Findings from a Peer Support and Learning Group pilot to support Trauma Informed Practice in Adult Social Care

4. Conclusion

There was evidence five of the Care Homes included in the study had benefitted from involvement and had progressed to some extent on their journey to becoming Trauma Informed.

Three of the Care Homes were still engaged by the end of the pilot and had made more headway on their Trauma Informed Journey than the others. Engagement tended to be multifaceted and largely affected by the pandemic and how the Care Home (and individual managers and Care Home workers) were finding dealing with potential COVID outbreaks, staff shortages as well as any understandable difficulties they may have been having personally in relation to the pandemic (for example home schooling, childcare or sick relatives). However, before the pandemic, Care Homes in the pilot explained the extreme pressure the sector has been under for some time, so it is likely even if this pilot had been implemented out with the pandemic, engagement may have been affected by staff shortages and time pressures. Participants recognised the importance of protected time being given to managers to work on implementation of TIP, having support from senior management to ensure organisations are committed to allowing protected time for staff training, as well as implementation group meetings and further associated tasks.

The training component of the pilot was well received by attendees, who reflected that it was pitched at the right level and valued the sessions specifically focusing on Trauma and Older Adults. The PSL Group element to the project was a success, and Care Homes reported about this component of the pilot positively. They found these groups helpful to connect with peers about their Trauma Informed journeys and the space useful to discuss motivators and barriers to implementation (with people who understood the challenges of implementing TIP in a Care Home setting). However, they also recognised the importance of skilled and experienced professionals facilitating the group who had knowledge of trauma and Trauma Informed Practice, a likely barrier to further roll out of this project. These facilitators would also have to be knowledgeable of the available NTTP resources to ensure they could raise awareness through the sessions.

Despite the challenges associated with this pilot, there are several key findings that are important to take into account in any future training or roll out of TIP training and PSL Groups:

Staff Wellbeing

• Staff Wellbeing is an issue following the pressures and scrutiny this sector has been under prior to and throughout the pandemic. This should be borne in mind when developing future interventions with this sector. Supervision was recognised by participants as important and should be offered by suitably trained individuals (SSSC leadership training) on a monthly basis.

Training

• It is important team leaders should be involved in training as they have such a key role on the floor.
• The individuals chosen to implement TIP need to have some seniority in the organisation and feel able to make some of the changes necessary to implement TIP or have access to leaders who can and will make those changes.
• Online training can be challenging with this sector as there is limited access to technology other than I pads, or technology in areas where it is possible to give the necessary attention to taking part in training (this was more difficult during the pandemic as this was often challenging at home as well for participants due to child care or relatives being at home). This may be of specific importance as those that were engaged the most and able to attend and focus on training seemed to be better engaged throughout the pilot.

PSL Groups

• Facilitators of the PSL Groups need to be knowledgeable in the area of trauma, Trauma Informed Practice as well as of the NTTP resources. They also need to be able to hold the PSL Group space in a compassionate, non-judgemental manner. Participants felt it would improve the experience if they had met facilitators face to face beforehand and if they had visited their Care Home (or had previous knowledge of the Care Home sector).
• The technology used for the groups needs to be carefully considered, Zoom seemed be easier for Care Homes to use in comparison to Teams.
• Protected time for training, implementation groups and tasks need to be pre agreed with leadership to ensure appropriate time and effort can be dedicated or this results in lack of progress and frustration among staff. For those representatives with less senior roles in the organisation, engaging with senior management in implementation should be a priority.

Implementation packs

• Participants valued the additional resources and found the organisational assessment useful to help them identify and prioritise their implementation tasks. They specifically like the fact the pack was on paper and that it could be tailored to each individual service/ organisation.

Identifying organisations to work with trauma survivors if necessary

• Early collaborative work to identify partners who can work with traumatised individuals in the Older Adult sector if necessary, should be a priority. This worked well in one Care Home, who when they approached the Third Sector, who identified developing work with Older Adults was also part of their strategic priorities (Rape Crisis).

Evaluating the implementation of TIP

• Whilst the pilot did not see the Care Homes progress their implementation plans, interesting ideas were raised on identifying trauma in Care Plans (potentially trying to use/ amend existing systems) and also using this identification as a way of monitoring and evaluating implementation of TIP (for example, counting the number of times this is mentioned in care plans or in team discussions).