DACHA-DASH

Why the research is needed?

During the COVID-19 pandemic, it was difficult to find information about which care home residents were at high risk and how many were catching COVID-19. Whilst a lot of information (data) is collected about older people living in care homes, it is held in different places and in different formats (e.g. records held by care homes, general practice, hospital, NHS and local authority). A recent study (DACHA) found it was possible to link information held in the care home with information held about residents in NHS datasets.  There is a need to do more to bring together the minimum, relevant information (minimum data set, MDS) to monitor and deliver care more efficiently, avoiding repeating or duplicating information. An MDS includes information about resident characteristics, medical conditions, medications, quality of life and care needs.

What is already known about the subject?

We will build on the learning from the NIHR-funded DACHA study, which developed and piloted an MDS for English care homes (https://dachastudy.com/), primarily for use by researchers. It was also designed to be helpful for care homes (residents, relatives and staff) and the wider health and social care system (decision-makers in policy and practice). Based on 996 residents in 45 homes, it was found to be feasible. What is not known is whether an MDS could become a resource for care home staff to inform care planning and delivery based on residents’ priorities and needs and how to use it day to day for discussing and thinking about people’s care. 

Who we will be working with?

We will work with care staff to develop three to four examples of how data could be used to improve care. We will work with the two leading care home software vendors by market share to consider whether they can implement our recommendations in the software they sell to care homes. 

How patients and the public are involved?

We will work with the DACHA PPIE panel members, including relatives, senior and junior care staff and other key stakeholders.

What we will do?

We will interview and analyse the views of those who live in, visit, and work in, or with, care homes about what information could be collected routinely, as part of an MDS, to enhance residents’ quality of life and care. These interview findings will inform four workshops with care home staff to develop worked examples of how using an MDS makes a difference to residents and staff. These would be a resource for practice, demonstrating what is possible.  For example, the DACHA study found examples of how residents’ responses and staff assessments to questions in the MDS about their quality of life led to improvements in care and a raised awareness of residents’ needs. A whole day meeting will bring care staff from different homes together with software developers, and people from the NHS and social services who routinely work with care homes to explore how to get these ideas into practice.

What the benefits will be?

The four worked examples will then be shared in ways that can help the uptake and use of an MDS by people who work in, work with, live in, and visit care homes. We will also produce an online video explaining the difference an MDS can make when planning and delivering care, and an academic paper describing what needs to be place for staff to make good use of residents’ information to improve care.

When the findings will be available?

Findings will be available at the end of the study.  

How we are planning for implementation? 

By closely working with practitioners, we will produce an MDS which will improve quality of life and care for residents. This will help ensure the prototype MDS developed as part of the DACHA study changes practice in the real world. We will work with policymakers to ensure this informs ongoing developments in national policy around how care homes collect and use data.

Contact

Rachael Carroll, Research Fellow, University of Nottingham, Rachael.carroll@nottingham.ac.uk.