By Claire Slatter, Project Worker at Community Catalysts
In October 2020, I started working on the Community Catalysts joint project with Borough Care. The principle of living ‘Life in Colour’ governs all the work the organisation does and this means that everyone in a Borough Care home should be enabled to live his or her best possible life, whatever their age, health or capabilities.
The aim of the three-year project is to give residents and their families a strong voice in the way services are designed and run. My role is to connect with those who live in the Borough Care homes, and their relatives, to give them that voice.
I don’t have a background in social care. I’ve spent the majority of my working life as a secondary school teacher. I do, however, have a direct interest and personal experience of dementia and of Borough Care. My mother was diagnosed with Alzheimer’s disease several years ago and now lives in one of the Borough Care homes.
Themes and approach
We started work with a blank piece of paper, knowing we had to develop an approach that was effective and replicable.
We began by getting in touch with the managers and ALFs (Activity and Lifestyle Facilitators) in each of the homes, to talk about the project and enlist their help. The majority of people in Borough Care homes are living with dementia and we knew that we would need input from staff to connect with them.
At the same time, I engaged and started to have conversations with several family members who had relatives living in Borough Care homes. I chatted to them about their experiences, both positive and negative, and any concerns they had. By December we had drawn up a list of themes. These were issues or areas for improvement mentioned by more than one resident, family member or member of staff. Areas that we thought would be good to focus on over the coming months.
Once the early themes emerged, I developed a process to discuss it in more depth with residents (either directly or with the support of the ALFs and other staff members), as well as family members and staff. The discussion led to ideas for action which were recorded in a report for the board. The board agreed to give their response and detail any action they intended to take, along with projected timelines using a ‘you said, we did’ model. This was shared with families and residents in a feedback loop and a tentative approach was born.
The biggest early challenge was Covid-19 and lockdown. It meant that I was unable to visit the homes in person to meet staff, residents and family members. It has also meant that I have yet to meet Angela or Helen, my colleagues at Community Catalysts, in person. All of these working relationships have been carried out via Zoom and telephone conversations.
So, when communication and connectivity – between families, residents and staff – emerged as the most pressing theme it wasn’t really a surprise. Families and their loved ones who live in Borough Care homes had had minimal contact over many months and staff were having to deal with an unprecedented and really challenging situation.
Communicating effectively with older people who live with dementia brings its own challenges.
I’ve come to realise that family members’ concerns may sometimes be different from those of their loved ones. For example, people living in Borough Care homes were keen to talk about food, drinks and mealtimes and their opinions were strong and varied on this subject, but it seemed much less important to their family members.
Connecting with and really engaging with relatives hasn’t been easy and this is an area I know we have to keep working on. We are lucky to have formed a core group of about eight family members who have been very supportive, but it would be good to have even more. It has made me realise how hard it is to get a message across to a diverse group of people, even in a medium sized organisation like Borough Care. Posters can be displayed, flyers sent out in the mail, articles written for the newsletter – but I’ve learnt that people don’t always have time to read everything that is put in front of them or don’t recall what they have read later on.
The Borough Care board and senior team have been amazing, showing a willingness throughout to help us to create a process that works. They have shown a real commitment to hear challenging and even dissenting voices, to reflect on the practice of the organisation and to take prompt action to improve what they do.
There was a real danger that this project could become an arena for individual niggles, and we have tried hard not to fall into this trap. Family members have been great, really understanding the issues and totally able to see the broader picture. They truly appreciate the staff in the different homes and have sometimes pointed out an area of concern which doesn’t directly affect their own loved one.
The vast majority of the homes have showed support for the principles of the project, which is amazing when you think of the extra work it brings at such a challenging time for everyone. I’m very grateful to the ALFs. Several of them have been amazing and really gone the extra mile to enable contact with as many residents as possible by recording what they say to capture their points of view, or facilitating Zoom meetings with them.
This has been a real learning curve for me. Angela and Helen have been very supportive – directing me in how to find ways to connect with people who could potentially be involved in the project and they both have lots of creative ideas about how to approach different tasks.
We’ve reviewed and build upon our initial approach, learning as we test and changing as we learn. When we started, we discussed a new theme and produced a report each month, but we have now have moved to a quarterly reporting timescale, which is more realistic and avoids juggling more than one theme at the same time.
As restrictions are gradually eased, I’m hopeful that at some point I will be able to visit the individual homes to meet the residents, their families and the staff.
I enjoy the challenge of this project and am optimistic that Borough Care are definitely listening and will respond positively, so that all residents and their families can have their voices heard.