Measuring the economic impact of care homes wellbeing programme


In spring 2012 OPM carried out research into the care homes sector in the UK, on behalf of the NHS Institute. This research informed the development and marketing of the NHS Institute’s Care Homes programme, a service improvement package aimed at residential and nursing care home providers, owners and managers.

The NHS Institute worked with several care homes across England to test and refine the programme’s service improvement tools. The NHS Institute wanted to know about the effectiveness of using the tools in care home settings, the critical factors underpinning successful implementation, and the challenges encountered by staff and managers.

The evaluation was commissioned to generate evidence of impacts emerging – including impacts on residents, staff wellbeing and retention, safety and efficiency. The NHS Institute also wanted evidence of the financial savings arising, to enable potential purchasers to assess the programme’s value for money.

What we did

We carried out two strands of work:

  1. We carried out fieldwork with three homes that tested some of the tools in the Care Homes Wellbeing programme. This included visiting homes to see the changes made, interviewing staff and managers about the processes they went through, and capturing evidence of outcomes achieved. Following this fieldwork, we developed three in-depth case studies outlining the test site experiences and impacts arising as a result of the programme. The case studies explored the impact of the tools on reducing falls and accidents within the home, saving staff time by re-organising systems and tidying shared spaces, and introducing ‘resident summary at a glance’ boards to enable all staff to quickly see the status of all home residents.
  2. We developed a ‘ready reckoner’ economic assessment tool, to enable care home owners and managers to assess the potential financial benefits and costs associated with the Care Homes Wellbeing programme. We reviewed programme documentation, cost data captured from case study sites (including staff time spent on implementing the tools) and secondary data from other sources in order to populate the ready reckoner.

Our understanding of the care homes sector, and the challenges it faces in realising service improvements, enabled us to explore the crucial issues in depth with care home staff and managers. The work also built on our experience of producing economic assessment tools for the NHS Institute High Impact Actions in Nursing and Midwifery – The Essential Collection, enabling us to employ a similar methodology to developing the ready reckoner tools.


The project enabled the NHS Institute to assess the effectiveness of the tools when employed in care home settings. We provided evidence of impact as well as insights regarding some of the challenges experienced and critical success factors.

The ready reckoner tools enable care home owners and managers to assess the value for money of the Care Homes Wellbeing programme before taking purchasing decisions, and provide a resource to assess the impact of the tools in different contexts (e.g. homes with different staffing structures or with residents with particular needs).