital admissions. Evidence generated will be used to produce a good practice guide for care staff, a guide for PWSD/families, learning materials for care home inspectors, case studies of good and innovative practice, briefings tailored for target audiences, an online webinar and presentations. We will use our links with organisations representing care homes and care home staff, social media, newspapers, radio, research briefings and presentations to disseminate the findings and guidance.

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