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 21st 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

MHL: 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 www.myhomelife.co.uk

• Update newsletters

• 8 x 4-page briefings

• 6 MHL magazine supplements

• 6 posters/ DVD

•Aggressive marketing of vision/ brand

Activities: MHL Networks– MHL Network 2400+ 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 processesIn 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 DetailsMy Home Life Programme

Julienne Meyer , DirectorTom Owen, Deputy DirectorCentre for Care Home StudiesCity UniversityPhilpot StreetLondon E1 2EA, England, UK

Tel: +44 (0)20 7040 5791Fax: +44 (0)20 7040 5529Email: j.meyer@city.ac.uk

tom.owen.1@city.ac.uk