Complex evaluation of support for care homes during the Covid 19 pandemic: A co-design project

Complex evaluation of support for care homes during the Covid 19 pandemic: A co-design project

We conducted an evaluation of the impact of an NHS England programme to support care homes during the pandemic

A younger person holding an elderly person's hand

There are over 2,300 care homes in the North East and Yorkshire region, caring for some of the most vulnerable people in their communities. With rising rates of Covid-19 infection in April 2020 — and 90% of care homes predicted to be affected — NHS England developed a programme to support these care homes in their delivery of safe care to all residents during the pandemic.

The Enhanced Universal Support Offer (EUSO) was built on strategic plans to deliver the NHS Long Term Plan to improve support to care homes. Working collaboratively with local authorities and primary care and community services, the EUSO sought to take immediate action to support care homes, as part of the pandemic incident command response.  

We conducted an evaluation to investigate the impact of the programme. A steering group of experts co-produced the evaluation research, drawing on stakeholders from across the region, analysis of qualitative data, and academic involvement to guide the investigation. 

Our data analysis resulted in five high-level themes: communication, working relationships, systemic perceptions, Covid implementation, and organisational support. 

We found that care worked best when the NHS, local authorities and care homes all worked together. Improvements included medication optimisation and technology use, access to a named GP and community nurse working as a part of a wider multidisciplinary team, and the local authority and partners maintaining regular contact. Conversely, an overly reactive response to care homes combined with ‘command and control’ limited the benefits that were achieved.

We found an increased appreciation of the value of the investment and focus on care home residents and staff. It is now important to identify ways to develop a consistent and sustained approach to the care home sector as part of the health and care system. 

We identified a range of recommendations that the North East and Yorkshire Region have used to inform planning with the Care Home Sector.  Integrated teams continue to be developed, based on a shared commitment to appreciate care homes’ knowledge and experience of their residents’ wellbeing, and to more fully involve them in the design of support. This includes a consideration of those with complex needs (such as people with dementia) and those vulnerable care home populations which went beyond the initial EUSO.

EHCH Evaluation slides FINAL 9 Nov 2020 (PDF, 873.3KB)

Research team

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Sally Fowler Davis

Associate Professor, Organisation in Health and Care