Powerpoint about the current state of care homes, about the evolution of My Home Life as a movement and our leadership course.

1. Promoting Quality of Life in Care Homes
My Home Life: Wiltshire
Professor Julienne Meyer

2. Promoting Quality of Life in Care Homes
So...what do we think about care
homes?
•Scandals?
•Poor quality?
•Money-grabbing?
•Undesirable?
•Less relevant?
•In decline?

3. Promoting Quality of Life in Care Homes
Number of care homes (CQC, 2010)

4. Promoting Quality of Life in Care Homes
Older people in care homes
• 400,000 older people
• Average age 85 years
• 66% Cognitive impairment
• 40% depression
• 75% classified “severely
disabled” (OFT 2005)
• Massive increase in
dependency levels
• Generally unable to remain in
the community

5. Promoting Quality of Life in Care Homes
Funding
• £446 state fee for care
homes (older people)
• Hospital bed = £2,051
• Children’s home =
£2,408
• Care home (LD) = £748
• 28% third party top-up
• Saving the NHS £billions

6. Promoting Quality of Life in Care Homes
Workforce
• ½ million employed in care
homes
• Care-assistants £6.56 per
hour
• Lack of funding for training
• Paid less than those looking
after our rubbish
• 66% NVQ2
• 39% feel unappreciated by
public (Skills for Care)

7. Promoting Quality of Life in Care Homes
Unsupported, isolated, mistrusted
•4 changes in regulation in 10
years
•“Feeding the system rather
than feeding residents!”
•High levels of personal
stress

8. Promoting Quality of Life in Care Homes
Quality?
•On-going improvements
over the past decade (CSCI)
•Steady improvements
around risk-taking,voice,
choice & control
•If supported, care homes
can deliver remarkable
outcomes!

9. Promoting Quality of Life in Care Homes
The future...
•Vital part of care spectrum
•Demand increasing (40,000
beds needed in next ten years)
•Greater specialism
•Reducing pressure on NHS
•A sector that is emerging as
having the potential to deliver
quality for our frailest citizens
in community and in care
homes

10. Promoting Quality of Life in Care Homes
Older people in care homes
• 400,000 older people
• Average age 85 years
• 66% Cognitive impairment
• 40% depression
• 75% classified “severely
disabled” (OFT 2005)
• Massive increase in
dependency levels
• Generally unable to remain in
the community

11. Promoting Quality of Life in Care Homes
The future...
•Vital part of care spectrum
•Demand increasing (40,000
beds needed in next ten years)
•Greater specialism
•Reducing pressure on NHS
•A sector that is emerging as
having the potential to deliver
quality for our frailest citizens
in community and in care
homes

12. Promoting Quality of Life in Care Homes
My Home Life Programme UK
Promoting quality of
life for those living,
dying, visiting and
working in care
homes for older
people.

13. Promoting Quality of Life in Care Homes
Support
Age UK, City University, Joseph Rowntree & Dementia UK
Other key organisations:
Relatives & Residents Association
National Care Forum
English Community Care Association
National Care Association
Registered Nursing Home Association
Care Forum Wales
Scottish Care
Independent Health & Care Providers
National Care Home R&D Forum

14. Promoting Quality of Life in Care Homes
Phases of My Home Life
Phase One: Vision
(2005-7 – HtA)
Phase 2: Dissemination
(2007-9 – BUPA)
Phase 3: Implementation
(2009-12 – JRF, DH, LA,
City Bridge etc)

15. Promoting Quality of Life in Care Homes
MHL Vision
Personalisation
1. Maintaining identity
2. Sharing decision-making
3. Creating community
Navigation
4. Managing transitions
5. Improving health & healthcare
6. Supporting good end-of-life
Transformation
7. Keeping workforce fit for
purpose
8. Promoting a positive culture

16. Promoting Quality of Life in Care Homes
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

17. Promoting Quality of Life in Care Homes
The value of the vision
• Evidence of what customers (residents)
want
• Articulates the expertise of the sector
• A framework for identifying evidence of
good practice for self-regulation
• Accentuating positive (disassociating from
bad press)
• Evidence base to inform commissioning
and regulation
• Driven forward by the care home sector
itself

18. Promoting Quality of Life in Care Homes
Activities
•Synthesising evidence
•Empowering leaders
•Developing resources
•Creating networks
•Supporting change
•Maintain momentum

19. Promoting Quality of Life in Care Homes
Best Practice
• She‟d been very poorly for a couple of days, and
in the middle of the night the staff came and woke
me up and said “We think Betty hasn‟t got long.
Do you want to come and say goodbye to her?”
So I put my dressing-grown on and went down
the corridor and they left me with her. I climbed
on the bed next to her and put my arms around
her and told her what a good friend she had been
to me. She died in my arms‟.

20. Promoting Quality of Life in Care Homes
My Home Life Spirit
•Building upon
energy, enthusiasm and best
practice out there
•Collaborating, sharing, reali
sing a vision for change

21. Promoting Quality of Life in Care Homes
Aims of MHL Wiltshire
•Provide learning experience for a
small number of care home managers
(Leadership and Support)
•Identify and reduce the barriers to
QoL across the wider system
(Community Development)
Celebrate and share good practice
across care homes
•To create a movement in Wiltshire
which celebrates positive practice

22. Promoting Quality of Life in Care Homes
Leadership: 4 day course
• Open to all deputies and managers of care
homes
• 4 day intensive training: reflective practice, stress
management, change management, evidence
based and relationship-centred practice
• Safe, confidential support on your personal
journey of improvement

23. Promoting Quality of Life in Care Homes
Support: 12 months Action Learning
Safe environment to learn from each other (share)
Allow time to focus on a real issue in depth (reflect)
Learn how to listen and question (non-judgemental)
Consider how the issue can be resolved (link to action)
Commitment to feedback and learn (process and outcomes)
Key questions include:
What is happening? What should be happening? What
is stopping it happening? What can be done to make it
happen?

24. Promoting Quality of Life in Care Homes
Community Development strand
• Identify what care homes want to work on
with local authorities
• Identify what local authorities want to work
on with care homes
• Run appreciative inquiry workshop to help
resolve a shared issue of concern
• Leave care homes and local authorities
working in better partnership

25. Promoting Quality of Life in Care Homes

26. Promoting Quality of Life in Care Homes
What managers say….
“We‟ve all got the same kind of problems
cropping up, it‟s great to know you‟re not alone
and when we talk through the problems, the
solutions become clearer.”
“It‟s been really helpful for my personal
development as well as beneficial to the
home….it‟s giving me the confidence to stand up
for doing things right, it‟s very motivating.”

27. Promoting Quality of Life in Care Homes
What are the benefits?
„It‟s like turning on a light bulb, suddenly things become
clear‟
•Managers tell us they are changing hugely
•They are engaging with their staff differently
•They are engaging rather than avoiding the emotion of
relatives
•They are avoiding being caught up in the anxiety and
stress caused by external demands
•They feel part of a wider movement for change!

28. Promoting Quality of Life in Care Homes
Contact Details
My Home Life Programme
http://www.myhomelife.org.uk
Prof Julienne Meyer, Exec Director
Tom Owen, Director
City University London
Adult Years Division
School of Health Sciences
Northampton Square
EC1V 0HB
London,
United Kingdom
Tel: +44 (0)20 7040 5776
Fax: +44 (0)20 7040 5529
Email: mhl@city.ac.uk