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University of Birmingham Research to Investigate How to Improve Outcomes When Care Homes Close

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The University of Birmingham and the National Institute for Health Research (NIHR) have announced a new £1.2 million study to explore what happens to older people and to care staff if care homes have to close.

Led by Professor Jon Glasby in the Department of Social Work and Social Care, the research is believed to be the first of its kind internationally, and will be crucial in helping local Councils to know how best to support older people and care staff if homes have to close.

Care homes for older people are a critical service, supporting some 400,000 people 24 hours a day/365 days a year. In an era of austerity, care markets are increasingly fragile, and the very logic of a ‘market’ implies that the risk of failure has to be real for there to be sufficient incentives for providers to deliver appropriate care at the right price. However, when care homes close – whether through financial problems, care failings or other factors – the received wisdom is that subsequent relocation can be detrimental to the wellbeing of older residents. 

Despite this, there is little formal evidence to guide services when undertaking such sensitive work, with local areas ‘reinventing the wheel’ each time a closure takes place and potentially failing to share learning externally. 

Building on a previous pilot in Birmingham (believed to be the largest closure programme in the UK), this new programme of research will explore what happens to older people and care staff when homes close, how best to manage closures in a way that minimises negative outcomes for older people and families, and key lessons for Councils as they manage future closures. 

Professor Jon Glasby said: ‘We all want to be cared for with dignity when we are older, and we want the same for our families. Being looked after in a care home is expensive, and we have high expectations of the care delivered. But due to increasing pressures, more and more homes are closing. This can affect the wellbeing of people in care homes and the people that work there.

 ‘This is crucial research that will support older people and care staff, and help Councils to undertake such complex and sensitive work.  We’re delighted that the NIHR has funded this research and is investing so significantly in social care.’

Professor Elaine Hay, Programme Director of NIHR Programme Grants for Applied Research, said: ‘The NIHR is committed to increasing the amount of social care research it funds, and we are delighted to commission this innovative social care-related Programme Grant. 

 ‘This is a very significant amount of funding for a series of linked projects – and such substantial funding for research into care home closures has the potential to make a real difference to policy, practice and people’s lives.’

Over three years from April 2021, this programme of research will investigate the pattern of care home closures nationally, how older people experience closures, and what impact do closures have on care staff and local care markets.

The researchers will also evaluate the costs and consequences of closures, and how can future closures be planned and conducted in a more evidence-based manner, so that outcomes for older people are improved and negative impacts reduced.

The study team will survey all 152 Directors of Adult Social Services, and consider these results alongside data from the Care Quality Commission.

Four Council areas experiencing closures will also be examined as case studies, with interviews with key stakeholders (commissioners, managers, Healthwatch and broader health partners), older people, families, care staff and social work assessors. Health and wellbeing data will be collected before, during and after the closure, and economic evaluations will compare the costs and consequences of alternative pathways of care for residents when homes close (including costs for residents, families, staff and local authorities).

The study will provide national guidance to improve outcomes for older people, supported by key implementation partners, to ensure that future closures are conducted in a more evidence-based manner.  This will include a good practice guide sent to every health and social care senior leader in England, an accessible guide for older people and families, and a free training video for care staff.

This study builds on initial work by the University of Birmingham to evaluate the closure of care homes in Birmingham (believed to be the largest closure programme in the UK and possibly beyond) and to provide guidance for Directors of Adult Social Services faced with the potential failure of a large chain of care homes all at once.

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