Nick Smith

Context: Ensuring the safety of older adults living in residential care homes is an international priority. Residents are often highly frail and vulnerable, making safety a critical concern. A growing range of organisations collect safety-related data from care homes, yet there is limited understanding of how effectively these data support learning and improvement.Objective(s): To explore strategic stakeholders’ views on the scope, collection, and use of safety data in older adult care homes, and to identify opportunities to better support learning and improvement.Method(s): Semi-structured online interviews were conducted with 18 purposively sampled strategic-level professionals in England, representing regulatory bodies, NHS organisations, local authorities, care home providers, and representative organisations. Data were analysed thematically.Findings: Data collection largely reflected organisational roles in regulation or quality monitoring and focused predominantly on adverse outcomes and incidents. Care homes were subject to overlapping data requests. Barriers to effective use of safety data included siloed data collection, limited sharing between organisations and care homes, a blame-oriented culture associated with harm-focused measures, and limited capacity to analyse and use data for improvement.Limitations: This was a small, qualitative study focused on strategic stakeholders; perspectives of care home staff, residents, and families were not included.Implications: Improving safety assessment in care homes requires rationalising and standardising data requests, balancing harm-focused indicators with measures of proactive safety practices, enhancing data sharing, strengthening analytic capacity, and ensuring care home staff have the skills required to use safety intelligence to stimulate safety improvement.

This study aims to understand how care planning is conducted in English older adult care homes and explore the views of staff involved in care planning. Drawing on 22 semi-structured interviews, the findings of the study are organised around five themes: the aims of care planning; conducting care planning; support and resources for care planning; the use of care planning information; and improving care planning. Our discussion notes the ways in which care staff would like to improve how care planning is conducted but highlights that a lack of resources may make improvement difficult.

Background: The involvement of family/friends in the care planning of an older adult residing in a care home can help to foster person‐centred care. This study explored and incorporated family/friends' views on the relevance and usefulness of a draft information resource focusing on care planning to address and support older adults' needs. Methods: The research team drafted an information resource to help family/friends better understand care planning. The contents of the draft resource were informed by previous research on care planning in older adult care homes, which included a scoping review, a modified Delphi survey and consultations with health and social care professionals. Feedback on the draft resource was collected through remote focus group discussions with family/friends of older adults residing in care homes in England in November 2024. Participants were invited to share their views on the draft information resource and if/how it could be improved. Audio recordings were transcribed verbatim and the data thematically analysed in NVivo. Findings: The views of 28 family/friends were obtained across four focus group discussions. Three main themes were generated: experiences with care planning, usefulness of the information resource and improving and sharing the information resource. Findings depict a heterogeneity in awareness of, and involvement in, care planning. Most participants perceived the information resource to have the potential to raise awareness of care planning and promote family/friend involvement. Subject to changes, several participants said that they would share the document. Some, largely due its presentation, said they would not. Conclusions: Most participants believed that an information resource on care planning would be helpful. Future research is required to explore whether the document leads to increased family/friend involvement in care planning. Patient or Public Contribution: Two family members with experience of supporting a relative in a care home were involved in devising and revising the different iterations of the information resource and topic guide, and in interpreting findings.

Purpose: In Norway, no standardized instrument has been available to measure outcomes of long-term care (LTC) from the perspective of the service users. The Adult Social Care Outcomes Toolkit (ASCOT), developed in England, was designed for this purpose. ASCOT is a suite of tools designed that assess outcomes from the perspective of different groups receiving LTC. This article describes the translation and cultural adaptation of the four-level interview version (INT4) for use in Norwegian LTC services. Methods: The translation followed international guidelines and included two forward translations and two back translations conducted by a professional translation company. These were followed by discussions involving the translators, the original developers, and the Norwegian in-country expert team to ensure conceptual equivalence with the original. Cognitive debriefing interviews were conducted with LTC users. The introduction and instructions for interviewers and respondents were adapted to fit the Norwegian context. Results: The initial translations were overly literal. Based on extensive team discussions and findings from cognitive interviews, the text was revised to achieve fluent, simple, everyday Norwegian language in the instructions, questions and response options. Any superfluous text was removed. Conclusion: The Norwegian version of the ASCOT INT4 is a carefully translated and culturally adapted instrument that closely reflects the constructs of the original English version.

Research capacity building in social care has received increased attention and dedicated funding in recent years, yet opportunities for practitioners to engage with research or apply evidence-based practice remain limited. This article evaluates one mechanism for developing capacity through a research-practice partnership: funding and supporting social care staff to undertake practitioner-research fellowships. This qualitative study incorporated interviews with fellows, applicants, mentors, line managers, and experts by experience; focus groups with academic supervisors and programme leads; and reviews of progress reports. Using thematic analysis, it identified three themes: challenges in applying for and undertaking fellowships, and partnership support that helped address them; the impacts of fellowships on social care practitioners and organizations; and lessons learned at individual, team and system levels, including the importance of engaging middle managers, creating a supportive academic environment, and widening access across a diverse social care workforce. Although research capacity building in social care remains in its infancy, fellowships provide valuable opportunities to nurture practitioner-researchers and foster a research culture. They enable two-way learning between practice and academia, bridging the research–practice gap. However, questions remain around sustainability, inclusivity, and long-term pathways for practitioner-researchers, highlighting the need for continued investment, infrastructure, and flexible models of support.

Adult social care in England has long lacked the research infrastructure and capacity common in health, limiting evidence-informed improvement. The Kent Re

Background: In England, care homes are the primary providers of long-term care for older adults. The increasing recognition of the importance of social care underscores the importance of collaboration between the National Health Service and care homes. The lack of data sharing among stakeholders limits opportunities for co-ordinated care, service development and research. Objectives: Identify how to support research, service development and innovation in care homes. Combine existing evidence with care home-generated resident data to create a minimum data set that is relevant and usable for stakeholders, including residents, relatives, practitioners, researchers, regulators and commissioners. Design and methods: The study used a mixed-methods approach, structured into five work packages, supported by patient and public involvement and engagement with residents, carers and staff: Work package 1: Conducted two evidence reviews on outcome measures and factors enhancing research productivity in care homes. Work package 2: Created a trial archive for secondary data analysis. Work package 3: Conducted a scoping review, a realist review and a national survey to define minimum data set content and assess implementation challenges in English care homes. Work package 4: Linked residents’ data from National Health Service and social care data sets with data from study care homes, deriving useful minimum data set variables and assessing data quality. Work package 5: Piloted the minimum data set at two points in care homes within three integrated care systems, conducted focus groups and interviews with care home and integrated care system staff. Three national consultations explored how stakeholders use resident information, measure quality of life and minimum data set usefulness. Additionally, subprojects examined data availability in domiciliary settings, staff reasoning when assessing resident well-being and completing research during rapid policy changes. Findings: The reviews revealed significant heterogeneity in outcome measurement and questioned the appropriateness of some methods and measures used for care home research. The Virtual International Care Home Trials Archive merged data from 6 United Kingdom randomised controlled trials with 5674 residents across 308 care homes. International minimum data set studies are a valuable resource for international comparative research. The wide range of measures used are mostly clinical with under-representation of measures important to care homes (e.g. quality of life). A national survey of care homes demonstrated the range of information, including clinical measures being routinely collected. The realist review identified motivation, front-line staff monitoring and embedded recording systems as important for minimum data set implementation. The pilot study recruited 996 residents from 45 care homes, with 727 residents’ data included in the minimum data set. Residents’ digital care records were linked to statutory health and social care data sets, creating a viable minimum data set prototype with metadata as resource. Conclusions: The study provided an evidence-based critique of care home research and a resource for secondary data analysis for future research. It developed a prototype minimum data set linking National Health Service, social care and care home data, demonstrating its importance as a basis for discussions between health and care staff. Limitations: The COVID-19 pandemic disrupted relationships and recruitment. Governance challenges prevented linking residents’ data to general practitioner records. Future work: Future research should assess whether the care home minimum data set improves resident outcomes, service delivery, staff experience, cross-sector collaboration, resource use and digital technology implementation. Funding: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR127234.

Research capacity building in social care has received increased attention and dedicated funding in recent years, yet opportunities for practitioners to engage with research or apply evidence-based practice remain limited. This paper evaluates one mechanism for developing capacity through a research-practice partnership: funding and supporting social care staff to undertake practitioner-research fellowships.This qualitative study incorporated interviews with fellows, applicants, mentors, line managers, and experts by experience; focus groups with academic supervisors and programme leads; and reviews of progress reports. Using thematic analysis, it identified three themes: challenges in applying for and undertaking fellowships and partnership support that helped address them; the impacts of fellowships on social care practitioners and organisations; and lessons learned at individual, team and system levels, including the importance of engaging middle managers, creating a supportive academic environment, and widening access across a diverse social care workforce.Although research capacity building in social care remains in its infancy, fellowships provide valuable opportunities to nurture practitioner-researchers and foster a research culture. They enable two-way learning between practice and academia, bridging the research–practice gap. However, questions remain around sustainability, inclusivity, and long-term pathways for practitioner-researchers, highlighting the need for continued investment, infrastructure, and flexible models of support.

This paper describes the development of an adult social care (ASC) research capacity-building partnership and the corresponding theory of change that underpins this work. In 2021, the National Institute for Health and Care Research (NIHR) funded six social care capacity building partnerships across England to improve the quality and quantity of social care research. These partnerships facilitate collaborative working between universities, local authorities, practitioners, providers, and people with lived experience. The Kent Research Partnership was established as one of the partnerships. Taking a co-produced approach, the Kent Research Partnership is a four-year partnership that aims to improve care quality by investing in and valuing the social care workforce and developing a culture of research and evidence-based practice and innovation. The Kent Research Partnership includes four interlinked streams of work- Communities of Practice, Researcher in Residence, Fellowships, and Access to Research. In addition, a fifth, cross-cutting workstream is dedicated to involving those with lived experience of ASC. To ensure robust programme planning and evaluation, we developed Theory of Change models for the overall partnership and each workstream. Within these models, we also how the Kent Research Partnership intends to change behaviour using the Behaviour Change Wheel as the underpinning model.

This paper describes the development of an adult social care (ASC) research capacity-building partnership and the corresponding theory of change that underpins this work. In 2021, the National Institute for Health and Care Research (NIHR) funded six social care capacity building partnerships across England to improve the quality and quantity of social care research. These partnerships facilitate collaborative working between universities, local authorities, practitioners, providers, and people with lived experience. The Kent Research Partnership (KRP) was established as one of the partnerships. Taking a co-produced approach, the KRP is a four-year partnership that aims to improve care quality by investing in and valuing the social care workforce and developing a culture of research and evidence-based practice and innovation. The KRP includes four interlinked streams of work- Communities of Practice, Researcher in Residence, Fellowships, and Access to Research. In addition, a fifth, cross-cutting workstream is dedicated to involving those with lived experience of ASC. To ensure robust programme planning and evaluation, we developed Theory of Change (ToC) models for the overall partnership and each workstream. Within these models, we also how the KRP intends to change behaviour using the Behaviour Change Wheel as the underpinning model.