To foster a relationship centred approach to practice the Senses Framework has been developed through research in a range of care settings by Professor Nolan and colleagues at Sheffield University. The framework suggests that the best care for older people involves the creation of a set of senses or experiences, for older people, for family caregivers and for staff working with them. They put forward that, to achieve enriched environments of care, staff, patients and their families have to have the senses of security, belonging, continuity, purpose, significance and achievement met.
Outcomes of relationship centred practice are where staff, patients and families achieve the 6 senses. Managers in the My Home Life programme have been using this framework to reflect on whether these senses are met for everyone. You may want to use the Care Profiles that have been developed by Nolan and colleagues to profile the extent to which people feel the senses are being met in your care home. (Nolan et al 2006)
Caring conversations is a framework that was developed in and for practice. It has 7 dimensions: be courageous, connect emotionally, be curious, consider other perspectives, collaborate, compromise and celebrate. It can help to guide meaningful conversations and develop relationships. Managers on the My Home Life programme have found that using this framework in their conversations has helped them to really hear the perspective of others, to remain calm in conversations that may be potentially challenging, to consciously value others, and to guide meetings so that they encourage active participation form all.
You may want to reflect on how you use caring conversations by completing the questionnaire on caring conversations
Caring conversation framework: 5 videos to consider. This link takes you to the NHS Education for Scotland site where you will find 5 videos about using caring conversations
Emotional touchpoints is a structured approach to frame conversations that help to understand another person’s experience. The technique focuses on touchpoints in a person’s experience. For example coming into the care home, mealtimes, having things to do, and being with other residents may be touchpoints in the care home setting. People are asked to select from a range of positive and negative emotional words to sum up what the particular touchpoint feels like. From this we can learn about feelings associated with an experience and use this to learn about other perspectives to celebrate what is working well and be curious about those aspects in people’s experience that could be enhanced. Managers on the My Home Life programme have used this resource in a number of ways including supporting discussions with relatives who are concerned about care, and to explore with staff how they are feeling about particular challenges in the workplace.
Visual Inquiry Tool
Using images can help to open up conversations and gain more meaningful information than questioning alone, helping to contextualise individual’s experiences and also promote participation with individuals who aren’t always able to clearly articulate ideas or express thoughts and feelings. Managers in the My Home Life programme are using images in a number of ways in their care homes. For example some are using these to promote discussions at meetings about topics, others are using images to help open up conversations about how people are feeling after a significant incident. Staff are also using the images to explore with people what matters to them.
For example in one care home residents were asked to select an image that said something about what matters to them. A resident picked a picture of ducks waddling along a grassy bank. He said it was important to have ducks, as everybody could feed them and it might encourage kids to come to the home.
The link here is to a set of images selected by My Home Life and available to purchase from the University of West of Scotland Online Shop
Positive Inquiry tool
To help to find out what is working well in your care home you can ask two questions – what’s working well for you here? and how could your experience be even better? Notice that we are not asking people what are the problems. By asking people how their experience can be better it engages people in a conversation about what they value, and what they would like and helps to explore possibilities. These questions can be used to engage in conversations with a range of people in your workplace – residents, relatives, GP’s, students, and staff. Some managers on the My Home Life programme have used this resource to guide supervision meetings with staff.
This form can help you reflect on and record developments that you and others have taken forward in your care setting in order to:
- Support your own personal reflection
- Share learning and impact with others (staff, relatives and residents, external visitors, inspectors)
- Encourage discussion about other impacts that the developments may have had.
Promoting learning from feedback
This resource can help to guide discussions with staff residents and relatives about specific feedback or stories that you have gathered about people’s experiences. The questions help people to explore how they feel about the feedback and to discuss ways of taking things forward.
Giving and receiving feedback
You may want to learn more about your practice as a member of staff in the care home. This resource helps others to give feedback in a structured way about what others value about you and things they would like to see more of.
Using images to learn about how people are feeling
Developing person centred language using a language poster
The way in which we use language can have an important impact on the culture of the environment. In the My Home Life programme we encourage people to spend some time noticing the language we use and reflecting on the impact this has. We have developed language posters to raise awareness of language used and how we can develop language to be more positive and person centred.
Understanding Dementia: Class in a bag
Understanding Dementia: Class in a Bag is a portable educational resource which raises awareness of dementia. It includes the physical resources and lesson guides for five experiential interactive workshops. The resource was developed from seminal UWS research ‘Dementia through the eyes of a child’. This project itself was the winner of the best educational initiative in Scotland Dementia Awards in 2016. Since then, the team at the University of the West of Scotland with input from Alzheimer Scotland have worked with the information and developed a resource from it that can be used at Public and Practitioner level. The resource supports the exploration of ways to support people with dementia and gives an insight into some of the challenges that an older adult and someone within dementia may face on a day to day basis.
Educational Resource (Bag) – http://shop.uws.ac.uk/product-catalogue/short-courses/short-courses/class-in-a-bag-educational-resource
Alzheimer Society – This is me – tool for people with dementia receiving professional care
This is me, is for people with dementia who are receiving professional care in any setting – at home, in hospital, in respite care or a care home. It was originally developed for people with dementia who were going into hospital.
This is me is a simple and practical tool that people with dementia can use to tell staff about their needs, preferences, likes, dislikes and interests. It enables health and social care professionals to see the person as an individual and deliver person-centred care that is tailored specifically to the person’s needs. It can therefore help to reduce distress for the person with dementia and their carer. It can also help to prevent issues with communication, or more serious conditions such as malnutrition and dehydration.
MHL UK resources
MHL UK has lots of resources for practice including toolkits, downloads, films on the 8 themes of MHL and dementia, please go to http://myhomelife.org.uk/resources/downloads/#London_Movement_Resources_8211_The_My_Home_Life_Toolkit
Living well through activity in care homes: the toolkit
This toolkit is a free online resource full of practical ideas of how to support care home residents to live their lives doing the day-to-day activities that are important to them. The toolkit promotes dignity and respect, mental and physical wellbeing and integration into the community. It includes free training materials and audit tools to review and evidence aspects of care such as personalisation and choice. http://www.cot.co.uk/living-well-care-homes
Find out more about appreciative inquiry as an approach to developing practice. It works with the principle that in every system something works well. Through a process of discovering what works well we can work with people to imagine a future where these good things are happening more of the time and work together to develop practice so that these good practices are embedded. Click on this link to learn more about the approach:
Key pointers to help open up dialogue about who people are. These can be useful for staff residents and families.
Self Portrait in Images
Values sort cards
Values sort cards help people to name the values that are important to them.
- MHL UK – My Home Life promotes quality of life for those living, dying, visiting and working in care homes.
- Scottish Care – represents the largest group of Health and Social Care independent sector providers across Scotland with over 400 members.
- Age Scotland – is an independently constituted Scottish charity, is the leading national authority on older people, age and ageing.
- Alzheimer Scotland – provides a wide range of specialist services for people with dementia and their carers. We offer personalised support services, community activities, information and advice, at every stage of the dementia journey.
- The Alliance – is led by its members who represent people living with long term conditions. They work jointly with a range of people and organisations, including people who live with long term conditions, unpaid carers, the third sector, the private sector, the NHS, local authorities and the Scottish Government.
- IRISS – promote positive outcomes for the people who use Scotland’s social services by enhancing the capacity and capability of the social services workforce to access and make use of knowledge and research for service innovation and improvement.
- Care Inspectorate – are the independent scrutiny and improvement body for care services in Scotland.
- University of the West of Scotland – the Institute of Care and Practice Improvement aims to develop safe, effective and person centered health and social care in Scotland and beyond.
- Scottish Older People’s Assembly
- National care home research and development forum
- Skilled Workers, Skilled Citizens – Workforce Scotland
Talking Points: a personal outcomes approach
You can download the practical guide from http://www.jitscotland.org.uk/resource/talking-points-personal-outcomes-approach-practical-guide/