The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approachesto retain high quality, resilient frontline care home workers, who are not registered nurses, areinformed by context specific, high quality evidence. We therefore conducted this scoping review toaddress the question: What is the current evidence for best practice to support the resilience andretention of frontline care workers in care homes for older people?MEDLINE, PubMed, PsycINFO, Embase, MedRxiv, CINAHL, ASSIA, Social Science Premium weresearched for literature published between 2010 and 2020. The search strategy employedcombinations of search terms to target frontline care workers in care homes for older people and thekey concepts relevant to resilience and retention were applied and adapted for each database.Thirty studies were included. Evidence for best practice in supporting the resilience and retentionspecifically of frontline care workers in care homes is extremely limited, of variable quality and lacksgeneralisability. At present, it is dominated by cross-sectional studies mostly from out with the UK.The small number of intervention studies are inconclusive.The review found that multiple factors are suggested as being associated with best practice insupporting resilience and retention, but few have been tested robustly. The thematic synthesis ofthese identified the analytical themes of - Culture of Care; Content of Work; Connectedness withColleagues; Characteristics and Competencies of Care Home Leaders and Caring during a Crisis.The evidence base must move from its current state of implicitness. Only then can it informintervention development, implementation strategies and meaningful indicators of success. Highquality, adequately powered, co-designed intervention studies, that address the fundamentallyhuman and interpersonal nature of the resilience and retention of frontline care workers in carehomes are required.


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Johnston, L., Malcolm, C., Rambabu, L., Hockley, J. & Shenkin, S. 2020, Supporting the resilience and retention of frontline care workers in care homes for older people: A scoping review and thematic synthesis, CSO Chief Scientists Office. Available at: http://researchrepository.napier.ac.uk/Output/2749183

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Last updated: 16 June 2022
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