A qualitative study exploring the experiences of multi-disciplinary staffs in a medium secure service when working from home and virtually during the COVID-19 pandemic
Authors: Liddiard Kim 
Published: June 2022

Purpose
Little is known about the personal and professional experiences of staff when working virtually and from home during the COVID-19 pandemic in a medium secure environment. This study aims to overcome this issue.

Design/methodology/approach
The current study used a qualitative design to specifically explore the following areas with nine multi-disciplinary staff using a semi-structured group discussion: how their everyday working practice had changed during the pandemic, the perceived impact of these changes on themselves as professionals, as well as identifying strengths and limitations associated with any new ways of working.

Findings
A thematic analysis was conducted producing four main themes: emotional overload and confusion; technological problems; accessibility and emotional connectivity; adapting and making good. Data suggested that staff could experience feelings of guilt, loneliness and a sense of under-performing when working from home and virtually. Problems with technology in terms of resources and connectivity were also evident although unexpected advantages of virtual consultations included supporting gatekeeping and admissions assessments, allowing external stakeholders to better attend inpatient care and treatment planning meetings alongside improved family relations for patients.

Research limitations/implications
While this study has added to the existing knowledge base, it does have limitations that should be acknowledged when reading and drawing conclusions from the paper. First, a small sample was used and so the findings likely have poor generalizability outside of secure settings. Second, the small sample could mean that the current findings may not be representative of the views and experiences of the wider staff group employed within the service. Finally, the lead researcher who subsequently analyzed the data was employed within the service and may well have imposed their own biases on the data; however, this was potentially overcome by having a second rater review the emerging themes.

Practical implications
The COVID-19 pandemic brought with it radical and innovative ways of working, and it is now important to consider lessons learned to further develop and support such new ways of working: one important area for further consideration is improved oversight of the psychological impact of home working on health-care professionals. It is, therefore, recommended that worker well-being be explored more regularly by line managers and clinical supervisors and sufficient safeguards introduced to reduce or remove any adversity identified. Of note, these safeguards/strategies should be both psychological and practical in nature. If elements of virtual working are set to continue post-pandemic, for example in the case of long distance admission assessments and/or to support external stakeholders attending patient meetings, then time and effort needs to be spent on improving access to resources, connectivity and the advancing of available technological equipment to support this working practice. This could be achieved via improved information technology relations to support technical troubleshooting and to provide much needed ongoing support. Enhanced training for staff in IT skills to better use equipment and approved platforms is also recommended. The acknowledged gains that emerged as a result of patients having access to iPads and tablets during the COVID-19 pandemic now needs to be extended and explored further to consider all of the other significant contributions greater access to these technologies could afford to patients’ recovery post-pandemic in secure environments.

Originality/value
The experiences of staff working virtually, and from home, through a pandemic in secure services are relatively unknown. This paper, therefore, aims to contribute to the limited evidence base.