Evidence-Based Supported Digital Intervention for Improving Wellbeing and Health of people living in Care Homes (WHELD) During COVID-19

The COVID-19 crisis is severely affecting care staff and the 400,000 older people living in care homes. Care home residents include the frailest members of society, many with dementia, mental and physical health symptoms. Care home staff are finding it challenging to provide support in these times and they face an increasingly difficult and distressing work environment. We urgently need to support care staff and provide the best environment possible for care home residents. Our care home training (WHELD) has shown benefits in two large clinical trials; and we have also demonstrated benefits from a digital version, incorporating virtual supervision in a new trial. We will optimise this programme by adapting it for the COVID crisis, to include peer networking and solution sharing. This will add to the person-centred approach, enhanced activities and reduction in sedative medications that the current WHELD programme already achieves. This digital intervention with virtual supervision will be available to 160 care homes within 4 weeks. We will further improve eWHELD based on benefits, feedback and barriers to implementation, make it available to almost 1500 care homes during the programme and ensure that it is ready to roll out to all UK care homes.

The 400,000 people living in care homes and those caring for them are severely impacted by the COVID-19 crisis. The residents are the frailest members of society, many with dementia, mental health/neuropsychiatric symptoms and/or concurrent physical illnesses. Providing support for these individuals is challenging for care staff who are facing a difficult, distressing and isolated work environment. We urgently need to support care staff and provide the best environment possible for care home residents. We developed a care home training intervention which improved quality of life, mental health and reduced sedative drug use across two large clinical trials in the NIHR WHELD programme. Subsequently we have evaluated and demonstrated benefits from a digital version of WHELD with virtual supervision. We will provide an adapted version of this programme to almost 1500 care homes. We will first develop specific adaptations for the COVID-19 crisis, such as peer networking and solution sharing, alongside evidence-based elements focussing on person-centred care, personalised activities, and reduction of unnecessary sedative medications. We will implement the optimized digital intervention in 160 care homes within four weeks, including virtual supervision. We will evaluate outcomes relating to staff mental health and attitudes, and resident quality of life, attainment of care goals, and use of sedative medications, and examine facilitators of and barriers to effective implementation. Building on the findings we will evaluate efficacy and cost-effectiveness in 1280 care homes using a randomized delayed start design. We will then make the programme "implementation ready" for national care home roll-out.