Improving end of life in care homes using an implementation science approach

Not Applicable

Completed

• Conditions: Health services research, care homes, end of life care; Not Applicable

• Registration Number: ISRCTN15863801
• Lead Sponsor: niversity of Stirling

Brief Summary

2021 Protocol article in https://pubmed.ncbi.nlm.nih.gov/33619205/ protocol (added 24/02/2021) 2024 Results article in https://pubmed.ncbi.nlm.nih.gov/39046763/ (added 25/07/2024)

Detailed Description

Not available

Study Timeline

• Study Start: 2020-12-17
• Study Completion: 2022-10-31
• Last Update Posted: 5 August 2024

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 349

Inclusion Criteria

Stakeholders (for interviews in Phase 1 & 2):
1. Work for specialist palliative care or a care home in one of the six cases; or are a resident in one of the care homes; or are a relative of a care home resident in one of the six cases; or work in acute care impacted by hospitalised care home residents
2. Willing to provide informed consent
3. Have capacity to provide their own consent to participate
4. Not engaged in any current safeguarding investigations

Care homes:
1. Located near to the specialist palliative care team
2. Provide care to residents who have high clinical nursing/medical needs
3. Willing to sign a memorandum of understanding with the research team, outlining provision of hospitalisation data, facilitate access to staff for interviews, and engagement in Needs Rounds
4. A range of sizes (focusing primarily on larger care homes, following CQC data indicating lower quality in larger facilities), sole traders and large corporate provider, and with a range of funding models (NHS/social care and self-funded residents)

Residents:
1. Resident in a collaborating care home in one of the six case study locations
2. An anticipated life-expectancy <6 months, or a deteriorating condition where they are at risk from dying without an adequate care plan in place
3. Experiencing sub-optimal bio-psycho-social symptoms

Relatives completing 'family perceptions of care' questionnaire
1. Relative of a resident who was discussed in Needs Rounds
2. Able to provide their own informed consent

Interviewees (PPI evaluation)
1. Co-investigator or staff at one of the case study sites
2. Able to provide their own informed consent

Exclusion Criteria

Does not meet inclusion criteria

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1. Characteristics of effectiveness regarding 'What works for whom, under what circumstances, with the UK Model of Needs Rounds' assessed through qualitative interviews with key stakeholders (residents, relatives, care home staff, specialist palliative care staff, and acute care staff) during the 12 month intervention

Secondary Outcome Measures

Name	Time	Method
1. Rate of hospitalization (in days) measured at baseline for 4 months and for the final 4 months of the intervention<br>2. Staff capability of all staff attending Needs Rounds measured using Staff capability of adopting a palliative approach (CAPA) gathered prospectively throughout the 12 months of implementation<br>3. Quality of Death and Dying measured using the quality of death and dying index (QODDI), gathered prospectively on all deceased residents throughout the 12 months of implementation<br>4. Family perceptions of care measured using the Canadian Health Care Evaluation Project (CANHELP) lite, gathered prospectively on families of residents discussed during the 12 month intervention