Abstract

Background: Ancillary staff (cooks, cleaners, housekeepers) working in care homes are often undervalued in society and overlooked in research. Their contributions during the pandemic have not been widely investigated or reported.

Objectives: The aim of this study was to investigate the working conditions, practices and relationships of a sample of ancillary staff's in care homes for older people.

Methods: In an NIHR-funded 10-month qualitative study in England, ancillary staff working in care homes (N=38), care home managers (N=8), care home residents (N=5) and their relatives or friends (N=7) were interviewed virtually between February and October 2021 to ask about experiences during the pandemic. Data were analysed thematically. Findings from all 63 interviews were distilled into a working document entitled "good practice guide to support ancillary staff in care homes". This was presented to stakeholders from 13 different organisations such as sector experts and regulators. At these workshops, we sought advice about whether the draft guide reflected their experiences and whether the guide would be useful.

Results: The final "good practice guide' aims to be useable in care homes. It sets out six key principles: (1) Fair Reward and Recognition, (2) Clear Communication through Leadership, (3) Effective Support Systems, (4) Person-centred Staff Development, (5) Equal and Respectful Treatment, and (6) Recognising Relationships with Residents and Relatives. Each principle is described briefly and contextualised with participant quotes, followed by "reflective questions' to help readers consider the topic more carefully, and offer them a lens with which to reflect on the support that might already be in place or could be improved in their home. A concluding "tips and prompts' section encourages further points of consideration.

Conclusions: The co-produced "good practice guide' has been developed to inform care home leadership, ancillary staff, and staff representative groups. For care home leadership, the guide may help them reflect on any gaps in support for ancillary staff. For ancillary staff and staff representative groups, the guide may assist with reflection on what makes for good support, how this can be achieved, and how to ask/who to go to for help and advice. It also provides an overview for policy makers about what was found to best support ancillary staff in care homes, and how local and national policy related to infection control and resident wellbeing can reflect this.

Slides