title: Evaluation of the 'Ladder to the Moon, Culture Change Studio Engagement Programme' staff training: Two quasi-experimental case studies.
abstract: OBJECTIVE
  To evaluate the impact of the CCSEP on care home staff in two care settings for older people in one nursing home and one residential home.
  
  
  BACKGROUND
  Care homes provide personal care and accommodation for older people. The English Dementia Strategy aims to improve the quality of service provision for people with dementia. This includes specific mention of improving the quality of life in care homes and as such includes objectives related to developing the workforce knowledge and skills. The Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP) is a staff training approach based on the Positive Psychology framework that uses theatre- and film-based activities.
  
  
  METHODS
  This study used a wait-list controlled design. However, the data analysis plan was amended to reflect difficulties in data collection, and a quasi-experimental case study approach was consequently utilised. Outcome measures for staff attitudes and beliefs were as follows: Sense of Competence in Dementia Care Staff; Approaches to Dementia Questionnaire; Job Satisfaction Index; Brief Learning Transfer System Inventory; and Scale of Positive and Negative Experience. The Quality of Interaction Schedule (QUIS) was used to observe changes in staff-resident interaction.
  
  
  RESULTS
  Fifty staff in two care homes completed the questionnaires and forty-one undertook formal CCSEP training. In Home A (nursing home), there was no significant change in any of the measures. In Home B (residential home), the QUIS showed an increase in positive interactions post intervention; a significant increase in the Building Relationship subscale of Sense of Competence; and a significant increase in staff sense of hopefulness towards people with dementia. The Brief Learning Transfer System Inventory showed a significant decrease post-intervention. The intervention did not significantly affect the happiness or job satisfaction of care home staff.
  
  
  CONCLUSIONS
  The results of this study provide tentative evidence about the efficacy of this staff training programme. Some significant improvement in staff attitudes to people with dementia, staff sense of competence and positive staff-resident interactions were found in one of two homes. It is likely that the organisational problems affecting the other care home limited the implementation and therefore efficacy of the intervention there. The results therefore suggest that when a supportive management structure is in place, CCSEP may be more effective in improving staff attitudes, sense of competence and interactions with residents.
authors.affiliation: Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK.
authors.forename: Azucena
authors.initials: A
authors.lastname: Guzmán
authors.affiliation: Division of Psychiatry, University College London, London, UK.|Dementia Research Centre, North East London NHS Foundation Trust, London, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wenborn
authors.affiliation: Dementia Research Centre, North East London NHS Foundation Trust, London, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Swinson
authors.affiliation: Division of Psychiatry, University College London, London, UK.|Institute of Mental Health, Nottingham University, Nothingham, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D000368:Aged; D003704:Dementia / Q000451:nursing*; D004324:Drama; D004739:England; D005851:Geriatric Nursing / Q000193:education*; D006707:Homes for the Aged; D006801:Humans; D007318:Inservice Training; D009040:Motion Pictures; D009735:Nursing Homes; D015279:Organizational Culture; D011787:Quality of Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: care homes; dementia; film activities; positive psychology; staff training