Involuntary relocation and safe transfer of care home residents: a model of risks and opportunities in residents' experiences

Few studies explore the application of literature on care home closures in practice or how it can influence residents' experiences. The aim of this study was to investigate from multiple perspectives how a protocol, designed by a local council for the involuntary relocation and safe transfer of older adult residents, was adhered to and the influence that the protocol had on the experiences of residents who relocated from two care homes. Interviews were conducted with 34 stakeholders, including relocated residents (N=11), relatives (N=2), care home staff (N=13), managers (N=6) and advocates (N=2), and analysed using framework analysis. The protocol covered key aspects of guidelines extracted from research evidence grouped into four themes: involvement; staff approaches; preparation; and consistency and familiarity, with the majority of the guidelines being followed in practice. Two further themes that centred on the processes of transitional adjustment and impact of relocation were influenced by the protocol but were also mediated by factors relating to the environment and the resident. Involvement of residents, relatives and advocates, extensive planning and a person-centred approach were of particular importance in improving residents' experiences of relocation. A model that places residents' experiences at the centre of relocations is proposed, which draws on and applies the themes identified in this study and applies them within the context of opportunities and risks.