Self-management support training for carers of older adults with osteoarthritis and additional conditions living in care homes

At the end of this award our aim is to have developed a training programme in personalised self-management support, for carers working in domiciliary and care home settings with older adults with osteoarthritis (OA) and multiple long term conditions (MLTC's) and family and friends of people living in these settings. Older adults with higher care needs are the group most in need of support to help manage their OA alongside MLTCs but are currently the least likely to be able to access support. Many older adults with OA living within these settings have different degrees of cognitive impairment and this is often seen as a barrier to self-manage without considerable support from carers (e.g. are unable to undertake exercise activity independently). The training developed in this project will aim to increase carers understanding of a model of personalised self-management support that becomes a 'way of working'. Carers will develop their knowledge and skills to empower them to make key changes in the way they support individuals to make decisions and be involved in their care. We want to achieve this so that older adults with joint pain and high and complex health needs feel confident and skilled to make the choices about everyday activities and create more opportunities for meaningful activity.

During this award we will used a staged approach to co-design of the self-management support training. This will use a variety of methods to engage and seek support from stakeholders so that the training developed is relevant to carers, family and friends, and older adults with OA and MLTC's living in care homes or receiving care in domiciliary settings. The approach will involve methods that enable reach and access to 'seldom heard' communities such as those with cultural, communication or knowledge barriers.
We will use Experienced-Based Co-design, and will involve the following steps:
1. Stakeholder identification and engagement, develop recruitment methods, project branding, and gaining ethical consent.
2. Interviews with carers, family and friends of older adults with OA and MLTC's and interviews with older adults with OA and MLTC's, to help us explore the challenges of self-management support across these settings and provide an indication of potential barriers and solutions.
3. Create a film that will combine narratives from the interviews from participants about their experiences of working as a carer, or accessing and using services and living with joint pain and additional conditions.
4. Host an initial co-design meeting of all stakeholders to share experiences, which will be prompted by the film developed previously. Priorities for change will be identified and discussed in small co-design workshops.
6. Develop training.
7. Final full group workshop to evaluate the training with co-design participants and wider stakeholders.

Beyond this award we want to scale up the training so that it is available to all carers in all domiciliary and care home settings, and raises awareness of personalised self-management support amongst members of the public, family and friends. We will achieve this though our established collaboration with Bridges, who are experts in co-design of self-management support training. The co-design process will allow for building on and refining existing training with all stakeholders so that it is fit for purpose. Through these partnerships we will identify ways to sustain this way of working. We will grow a community of carers that feel knowledgeable, skilled and confident to integrate key ways of communicating and strategies to enable greater control, autonomy and self-management, so this is spread to colleagues within their services. Bridges not for profit model will be a vehicle for spread and adoption across health and social care sectors and we utilised this strategy in previous projects.