Measuring and Improving Care Home Quality (MiCare HQ)

Over 425,000 older people in England live in care homes due to significant long-term health problems. To ensure the quality of care provided and inform public choice, homes are regulated by the Care Quality Commission (CQC). Care home quality varies for many reasons but the nature and characteristics of the workforce, and their approaches to care, are likely to be major determinants.

This project, which ran between July 2017 and August 2020, was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Programme [15/144/51], and was a collaboration between the University of Kent, the University of Sussex, and Brighton and Sussex Medical School.

Specifically, it aimed to:

  • Measure the health and social care-related quality of life of care home residents, including those who cannot self-report.

  • Assess how far regulator quality ratings are consistent with indicators of residents’ care-related quality of life.

  • Assess how much the skill mix and employment conditions of the care workforce matter for quality, including factors such as training provision, staff turnover rates and wages.


The aims of the study were addressed through a mixed-methods design, involving three interlinked work packages, which together:

  • Developed and tested new domains of pain, anxiety and low mood that could be used alongside the care home version of the Adult Social Care Outcomes Toolkit (ASCOT)

  • Undertook primary data collection to measure the social care-related quality of life of older care home residents and examined the relationship with CQC quality ratings.

  • Undertook secondary data analysis of a nationally representative sample of care homes over time to assess the impact of staffing and employment conditions on CQC quality ratings.


The National Institute of Health Research has study protocols on their website, they are available to download at the bottom of the following page: https://fundingawards.nihr.ac.uk/award/15/144/51

MiCare HQ was led by Professor Jackie Cassell at the Brighton and Sussex Medical School (BSMS), with work packages led by the team at the University of Kent.

 
Professor Jackie Cassell (BSMS)
Ann-Marie Towers (CHSS, University of Kent)
Nick Smith (PSSRU, University of Kent)
Dr Stephen Allan (PSSRU, University of Kent)
Dr Florin Vadean (PSSRU, University of Kent)
Professor Julien Forder (PSSRU, University of Kent)
Grace Collins (PSSRU, University of Kent)
Dr Stacey Rand (PSSRU, University of Kent)
Madeline Naick (PSSRU, University of Kent)
Stefania Lanza (BSMS)
Dr Lisa Chen (University of Sussex)
Dr Maxwell Cooper (BSMS)
Jennifer Bostock (PPI co-researcher)
Helen Ramsbottom (PPI co-researcher)
Rafaella Tate (PPI co-researcher)
Webinar 9th December 2020MiCare HQ Findings presentation - Ann-Marie Towers - CHSS, University of Kent


Paper 1. Developing new items for pain, anixety & low mood to be used alongside ascot - Nick Smith, Research Fellow, PSSRU, University of Kent, Jennifer Bostock, Helen Ramsbottom & Rafaella Tate, PPI co-researchers


Paper 2. Psychometrics of the pain, anxiety and low mood items - Grace Collins, Research Officer & Dr Stacey Rand, Senior Research Fellow - PSSRU University of Kent


Paper 3. Regulator Quality Ratings and Care Home Residents’ Quality of Life - Ann-Marie Towers CHSS, University of Kent, Florin Vadean, Stephen Allan & Julien Forder, PSSRU, University of Kent


Paper 4. The Impact of Wages on Care Home Quality Stephen Allan & Florin Vadean - PSSRU, University of Kent
Blog PostCare homes and the spread of COVID-19 By Dr Stephen Allan
PresentationRegulator Quality Ratings and Care Home Residents’ Quality of Life By Ann-Marie Towers – CHSS, University of Kent and Florin Vadean – PSSRU, University of Kent
PresentationMeasuring and Improving Care Home Quality for older people By Jackie Cassell, Ann-Marie Towers, Nick Smith, Florin Vadean, Stephen Allan, Madeline Naick, Grace Collins, Stefania Lanza, Lisa Chen, Julien Forder, Jennifer Bostock, Helen Ramsbottom and Raffaella Tate

Forthcoming publications:

Webinar - 9th December 2020 - 12.30-1400 GMT


Measuring and Improving Care Home Quality (MiCare HQ): Study Findings


Register here: https://www.eventbrite.co.uk/e/measuring-and-improving-care-home-quality-micare-hq-study-findings-tickets-127988193131

The MiCare HQ Study was funded by the NIHR Health Services and Delivery programme between July 2017 and August 2020. The study was led by Professor Jackie Cassell at Brighton Sussex Medical School and Ann-Marie Towers at the University of Kent. The overarching aim of the study was to assess how care home quality is affected by the way the care home workforce is organised, supported and managed. We sought to understand the relationship between workforce employment conditions and training, CQC quality ratings and the health and care-related quality of life of care home residents. This webinar will give an overview of the study’s findings, which are still in peer review. This webinar will give an overview of the study’s findings through four presentations by the research team:

Presentation 1: Developing new items of pain, anxiety and low mood to be used alongside the ASCOT

Presented by Nick Smith (Research Fellow), PSSRU, University of Kent.

Presentation 2: Psychometric testing of the new items of pain, anxiety and low mood

Presented by Grace Collins (Research Officer) and Dr Stacey Rand (Senior Research Fellow), PSSRU, University of Kent.

Presentation 3: Regulator quality ratings and residents’ social care-related quality of life

Presented by Dr Florin Vadean (Research Fellow), PSSRU, University of Kent.

Presentation 4: The impact of wages on care home quality

Presented by Dr Stephen Allan (Research Fellow), PSSRU, University of Kent.

This paper reports on independent research funded by the National Institute for Health Research School for Social Care Research (NIHR SSCR). The views expressed in this presentation are those of the author(s) and not necessarily those of the NIHR, the NIHR SSCR, NHS or the Department of Health and Social Care or its arm’s length bodies or other government departments. This project is funded by the National Institute for Health Research (NIHR) HS&DR (project reference 15/144/51 ). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

The MiCare HQ study steering group, chaired by Professor Claire Goodman, brought together stakeholders and lay research advisors with experience of care homes for older people.


Professor Claire Goodman, University of Hertfordshire
Joy Fletcher, lay research advisor.
Clare Ockwell, lay research advisor.
Dr Nils Gutacker, University of York.