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Up and About in Care Homes
Up and About in Care Homes Project is a national improvement project aiming to reduce the number of falls in participating care homes. Sponsored by the Scottish Government, the project has been implemented in three partnership areas: West Dunbartonshire, North Highland and Dumfries and Galloway. Newsletters on the project called 'Up and About in Care Homes' highlights improvements being made. Issues to date can be accessed on the Knowledge Network's Falls and Bone Health Community website. The project comes to an end at the end of June 2015, however it is hoped that with support from the wider health and social care team the improvements made can be sustained.
The Care Inspectorate and NHS resource pack Managing Falls & Fractures in Care Homes for Older People published in 2011 has been updated and improved in 2016.
A list of the Project Leads for falls can be found here
Go for Gold Challenge Scotland
The Go for Gold programme is designed to encourage care home staff and residents to engage in physical activity on a regular basis. Led by Care Inspectorate Rehabilitation Consultant Edith Macintosh, the initiative was launched in 2012 with a range of activities to coincide with the Olympic Games and also the 8th World Congress for Active Ageing in Glasgow. You can watch a video of an example of what can be done for the games challenge.
Moving towards 2015 the focus this year is on walking and functional fitness. The original challenges can still be selected which are dance, games, triathlon and 'try anything'! The week for the challenges will be 6 July 2015 but the main thing is to participate, so if a challenge does not fall into that week its not important.
Over the past year the events ranged from an individual care home hosting its own Highland Games to multiple care homes taking part in challenges for up to 150 older people. Some areas also included day services and sheltered housing complexes in their events. Services have taken part in different challenges, including walk with me, hike and bike, pedometer challenge, hunt the haggis, bowling, New Age Curling and even a ‘Come Dine With Me’ dance event.
A newsletter is published highlighting developments in the project: Issue 1, Issue 2, Issue 3, Issue 4 and Issue 5 are available.
The Care Inspectorate has published an Ideas for Action guide, "Walk with me to functional fitness in care homes", to help services plan their walking plan as part of the G4G challenge.
Case study - South Lanarkshire Go for Gold
16 day care units and six care homes participated in a range of events, including games and dance challenges. Seven units took part in a Walk with Me challenge, which involved residents, staff and carers wearing pedometers for a five−day challenge to see how many steps they could take during that time. The event was a great success with a total of 169 participants walking a total of 2,530,733 steps, which is the equivalent of 1,199 miles – walking from Hamilton to Milan!
The care staff noticed that because of the challenge it encouraged the residents to walk more often and they felt the challenge really supported one resident’s rehabilitation, following a hip fracture, by encouraging his mobility. The resident in the picture above is now using the pedometer as a measurement of his daily activity level.
Care home residents, supported by trained carers, took part in a national pilot project last year to support them to go swimming and have the opportunity to enjoy being in the water. This was run in Perth & Kinross and West Lothian and since then other areas have successfully supported care home residents to go to their local pool such as Lanarkshire and Aberdeenshire.
Many of these residents have visited a swimming pool for the first time in 30 years, with some discovering an increase in their mobility in the water. Local authority, health and leisure services have worked together to ensure staff were trained to support people in the pool and all the necessary equipment was available.
Talking about her experience, one resident said: “I felt so free in the water and very happy to float with support. I cannot wait to come again next week.”
A report is available about the pilot projects. We have included the following resources used during the pilot to help care homes across Scotland to support their residents to take part in swimming:
Care...about physical activity
'Care...about physical activity' has been developed by the Care Inspectorate in partnership with the British Heart Foundation National Centre for Physical Activity and Health at Loughborough University. The resource is based on the World Health Organization model of ‘Health Promoting Settings’. It provides principles and a self-improvement framework for care homes and is designed to stimulate simple solutions and practical approaches to enable all residents to choose to be active every day.
The resource pack is based on current good practice and includes:
1. A booklet with:
• An introduction to the resource, an introduction to physical activity in care homes and how to make improvements.
• The physical activity self assessment tool and guidance for its use.
• A description of the three key principles to promote physical activity.
2. A DVD to support implementation of the resource pack.
3. Make Every Move Count – a pocket guide to active living.
4. A call to action poster.
5. Physical activity and self assessment tools.
The intention is that this resource will provide care homes with guidance and the tools to identify what they are doing well to promote physical activity and what improvements they now need to make. The physical activity self assessment tool contained in this resource pack helps you to do that. There is step by step guidance in the booklet within the resource pack about how to use the physical activity self assessment tool
An App is also available to support for care home staff to implement this resource and it provides additional learning along with hints and tips on what they can do to encourage an active life.
Allied Health Professional Placements in Care Homes
The primary aims of this initiative is to support a group of Allied Health Professionals (AHPs) to gain valuable practice learning experience while supporting care home residents and staff to live well. Several pilots have taken place including, Occupational Therapy, Physiotherapy, Dance Movement Psychotherapy, Dietetics, Speech and Language Therapy and other professions are keen to test this out also. Recently there was a very successful dietetic placement in Highland, 'Rabbit stew anyone?'
Catherine Tosh from Robert Gordon’s University, has recently completed the first pilot placement of a student dietitian in a care home setting in Scotland. She has spent 2 days a week at Urray House, Muir of Ord, Ross shire, over the 5-week period from 14 October 2014.
During this time Catherine has:
- carried out an audit of nutritional care plans
- completed a case study review of 1 resident
- presented her findings to staff and dietetic colleagues
- developed her communication skills and understanding of the challenges in engaging with residents who have dementia
Catherine explained “This group of people are often hard to engage in conversation and often find it hard to recall recent events or express their views when asked.” However she and the home’s activities co-ordinator (Fiona Barclay) recently spent a few hours trying to tap into memories of 7 such residents by asking them to discuss their recollections of mealtimes, special occasions and their favourite foods. The results of this exercise were astonishing, as they rekindled thoughts of family mealtimes and favourite foods. One resident, normally a very quiet lady, became really actively involved in the conversation, articulating herself really well. Catherine described her “She came alive when we were talking: it was wonderful to see.”
The residents were asked to help create a favourite menu and Urray House’s cook, Muriel Fotheringham, was happy to help prepare it for a themed day on Catherine’s last day. It contained Scotch broth, Rabbit stew followed by Clootie dumpling for pudding. Menus were developed and care home residents and staff were asked for their views about the lunch, which is pictured here.
Some of the quotes which sum up the event are :
- “Clootie dumpling was the best part” – resident
- “We always got clootie dumpling at birthdays and if you were lucky, you got a silver threepence” – resident
- “I haven’t had rabbit in years” – resident
- “I was brought up on rabbits; they were more tasty before the war” – resident
- “I thought the rabbit was lovely; I used to get rabbit when I was a child too” – care worker
- “I think the whole idea was great. My mother was telling me about when she was little when her mother used to go to the butcher and get a rabbit for a shilling. She’d then sell the rabbit skin to a man that came round the houses; there’s no way she’d have remembered that without this themed lunch bringing back those memories” - resident’s daughter
Denise Scott, manager at Urray house said ”Having a focussed discussion around food memories is a great way of engaging with dementia residents and their families, giving them a voice in choosing their favourite menus and following up with a themed meal, where staff dress up to serve the food. Everyone can participate have fun and enjoy the memory. Congratulations to Catherine, Fiona and Muriel for doing this work which we will continue in the future.”
Evelyn Newman, nutrition and dietetics advisor for care homes, described Catherine’s placement as a great success due to her hard work, interest in the care of the residents and the support she had from Dietetics and Urray House staff, “A huge amount has been achieved in a relatively short space of time and we hope to continue to offer care home placements to student dietitians in Highland in future. The themed lunch has tapped into the memories of some of our hard to reach residents and it’s great to see how everyone in the home helped to bring the lunch to fruition. The learning from the audit and Catherine’s work is actively being shared across care homes, both in Highland and more widely across Scotland by NES and RGU, which will benefit many more residents in future.”
The next part of the work is to test out placements within care at home services and it is hoped this will happen during 2015.
Seniors USP (Understanding Sedentary Patterns)
Seniors USP (Understanding Sedentary Patterns) is a Scotland-wide research project, led by Professor Dawn Skelton of Glasgow Caledonian. Its overall aim is better understanding the causes and effects of activity behaviour, especially sedentary behaviour in older people, to inform future interventions. Sedentary behaviour is when people tend to spend lots of time seated or lying down, and has been linked to frailty, mortality and chronic health problems
Read a presentation given by Professor in Ageing from GCAL Dawn Skelton who is leading this work. Edith Macintosh, the Care Inspectorate’s Rehabilitation Consultant, is part of the Dissemination Group for this three-year project. If you would like further information, please contact firstname.lastname@example.org.
My Home Life
My Home Life was initiated in 2006 by the National Care Forum and Help the Aged - it will mark ten years of the programme with a series of briefing papers to be published throughout 2016. It has become a high profile collaborative social movement to improve the quality of life of everyone connected with care homes for older people. My Home Life has completed a series of films commissioned by the Department of Health, produced in conjunction with Let’s Respect and Dementia UK. The films look at the challenges of dementia and other mental health issues.
In Scotland the programme is led by University of West of Scotland (UWS) in partnership with Scottish Care and Age Scotland.
To date, nine Reshaping Care for Older People partnerships have funded 12 My Home Life Leadership Support and Community Development Programmes. The University of West of Scotland in partnership with Scottish Care implement and evaluate these programmes across Scotland. There are currently over 120 care home managers participating in the programme.
The aim of the LSCD programme is to help managers to:
- develop strategies for taking forward improvement in line with the research evidence, practice knowledge, local experience and expertise of managers, residents, relatives and staff in care homes
- recognise the value of transformational leadership and relationship-centred care (that relationships are crucial to success)
- recognise the value of a positive (or appreciative) focus on what currently works well and what can be learnt from this in taking things forward
- recognise the importance of creating on-going dialogue with their communities both inside and outside the home
“My Home Life is an essential aid for learning and developing best practice. It focuses attention on the experience of residents in care homes, whilst valuing and encouraging the efforts of those working there.” Ranald Mair (Chief Executive, Scottish Care)
My Home Life case studies
Managers had greater confidence in their role, developed their leadership capacity and created cultures within their homes that were more open; they actively developed more strategies to seek out the views of others including residents and relatives.
Managers developed their influencing skills, took forward new and creative approaches to improve the quality of relationships, share learning and try out new ways of working that enhanced the experiences of those giving and receiving care.
Managers learned to trust others in their team to lead developments, develop meaningful relationships with relatives who had concerns about the care provided; seek feedback from others about how they perceived the service they provided and work more closely with residents, relatives and other staff to decide on how to take forward improvements.
City of Edinburgh
The Leadership Support part of Edinburgh MHL is about to conclude and now, as part of the Edinburgh Community Development programme, invited local stakeholders are taking part in a learning journey to a small number of care homes in Edinburgh.
Participants will take part in an initial briefing and an introduction to MHL, and then travel in small parties to homes across the city, reconvening later for a debriefing session. This will provide a valuable and unusual chance to see and hear at first-hand about what’s working well and how life for residents, relatives, staff and managers is changing. Importantly it will start a dialogue about what else needs to happen locally to support care homes to meet the challenges of reshaping care for older people in Edinburgh.
Click here for other projects and programmes related to dementia.
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