My Health, My Care, My Home - healthcare framework for adults living in care homes: annual progress report September 2023

Nurturing Environment

Developing a nurturing environment for all those living in the care home is important, but it is also vital that this is balanced for every individual living in the care home.

The direct and indirect impact of the COVID pandemic on people living in care homes has been immense and damaging. However, the lifting of visiting restrictions and the resumption of a multitude of meaningful activities has greatly benefitted people living in care homes.

During the past year we enjoyed engaging with care homes to explore how they are taking a proactive approach to care that also provides access to meaningful activities and social connections, to help improve physical activity and mobility and reduce ill-health and deterioration.

A Dementia Care Manager at HC-One Scotland described a situation to us where ‘establishing the why’ about an individual’s behaviour was so important to how staff provide care and support and build a care plan that supports them to enjoy a better quality of life.

The gentleman had become very challenging to support and live within the care home. One to one care was being funded to support and prevent altercations with other residents and staff – who were becoming scared.

The team set out to establish the root cause of the gentleman’s behaviour and developed a collaborative approach to better understand the issues and find a positive outcome for the individual. Management provided training and created a safe, encouraging environment for staff to engage and explore ideas.

This helped staff identify that the lack of occupation and engagement during the day was leading to the gentleman becoming bored. In response, staff built up a meaningful day for him, starting with him helping the maintenance operative bring in deliveries, followed by him establishing and attending to his own space within the communal garden. Every day the resident now has purpose and meaning to his day that has enhanced his wellbeing and quality of life.

Meaningful Activities

Meaningful activities have become embedded in staff routines across the country. Staff create a proactive approach to care that makes the resident feel included, as well as improving their physical activity and mobility, reducing ill-health and deterioration.

For example, Belsize Healthcare Scotland have commissioned a company to create an e-learning training programme that looks at meaningful activities. One of their care homes in Grampian, Laurels Lodge, have made this e-learning course mandatory for all staff, including carers and domestic staff, who are encouraged to get to know residents and involve them in jobs around the home.

We have also heard how moving into a care home brings with it many changes, not only for the person, but for their family too. It can bring disruption to their routine daily activities and connections, but it can also enhance them. This transition is enabled by the professional, dedicated and committed workforce across the care home.

While speaking with care homes we heard of numerous examples where individuals were helping out the gardener, handyman and kitchen staff. We also heard how care homes were creating and maintaining strong links within their local community.

Kincarrathie House in Perth undertake many activities, including lots of inter-generational work with nurseries, schools and universities in the local area. This has resulted in a positive influence on both the young people in the community and the residents in the care home.

Durnhythe Care Home in Portsoy use their digital devices to have “10 minutes of fun” sessions with music. Everyone gets involved however they want; this could be listening or dancing to the music. These sessions are now daily with care staff, domestic and kitchen staff all getting involved.

Parklands Care Home in Alloa have a close relationship with local school children who visit the care home to take part in a number of activities, such as drawing and reading. In June this year, the care home and local primary school had a joint sports day and took part in fun games like an egg and spoon race.

Abbotsford Care in Fife have created unique namaste boxes which help to create a sense of security and tranquillity for residents and staff. The use of various senses, such as touch, scent, and sound, in a calming and intentional manner has proven to be a powerful way to communicate care and affection without relying solely on verbal communication.

“The impact on staff is bringing the staff closer to the resident and promoting person centred care, with the impact on residents is reducing agitation levels, promoting 1-2-1 time with staff and residents are able to build closer bonds with staff.”

Abbotsford care staff member

Care homes across Perth and Kinross hold an annual Go4Gold event. Now in its eleventh year, the event has far exceeded expectations with significant physical and mental health benefits being realised as well as the creation of opportunities for socialising. We wrote a blog about last year’s event.

We also spoke to a number of staff who have a support worker or “activity co-ordinator” role. It is their job to support residents to create their own meaningful day. Whilst we are aware not every care home has a full-time activity co-ordinator, those that do really emphasised the positive impact the activities and connections they organise, no matter how big or small, have on an individual’s self-esteem and independence. You can read more about the experiences of those we spoke to at Annex C.

Care Inspectorate and Meaningful Connections Project

The Meaningful Connections Project being undertaken by the Care Inspectorate aims to uphold the rights of those who live in care homes, with a particular focus on promoting meaningful social connection and community involvement. There is a clear overlap between this and the framework, given their person-centred outcomes and seeing social connection as an essential and fundamental component of good healthcare and positive wellbeing.

In addition, the Care Inspectorate have created a Practice guide to show how technology and digital devices can be used to make a positive impact on health and wellbeing for people experiencing care. They also developed and published a poster during the pandemic on the Enriched Model of Psychological Needs which highlights the importance of engaging in activities that are important to the individual and of being an active member of the community.

Provision of danceSing Care for Care Homes

We are delighted to be working with danceSing Care and the University of Stirling to roll out danceSing to 60 care homes across Scotland.

This ‘tech-powered, human-led' creative healthcare platform focuses on improving personal and preventative care for inspirational and fulfilled living through the power of music, movement, and the community.

The participating care homes cover the length and breadth of the country and are representative of the whole sector. Training for staff will commence in September before the service is rolled out between October 2023 and September 2024. During this time, care homes will be able to take part in music and movement sessions, as well as listen to a “reminiscence radio station”. The programme will also be evaluated by the University of Stirling.

Cabinet Secretary’s visit to Barleystone Court care home

When Mr Matheson, Cabinet Secretary for NHS Recovery, Health and Social Care, visited Barleystone in August 2023, we were able to have a discussion with their wellbeing co-ordinator and see first-hand a sample of the wide range of activities available to residents.

We were lucky enough to take part in an arts and crafts session where residents were painting butterflies while chatting to the care home staff. This is a frequent activity at the care home as it is very popular. We also got to see residents take part in a live, virtual exercise class.

The wellbeing co-ordinator told us of the positive impact the activities have on residents, and in particular, the live, virtual exercise is a favourite that lifts the mood of residents after they have taken part. The care home’s close links to local schools and nurseries also has a positive impact on the residents.