Barriers and facilitators in care home training implementation: A rapid review to inform rollout of a mealtime care intervention

Introduction

Care homes face growing pressures in delivering high-quality, person-centred care. Effective and sustainable training can enable staff to develop the knowledge, skills, and confidence required to provide this care. This rapid review aimed to identify the barriers and facilitators in implementation of training programmes in care home settings. The findings will inform rollout of a training intervention to improve mealtime care for people living with dementia.

Method

Methods were informed by Cochrane Rapid Reviews Methods Group guidance. A structured literature search was undertaken in MEDLINE and Embase. Data were extracted using a piloted form capturing study characteristics, intervention description, and reported barriers/facilitators. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal. Extracted data were synthesised via reflexive thematic analysis. All steps were conducted by two authors for rigour, with discussion to resolve disagreement.

Results

After title/abstract screening and full-text screening, nine studies were selected for inclusion in the review. Five themes were identified through reflexive thematic analysis: suitability of delivery methods and materials; time and resource limitations; organisational stability and leadership support; staff’s perceived value of training; and planning and process. Face-to-face and discussion-based approaches were preferred, while workload pressures, staff turnover, and weak communication commonly hindered uptake. Training was most effective when aligned with existing routines, supported by leadership, and tailored to the local context.

Conclusions

Recommendations for practice include engaging with care homes leadership to assess organisational readiness and co-develop realistic rollout plans. Further research is needed to strengthen the understanding of practical strategies for embedding training sustainably in care homes.