For staff working in care homes for older people, excellence is about getting to know people
who live in the home as an individual, understanding and being responsive to the things that are
important to them. Excellent care homes are places where people using services have choice and control,
build good relationships, control, build good relationships, and spend their time enjoyably.
In this film we brought together a panel of experts,
including people who use services, to discuss what excellence means in a supported living setting.
First, let’s meet the panel.
Ann Netten is a Professor of Social Welfare who helps define excellence for the Social Care
Institute for Excellence. Julie Beadle-Brown is a Reader in Intellectual and Development Disability at
the University of Kent.Dorothy Runnicles uses social care services and is a campaigner for older people.
The panel will be looking at how staff deliver good care and encourage activities at Wood Grange,
a residential care home for older people and those with dementia.
At Wood Grange, staff work on sharing meaningful one to one time with the residents.
- You did that with the Red Cross, weren’t you? - I was [unclear]
Yes you were, weren’t you? Lots of different things weren’t you.
- Oh yes, I was active. - You were very active.
- [sings] Would you like to be… - Under the deep blue sea… [sings]
- Keep going Geoff, keep singing. - Would you like to be [sings]
One to one moments here are called butterfly moments, which we always class as like a butterfly
flits from flower to flower, us as workers here do that. And that is from domestics, from management…
- What’s that a picture of? - That’s me on the flight deck of the carrier.
And what did you have to do? Go on tell me. What did you have to do - what was your job?
- I was a mechanic. - A mechanic, you clever man.
You will see no one walk by a resident, just because they’re sat quiet in a chair
doesn’t mean they’re ignored. It is a very strict thing here that no one is ignored.
We all join in, do things, we all join in and help out
and the residents just love everybody, everybody that works here, you can see that with them.
The panel discusses the importance of good relationships with all staff.
I think this idea of butterfly moments, if it’s sustained, sounds lovely.
That idea that you just make just that little bit of engagement.
Again, not too demanding of people, but actually just brings them out of themselves a bit.
Understanding goes both ways, so that the carer learns as well as the person whose
memory is being triggered.
But I think that the activities organiser was right, you have to involve lots of people.
We saw some wonderful examples of rapport and relationships there.
And I think in that setting, I would like to believe that those go across other times.
Across personal care tasks, across feeding tasks etcetera, not just in the activity sessions.
And that’s what you’re aiming for.
One example of excellence is turning a problem into an opportunity, with creative thinking.
One nice, nice little story when I started this job was,
we had a gentleman on our memory lane who fell in love with his wife again when she visited.
And he kept asking her repeatedly to marry him and of course she tried to get him
to say they’d been married about sixty years, but he just didn’t take that on board.
So what we thought would be a nice thing, we got the local vicar to come in and give them a blessing,
so that he thought they were getting married again.
And after that, he never did ask her again, so he obviously accepted the fact that they’d
got married. Which was lovely, everybody was sort of there, we had a cake and drinks and that. So that
was a lovely moment, that was a special little moment I think, for both of them, for both of them.
The panel discuss the benefits of a creative approach.
I think one of the things that was really nice was turning something that could
have been seen as a problem into a really positive experience for all concerned.
I imagine that went wider than just the individuals concerned, you can imagine
the whole home would’ve rejoiced in that.
And it could’ve been seen as a persistent problem that had to be dealt with,
but instead they turned it into something really positive, which was great.
And it wasn’t in the long run a very resource intensive solution,
I mean it was a day, the cost of a cake, that creativity isn’t it, that we talked about earlier.
And a positive illustration of a worker understanding how you respond to people
who’ve lost a part of their memory but have other parts of their memory
still very alert which give them pleasure.
And it’s part of what people’s lives consist of,
and it’s part of anniversaries, weddings, parties, birthdays, and so on,
are part of what we call our activities and so on, so it’s real activity, it’s meaningful.
Careful assessment and planning by staff helps to develop a good picture
of each individual who comes to live in the home.
When somebody gets admitted to us, we need to get to know them as much as we possibly can
and that’s not just purely around the medical side of things. That’s about them as a person,
what have they done as a career, what have they done in their life.
So we can get a picture of that person. And then based on that we can identify
what is important to them, what activities they will enjoy doing.
It would be too easy for somebody to come in and say
‘this is a resident who is in room 24 and they’re suffering with Alzheimers disease.’
We don’t want it like that, you know. This is a person who’s got a name,
who’s got a family, who’s got a life. And we treat them in that way.
At Wood Grange’s specialised dementia unit, Memory Lane,
they try to use the resident’s personal experience to create relevant activities.
On our Memory Lane unit, activities are 24/7.
If anyone gets up in the night and wants to do something, they’ll do it.
We tried to do a lot of activities that could bring back memories, nostalgic activities I think.
The funny story is one day I thought I’ll do shoe cleaning
and I thought the gentlemen would love that because of the forces and all this, they all cleaned their
shoes and all this. But I haven’t got any black shoes, men’s shoes.
So I sort of quite secretly brought a pair of my husband’s in, black leather shoes, which was fine,
this gentlemen cleaned them, lovely, you could see your face in them. But unfortunately he
wouldn’t give me them back. He thought they were his. So I had to own up to my husband
when he wanted his shoes where they were. [laughs]
I said I think there’s someone walking around with them on Memory Lane at work.
This clip illustrates the point that we were talking about on the last one, the butterfly moments clip.
About the - you know, what she’s clearly said here is that the activities are 24/7. That these
people on this unit can get up and staff will support them to be able to engage in activities.
That was what struck me particularly as well, this 24/7, I thought that was excellent.
That’s very rare I think for activities and I think it’s really the way to go.
Meaningful activity can be really meaningful in terms of contributing to the work of the home,
or the unit or the clinic or the day centre.
Really helping and taking some responsibility which is meaningful in terms of the functioning -
- Having some responsibility… - It’s a whole range of possibilities, isn’t it?
Yes, absolutely.
Each month, Wood Grange holds a themed day
to get residents and their families enjoying activities together.
Today, it’s the home’s Christmas party. For activities co-ordinator, Sandra Baker,
it’s a big part of building relationships with residents and their families.
Today, we have Music for Health coming in, which is a real big favourite of Wood Grange.
Lots of action, lots of laughing, music, playing musical instruments, dancing, singing,
everything that we’re good at here - or that we like to think that we are, we’re good at.
But - so these things we like to encourage families to take part in so that we’re all together.
And it’s nice for everybody else as well, everybody else sees other people’s families and
it’s a talking thing for them then, they’ll talk about it.
[drumming] - Fabulous!
For the residents, activities make a huge difference to their quality of life.
Jeannie remembers a care home she lived in previously.
There was hardly any activities. After meals, people went back to their rooms.
Didn’t like that. Didn’t like that. Everybody back to their rooms after their meal.
There was no getting together.
But Jeannie feels much more happy with the activities on offer at Wood Grange.
When we have visitors come in, people to entertain us, they bring their music, and they’re dancing,
people who can get up and dance, and there’s a good old, you know, sing song, and
it’s really nice, enjoyable. We really enjoy it, it keeps us alive, it really does.
You don’t see many sleeping when we’ve got entertainment. I’m very happy here. We love the
staff, they all love us. They treat us as if we’re their grandmas, like they’d treat their own.
They really are very loveable, and it does really make you feel good.
If we were thinking about what makes excellence in social care settings,
one of the things would be that staff look at the people that they’re supporting and really think
well if this was my grandmother, if it was my mother, if it was me, how would I be feeling,
if I was doing this. You know, if I was sitting staring at the wall, how would I feel.
You get that real sense of an engagement across the generations and involving the family
so that they feel part of what’s going on in the homes, and they can get the benefits as well.
The panel has been encouraged by the examples they’ve seen.
These social care needs will remain with us, and we have an ageing population, we’re living longer,
and I think that not to see older people as a burden but a resource,
not to see older people as excluded but included
will actually help the solutions to the problems that currently are overwhelmingly there.
Residential care doesn’t mean treating people the same.
The diversity of the way that - the individualised levels of care that people were getting
apparently in like an institutional setting, as in they were all in residential settings,
but actually what was happening for people was very different and dependent on themselves,
their histories, what they brought and what their needs were.
I think that one of the key things in achieving excellence in residential care is
that we need to focus on the relationships. The relationships between staff
and the people they are supporting, in whatever environment that might be in.
I think that individualised care which can happen is illustrative
of the excellence can happen in care homes, in residential care homes.