My Home Life Introducing the My Home Life Programme Tom Owen, Deputy Director

My Home Life Programme Promote quality of life for those living, dying, visiting and working in care homes for older people.

Aims To work with the sector to develop an evidence-based vision for care home practice which communicates the expertise and the vital role of care homes in the 21 st Century

Research into practice Much research appears to have little or no impact on practice - Not an exact science! (e.g. Hillage et al., 1998; Davies et al., 2000). Very low uptake of research findings, particularly within the Independent Care Sectors and among non-professionals Utilisation is greatly dependent upon culture of organisation Many practice interventions have weak evidence bases Practitioners have different set of priorities, Passive dissemination does not significantly improve the implementation of research findings

Improving Research utilisation Users should believe in the importance of using evidence. Users should be partners in production of evidence. The research results should be robust and practical in accessible format Messages should respond to motivations of the user

How? Building relationships: - Getting to know the key players - A source of quality information - Accessible and relevant - Building up a two way flow - Working together

What? Different groups need different messages: - What motivates them? - - Professionalism ? - Money? - Personal Commitment? - Principle?

My Home Life programme Collaborative User- focused Motivational – positive messages Practical Supportive Evidence owned by sector

M HL: Steering Group/Collaborators Relatives & Residents Association National Care Forum English Community Care Association National Care Association Registered Nursing Home Association Care Forum Wales Independent Health Care Providers, NI Scottish Care CSCI, Care Commission Skills for Care SCIE

Stage 1: My Home Life: Literature Review

1.Managing transitions 2.Maintaining identity 3.Creating community 4.Improving health & healthcare 5.Sharing decision-making 6.Supporting good end-of-life 7.Keeping workforce fit for purpose 8.Promoting a positive culture MHL: Literature Review

Collaborative - My Home Life Steering Group Help the Aged Care Homes Associations CSCI/Care Commission Social services Skills for care Independent Advisors (OT) NCHR&D Forum

1) Managing transitions “I have lived in this residential home for two years … I have now rebuilt my life, thanks to the proprietor and staff. I now want to put the past behind me and live in the present and live as active a life as possible.”

1) Managing transitions Recognising the effects of the transition Easing the transition Care homes as a positive option

2) Maintaining identity “It is important for people to realise that what may seem a small matter to the management of the organisation is of great importance to some people living in a place. Everyone has different standards and tastes, but knowing the individual and their ways is helpful”

2) Maintaining identity The need for person-centred care A variety of creative approaches Staff education and support

3) Creating community “When I was not well one day, a lot of residents came up to see me as they missed me and visited me. It has helped. It is the other residents and staff together – everybody. I have more friends here.”

3) Creating community The importance of relationships The care environment Relationships with the local community

4) Sharing decision-making “There is a lot of experience among us [residents] but the skills we have developed in our lives are completely wasted … There are a lot of things that residents could share if give an opportunity.”

4) Sharing decision-making Involvement in decision-making Decisions to influence change Ongoing shared decision-making through negotiation

5) Improving health and healthcare “It was useful to have access to a physiotherapist or occupational therapist when I needed it to help me with my mobility to enable me to be independent and keep my confidence"

5) Improving health and healthcare The need for health care Ensuring adequate healthcare services Health promotion

6) Supporting good end-of-life “Death is such a taboo subject. It’s a big problem because all of us are so near to death. By 90 you can’t get much nearer without knowing that it is around the corner, and we need to be able to express that sometimes if we want"

6) Supporting good end-of-life Valuing living and dying A ‘good death’ Ongoing support

7) Keeping workforce fit for purpose “The more training we’ve given the girls, the better it’s been. The better the care’s been … the place is starting to get a better reputation”

7) Keeping workforce fit for purpose Identifying the need for education and training Education and training as integral to practice Care homes as learning environments (Care School proposal)

8) Promoting a positive culture “You get everything done for you here, but I think it tends to make you lazy. I would love to be working. I would rather cook for myself but you are not allowed in the kitchen, and you are not allowed in the laundry either”

8) Promoting a positive culture Defining positive culture Promoting positive culture Leadership, management and expertise (Care Action for Well-being)

Relationship-Centred Care Security – to feel safe Belonging – to feel part of things Continuity – to experience links and connections Purpose – to have a goal(s) to aspire to Achievement – to make progress towards these goals Significance – to feel that you matter as a person Positive relationships within the home and across the community of practice

Activities Developing resources Creating networks Supporting change Maintain momentum

Activities: Delivering accessible tools/resources Website Update newsletters 8 x 4-page briefings 6 MHL magazine supplements 6 posters/ DVD Aggressive marketing of vision/ brand

Activities: MHL Networks –MHL Network care homes –All umbrella bodies engaged –Developments in Wales, Northern Ireland, Scotland –MHL Theme Leads established –Provider engagement –Regional groups and training

Action: Supporting change 75 MP engaged Regulators and commissioners engaged Key champions in care homes Link themes to key practice development initiatives Foster communities of practice Influencing policy

Action: Maintaining momentum Communication strategy and press releases Build on and learn from other initiatives

The value of the vision to the care home Evidence of what customers (residents) want A sense of what practice could look like An evidence base from which care homes can articulate decision-making A framework for identifying evidence of good practice for self-regulation An evidence base for inspectors/ commissioners to assess practice Accentuating positive (disassociating from bad press) Sector ownership of expertise

Why engage with Commissioners? Positive Outcome Ensure that local authorities are commissioning according to evidence on what works and what residents want. Fits with current agenda for developing world class commissioning Negative Outcome Possible rebound on the sector if expectations of commissioners are too high

World Class Commissioning Key Points Outcome focused high quality services Giving people greater choice and control over services (personalisation) Understanding population needs Reorientation to health and wellbeing More confident partnerships Stimulate market / promote innovation Information/ transparent processes Sound investments

A Shift in the Culture of Commissioning Key Points from ‘Commissioning for Health & Wellbeing’ Services that are: Outcome focused Innovative High quality Offer choice and control In line with population need and choice And priorities health and wellbeing Value for money

How? Through Nurturing longer term trusting relationship with providers Sharing ideas, problems and practice ideas together More sophisticated contracting processes In order to… stimulate quality, development, innovation and new markets …….for better outcomes for older people

Initial progress ADASS Briefing 2 Local authorities engaged –1 rural/ affluent –1 urban + Deprived 2 others in negotiation

Positive signs of progress Quality of Life = shared responsibility / shared goal for quality improvement Develop in true collaboration with sector Emphasis on better relationships for improvement Acknowledge but not preoccupation of funding limitations

My Home Life Spirit Building upon energy, enthusiasm and best practice out there Collaborating, sharing, realising a vision for change What can we do together?

Contact Details My Home Life Programme Julienne Meyer, Director Tom Owen, Deputy Director Centre for Care Home Studies City University Philpot Street London E1 2EA, England, UK Tel: +44 (0) Fax: +44 (0)