Blog – Care Home Research: Getting the Balance Right

Care homes are busy places. Alongside the everyday routines of providing care and support, there are the many unexpected things that can happen during a day. Research needs to sit alongside all of that.

Recently, we found ourselves with eight research requests going out to care homes around the same time. Seeing eight requests was a moment that made us pause. Individually, each study was important, but when we looked at the bigger picture, we realised something important: eight reasonable requests can quickly become one unreasonable burden.

It prompted our team at ENRICH Scotland to think more carefully about how, when and why we approach care homes about research. How can we make sure care homes continue to have opportunities to participate in and shape research, without research itself becoming an additional pressure? And what can we all do to make the process work better for everyone?

This blog is an opportunity to explore that balancing act – and to consider how we might make the research process more coordinated, relevant and rewarding for researchers and care home communities.

One short survey may seem manageable, but several studies can create a substantial burden. Coordinate requests, consider the total workload, and respect a care home’s right to say “not now”.

How ENRICH Scotland supports care home research

ENRICH Scotland brings care homes and researchers together, helping to build meaningful relationships and supporting research that works with care homes. We support research across a wide range of topics relevant to care homes, the people who live and work in them, and their families.

Dementia research is an important part of this. Many people living in care homes are living with dementia, yet their experiences are underrepresented in research. We want to support opportunities for people living with dementia in care homes to contribute to and shape research in ways that are inclusive and appropriate.

Our role as a bridge between researchers and care home communities also gives us a view of the bigger picture. While each research opportunity may be valuable, we need to consider the cumulative impact of what we are asking of care home communities – and, importantly, what value taking part offers them in return.

Making research participation manageable

Getting this right isn’t the responsibility of researchers alone. Researchers, ENRICH Scotland and care homes all have a part to play in making research participation meaningful and manageable.

For good reasons, researchers are focused on their own study – deadlines, recruitment targets and milestones. It can be easy to think, “It’s only a short survey” or “We’re only asking for a small amount of their time.” But the care home receiving that request may also be hearing from other researchers, and research is only one of many demands on their time.

So, before approaching a care home, there are some simple questions to ask: Why this care home? Why now? What are we asking of them – and what are we offering in return?

The value of taking part doesn’t necessarily need to be financial. It might be an opportunity for learning or staff development, access to new knowledge or resources, the chance to influence practice, or an opportunity to contribute to research that matters to residents, relatives and staff. Being clear about the potential value from the outset can help a care home decide whether a research opportunity is right for them.

Coordinating research, not limiting it

ENRICH Scotland also needs to ask itself some important questions. Are we looking at the overall volume and timing of research opportunities? Could requests be better coordinated or staggered? Are we helping researchers understand the realities of the care home environment?

Our role isn’t simply to pass research opportunities on. We need to help create the conditions in which care homes can engage with research in a way that is meaningful and sustainable.

Part of this is helping researchers and care homes make connections between research and the things that matter to care homes. We have recently looked at how taking part in research can align with the Quality Framework for Care Homes, helping to demonstrate how research can contribute to learning, improvement and the wider priorities of a care home.

Of course, we don’t want to become so cautious that care homes miss opportunities to participate in research that matters to them. Different homes will have different levels of capacity and interest. What feels overwhelming for one may be manageable for another.

So, the answer isn’t necessarily to limit research – it is to coordinate it better. That means having greater visibility across research activity, considering the timing of requests and, most importantly, listening to care homes about what works for them.

We need to move away from asking only, “Is this research request reasonable?” and also ask, “What else are we asking of this care home right now?”

Care home research should be a relationship. Listen to residents’ and staff’s priorities, explain the potential value of participation, and share what the research found and what happens next.

Care homes shaping the research agenda

Care homes also need to feel able to ask questions before saying yes. Is this research relevant to us? Do we have the capacity to take part now? What will involvement require from residents, relatives and staff? What might we learn or gain from taking part?

Saying “not now” should be an entirely reasonable response. A home may be interested in research but simply not have the capacity at that time.

Equally, we want care homes to continue to tell us what research they are interested in and what questions matter to the people who live and work there. Research should not only be offered to care homes; they should have opportunities to help shape the research agenda too. RICH Voices, our public involvement group, plays an important role in helping us do this by bringing care home voices and perspectives into research.

This gives us an opportunity to think about research differently. Rather than being another task competing for time in an already busy environment, the right research, at the right time, can become part of a home’s wider approach to learning and improvement.

It also means thinking not only about how much research we are asking care homes to participate in, but how well it connects with their priorities. A research opportunity that speaks to something a home is already trying to understand or improve may feel very different from a request that arrives without that connection.

Ultimately, research participation should feel like a relationship rather than a transaction.

Care homes bring their time, knowledge, experience and expertise. Researchers bring their questions, methods and expertise. ENRICH Scotland can help bring those worlds together and support relationships that work for everyone involved.

Closing the loop with care home communities

And there is one final responsibility we all share: closing the loop. If a care home, its staff, residents or relatives give their time and expertise to research, they should have opportunities to hear what happened next. What did the research find? What was learned? Did it influence practice, policy, further research or understanding? Even when change takes time, how can we make sure the people who contributed don’t feel that their involvement simply disappeared into a research project?

Getting the balance right means considering not only how much we are asking, but when we are asking, why we are asking, what value it brings and what happens after a care home says yes.

If we can get that balance right, we can support more care homes – and more people living with dementia – to be active partners in research, while recognising and respecting the realities of care home life.

We would love to hear your thoughts. If you have ideas prompted by this blog, questions, or would simply like to find out more about ENRICH Scotland, please contact us at tay.enrichscotland@nhs.scot.

Lesley Cousland

Author

Lesley Cousland is a Clinical Studies Officer with the Neuroprogressive and Dementia Network and ENRICH Scotland. A retired mental health nurse with over 40 years’ experience, she now supports research in care homes, ensuring residents and staff help shape studies that matter to them.

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