Learning Lessons in the Design and Delivery of Care Home Research

Care homes for older adults pose a unique set of challenges for research. Despite having high healthcare needs, this population are often excluded from clinical research, in part due to the challenges of this care context. This study identifies barriers, facilitators and potential solutions to performing research in care homes for older adults and reaches a consensus on the relative importance of these approaches.The study consisted of three parts: a survey, qualitative interviews and Delphi exercise. The survey was designed to gather views from a wide range of stakeholders including care home staff, managers and researchers alongside residents and family members. It was initially distributed in the East Midlands and then the wider UK, A purposive sample of those who took part in the survey were interviewed to explore challenges surrounding research in care homes in greater depth. Finally, an e-Delphi was conducted with statements constructed by the study team using themes gathered from the first two stages.63 participants responded to the survey. Most rated resident characteristics including cognitive and physical abilities as important considerations when running studies. They thought it less important that care staff had experience in research, but did have experience of the tasks that may be involved in conducting research.Eight people were included in qualitative interviews which identified 5 key themes including barriers and facilitators to research involvement, the need for care home research, reasons for participation and some potential solutions.From these themes 24 statements were developed including: facilitators to care home research; inclusion in research and potential solutions.19 participants took part in Round One of the Delphi with 15 continuing to Round Two. Consensus was reached on 23 out of the 24 statements.Care home research is different to that conducted in hospitals and other community settings. Researchers need to be flexible, fit in with the routines of the homes and value contributions from care home staff, with a specific focus on developing relationships with staff and managers. Time is needed to develop these relationships and may need to be a focus even before project commencement.