Social care - defining, evidencing and improving: mixed-methods qualitative study

Annex A: Interview Topic Guide

Care Home Managers

Welcome

Introduce self and the purpose of the interview.

Thank participants for their time and give an indication of how long the interview will take

Recap the participant information sheet i.e. recording, confidentiality, voluntary participation, right to decline or withdraw, how findings will be used.

Gain consent – verbal if online, hard copy in person.

Let's start by finding out a bit more about you…

Ask participants to describe their:

• current role
• professional background and experience

Tell me about your care home…

Ask participants to describe the home:

• size
• urban/rural
• population living there
• staff profile

My research project is interested in how policy makers use local examples of 'good' practice to inform policy decisions at a national level…

What does 'good' social care mean to you? (Try to gently unpick assumptions, beliefs and knowledge).

What examples of good practice can you share with me from your home? (Probe for specific details about what it is, antecedents, outcomes, staff and resident perceptions. Be flexible and allow participant to talk freely with minimal prompts as necessary)

What counts as evidence for 'good' practice?

Prompts: How do you know what good looks like?

From whose perspective?

How is this documented?

How is this shared, who with and why?

How have your 'good' practice examples received policy attention? Please tell me the story of how this happened (prompt for specific detail about what the good practice example was, the pathways through which it got policy attention, what enabled this to happen, and the outcomes)

How do you think local 'good' practice examples can and should help policy makers design the National Care Service?

What are the barriers that prevent this from happening? And how can these be overcome?

How do you currently build on your 'good' practice and use this as a basis for improvement within your care home? What supports/hinders this?

I'd like to ask you specifically about the healthcare framework…

What do you know about the healthcare framework for adults living in care homes? How have you been involved in its development?

What is your understanding of how the framework has been developed?

What is your understanding of how the policy makers used different types of evidence to help design the framework?

What is your understanding of how the framework will be implemented and evaluated? What are the consequences of this for your care home?

What will 'good' like under the healthcare framework and how will we know if this has been achieved?

Now thinking more broadly about the National Care Service…

What advice would you give other care homes about how to evidence and share their 'good' practice examples to inform the National Care Service?

What advice would you give to policy makers to help make sure that the National Care Service recognises and builds on existing good practice in the care sector?

Closing the interview and debriefing…

Is there anything else that you would like to add?

How did you find the experience of taking part in the interview today? What motivated you to take part?

Thank participants for their time and reiterate messages from the participant information sheet about how their data will be used, the option to review their transcript, and dissemination plan

People involved in developing the healthcare framework:

Welcome

Introduce self and the purpose of the interview.

Thank participants for their time and give an indication of how long the interview will take

Recap the participant information sheet i.e. recording, confidentiality, voluntary participation, right to decline or withdraw, how findings will be used.

Gain consent – verbal if online, hard copy in person.

Let's start by finding out a bit more about you…

Ask participants to describe their:

- current role

- professional background and experience

Tell me about your involvement in the healthcare framework…

What was your role in developing the framework and how did this come about?

What particular perspective did you bring to developing the framework - what does 'good' social care mean to you? (Try to gently unpick assumptions, beliefs and knowledge).

Can you share any particular examples of how your particular perspective/way of knowing contributed to decisions about what was included in the framework?

What is your understanding of evidence-informed policy making – what does 'evidence' mean to you?

I'd like to understand more about the role of knowledge and evidence in developing the framework… and how you were involved in it…

The framework states: "we have used the various comments, stories, experiences, opinions and suggestions from these engagement activities to shape the framework and inform the recommendations" (p11) – can you tell me more about your understanding of this process?

What other types of evidence and knowledge informed the development of the framework?

What is your understanding of how different types of evidence were identified and accessed?

How was local evidence included? How did included examples of 'good' practice gain policy attention? What were the pathways through which this was achieved and how?

What was the role of good practice examples? How was 'good' defined, by whom and against what criteria? When was evidence of 'good' practice most influential and useful, under what conditions?

How was good practice evidence integrated with other knowledge sources?

How was evidence assessed and which forms of evidence were considered most useful to the framework and why?

Can you provide any concrete examples of evidence-informed decision making as part of the framework development, e.g. a time when you considered different types of evidence/perspectives and arrived at a decision?

Were any knowledge and evidence gaps identified during the design of the framework? If so, how were these addressed?

What was the impact of having so many different actors interacting with one another from different perspectives? How did you arrive at a final set of recommendations?

What is your understanding of how definitive decisions were made about the framework content? Were you aware of any evidence thresholds i.e. points at which the team had 'enough' evidence or enough 'good' evidence to support decisions? If so, what did these look like? How were thresholds decided and negotiated?

I'd like to ask you about the future of the framework as it is implemented and evaluated…

What is your understanding of where the framework is currently in terms of implementation?

What is your understanding of how the framework will be evaluated?

What is the role of evidence in implementation and evaluation? How will this be accessed and used?

What will 'good' look like under the healthcare framework and how will we know if this has been achieved?

Some final reflection questions about the National Care Service more generally…

Has your perception of 'good' social care, and how it can be evidenced, changed over time? If so, how and why? Prompt for antecedents, consequences, lightbulb moments.

What do you think are some of the opportunities and challenges of using 'good' practice evidence within policy development, implementation and evaluation?

What is the most valuable piece of advice, drawn from your learning as part of the healthcare framework, that you could give to policy makers designing other evidence-informed aspects of the National Care Service?

Closing the interview and debriefing…

How did you find the experience of taking part in the interview today? What motivated you to take part?

Is there anything else that you would like to add?

Thank participants for their time and reiterate messages from the participant information sheet about how their data will be used, the option to review their transcript, and dissemination plans.