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Business Clinic
Making Pals – Encouraging community integration

Activities in care homes should be engaging, personalised and inclusive, but putting together a schedule can be hard. This, coupled with the drive to get homes interacting more with their communities, has led to Alive’s ‘Making Pals’ project.

Through its work, Alive had seen the positive impact that social connections can have on care home residents and knew that connecting homes with their communities could have a significant influence on wellbeing.

Funded by The Henry Smith Charitable Foundation, Alive’s three-year Making Pals project was designed to help homes build long-lasting and meaningful relationships with their communities across parts of Somerset, Bristol and Gloucestershire. This included encouraging homes to find new ways to engage their residents with people and spaces outside of the home and building the homes’ capacity to carry on the relationships beyond the project.

Selecting the homes

Alive began by choosing ten care homes to be part of an intensive pilot. The homes were selected to ensure that the results were applicable to care homes across the board. They were chosen based on their CQC rating, their location (a mix of urban and rural), their size and whether their residents were living with dementia. The project also worked with a further 50 care homes to signpost and connect them to their communities.

Co-producing community activities

Alive developed a co-production process to understand how residents in the pilot homes wanted to engage with their communities and what activities they wanted to take part in. A combination of group discussion, reminiscence, suggestion boxes, one-to-ones, handling items and sensory stimulation revealed potential avenues for activities.

Alive compiled the results of these interactions and reported back to care homes, creating activity plans and recommendations. The charity then supported the homes to create new, and utilise existing, opportunities in the local area. For example, fishing was identified as something several residents wanted to take part in, so the team organised accessible fishing days.

The homes could also use the co-produced information in their day-to-day caring; they could make small changes, tailoring their support to enable someone to go out for half a pint or stay in to watch the cricket.

The project also encourages care homes to play a bigger role in their communities. Alive supports homes to run events for the public and to offer space for community activities, allowing the public to spend time there and enabling residents to socialise with people from the community. Alive has also brokered relationships with local organisations like gardening clubs, youth groups and universities to encourage long-term collaboration.

To help more homes with their community engagement, Alive has developed volunteer management training for care staff, supporting them to find and manage volunteers who can assist residents with skilled or specific hobbies. One home in the project has a volunteer who visits regularly to build model planes with a resident. Making Pals offers this volunteer management training to up to four staff from each home it is working with.

Challenges

Anxiety and a loss of confidence among residents in going outside of the care home, combined with staff concerns about health and safety has been a significant barrier. However, Alive has found that by documenting the successful outings (through photography and case studies) and sharing these stories with staff and residents, this barrier can be overcome.

Emma Dyer, Making Pals Project Manager said, ‘At the first fishing trip we ran, all five men dropped out, with care staff citing anxiety and unease about going to do something they’d not done in a long time as the main reason. However, once those involved had seen photos of other people successfully enjoying trips out, they became more confident. We’ve had particular success with our men’s fishing trips; now there are a number of men confident enough to come along without carers, giving them a huge amount of independence that they did not have before.’

Access to suitable transport has also proved an issue, with many homes that have a minibus not able to recruit a regular driver. To combat this, Alive is training a bank of drivers for homes to call upon and is working with community transport charities to offer trips that are affordable for residents and profitable for the charities.

Seeing results

Making Pals is in its second year and is seeing positive results. Residents’ wellbeing has improved, there is a better understanding of residents’ needs, and staff are better equipped to respond to anxiety or distress. The increased level of community engagement enables residents to feel more included in their community, less lonely and less isolated.

Looking to the future, Alive’s Chief Executive, Simon Bernstein said, ‘Making Pals proves that these kinds of community partnerships, events and trips out are hugely beneficial for care homes and their residents. Low budgets, limited staff capacity and perceived risks, need not be barriers if some creativity, ingenuity and enthusiasm can be injected into care home activity planning. For 2019 we’re producing a series of ‘how-to’ training courses and toolkits for care homes to gain the skills they need and try the process for themselves.

‘In the final year of the project, and beyond, we would love to see care homes using our resources to develop their activity plans directly with residents, as well as making those all-important connections with their local communities. We hope Alive’s Making Pals project will not only transform the way the general public perceive care homes but will encourage care home residents and their care staff to believe they can make important contributions to community life too.’

Over to the experts…

How can Making Pals be adapted to suit the wider market? How easy will it be to replicate the support and training care homes are offered? Can this change the way communities view care homes?

A positive ‘can do’ approach

It struck me that the article refers, directly or indirectly, to ‘confidence’ or the lack of it. It is relevant to both the residents and to the staff. What the Alive project team seem to bring is a ‘can do’ approach that recognises potential barriers and looks for creative solutions. In the process they are building the confidence to do things differently which can be hard for many residents to embrace and seen as a step too far for some staff.

In our experience, once you can persuade and motivate a care team to look for innovative ways of doing things, you can step back and watch a significant culture shift take place. But it does take some skill to achieve this and often needs the enthusiasm of an ‘outsider’ to get it going. In some care settings, the activity team can motivate and inspire but they too can be defeated by policies that seem to be insurmountable.

It is sensible to share Alive’s learning through a ‘How to guide’ but I believe it will take more than that to spread this effective initiative. On-site, face-to-face training encourages questioning and gives the opportunity to break down myths and taboos about what can and can’t be done in a way that no other medium can.

I believe that changing the perceptions of care by the community will only come about when most people have made a positive connection with care. It might be by meeting residents fishing on a river bank, or the man running the model shop that the activity co-ordinator buys the kits from spreading the word. Either way, it will be about the relationships forged that make a difference in the long term. All credit to Alive and the Henry Smith Foundation for getting the ball rolling.

Sylvie Silver Executive Director, NAPA 

Brings communities closer together

Being involved in your local community is a great way to improve the health and wellbeing of people with care and support needs. For care homes, enabling people who live there to stay engaged in their local community can be a challenge.

Maintaining relationships with local groups is an important part of meeting this challenge. The Making Pals project is a great example of what can be achieved by engaging with people beyond the walls of the care home.

As with most things in life, it’s how personalised things are that makes the difference. ‘Likes going out’ is not enough if someone’s interpretation of that means an individual goes to a place they don’t like, with no way of leaving by themselves.

Projects like Making Pals have an important role to play in enabling people living and working in a care home to be more than a ‘client’ or a ‘care worker’ and stay in touch with who they really are and what matters to them outside the home in the community they live in.

Skills for Care has worked on developing community skills itself, and our work showed that community involvement in a care home can impact positively on everyone – the workforce, people with care and support needs, and people in the local community.

Projects like this also change the way that communities see care homes. Realising that the local care home for older people is actually full of retired accountants, librarians and dress makers for example, who could, in different ways, share their knowledge and skills with local people, changes perceptions and can even bring communities closer together.

Jim Thomas Programme Head for Workforce Innovation, Skills for Care  

The extra support the care sector needs

A charity project like Making Pals can really make a difference to the lives of older people living in care homes. We know that activities that are designed bespoke for the individual, from young to old, contribute to well-rounded, fulfilling lives where people are seen and heard, and for older people, especially those who require long term nursing care or have various stages of dementia. For care homes who don’t have the capacity to provide the activities calendars and facilities as thoroughly as bigger brands, the support from Making Pals can help more individuals by connecting them to new friends in their neighbourhood, and connecting the home itself to its community.

It will be challenging to train and monitor all of the volunteers necessary to make Making Pals nationwide and keep its quality of care consistent; as with all types of care we want to make sure our loved ones are in safe hands. It can also be quite costly to support all residents who would benefit from a volunteer friend. But if there is enough support, Making Pals could really become a care institution which can upgrade the quality of care across the country. Each older person deserves a good quality of life, and a project like Making Pals has great potential to provide the extra support the sector needs.

Providing activities for the elderly can be a hugely rewarding career, and can truly support residents to live well-rounded lives.

Community activities, such as those the Making Pals project organises, support personal interests of residents with their personal hobbies, which can help maintain their independence, as well as boost social interaction so they don’t become isolated.

Michael Butler Activities Champion, Barchester Healthcare  

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