Insights From Research With Care Homes from Dr Calisha Allen

At the most recent Care Home Research Forum hosted by Nightingale Hammerson we heard from Dr Calisha Allen, an NHS doctor and PhD student inspired to improve communication between hospitals and care homes through better discharge summaries. In her first year of research, she has visited a range of care providers to learn from the staff and residents. Here she reflects on 3 lessons she has learnt so far about the wider context and relationship between health and social care, to help build a bridge between them:

1. Shared experiences: As one care home manager told me, “It’s all care.” Speaking with those who work in care has highlighted to me the similarities between our work and our days. As health and social care workers, we share privileges and responsibilities that are unique to our roles. We share the pattern of our day’s: handover, documenting care provided and short quiet breaks alone snatched from a busy ward, wing or floor. Stock rooms, night shifts and squeaking trainers on non-slip floors these are our shared experiences. Person-centred care and patient-centred care this is our shared ethos.

 

2. Each care home is different and they are not mini-hospitals. It is important that discharging hospital teams understand the range of resources and skill sets in care homes. This can mean understanding what is common to have in a care home stock room and therefore ensuring that patients are discharged with less common items such as spare dressings. Or it can mean not assuming a patient who is not mobilising at their pre-admission baseline can return to their previous care home, as for example their bedroom may be on the first floor in a care home without a lift. A better understanding of the variety in the care sector can support early and ongoing communication with care homes, so patients are discharged to care homes that can meet their needs and care homes are ready to receive them.

 

3. Our intentions are the same, our normals are different. Hospital teams meet patients at their most unwell; whereas care homes know residents at their best in their day-to-day. So, a patient that is medically ready for discharge will appear far from their day-to-day baseline to care home staff. This can lead to tension between the hospital and care home as they are seeing the same patient/resident in different ways. I think we need to do better in thinking about the point-of-view of the other person providing better two-way discussion to set and mediate expectations. My research was inspired by a care worker who shared with me the challenges they experience with discharge summaries and how they could be improved. My PhD research focuses on improving the hospital discharge summary documentation and I would welcome the chance to hear your thoughts on the issue and to visit your service. If this is of interest to you, please do get in touch. With thanks to the staff, residents and families at Nightingale Hammerson, Dorset Care Association and local care providers and The Shrubbery for welcoming me and providing me the opportunity to learn.

Care England welcomes research that is shaped by the experience and expertise of care homes. Dr Allen’s reflections highlight the value of closer collaboration between health and social care and the importance of involving care providers in research from the outset. Care England encourages care homes to engage with research that seeks to better understand their role and improve hospital discharge processes, helping to deliver better outcomes for residents, staff and the wider system.