Staff AttitudeECHONCT02703792
Enhanced Care Home Outcomes: A Qualitative Study
An observational study of Staff Attitude, run by Oxford Health NHS Foundation Trust at 1 site in United Kingdom.
Trial summary
This qualitative study uses focus group methodology and purposive sampling with the aim of obtaining views of Care Home Support Service staff and other stakeholders about their experiences of a redesigned National Health Service (NHS) Care Home Support Service. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Staff Attitude
- How many people
- 19 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- Mar 2016to Aug 2016
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: Staff and relatives of service users
Who may be able to join
- Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- Service user representatives from Age UK carer groups
- Note: * Sampling GPs, care staff and relatives through the top 10% of care homes referring to and using services of the care home support service will ensure that they have adequate awareness of the care home support team to contribute to the focus group discussion.
Who cannot join
- Not fluent in English
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
Department of psychological services, Fulbrook centre
Oxford, Oxfordshire, OX37JX
About this study
Official title: Enhanced Care Home Outcomes (ECHO): An Evaluation of the Experiences of Staff and Stakeholders Working With an Integrated Care Home Support Service (CHSS)
This qualitative study uses focus group methodology and purposive sampling with the aim of obtaining views of Care Home Support Service staff and other stakeholders about their experiences of a redesigned National Health Service (NHS) Care Home Support Service. Individual stakeholder focus groups will be conducted with General Practitioners (GP), care home staff, relatives of residents in care homes, service-user representatives (Total N=32, across 4 focus groups). This study forms part of a larger evaluation of the CHSS service; service improvement workshops will be conducted with Oxford Health NHS Care Home Support Service, Community Nursing and Community Mental Health staff that are working in the 102 participating homes. Each participant who consents will take part in a focus group to explore their experiences of a redesigned NHS care home support service. Participants will be involved in the study for up to six months from gaining informed consent until last contact with the research team when a summary of the research will be sent. The data will be analysed using thematic analysis and applied with the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.
Read the detailed description
There are currently 800 000 people in the United Kingdom (UK) living with dementia and this is predicted to grow to 1 million people by 2021. Studies suggest that 250 000 of people with dementia reside in care homes. Reports such as the National Dementia Strategy and subsequent government initiatives, such as the Dementia Challenge and the Prime Minister's Challenge on Dementia 2020 have helped the nation focus on provision of services for people with dementia. Further, our media remind us that the quality of care being delivered in care homes needs significant improvement. With an ageing population effective, safe, good quality care for our older people is paramount.
A high proportion of people in care homes have dementia and many have co-existing physical health problems and/or additional mental health needs. An integrated Care Home Support Service (CHSS) delivers care and treatment of both physical and mental health problems at an early stage of development. This integrated service combines two approaches which have been shown to be effective in randomised control trials and open studies in a stepped care model. Evidence suggests it is feasible to implement some elements of such approaches into a specialist mental health NHS context. However, no widespread implementation of this combined approach had been undertaken in an NHS context until the integration of this Care Home Support Service.
Evaluating the implementation of health care initiatives is crucial in determining their impact and sustainability in a routine NHS setting. This qualitative evaluation is part of a broader evaluation of the service. Focus groups and service improvement workshops will be conducted with NHS staff and other stakeholders. The data will be analysed using thematic analysis and applied to the RE-AIM framework to:
- Provide valuable information from NHS staff and stakeholders regarding the impact and sustainability of this model.
- Explore key factors to consider when integrating physical and mental health services.
- Increase understanding of the potential barriers and facilitators of integrating evidence-based practice into a routine NHS setting.
On completion of the research the findings of the study will be disseminated to research participants and health professionals to support learning and best practice both locally and nationally.
- Conditions
- Staff Attitude
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Care home staff | Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service | |
| NHS staff | GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service | |
| Service user representatives | Service or carers of an older person with dementia attending and Age UK carers group | |
| Relatives of residents | Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service |
What is being measured
The primary outcome is the main question the study is designed to answer.
Themes derived from a thematic analysis of staffs attitudes to the implementation an integrated care home in-reach team.
Measured: 1.5 hour focus group
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Mar 2016 (estimated)
- Study startMar 2016
- Primary completionAug 2016
- Study completionAug 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Staff AttitudeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Other
- Enrolment
- 19 participants (actual)
Sponsor and investigators
- Lead sponsor
- Oxford Health NHS Foundation Trust
- Sponsor type
- Other government
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02703792
- Sponsor's protocol ID
- 1163
- Acronym
- ECHO
- Status last verified
- Apr 2017
- First submitted
- 24 Feb 2016
- Last updated
- 4 Apr 2017
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- Undecided
Publications
Ballard C, Brown R, Fossey J, Douglas S, Bradley P, Hancock J, James IA, Juszczak E, Bentham P, Burns A, Lindesay J, Jacoby R, O'Brien J, Bullock R, Johnson T, Holmes C, Howard R. Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). Am J Geriatr Psychiatry. 2009 Sep;17(9):726-33. doi: 10.1097/JGP.0b013e3181b0f8c0.
PubMed 19700946Ballard C, Orrell M, YongZhong S, Moniz-Cook E, Stafford J, Whittaker R, Woods B, Corbett A, Garrod L, Khan Z, Woodward-Carlton B, Wenborn J, Fossey J. Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster-Randomized Controlled Trial by the Well-Being and Health for People With Dementia (WHELD) Program. Am J Psychiatry. 2016 Mar 1;173(3):252-62. doi: 10.1176/appi.ajp.2015.15010130. Epub 2015 Nov 20.
PubMed 26585409Brooker DJ, Latham I, Evans SC, Jacobson N, Perry W, Bray J, Ballard C, Fossey J, Pickett J. FITS into practice: translating research into practice in reducing the use of anti-psychotic medication for people with dementia living in care homes. Aging Ment Health. 2016 Jul;20(7):709-18. doi: 10.1080/13607863.2015.1063102. Epub 2015 Jul 13.
PubMed 26167720Fossey J, Ballard C, Juszczak E, James I, Alder N, Jacoby R, Howard R. Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. BMJ. 2006 Apr 1;332(7544):756-61. doi: 10.1136/bmj.38782.575868.7C. Epub 2006 Mar 16.
PubMed 16543297Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322.
PubMed 10474547
Study at a glance
From the registry record, last updated by the sponsor on 4 Apr 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Enhanced Care Home Outcomes (ECHO): An Evaluation of the Experiences of Staff and Stakeholders Working With an Integrated Care Home Support Service (CHSS)
- ClinicalTrials.gov ID
- NCT02703792
- Acronym / sponsor ID
- ECHO / 1163
- Conditions
- Staff Attitude
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 19 participants (actual)
- Lead sponsor
- Oxford Health NHS Foundation TrustOther government
- Study start
- Mar 2016
- Primary completion
- Aug 2016 (actual)
- Study completion
- Aug 2016 (actual)
- First posted
- 9 Mar 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This qualitative study uses focus group methodology and purposive sampling with the aim of obtaining views of Care Home Support Service staff and other stakeholders about their experiences of a redesigned National Health Service (NHS) Care Home Support Service. Individual stakeholder focus groups will be conducted with General Practitioners (GP), care home staff, relatives of residents in care homes, service-user representatives (Total N=32, across 4 focus groups). This study forms part of a larger evaluation of the CHSS service; service improvement workshops will be conducted with Oxford Health NHS Care Home Support Service, Community Nursing and Community Mental Health staff that are working in the 102 participating homes. Each participant who consents will take part in a focus group to explore their experiences of a redesigned NHS care home support service. Participants will be involved in the study for up to six months from gaining informed consent until last contact with the research team when a summary of the research will be sent. The data will be analysed using thematic analysis and applied with the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.
Detailed description
There are currently 800 000 people in the United Kingdom (UK) living with dementia and this is predicted to grow to 1 million people by 2021. Studies suggest that 250 000 of people with dementia reside in care homes. Reports such as the National Dementia Strategy and subsequent government initiatives, such as the Dementia Challenge and the Prime Minister's Challenge on Dementia 2020 have helped the nation focus on provision of services for people with dementia. Further, our media remind us that the quality of care being delivered in care homes needs significant improvement. With an ageing population effective, safe, good quality care for our older people is paramount.
A high proportion of people in care homes have dementia and many have co-existing physical health problems and/or additional mental health needs. An integrated Care Home Support Service (CHSS) delivers care and treatment of both physical and mental health problems at an early stage of development. This integrated service combines two approaches which have been shown to be effective in randomised control trials and open studies in a stepped care model. Evidence suggests it is feasible to implement some elements of such approaches into a specialist mental health NHS context. However, no widespread implementation of this combined approach had been undertaken in an NHS context until the integration of this Care Home Support Service.
Evaluating the implementation of health care initiatives is crucial in determining their impact and sustainability in a routine NHS setting. This qualitative evaluation is part of a broader evaluation of the service. Focus groups and service improvement workshops will be conducted with NHS staff and other stakeholders. The data will be analysed using thematic analysis and applied to the RE-AIM framework to:
- Provide valuable information from NHS staff and stakeholders regarding the impact and sustainability of this model.
- Explore key factors to consider when integrating physical and mental health services.
- Increase understanding of the potential barriers and facilitators of integrating evidence-based practice into a routine NHS setting.
On completion of the research the findings of the study will be disseminated to research participants and health professionals to support learning and best practice both locally and nationally.
Study design
- Observational model
- Other
- Time perspective
- Other
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Care home staff | – | –Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service |
| NHS staff | – | –GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service |
| Service user representatives | – | –Service or carers of an older person with dementia attending and Age UK carers group |
| Relatives of residents | – | –Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Staff and relatives of service users
Key inclusion criteria (5 listed)
- Care home staff working in the homes in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- Relatives of residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- GPs supporting residents living in the top 10% of service use of the 102 participating homes referring to the Care Home Support Service*
- Service user representatives from Age UK carer groups
- Note: * Sampling GPs, care staff and relatives through the top 10% of care homes referring to and using services of the care home support service will ensure that they have adequate awareness of the care home support team to contribute to the focus group discussion.
Key exclusion criteria (1 listed)
- Not fluent in English
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Themes derived from a thematic analysis of staffs attitudes to the implementation an integrated care home in-reach team.
Time frame: 1.5 hour focus group
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Apr 2017.
- Background: PubMed 19700946Ballard C, Brown R, Fossey J, Douglas S, Bradley P, Hancock J, James IA, Juszczak E, Bentham P, Burns A, Lindesay J, Jacoby R, O'Brien J, Bullock R, Johnson T, Holmes C, Howard R. Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). Am J Geriatr Psychiatry. 2009 Sep;17(9):726-33. doi: 10.1097/JGP.0b013e3181b0f8c0.
- Background: PubMed 26585409Ballard C, Orrell M, YongZhong S, Moniz-Cook E, Stafford J, Whittaker R, Woods B, Corbett A, Garrod L, Khan Z, Woodward-Carlton B, Wenborn J, Fossey J. Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster-Randomized Controlled Trial by the Well-Being and Health for People With Dementia (WHELD) Program. Am J Psychiatry. 2016 Mar 1;173(3):252-62. doi: 10.1176/appi.ajp.2015.15010130. Epub 2015 Nov 20.
- Background: PubMed 26167720Brooker DJ, Latham I, Evans SC, Jacobson N, Perry W, Bray J, Ballard C, Fossey J, Pickett J. FITS into practice: translating research into practice in reducing the use of anti-psychotic medication for people with dementia living in care homes. Aging Ment Health. 2016 Jul;20(7):709-18. doi: 10.1080/13607863.2015.1063102. Epub 2015 Jul 13.
- Background: PubMed 16543297Fossey J, Ballard C, Juszczak E, James I, Alder N, Jacoby R, Howard R. Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. BMJ. 2006 Apr 1;332(7544):756-61. doi: 10.1136/bmj.38782.575868.7C. Epub 2006 Mar 16.
- Background: PubMed 10474547Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322.
- Alzheimer's Society (2012). Dementia 2012: A National challenge reportLink provided by the sponsor.
- Department of Health (2009). Living well with dementia: A national dementia strategy. Leeds: Author.Link provided by the sponsor.
- Department of Health (2012). Prime Minister's challenge on dementia: Delivering major improvements in dementia care and research by 2015. Leeds: AuthorLink provided by the sponsor.
- Department of Health (2015). Prime Minister's challenge on dementia 2020. Leeds: AuthorLink provided by the sponsor.
- James I. A. (2011). Understanding Behaviour in Dementia that Challenges. London: Jessica Kingsley PressLink provided by the sponsor.
- Knapp, M. Comas-Herrera, A. Somani, A. \& Banerjee, S. (2007) Dementia:International Comparisons Personal Social Services Research unit, LondonLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Staff Attitude, run by Oxford Health NHS Foundation Trust at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Apr 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Themes derived from a thematic analysis of staffs attitudes to the implementation an integrated care home in-reach team. (time frame: 1.5 hour focus group). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02703792, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Apr 2017.