Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions

Williams, L and Rycroft-Malone, J. and Burton, C. R. and Edwards, Stephen and Fisher, Denise and Hall, B. and McCormack, B. and Nutley, S. M. and Seddon, D. and Williams, R (2016) Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions. BMJ Open, 6 (8). ISSN 2044-6055

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Abstract

Objectives This evidence review was conducted to understand how and why workforce development interventions can improve the skills and care standards of support workers in older people's services. Design Following recognised realist synthesis principles, the review was completed by (1) development of an initial programme theory; (2) retrieval, review and synthesis of evidence relating to interventions designed to develop the support workforce; (3) ‘testing out’ the synthesis findings to refine the programme theories, and establish their practical relevance/potential for implementation through stakeholder interviews; and (4) forming actionable recommendations. Participants Stakeholders who represented services, commissioners and older people were involved in workshops in an advisory capacity, and 10 participants were interviewed during the theory refinement process. Results Eight context–mechanism–outcome (CMO) configurations were identified which cumulatively comprise a new programme theory about ‘what works’ to support workforce development in older people's services. The CMOs indicate that the design and delivery of workforce development includes how to make it real to the work of those delivering support to older people; the individual support worker's personal starting points and expectations of the role; how to tap into support workers' motivations; the use of incentivisation; joining things up around workforce development; getting the right mix of people engaged in the design and delivery of workforce development programmes/interventions; taking a planned approach to workforce development, and the ways in which components of interventions reinforce one another, increasing the potential for impacts to embed and spread across organisations. Conclusions It is important to take a tailored approach to the design and delivery of workforce development that is mindful of the needs of older people, support workers, health and social care services and the employing organisations within which workforce development operates. Workforce development interventions need to balance the technical, professional and emotional aspects of care.

Item Type: Journal Article
Journal or Publication Title: BMJ Open
Uncontrolled Keywords: /dk/atira/pure/subjectarea/asjc/2700
Subjects:
Departments: Faculty of Health and Medicine
ID Code: 135178
Deposited By: ep_importer_pure
Deposited On: 10 Jul 2019 12:20
Refereed?: Yes
Published?: Published
Last Modified: 13 Nov 2019 08:03
URI: https://eprints.lancs.ac.uk/id/eprint/135178

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