The uncertainties and questions of care home residents, relatives and staff as a basis for evidence-based improvement and research

ORCID

Abstract

Background: Research in long-term residential care settings (or care homes) for older people should address questions and uncertainties that matter most for those receiving and delivering care. Whether research does this effectively is unclear. In part, because the uncertainties and questions of key stakeholders are unmapped. Objective: To capture and prioritise the uncertainties of older people living in care homes, their relatives and staff. Methods: A three-phase mixed-methods study: (i) gathering uncertainties, (ii) data analysis and (iii) prioritisation. Phase 1 used interviews to gather uncertainties from residents (n = 14), relatives (n = 10) and staff (n = 44). In phase 2, uncertainties were coded using thematic inductive analysis, represented as ‘foreground’ (necessitating research) or ‘background’ (not needing research) questions, and a prioritisation tool developed. The tool included optional open-text responses, capturing new questions fitting (and additional detail around) the existing subthemes. During phase 3, the prioritisation tool was completed by residents (n = 95), relatives (n = 85) and staff (n = 158). Results: 319 uncertainties were identified: 274 foreground (research-based) and 45 background (fact-based) questions. Six broad and 38 subthemes were developed. Broad themes included (i) communal living, (ii) health and care services, (iii) resident care, (iv) residents’ health and well-being, (v) residents’ daily life and (vi) care home staff. Priority subthemes included enjoy living with others, dignity and respect, support with emotions, meaningful activities, and staff recruitment and retention. Conclusion: This is the first study of care home prioritised uncertainties informed by residents, relatives and staff. The uncertainty-based questions represent important targets for care home research and practice improvement.

Publication Date

2025-05-27

Publication Title

Age and Ageing

Volume

54

Issue

5

ISSN

0002-0729

Acceptance Date

2025-05-07

Deposit Date

2025-06-10

Embargo Period

2026-05-27

Funding

This project was supported by research capacity funding from the University of Leeds, NICHE-Leeds and the NIHR Applied Research Collaboration Yorkshire and Humber. M.D. is supported by ENRICH Scotland, which is funded by the Chief Scientist Office in Scotland. R.D. and K.H. are part funded by the NICHE-Leeds partnership. S.P. is supported by the NIHR Applied Research Collaboration South West Peninsula. K.S., E.G., A.C. and A.F. are supported by the NIHR Applied Research Collaboration Yorkshire and Humber. K.S. and A.F. are NIHR Senior Investigators. A.C. is funded by an NIHR Research Professorship award and is also supported by NIHR Leeds Biomedical Research Centre and Health Data Research UK, an initiative funded by UK Research and Innovation Councils, NIHR and the UK devolved administrations and leading medical research charities. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Keywords

care homes, long-term care, older people, priority setting, research priorities

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This item is under embargo until 27 May 2026

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