My Health, My Care, My Home - healthcare framework for adults living in care homes

What We've Heard

Our programme of engagement, most of which took place online between November 2021 and April 2022, involved the following:

• 29 Engagement events
• 674 Stakeholders invited
• 44 Residents and families
• 6 Focus groups
• 508 Online survey responses
• 73 Good practice returns

Whilst the opportunity for face-to-face engagement was limited by the Omicron wave of the COVID-19 pandemic, it was possible to engage directly with 25 people living in care homes. People were encouraged to share their views on living in the care home, and their experiences of accessing healthcare. We also wanted to know what was important to them. Some of this feedback was collected using postcards (see below).

We also engaged directly with 19 family members. However, many stakeholders attending other engagement sessions in a professional capacity also gave views on their personal experiences of family members living in care homes.

We have also used social media, surveys and focus groups to hear from a wide range of stakeholders. These included care home providers and staff, the Care Inspectorate, Healthcare Improvement Scotland (HIS), the 'third' and independent sector and numerous other professionals from across the system who plan, provide and deliver care. We are extremely grateful to everyone who provided their thoughts, insights and suggestions.

A consistent comment emanating from our engagement was the need to do work 'with' the care home community rather than doing things 'to' them. There was a strong desire for everyone to work together in a supportive way to enable better health outcomes for people living in care homes.

An online survey was developed and sent to all care homes across Scotland. There was an overwhelming view from respondents (93%) that healthcare for people living in care homes could be improved.

All the various comments, stories, experiences, opinions and suggestions from our engagement activities have been used to shape the framework and inform the recommendations. Engagement is not a one-off exercise and must continue as we start implementing the various recommendations within this report. More information on implementation can be found in the 'Making This Happen' section.

Resident Engagement Sessions – Fife

In 2021, Abbotsford Care, the Care Home Hub from Fife Health and Social Care Partnership collaborated to develop the 'Hear My Voice and Return to Sender' initiative as a means of exploring new methods of engagement with people living in care homes. The immediate aim was to influence this framework but the group has longer-term aims to develop methodology utilising an activities-based approach to supporting and prioritising the voices of people living in care homes throughout Scotland.

The focus of this initiative centred around a creative approach, using fun and activities in focus group sessions to begin conversations and support the generation of feedback in a comfortable environment. Using person-centred activities, participants engaged in a number of activities; for example, they were asked to assign a colour scale to a set of emotive questions, create a shape to reflect their feelings representing their experiences, discuss and sharing a mind map of all the support services who have helped them, and detail their personal experiences on a postcard which centres around a performative moment for residents and staff to engage in.

The importance of being well-cared-for was emphasised, as was the sense of living and enjoying life. While some residents expressed a preference to be able to live independently at home, others highlighted that they felt safe in the care home. Individual preferences for company and solace were shared. Some spoke of their enjoyment of activities within the home, shared with staff and other residents. The negative impact of restrictions on access to family, opportunities for leaving the home and going outside were noted, with residents looking forward to greater opportunities now restrictions have eased. Connectedness and relationships with families and care staff were shared.

What was noted as one of the most positive outcomes from this initiative was the direct opportunities for Care Home Liaison nurses from the Health and Social Care Partnership to spend time with those living in Care Homes and to learn more about their experiences.

A further 1,000 postcards have been distributed to people living in care homes across Scotland which will be used to inform the roll-out and implementation of the framework.