Supporting the resilience and retention of frontline care workers in care homes for older people: A scoping review and thematic synthesis

Abstract

The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approaches to retain high quality, resilient frontline care home workers, who are not registered nurses, are informed by context specific, high quality evidence. We therefore conducted this scoping review to address the question: What is the current evidence for best practice to support the resilience and retention of frontline care workers in care homes for older people? MEDLINE, PubMed, PsycINFO, Embase, MedRxiv, CINAHL, ASSIA, Social Science Premium were searched for literature published between 2010 and 2020. The search strategy employed combinations of search terms to target frontline care workers in care homes for older people and the key concepts relevant to resilience and retention were applied and adapted for each database. Thirty studies were included. Evidence for best practice in supporting the resilience and retention specifically of frontline care workers in care homes is extremely limited, of variable quality and lacks generalisability. At present, it is dominated by cross-sectional studies mostly from out with the UK. The small number of intervention studies are inconclusive. The review found that multiple factors are suggested as being associated with best practice in supporting resilience and retention, but few have been tested robustly. The thematic synthesis of these identified the analytical themes of - Culture of Care; Content of Work; Connectedness with Colleagues; Characteristics and Competencies of Care Home Leaders and Caring during a Crisis. The evidence base must move from its current state of implicitness. Only then can it inform intervention development, implementation strategies and meaningful indicators of success. High quality, adequately powered, co-designed intervention studies, that address the fundamentally human and interpersonal nature of the resilience and retention of frontline care workers in care homes are required.

A rapid review of innovations for attraction, recruitment and retention of social care workers, and exploration of factors influencing turnover within the UK context

“…Despite a proliferation of initiatives to promote attraction, recruitment, and retention, there has been very little robust evaluation of specific approaches, which concurs with other international work in this area (Johnston et al 2020;Turley et al 2020;Webb & Carpenter 2012). Out of nine innovations identified in this rapid review to attract, recruit, and retain social workers, only three have been implemented and evaluated using robust methods.…”

“…A more significant issue with the available UK evidence is that included primary research studies mainly relied on more descriptive and explorative methodologies, such as surveys, qualitative research, and mixed methods, and none of the available evidence used experimental (comparative) designs. This is also the case from the international evidence base, where a lack of controlled studies has also been noted (Johnston et al 2020;Lethbridge 2017;Webb & Carpenter 2012). While this does not mean that the interventions and strategies summarised in this rapid review could not be advantageous in attracting, recruiting, and retaining social care workforce, the findings of the included primary studies should be interpreted with caution.…”

Good Practice in the Implementation of Digital Social Care Records: A Rapid Scoping Review (Preprint)

“…The article selection process and reasons for exclusion are presented in Figure 1. As Table 1 shows, of the 29 studies, ten were carried out in the UK -seven in England [3,7,10,20,[47][48][49], two in Scotland [43,45], and the remaining study [50] included multiple UK countries. Five were undertaken in the United States [9,[14][15][16]18].…”

“…Studies in the UK were carried out in care homes (n=3) [43,45,47], health and social care organisations/providers (n=4) [3,7,20,48], multiple social care settings (n=1) [50], councils (n=1) [49], and a continuing health care team (n=1) [10]. Over one-third of studies from other countries were conducted in nursing homes/facilities (n=7) [6,8,9,14,15,17,18].…”

“…During the data extraction, we discovered that two publications [42,43] reported results from the same study. Another publication [44] was a pre-print version of one peer-reviewed article [45] also included in the review.…”