A collective case study of the features of impactful dementia training for care home staff

Abstract

Background Up to 80% of care home residents have dementia. Ensuring this workforce is appropriately trained is of international concern. Research indicates variable impact of training on a range of resident and staff outcomes. Little is still known about the most effective approaches to the design, delivery and implementation of dementia training. This study aimed to investigate the features and contextual factors associated with an effective approach to care home staff training on dementia. Methods An embedded, collective case study was undertaken in three care home provider organisations who had responded to a national training audit. Data collected included individual or small group interviews with training leads, facilitators, staff attending training, managers, residents and their relatives. Observations of care practice were undertaken using Dementia Care Mapping. Training delivery was observed and training materials audited. A within case analysis of each site, followed by cross case analysis using convergence coding was undertaken. Results All sites provided bespoke, tailored training, delivered largely using face-to-face, interactive methods, which staff and managers indicated were valuable and effective. Self-study booklets and on-line learning where were used, were poorly completed and disliked by staff. Training was said to improve empathy, knowledge about the lived experience of dementia and the importance of considering and meeting individual needs. Opportunities to continually reflect on learning and support to implement training in practice were valued and felt to be an essential component of good training. Practice developments as a result of training included improved communication, increased activity, less task-focussed care and increased resident well-being. However, observations indicated positive well-being and engagement was not a consistent experience across all residents in all sites. Barriers to training attendance and implementation were staff time, lack of dedicated training space and challenges in gaining feedback on training and its impact. Facilitators included a supportive organisational ethos and skilled training facilitation. Conclusions Effective training is tailored to learners’, delivered face-to-face by an experienced facilitator, is interactive and is embedded within a supportive organisational culture/ethos. Further research is needed on the practical aspects of sustainable and impactful dementia training delivery and implementation in care home settings. Electronic supplementary material The online version of this article (10.1186/s12877-019-1186-z) contains supplementary material, which is available to authorized users.

Capacity building for dementia care in community care services: a mixed methods approach

“…The subtle within-group changes could suggest that their training needs might be different from those working at frontline. Such observation was not noted in previous studies because the staff members of the managerial grades were not analysed separately [8,25]. Given that organisational and managerial support is often regarded an a contributing factor to the implementation of dementia training [7,25,27], the findings seem to suggest the need for devising a specific program to address the training needs of this staff group.…”

“…Given that people with dementia interact with different staff members in the care environment, their reactions and responses would also be influential to care recipients' wellbeing and thus care quality. Therefore, an inclusive approach to enhance the training impacts on care culture is warranted [10,25]. The success of the present training program may be partly because it follows several key recommendations of teamwork education drawn from a meta-synthesis, including participation of all members, understanding on how the team function, opportunities for practice as well as reflection and debriefing [26].…”

The barriers and facilitators to implementing dementia education and training in health and social care services: a mixed-methods study

“…The research took place in a range of health and social care provider organisations in the UK, who were delivering dementia care. These included acute hospitals, Mental Health Trusts, social care services (care homes), and [16][17][18][19] and an overview is presented below.…”

“…study aimed to investigate the components of effective dementia training and education, and the barriers and facilitators to its implementation. This was achieved through a systematic literature review [3], a national audit of 386 dementia training programmes in the UK [16], a survey of staff who had completed dementia training and ten organisational mixed-methods case studies in acute hospitals (n = 3) [17], mental health Trusts (n = 3), care homes (n = 3) [18], and primary care (n = 1) [19].…”

Focus Group Findings to Support the Preliminary Development of the Augmented Reality Education Experience (AREduX)

“…To date, there are limited programs that train HCPs or caregivers to develop empathy [ 7 ]. Research indicates the variable impact of training on a range of staff outcomes, yet there is little evidence about the most effective approaches to the design, delivery and implementation of training to prepare HCPs caring for PLWD [ 8 ]. Currently there is limited research within the field of augmented reality (AR).…”