Professor Barbara Hanratty, Dawn Craig, Dr Katie Brittain, Professor John Vines, Paul Wilson, Professor Karen Spilsbury

This study focuses on gathering the research evidence available on new ways of working to promote health in care homes.

Health and social care services are facing new and complex demands from an ageing population. The Department of Health has acknowledged this, and selected 37 different areas in England ('vanguard' sites) to take a lead on new ways of working to meet changing patient needs. Six of these vanguard sites have been funded to look at how to improve health in care homes. Others are investigating bringing primary and hospital care together, community providers that include multiple specialities, and urgent and emergency care.

At all the vanguard sites, there will be an emphasis on how services can work together, responding to local needs, and preventing rather than treating illness. In order that the vanguard programme can build on what is already known, the National Institute for Health Research has invited researchers to bid to produce summaries of the research evidence.

This piece of work is a research summary that focuses exclusively on care homes. Delivering high quality care for older people in care homes is important, as residents are some of the most complex, potentially vulnerable patients in the NHS. But bringing services together to produce the best outcomes for residents is difficult in this setting. The funding of care homes, resident care and visiting services are a mixture of public and private. A single resident may receive care from many different organisations, all with different priorities and ways of working. Communication between the different services that provide care for residents is not always good. High staff turnover in care homes does not make it easy for homes to build relationships with health and social care organisations. One third of care home nurses leave their jobs every year, and it is not a popular career choice for nurses or support staff. Many homes are using technology to help with resident care, or communicate with the health service, but which aspects of technology are good for residents' health and wellbeing is not clear.

The aim of the work is to identify and pull together existing evidence on new ways of working to promote health in care homes. The vanguard programme has identified eight factors that they believe to be important for success. We have selected four of these eight factors, because they matter most to care homes: the use of technology, workforce, communication and engagement between care homes and external bodies, and how any changes in care can be evaluated.

In each of these four areas, we are looking at a range of different issues, including how technology can improve communication between care homes and other organisations, flexible use of the workforce in care homes, the best ways for care homes, communities and other health services to communicate and work together, and how the quality of care received by residents can be assessed.
We are conducting rapid evidence assessments. This is a specific research technique to review and critically summarise research evidence in a short timescale. Established methods are being used to search for published and online research. Two researchers will select material to be included in the review, pull out the relevant findings, identify any shortcomings of the research, and produce summaries. We are working with the care home vanguard leads, so that we produce summaries of the research that are useful and in a format that is easy to access. We will also be helped by an advisory group with a range of different expertise, including public & patient involvement.