What influences the sustainability of an effective psychosocial intervention for people with dementia living in care homes? A 9-12 month follow- up of the perceptions of staff in care homes involved in the WHELD Randomised Controlled Trail.

OBJECTIVES: To understand the factors that care home staff felt enabled or hindered them in continuing to use the WHELD psychosocial approach in their care home and investigate whether there was sustained activity nine - twelve months after the study ended.

METHODS: This qualitative study is part of a wider clinical trial which demonstrated effectiveness of a psychosocial intervention on quality of life outcomes and neuropsychiatric symptoms for residents. 47 care home staff within nine care homes in the UK participated in focus groups, between nine and 12 months after the intervention had finished. Inductive thematic analysis was used to identify themes and interpret the data.

RESULTS: The findings highlighted that staff continued to use a range of activities and processes acquired through the research intervention, after the study had ended. Three overarching themes were identified as influential: 'recognising the value' of the approach for residents and staff, 'being well practiced' with sufficient support and opportunity to consolidate skills prior to the withdrawal of the researchers and 'taking ownership of the approach' to incorporate it as usual care.

CONCLUSIONS: Sustaining the use of the WHELD approach related to personal, implementation and organisational factors. Further follow up is required to understand longer term use and the impact for residents.