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Cesagen · Research

Promoting Excellence in All Care Homes

Win Tadd, Martin O'Neill, Simon Read

Start date


Affiliated staff

Bob Woods, Charlotte Hall, Diane Seddon, Gill Windle, Anthony Bayer

Funded by

Department of Health and Comic Relief


Despite the belief that abuse, neglect and lack of dignity is common in institutional care for older people, hard evidence is lacking. A systematic review identified only 5 care home studies with 16% of staff admitting significant psychological abuse. Identified obstacles to appropriate care include values and motivation of practitioners, organisational factors, inadequate resources and lack of education. For many paid carers these factors result in frustration and loss of personal dignity. There is little guidance or training in relation to dignified care and lack of knowledge about recognising and dealing with abuse and neglect. This study built on work undertaken by Win Tadd within the NHS (see Dignity in Practice project ) and will inform a proposed prevalence study of abuse and neglect of older people in care homes.´╗┐


This multi-method study, building on previous and current research, filled this gap by developing evidence-based guidance for policies and practice to promote dignified care. It explored the views and experiences of the care home sector and its workforce in relation to the provision of dignified care and avoidance of abuse and neglect. It examined the influence of an evidence based training intervention on attitudes and practice.

Study Objectives:

  1. Identify positive and negative factors in relation to abuse, neglect and dignified care.
  2. Explore views and experiences of the care home sector and its workforce in relation to best practice, training, job satisfaction and wellbeing.
  3. Determine organisational, personal, and practice contexts in which abuse, neglect and lack of respect may occur to staff and residents.
  4. Undertake a preliminary evaluation of the effects of a training intervention.
  5. Make recommendations for policy development, training and regulation in care homes´╗┐.


Research methods for the study include:

  • focus groups with care home owners/managers and relatives/residents exploring educational needs of the workforce.
  • review of existing training materials
  • observation of care practices and dynamics between residents and providers in 8 diverse care homes and completion of validated measures with staff of attitudes to older people, approaches to dementia, sense of control, job satisfaction and burnout.
  • survey of and in-depth interviews with care staff to explore experiences and views and identify factors leading to abuse, neglect and loss of dignity
  • development and evaluation of an evidence-based training package informed by the findings of focus groups, observations and interviews.


The PEACH project's final report is awaiting publication.

Further information

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