About Rights Made Real in Care Homes
About the project
Rights Made Real in Care Homes is an exciting new project, funded by the Life Changes Trust and delivered in partnership with Scottish Care and the University of the West of Scotland.
The overall aim is to improve the quality of life of those living in a care home and to help support staff to not only recognise but embed human rights into their everyday practice.
The project funds creative and innovative projects and ways of working that will benefit people living with dementia and show others how to make rights real in care homes. All partners in this project are committed to ensuring that older people, including those living with dementia, have a right to maintain strong connections with family and friends, with their communities and with the things that matter to them regardless of where they live. We believe that people of all ages, circumstances and conditions have a life to live, the right to thrive and hopes and dreams to achieve.
Life Changes Trust is an independent Scottish charity, established in April 2013 with a £50 million endowment from the Big Lottery Fund. Their vision is to see a Scotland where all people affected by dementia and young people with care experience see a positive and permanent shift in their quality of life, well-being, empowerment and inclusion. They have therefore funded this rights focused project “Rights Made Real in Care Homes” with a sum of £135,000.
Scottish Care is a membership organisation that represents over 400 independent sector health & social care providers across Scotland. They are the voice for Scottish care providers and service users and their vision is to shape the environment where care services can not only operate but thrive. Their role in this project is to share the learning coming out of the projects with their membership and wider networks with a view to celebrating the great work that the workforce is involved in and the difference it is making to the lives of those living in a care home.
The University of the West of Scotland believe in their students’ future and have a proud record in delivering work-ready graduates and developing effective partnerships with business, industry and the public and voluntary sectors. Through their innovative learning partnership they invest in people’s potential to shape their future. Built on uniting students, professionals, industry and our communities, this partnership stretches from the West of Scotland around the world. They believe in the transformative power of active learning and engagement. They treat students as individuals, partners and potential leaders in their fields and professions, providing them with the globally relevant knowledge, skills and confidence to think critically and to challenge received wisdom. Life Changes Trust awarded funding to the University of the West of Scotland for the role of learning partner to support the seven projects who have been allocated funding as part of the Rights Made Real project. The learning partner role aims to provide support with data generation and analysis, provide opportunities for ongoing reflection and learning, and harness and share the learning between projects through the development of a learning community.
Project support staff
Verity Monaghan - Human Rights Project Worker (Scottish Care)
Verity Monaghan is the human rights project worker working under Scottish Care. Her role centres around helping people with their capacity to understand human rights and how this is delivered in practice. This takes the shape of encouraging care home staff and residents to use human rights language in their everyday language. This includes helping to shift the culture to one of empowerment and participation for all in relation to human rights, facilitating small human rights workshops to further understanding, sign posting to relevant resources and building confidence of staff in taking a human rights based approach to care.
Tamsin MacBride - Learning Partner (University of West of Scotland)
Tamsin MacBride is a lecturer from the University of the West of Scotland and, alongside Professor Belinda Dewar (Principal Investigator), has been funded by Life Changes Trust to be the Learning Partner for the Rights Made Real In Care Home project. This role involves offering advice and support in relation to different participatory methods that help to capture project outcomes; supporting project leads with evaluation; facilitating connection between projects to help to create a community of learning, where there is ongoing inquiry and reflection and in partnership with Scottish Care working with the project sites to articulate the how of bringing human rights to life in care homes.
How the project will help make rights real in care homes
Life Changes Trust has invested £135,000 into seven individual or groups of care homes across Scotland that have set up different projects that aim to enhance the lives of those living with dementia. There are a diverse range of projects which differ from a sensory garden in Tiree which will give the residents a safe and nurturing place to relax and access nature, to creating an auditing tool that helps residents to participate in the decisions around their care from beginning to end.
Different approaches and tools are being used to bring human rights to life and help those working in the care homes:
- To become confident in looking at practice and conflicts from a human rights perspective and able to link the health and social care standards to their everyday practice.
- To make the language of human rights user-friendly for all that work and live in care homes rather than a scary concept that is only used by specialists.
Workshops are one route so that staff members can develop and reflect on their practice but working alongside people is also vital as it allows staff to reflect in action and build confidence of identifying human rights.
Care homes involved in the project
Fairfield Care are a group of three care homes located on the East Coast in Fife and in West Dunbartonshire. There are over 30 staff and residents included in this project from August 2018 – July 2019. The ultimate objective is to develop the staff existing knowledge, behaviors and feelings towards human rights and what the new standards expect to achieve. For the person receiving care to be fully enabled to exercise choice and control over their lives the staff providing this care must also understand and be able to have the autonomy and confidence to support this person. Fairfield are using different approaches which consist of workshops on human rights, using the My Home Life tools namely caring conversations and the LIFE approach to explore conversations with residents and their relatives.
Fairfield are well on their way to becoming confident in the language of human rights and are developing a tool based on the health and social care standards that staff can use to map out the human rights they are covering in conversations and Life Sessions they are taking part in. This can then be developed and used in reviews and in anticipatory care planning. They are holding an event at a Future Forming event in August 2019 to share and celebrate that learning with other organisations and stakeholders.
North East Angus Care Home Group
North East Angus Care Home Group is a group of five care homes in the Angus area. Working together with colleagues from the NHS, Dementia Liaison team and care managers this long term project is running from December 2018 to December 2020 and aims to create an innovative toolkit of participation that is built upon the individual regardless of their cognitive impairment. The end result will be a mobile app that allows this learning to be easily shared with other care homes.
This is an area of work that has not been interrogated in the same ways as some other aspects of care home life for people living with dementia and Angus East Care Home Group is leading the way in making this a reality for those living in their care homes. An auditing tool has been created and is currently being used to identify all areas in which a person receiving care should be involved and making this as transparent and accessible as possible. Participation looks different for each individual, from small decisions to be included in larger processes. Therefore, the project is not focusing on solely changing formal processes but looking at how to shift the culture within their care homes. A piece of work that will firstly require current levels of participation within the home of each resident will be mapped. This will be done via observation - resident meetings, care practice, document review, care plans, reviews, service plans, discussions - with participating residents, relatives and staff members.
Evaluation of this mapping will then inform a series of culture changing and introduction to human rights workshops will be carried out with staff and care managers. They then hope to introduce new ideas and processes that allow individuals to participate fully in their care. My Home Life tools and input from the Scottish Health Council will be vital at this stage to map out the progress of the interventions with the final hope that a mobile app will be developed to share the valuable learning that has been achieved.
Andersons Care Home in Elgin is a striking care home in the heart of their community. The building itself is steeped in history and those that work and live there are no different. This project has been running since August 2018 with the aim to finish in July 2019. The overall aim of this project is to develop person-centred interventions that explore the role of music in supporting a rights-based approach for people affected by dementia to: tell their story; support their personhood and identity and connect them with their community. This will hopefully take the shape of a toolkit that can be shared with other care homes and used to enhance the lives of those they support, from reminiscence to anticipatory care planning. The aim is to redefine a care home as a “community based home” rather than being attached to the current stereotypes there are to living in a care home. This aim has taken the researchers involved from Glasgow School of Innovation and those working in Andersons to the local community to involve the public and explore what people think of care homes.
There is work being done in both solo and group music sessions with those of all levels of cognitive impairment. The activity coordinator and the staff have invested time and devotion into making a difference in the lives of those they support. Themed events are planned throughout the year, with this year it being a “cruise around the world” where residents can experience familiar music as well as new music and sounds. This has linked in with other activities such as road trips around the community to help those living in the care home connect with memories. Music is being used to help create memories leading up to the end of residents lives and helping fulfill decisions even in their last moments.
Bankhall Court in Glasgow is a small care home in the heart of Govanhill in Glasgow run by The Mungo Foundation. On the outside it blends in well with the surrounding tenement flats, it is not the conventional image of a care home! However, internally the staff team and management are doing all they can to stand out and make the quality of those living within Bankhall Court as varied and exciting as possible. The project is running from September 2018 – August 2020 and will give Bankhall the resources to be able to access activities tailored to the individual person. With one member of staff to five residents this makes outings difficult. The hope is to have the residents participating in their local community doing things they enjoy and leading fulfilling lives lessening the feelings of social isolation or depression that can happen when living with Dementia. Throughout the project each Dementia Care Worker would be encouraged to spend more time with individuals, tailoring communication methods to help people to understand the choices available to them. Building staff confidence with regards to risk assessing activities and accessing the community.
Facilitating regular outings which involve family, friends and volunteers and evaluate how these are helping our residents to meet the outcomes in their person-centred care and support plans. Building staff confidence in carrying out outcome based reviews tailored to the health and social care standards. This has already had an impact on how staff are interacting with the person they support. By moving away from a formal process approach and replacing it with n individualistic approach, staff are able to have meaningful interactions and conversations and find out how to best support the person.
Jenny's Well Care Home
Jenny's Well care home is a newly built care home that opened in 2017 by the Royal Blind and supports older adults with sight impairment and other complex needs including dementia. Royal Blind used the opening of Jenny's Well to rethink the way that they support people moving from task centered routines to person centered empowered lives.
They are using the Senses Framework in their approaches which incorporates many aspects of human rights into it.
- a sense of security (to feel safe)
- a sense of continuity (to experience links and connections)
- a sense of belonging (to feel part of things)
- a sense of purpose (to have a goal(s) to aspire to)
- a sense of fulfilment (to make progress towards these goals)
- a sense of significance (to feel that you matter as a person)
This project will run from August 2018- July 2020 with the aim of enhancing and creating a range of activities that those with sight loss and dementia have chosen and enjoy. Two meaningful activity assistants have been coordinating this work, identifying and analysing the activities before and after to gain a sense of what people want and enjoy.
Jenny's Well already provides internal activities such as reminiscence, musical events, celebrations of key dates such as Valentine’s Day and Burn’s Day, news reading groups and exercise and dance groups. However, they are keen to look at external agencies that can come into provide activities for the residents based on what they enjoy within the home such as providing entertainment, using new technology that can improve accessibility for those with a visual impairment and bringing dogs or other animals into the home. Through this project, Royal Blind will gather further evidence of the best support for people with dementia in care homes to ensure they can continue to be active, be stimulated emotionally and intellectually and continue to have a good quality of life. Using this evidence as well as the knowledge and expertise the charity has already developed in supporting older people with dementia and sight loss, they will develop resources so this expertise can be shared with other care homes supporting people with sight loss and dementia. This will include the design, production, and distribution of information resources including a guide for homes supporting people with dementia who have sight loss.
Tigh A Rudha
Tigh a’ Rudha is the only care home on the beautiful Isle of Tiree. Ironically, the island boasts beautiful scenery and wildlife however the residents do not have access to a safe garden to experience all they have grown up with. This project takes the shape of creating a sensory garden from the car park area at the back of the care home. With initial setbacks through building permissions, they are now well under way to making this project a reality for those living in Tigh a’ Rudha.
Residents and their families have already given their input into the design of the garden and, once the garden is created, it is anticipated that residents will be involved in deciding how they want to use it and how they would like it to develop.
Tigh a' Rudha hope that the garden will contribute to a number of positive outcomes for residents, including a hope that they will have the freedom to choose to go outside and not to be discriminated against because of their age or cognitive impairment. They will be able to experience a high quality environment, outdoors as well as indoors and reap the benefits of having increased opportunities for sensory experience, both stimulating and calming with both raised flower beds, and herbs. The hope is that residents will have new sensory impressions from spending time in the garden and will become reacquainted with once familiar ones now lost to them. It will give opportunities for relatives to come and spend time with their loved ones in their home and maintain or re-establish the connections with the outdoors that come from living in a rural community. The project is currently at the stage where building work has commenced, the human rights project worker and other colleagues from My Home Life are planning to visit in the Summer months and carry out an introduction to human rights workshop which will link staff with the health and social care standards and why it is so important for people to be able to access the outdoors in their home in a safe and relaxing environment.
One relative commented that….
“Mum loves to get her hands in the earth. Gardening helps her keep in touch with part of herself, keep in touch with life. For example, with cut flowers she checks they have enough water. The garden will be somewhere to be but also something to look at. My mum comes alive…it is deeply ingrained in her, she lives and breathes with what is happening in the garden, it perks her up. I think it will be fantastic [the garden] I feel hopeful. When Mum goes outside, she takes a big long sniff, she is desperate to get out.”
Laurels Lodge Care Home in Aberdeen is owned and managed by Four Seasons Health Care. They have been working on their project since November 2018 and are due to finish up in November 2019. The overall aim is to create an enhanced process of anticipatory care planning workshops on human rights and anticipatory care planning from colleagues from Scottish Care and also lecturers in Nursing at Robert Gordon University. The aim is to build staff confidence around navigating end of life discussions which means working closely with families (who might have power of attorney or guardianship) to ensure that the persons previous preferences are not lost in discussions and decision making around anticipatory care with professionals. From a ‘rights’ perspective this is challenging and requires excellent adapted communication with people who live with dementia and those who support them.
The workshops have been running since March time and have so far have been very successful, with staff commenting on how much more confident they feel in themselves. It has enabled staff to be more autonomous and build trusting relationships with relatives and the residents as they both learn about each other.
My Home Life tools have been successful in identifying and celebrating what staff already do and how to build on this. They are now mirroring this approach in their outcome-based reviews. There has been a shift from a formal process in the shape of a tix box exercise to ensuring they keep the person at the centre of the process, working with them to help them live life on their terms, whatever that may be.
Whether it is arranging reviews at a time and place that suits the relative and resident or making sure that their views are taken into consideration for such times where they may not be able to express them any longer. The project has been very successful so far and the hope is the legacy of this work will continue to positively influence and empower staff and management to continue their journey of co-creating, learning and enablement of making rights real for those living within Laurel’s Lodge.