The PROSPER programme was set up to test whether quality improvement (QI) methods could be implemented in care homes to improve safety and reduce harm for vulnerable residents at risk of admission to hospital or significant deterioration.
Initial funding for the PROSPER programme was provided by The Health Foundation, whose support was secured by a persuasive bid written by UCLPartners in collaboration with Essex County Council staff, care home managers, academics and Clinical Commissioning Group leaders.
From 2014-2016 PROSPER was delivered collaboratively by care homes teams in Essex, Essex County Council, UCLPartners and Anglia Ruskin Health Partnership. The programme used QI methods to reduce preventable harm from three of the most common safety issues in care homes: falls, urinary tract infections and pressure ulcers.
Ninety care homes participated in the initial programme which comprised:
- Training in QI methods
- A toolkit of ideas and information specifically designed to support care home staff to implement QI
- Tools to help monitor change in resident outcomes
- Opportunities to share learning with other homes
- Support visits from Council improvement facilitators
The care homes collected baseline data prior to implementing improvement ideas. Teams used Plan Do Study Act cycles to conduct small tests of change, collecting data to assess if the changes were effective in the reduction of harms.
Dedicated support from Essex County Council, informed by expertise from UCLPartners, was provided to the care homes for six months. In the time following, teams continued to receive support through a community of practice, regular newsletters, ‘champion’ study days and ad-hoc meetings.
When The Health Foundation funding came to an end, Essex County Council decided to make an ongoing investment into the programme, swayed by strong evidence advocating the model penned in part by UCLPartners experts and published in the Journal of The Royal Society of Medicine and BMJ Quality and Safety.
This ongoing funding has enabled the PROSPER model has spread through care homes in Essex, with 164 homes now using the model. Since implementing the approach, four homes have received an outstanding rating by the CQC, with much praise attributed to their QI activity in the reports.