SPACE is an exiting new care home education programme that has rolled out across the West Midlands

Thank you to the West Midlands Academic Health Science Network for this Case Study.


Safer Provision and Care Excellence (SPACE) is a new and exciting care home regional educational programme that has been rolled out across the West Midlands region. The WMAHSN has been supporting staff in care homes to improve quality of care and reduce avoidable harm in their care settings. 

The SPACE programme was originally a 2-year large-scale Quality Improvement (QI) pilot programme in 35 care homes across the West Midlands sponsored by the West Midlands Patient Safety Collaborative. 

It aimed to up-skill care home staff through training them in basic QI techniques and methodologies which empower staff to identify solutions to common problems within their care settings.

Challenge Identified and actions taken

A large number of older people currently live in care homes and this number is set to almost double by 2035. This forecast poses a major challenge. It is widely acknowledged that building QI capacity and capability in health and social care will help providers meet this challenge. The number of residents in the care home sector far exceeds the number of patients in acute hospital beds and therefore this represents a significant opportunity to impact on the whole health care economy. 

There is also increasing recognition that care homes are a critical part of the whole health care economy and there is great potential to improve quality of care by improving QI capability in this sector. The Care Quality Commission (CQC) are also increasingly seeking out evidence of care homes’ approaches to improve their quality of care.

Impacts and Outcomes

During the SPACE programme, the following improvements were observed: 

  • A downward trend in recorded falls
  • A reduction in the number of more severe pressure ulcers
  • Significant improvement in safety culture and in uptake of Quality Improvement methods 
  • Significant uptake of staff led initiatives

Following the original success of the SPACE programme, the WMAHSN has developed a model to extend the SPACE QI support to care homes across the whole West Midlands region. 

The Patient Safety Team within the WMAHSN embarked on a rolling programme to support adoption and spread of Quality Improvement skills in the 1200 care homes across the West Midlands region.  A series of workshops were jointly held with Clinical Commissioning Teams.

Training included the IHI Model for Improvement, human factors, and gathering baseline data about potential areas for improvement within their care homes. Teams were also encouraged to consider different techniques to engage staff in an improvement project, identify how they would generate possible solutions and measure improvement. A range of SPACE QI resources were also made available following the workshop to provide practical support to support the workshop content and facilitate care home led Quality Improvement projects.

During the workshops, care home teams identified local Quality Improvement projects to take forward in a range of subjects such as falls, hydration, UTI, oral care and to improve the recognition and management of deteriorating residents.

Interactive activities including the development of a driver diagram, PDSA testing and process mapping were an integral part of the workshop giving delegates the opportunity to apply QI theory into practice.

Next Steps 

The SPACE QI programme was recently incorporated into the four day My Home Life Leadership and Professional Support Programme, to further up-skill 50 care home staff and managers across Birmingham, Coventry, Hereford, Worcester and London, and support them to develop best practice in their care settings.