A new study has brought to light a significant finding: care home residents experience a marked improvement in care when they establish ‘family-like’ bonds with staff. The research, a collaborative effort between the University of Leeds and The National Institute for Health and Care Research, underscores the pivotal role of stable, consistent staffing levels in fostering deep connections between employees and residents. This, in turn, leads to personalised and high-quality care. Professor Karen Spilsbury, the lead researcher and a distinguished figure in the field of Nursing at the University of Leeds’ School of Healthcare, has stressed the societal importance of understanding and meeting the complex needs of those living in care homes. She has also underlined the critical role of optimising workforce resources in care homes to promote high-quality and efficient care delivery.
The investigation into the varying quality of life and care among the 441,479 individuals residing in UK care homes has previously needed more robust explanations. Collaborating with managers, residents, families, and staff from various care homes across England, the researchers explored how staffing levels and operational methods influence the overall care quality. This comprehensive study involved analysing academic journals, care home data, reports from the Care Quality Commission (CQC) regulator, and staff networks within care homes to identify staffing factors that significantly impact care quality.
The findings indicated that several staffing practices could improve care quality. These include maintaining stable management, ensuring adequate staff numbers to foster family-like relationships, prioritising residents’ needs, empowering staff with decision-making autonomy, and promoting leadership by example among crucial staff members. The research also showed that increasing the number of registered nurses led to fewer adverse incidents, such as falls, infections, and medication errors. However, the financial implications of hiring additional nurses were not deemed cost-effective, as the high costs involved could offset the potential savings from reduced healthcare expenditures.
The study further highlighted that care homes with a consistent manager for at least 12 months before a CQC inspection were likelier to receive ‘good’ or ‘outstanding’ ratings. A higher staff-to-bed ratio was associated with better inspection outcomes, and long-term staff placement (five years or more) tended to improve quality as assessed by CQC ratings. Additionally, the organisation of care teams into small groups (5-15 residents per staff member) facilitated more effective communication and a familial environment, which is crucial for cultivating quality relationships and care.
Interestingly, the use of agency nurses to cover staffing shortages did not result in increased incidents of falls, infections, or pressure ulcers but was linked with more medication errors. This aspect underscores the complexity of staffing strategies and their direct impact on care quality in care homes.
Concluding the findings, Professor Spilsbury, also the Academic Director of NICHE-Leeds, reiterated the importance of valuing care home staff appropriately. She highlighted that staffing needs to be stable, skilled, and competent to harness the benefits of person-focused care and enhanced teamwork. The study underscores the necessity for effective leadership, staff recognition, and a cohesive philosophy of care to improve the quality of life and care experienced by residents. This underscores the importance of recognising the hard work and dedication of care home staff, fostering a culture of appreciation and respect that is crucial for managing care home environments that benefit both residents and staff.
More information: Karen Spilsbury et al, Relationship between staff and quality of care in care homes: StaRQ mixed methods study, Health and Social Care Delivery Research. DOI: 10.3310/GWTT8143
Journal information: Health and Social Care Delivery Research Provided by University of Leeds
