ABSTRACT
Care homes care for people with complex needs, supporting them to the end of life and are now being seen as the 'de facto' hospice. Reflective debriefing for care home staff has been found to help support staff and provide an educative and communicative function when a resident dies. Pre-COVID-19, one of the authors had been conducting reflective debriefings face-to-face with care home staff but when COVID-19 struck, face-to-face sessions were impossible. An online format was developed with the aim of providing emotional support and practice-based learning in relation to death and dying through reflection. This study assessed the acceptability and feasibility of delivering online supportive conversations and reflective sessions (OSCaRS) on palliative and end of life care to care home staff during the pandemic. A mixed methods study design was undertaken in April to September 2020. Qualitative data comprised of digital recordings of sessions and semi-structured interviews with OSCaRS participants, managers and session facilitators. An online survey was sent to all staff and had a response rate of 12%. Eleven OSCaRS were conducted over ten weeks. Thirty-four staff members attended one or more sessions. Three overarching themes were identified from the data: pressures of working in a pandemic, practicalities of delivering online support and, practice development opportunities. Engaging care home staff in online structured supportive conversations and reflections in relation to death and dying is acceptable, feasible and valuable for providing support with the pressures of working in a pandemic. There is value for OSCaRS to continue as online sessions as they provide care home staff access to practice-based learning and support from professionals and allows specialists based in a range of settings to in-reach into care homes in an efficient way. Future implementation must consider the availability of sufficient devices with cameras to aid participation, timing and frequency of sessions to accommodate staff workflows, the engagement and support of managers and post-session support. © 2022 Lucy Johnston, Jo Hockley, Julie Watson & Susan D. Shenkin. This Open Access article is distributed under the terms of the Creative Commons Attribution Attribution-Non-Commercial No Derivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is unaltered.
ABSTRACT
An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth café-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship. © 2021 The Author(s).
ABSTRACT
Introduction COVID-19 Trauma Guidance suggests opportunities for structured,time-limited discussions about challenging experiences should beoffered. It is unknown if such discussions can be effectivelydelivered online by palliative care specialists to support care home(CH) staff in relation to death/dying. Funded by Scotland's ChiefScientist Office COVID-19 “rapid research” fund, online OSCaRS isbeing piloted. Methods Fortnightly OSCaRS delivered to small groups of CH staff via asecure online platform in three local CHs over 10 weeks. Sessionsare digitally recorded. The shortened version of the Chesneycoping self-efficacy questionnaire is completed by all staffpre/post. Additional post-study questions asked of OSCaRSparticipants and in-depth staff interviews will be undertaken (n = 10). Thematic analysis of the recorded sessions and interviews willbe undertaken and related to the staff questionnaire and context of each CH. Results New learning on the feasibility and acceptability of providingOSCaRS to frontline staff. The benefit of OSCaRS to CH staff copingmechanisms, team cohesion and communicaton with relativesduring the COVID-19 pandemic will be presented. Initial results show that OSCaRS are feasible, valued by all care home staff and support staff in coping with the challenges of COVID-19/. Key Conclusions The analysis will inform future practice, and an ImplementationGuide for OSCaRS in CHs will be produced. Key learning on thepotential for online support in relation to death/dying during thepandemic and beyond will contribute to future education, trainingand staff wellbeing resources. It will also inform the role of suchsessions in developing individual coping mechanisms and teamworking alongside communication with relatives duringlockdown.
ABSTRACT
Introduction: COVID-19 in care homes has heightened the risk of staff burnout, undermining already problematic staff retention and low morale. There has been an associated proliferation of resources and online initiatives to support frontline workers, however, few of these are directly targeted at the care home workforce. Care home workers are highly skilled in caring for people with complex needs, but have very variable levels of formal training, and just over half of care homes in Scotland include registered nurses.This project will rapidly collate existing resources and identify, direct from care home workers, their best practice, initiatives, and resources used to support resilience and retention during this pandemic and moving forward. Methods: 1) Rapid review of care home specific evidence and resources (including published research and social media);2)Online survey of Enabling Research in CareHomes (ENRICH) members across Scotland (n=55);3) Case studies within six care homes to identify what is working well and what is not in terms of promoting resilience and emotional support. Results: The rapid review has identified a wide range of resources directed at supporting staff working in care homes;the survey and case studies will provide data on the key learning and resources that have supported staff, and outline the challenges identified. There are many resources available but staff do not access these. The role of the care home manager is key. Key conclusions: This comprehensive review of resources and initiatives will make a valuable contribution to policy and practice designed to reduce burnout and foster retention not just in care homes but more widely across health and social care.