Growing a good life

Planting a tree for the Queen’s Jubilee  

Even when the weather isn’t perfect, people can be keen to wrap up and get outside into the lovely Scottish weather, whatever the season. Sometimes we can forget this in our desire to keep people warm and safe.  

There was no such problem here at Durnhythe Care Home in Aberdeenshire. Residents decided to plant a tree to join in with the Queen’s Green Canopy Jubilee celebrations.  The vote went for an apple tree, which staff helped residents source from the Greenspace Project. 

People were fully involved in exploring the best site for fruit trees in the grounds. And here we can see a couple of residents getting stuck in with a staff member to plant the apple tree on a misty day.  

This story is a good reflection of Quality illustrations as outlined in the Quality Framework for care homes for adults and older people , particularly for Quality Indicator 1.2 ‘People get the most out of life’ where ‘people … experience support that promotes independence ….. and to take part in meaningful occupations that validate a person’s identity’ 

We would love to hear your tale of how people experiencing care are up and at it outdoors, fully involved in digging, planting, painting or doing DIY as we get ready for better weather. Please send your stories to hscimprovement@careinspectorate.gov.scot

Activity packs - supporting people to live independently in their own homes

by Catriona Binns, reablement facilitator, Bon Accord Care

“I like being active - so myself and my friend did this together."

Here is a story of what can happen when different people in Aberdeen City worked together to develop activity packs.  There are many things you can try for people still living in their own homes to support their independence.

Catriona Binns, reablement facilitator at Bon Accord Care picks up the story. ‘’It was during a very difficult and extremely challenging time with Covid and all the restrictions we did this. Yet this been a great opportunity for staff to re-engage and encourage people to keep active and independent. ‘’

Everyone involved (people over 65 living in sheltered housing) got a bag of tricks which included:

• A stretchy band to help build strength (theraband)
• wipeable cards with a variety of activities including sit to stand, leg extension, seated row
• checklist to reduce risks

The feedback from those who took part was very encouraging and positive.

"I didn’t think I would be able to do this but having the pack made me try and I really enjoyed it after keeping going."

"I like doing this and really enjoyed it when one of the carers did it with me too."

"I have been in hospital lately and found this helpful to get me back doing night exercises."

"This was very good and funny at times; I did this with my friend."

"I enjoyed doing something different - because of Covid we are not doing many activities, so I enjoyed this."

Some very simple interventions and ideas can have a remarkable impact on people’s lives.

Find the safety checklist and information cards that were distributed below:

Seated Exercises

Seated & Standing exercises

Standing Exercises

You might like to try these out where you work or live. They were developed with input from staff from sheltered housing, occupational health, speech & language therapy, university students, volunteers, and Sports Aberdeen.

Intergenerational practice

Durnhythe Care Home, Aberdeenshire

It has been difficult to keep relationships going over the last year.  In Aberdeenshire, children from a local childminding service and care home residents had well-developed connections going back a few years before Covid-19 struck and everything locked down.

The two services had a solid foundation to work on.  Attachments had formed over the years so they tried various ways to maintain relationships and even build further upon them. They kept in touch by exchanging artwork and letters and recently built on and extended these relationships in different ways through organising:

• A socially distanced sing song in the garden with parents and youngsters (and a very large speaker)
• Inviting a youth Highland dancer and pipers in the garden
• Building up virtual calls. Half an hour a week where:
  • youngsters and residents agree songs to sing and actions to take.
  • they all complete the songs together.
  • the children are on a large screen, while an iPad is used so that individual residents can have their say and be seen by the children

Anuj Dawar, the Care Home Manager at Durnhythe Care Home is hoping that these weekly calls help everyone to be comfortable to come back together.

Anuj feels the greatest challenge in this venture has been the technological issues due to the absence of wireless broadband in the care home and the greatest asset has been the sheer dedication from Christine (Owner, Welly Walkers Childminding family) and the Durnhythe team. They persist through the technological issues and keep trying different things to overcome the issues. They continue working on finding ways to improve the experience further, but the key is that the children and the residents now get to meet weekly, just as they did prior to the pandemic! 

Being productive, and good neighbours while living in a care come

It makes sense to connect to businesses and to volunteer for others whatever your age and wherever you live. 

After much debate with residents, wooden planters were used to create a vegetable garden at Carrondale Care Home in Falkirk. Seeds were purchased from the local supermarket and talented residents got to work. Being mindful of how difficult it can be for young families, the resident gardeners decided to donate vegetables to local foodbanks. Good connections with local business also meant that the local builders' merchants and B&Q helped with setting up this project.

Are there local charities near you who could do with some input? Is there a way for people experiencing care to contribute to their neighbours? Giving to others is one way to build wellbeing.

Improving the management of medicines, improving care

Staff at Wallace Court Care Home in Johnstone, run by Capability Scotland, have changed their approach to managing medicines to allow for safer, more person-centred care.   

Care home manager Gillian Connelly was proud of the existing person-centred approach to medication administration they had in place but felt the rate of medication errors was still too high:     

“My quality manager passed on the Care Inspectorate’s Medicine Improvement Project report.   After reading it, I felt inspired that we too could improve the system at Wallace Court.   It was good to see that other homes were having similar issues and were able to improve.   I was encouraged by it but was not really sure how to proceed”.    

Gillian contacted David Marshall, the Senior Improvement Adviser for Pharmacy, who helped them identify some potential improvements.  He discovered that team leaders were checking and counting all medications after each administration. This was very time consuming (taking around 2 hours per shift), reducing the time staff had for more personal interactions with residents.   

“As our success rate for reconciling stock was consistently high, we were able to reduce the frequency of stock checks for non-controlled medicines to twice weekly - and move to a sampling approach.  We continue to monitor, but we have created some time in our system with no drop off in quality”.   

Gillian now uses this time to focus on reducing medicine administration errors and has done this by setting up a project group of team leaders and a support worker.   

“We agreed on our definition of a medicine error and set about collecting our baseline data.  I asked them for their improvement ideas, and they suggested having two staff administering medication on each shift.  We began to test this with one team leader and one staff member responsible for administering all medication on shift”.   

Workload expectations and tasks had to be tweaked to ensure equity amongst staff but the initial data for the reduction of medication errors looks promising and this has in turn motivated staff.  

Overall the benefits of this project are that: 

• Customers are in a safer environment as the risk of medication errors is reduced  
• Staff are freed up to provide more 1-1 support and activities and ensure quality in other areas.  

• Team leaders are able to offer support to staff when paired on medication  
• Staff feel their ideas are taken seriously and put into practice  

Gillian concludes:  

“We next aim to test two support workers on each shift.   We are developing our learning journey and will continue to improve.  I feel confident in this because we are doing it together as a team”. 

Sporting memories 

The sporting memories kitbag, developed by Sporting Memories Network, provides a gentle, practical way to encourage and aid activity at home. 

Sporting Memories Chris Davies:

‘’We created our new KITbag at the start of the year and this lockdown to encourage our frailer members to get active at home. Subsequently the Scottish Government ordered a further 500.

"We are gathering in-depth feedback from people members who received the pack and will have soon have initial findings. We use some of the items from the KITbag in group activities and they have already been well. We see this through our weekly online zoom sessions and weekly phone circle groups. A good number of our members have certainly been getting active at home.

"Uniquely, our KITbag included reminiscence materials, as well as, physical activity equipment and exercise guides, to tap into an interest in sport to help nudge members into becoming active. This all really developed out of some of the activities we began to scope through our Care Inspe3ctorate CAPA project’’

Find out more about Sporting Memories kit bag and how to get hold of one here:   https://www.sportingmemoriesnetwork.com/sporting-memories-kitbag

Dementia together

Connecting People, connecting support is a website where people with dementia, families and supporters can come together to explore ways of living well with dementia.  

New resources are shared here every week. The Tuesday resources focus on practical information such as how to maintain a routine and the benefits of using a memory book, with Friday resources focusing on hobbies and interests including music and photos. The resources have all been tried, tested and recommended by people with dementia.

An indoor marathon during lockdown

Scavenger hunt anyone? Using technology to connect people of different generations

It can be a puzzle to find ways to keep connected with local nurseries and schools when regular visits cannot take place.  

One way around this is to use digital technology.  Edenholme Care Home in Aberdeenshire did just that – and residents ended up being shown how how Anderson Shelters were built while chatting virtually with a young guide.   Babes in the Woods Nursery ran a scavenger hunt with the residents. The residents enjoyed shouting out colours and items and watched the large screen with delight while the youngsters searched for them.  

A quiz where two schools (Catterline and Kineff) took on the might of the Edenholme residents was a big success for everyone involved.  

Here’s the quiz that they kindly offered to share. Perhaps this is something that someone you know might be interested in organising? 

Carolyn Shaw, Assistant Manager, Edenholme Care Home in Stonehaven sent us this story 

Ten minute breaks for keeping in touch and having fun

Here is an idea to help staff de-stress, let their hair down and have a bit of a laugh - all while promoting good lives for residents.  

Anuj Dawar, the Care Home Manager at Durnhythe Care Home in Aberdeenshire wondered how to encourage even more activity and movement and action in these times, while ensuring strict IPC measures are upheld. Anuj and staff discussed ideas in detail one morning, figured out how to safely run a session and started ‘10 minutes of Fun’ that afternoon.  

This follows the approach that sometimes it is best to crack on with an idea, then adjust as you go.  

The 10 minutes of fun session is now announced daily over the intercom, so everyone knows to gather in a large living area. Care staff, domestic staff and the cook have all been involved. Anuj makes sure to prioritise it also, to show his staff that it is OK to take 10 minutes to have a bit of fun. The music goes on and a different staff member leads each session.  Everyone gets involved however they want, this could be moving to the music, dancing, twirling or whatever folk fancy. Mind you, the staff find it difficult to refrain from singing. 

What has the result been? Staff and residents have experienced hilarity, giggles, jokes and the atmosphere feeling lighter. Stress levels appear to have reduced. And of course, those involved will have been active for 10 minutes, that build up to over an hour a week, cunningly hidden in a fun activity. When the session is finished, IPC controls ensure all risks are reduced. And the risks of loneliness, inactivity and lethargy are also reduced for residents along with stress levels for staff. 

Betty uses technology

Betty, who is 103, started using more technology during the Covid-19 lockdown. Betty is keen to encourage others to learn something new that can open up new worlds, whatever their age. Here is Betty talking to BBC North East about how she uses technology in a way that makes a difference. 

Keeping connected with the community 

Louise Kelly, Senior Improvement Adviser, shares a story from Kirriemuir in Angus:

"We all want to be valued members of our community, no matter where we live.  At Storyville Care Home in Kirriemuir, Angus, the staff work to make sure that each resident has opportunities to come up with ideas and then take the time to follow these ideas through. 

"When the normal ins and outs of the busy home had to cease, residents puzzled about different ways to connect with their neighbours. Here are some examples of how they stayed in touch. 

"Last year the residents challenged neighbours and friends to paint and swap stones. The staff helped figure out how this could be done safely.   

Watch their video here 

"We know that having different experiences can add to our lives, which was certainly difficult during lockdown.  By listening and following through with resident Nettie Cameron’s idea, many of the older people ended up in the paper and on TV.  Folk were buzzing with the excitement and the new experiences. 

"At Christmas, they invited the local community to contribute to decorating the garden. 

"It is not just asking for something but achieving something together that makes all the difference to building community. The local community rallied around to decorate outdoors, with a ceilidh band offering to serenade the residents and locals invited to drop by to be part of the ceremony when the lights were switched on. 

"And this year Storyville is still working on building community, by focusing on connections with children.  The nursery children used to benefit from visiting the home and meeting their older neighbours. Now the residents send cards and swap paintings. It gives both older and younger people a lift to receive something personal."

New flat, new opportunities 

Hazel Maitland at Key explains how the support they gave helped Diana West become more independent in her new home:  

"Diana, in her 60’s, recently moved to a new flat in Falkirk. She now lives with a flatmate in a shared tenancy and is enjoying the opportunities and challenges of her new life. Key supports Diana and other adults and young people with disabilities and long-term conditions throughout Scotland. 

"Key staff encourage the people they support to move more often in little ways every day. They know that this adds to people’s physical, psychological, and social wellbeing. When Diana moved into her flat, she hadn’t had the experience of getting herself ready for bed and needed help from staff every step of the way.  Diana’s support team started to suggest small actions for Diana to take so that she could move more and to be more independent when going to bed. This started with Diana being encouraged to head through to close her own blinds.  By building on such small steps, Diana is now in charge of everything, from preparing her room and undressing to getting her clothes out for the next day. 

"Diana feels more independent as she now chooses clothes to suit her mood and decides when she wants to go to bed in the evening without having to wait for staff.  

"The approach Diana's team took was to always encourage her to try things for herself and build her confidence around tasks that she felt less sure of.  

"A knock-on effect is that Diana has started to do other things for herself such as make her own cup of tea.  Congratulations Diana, as you live your new life in your flat."

High tea boxes

Rosie the activity coordinator at Park Springs Care Home, Motherwell talks about an idea the residents had to boost morale during the lockdown:

“At a meeting the residents said that they wanted to give an afternoon tea box to the NHS local Emergency units in the hospitals, local police, Firefighters and the doctors in the local surgeries to say thank you. Residents watched them on TV and saw what an amazing job everyone was trying to do in these strange and frightening circumstances.  

"Frances our resident said ‘’They are amazing the jobs they do and it's nice to be nice’’. 

"We had so many questions - so many things we were unsure of and had to figure out. 

• what could we use? 
• what would be allowed?  
• would they be able to accept the items? 
• would we get in to deliver the boxes? 
• what could we put in the boxes? 
• how could we make them look nice? 

"Rainbows had been used to decorate the home, so we all decided to use rainbows to cover the boxes. The residents and the staff started colouring lots and lots of rainbows. Again, it was a project to focus on good things, it was a great talking point - kept everyone busy and changed the atmosphere at a time when it was hard not seeing families, not being able to go out.  Not being able to do the little things which mattered so much.”  

“The tea boxes were giving everyone a purpose and making people feel useful and positive.  Donations from the community helped fill part of the boxes with items that were considered safe. We had to order paper, boxes and ribbon as we didn't have any shops to use but it all came together with lots of fun and excitement about giving back to our community.” 

“We contacted the three local hospitals Wishaw, Monkman's, Hairmyres and the local Police station, Fire station and surgeries to see if they would accept our tea boxes and we got special permission and delivery times.”    

“We took photos of everyone accepting the gifts and it was even more special as the staff in all the areas loved it coming from the residents. It was just such a shame they the residents were unable to deliver the items themselves and see the reaction from the staff - the Police Chief said it's the nicest thing ever and could feel tears when he accepted our gifts.”  

“The residents and staff were all so pleased and happy and proud of the High Tea Boxes. We all felt we had helped a little by sharing with some amazing people.” 

Superhero pictures

Lynn Rell, RGN at Parksprings Care Home started creating Staff Hero Pictures during the lockdown.

“Lynn has painted pictures of her colleagues at work in superhero style.   She has since created an army of superhero pictures - nurses, carers, domestic, maintenance, admin staff and management.  

“Each picture is full of fun and has been a huge boost to staff around the home and a great talking point for the residents.  They all love the pictures as they are so real and yet so funny.  Lynn has an amazing talent, and her dedication and kindness has made her our hero.” 

To show Lynn their appreciation, staff and residents created a gallery of Lynn’s work which is displayed in the centre of the home.  It brings smiles and is just what the doctor ordered - a wee tonic to boost spirits and help everyone's morale. Here are Rosie, Michelle and Linda with artist Lynn - superheroes all of them. 

Mary Tait & Robert Edenholme

By Carolyn Shaw, Assistant Care Home Manager, Edenholme Care Home:   

‘’Mary says that watching old films of your hometown can be very interesting.  You can see Mary catching up with some Glasgow memories as she is supported by Robert to use an iPad in Edenholme Care Home, Aberdeenshire. It is amazing what you remember when something catches your eye”. 

“Apps that have meaning and make a difference to people have been put onto the iPads to allow the residents to enjoy their interests. This is having such a positive effect.  We also set up digital surveys, and with the help from staff, all residents share their views in the knowledge that they will be listened to.  For example, the residents individually voted from around the care home to decide what to do with some extra money. The majority choose to build a summer house. It was good to see democracy in action.’’ 

Reminiscence means sharing life experiences, memories and stories from the past.  Where a person with dementia is more able to recall things from many years ago than recent memories, reminiscence draws on this strength.  Objects, video clips, photos as well as sounds and smells can be helpful in reminiscence, invoking memories and stories that give both comfort and stimulation (Alzheimer Scotland).  

Here is a short film which shows how reminiscence is used by Alzheimer Scotland to support older people on an experience outdoors.  

Sharing hearts

Rosie Brennan, Lead Activities Co-ordinator,  picks up the story. 

"The residents and families missed each other so much we were always looking at ways to keep everyone connected.   

“The local community sent us in some lovely hand knitted hearts. We came up with the idea that residents could share a knitted heart with their relative and keep a similar one for themselves, like two pieces of a puzzle. It was a way for families and residents to have something from each other that they could each carry around and squeeze when they were feeling low or lonely.  Just a little something to help with happy thoughts during a difficult time.

“We took wee photos of the resident holding their knitted heart and then packaged the other one up and sent it with this photo to their relative. Some of the families shared that they still keep their wee heart in their wallet close to them. It kind of helped everyone as no-one had experienced a pandemic before and missing each other was devastating on everyone, both inside and outside the care home.

“It brought smiles to everyone's faces and one of the residents, Frances, still carries her heart with her." 

Movement sticks

The idea of movement sticks, from Kirkburn Court Care Home in Aberdeenshire, is a good and simple way to inspire people to keep themselves moving in later life.