Dignity in care

Dignity factors - Social inclusion: Ideas you could use

• Enable people who use services to contribute their skillsOpen

  Invite people who use services to contribute their skills and experience to planning, developing and delivering projects in your service.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Manchester Alliance for Community Care (MACC), which is a campaigning organisation that wants to see an inclusive society that supports and increases the health and social well-being of people in Manchester. It facilitates the Manchester Older People’s Network and encourages older people to contribute to the planning, development and delivery of local services.

  The work is driven by a core group of older people and is supported by MACC. Individual older people have been recruited for their particular skills and experience.

  For further information contact Mary Duncan, Development Worker. Tel 0161 834 9823. Email mary@macc.org.uk.

• Use the phone to keep people includedOpen

  When people are unable to leave their homes, setting up telephone conference calls can provide a link to the outside world.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Community Network, a national charity that aims to help organisations tackle social isolation through the provision of 'social telephony’.

  Local authorities and voluntary organisations have worked with Community Network to facilitate regular sessions linking up older people who are unable to get out and about as they wish due to their own frailty, mobility, location or transport issues. These Friendshiplink groups have provided a lifeline for a group of people who might otherwise be unable to have any other social interaction in the course of the week.

  This example of helping to overcome social exclusion comes from 'A sure start to later life'  (SEU / ODPM, 2006)

  For further information see the Community Network website.

• Start a project that connects people with the wider communityOpen

  Think about how local schools and organisations might be able to work with you to make connections between the people who use your services and other members of the community.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Merseyside Fire and Rescue – they have established a schools initiative that plays a key role in bringing older people to the attention of the service, as well as raising awareness of fire safety among children.

  A fire fighter leads a session on fire safety, after which children are offered prizes in return for signing up older relatives and neighbours for a home safety check. In 2004/2005, 15,000 checks were made as a result of the project, almost one third of the total target number for Merseyside.

  This project has a strong intergenerational focus, encouraging children to make contact with older people in the community to improve the safety of their homes.

  For further information see 'Good practice in services for older people' (434kb PDF file).

• Connect older people with schoolsOpen

  Encourage older people to become volunteer teachers at a local school, where they can pass on their knowledge and skills, especially in practical areas such as gardening and crafts.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, one school involves older people in teaching children how to grow vegetables in school-based allotments. They have found that the older people tend to stay working with the school, and the scheme provides a valuable way of passing know-how down to a new generation while appreciating the knowledge older people possess.

  For further information see the Older People's Inquiry: 'That little bit of help' (108kb PDF file).

• Create opportunities for people to make new friendsOpen

  Look at ways you can support the people who use your service in making new friends to reduce isolation.

  For example, set up a befriending scheme, or provide people with training to use email to keep in touch.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Help the Aged’s Sunshine Project. Two schemes have been taking place in care homes in the East of England: a befriending scheme and a computer training scheme. The purpose of both is to increase social contacts, reduce isolation and improve quality of life. Computer training introduced people to information technology and to using email as a means of communicating with family and friends.

  An interim evaluation by a research team at Essex University concluded that ‘health and social care agencies need to recognise the non-clinical aspects of ageing and work together to maximize well-being in all areas of daily life by whatever means they have at their disposal.’

  For a copy of the report, contact Dorothy Seymour, telephone 01255 477939.

• Train staff to provide extra therapeutic skillsOpen

  Train staff in occupational and physiotherapy skills, for example, as well as recreational therapies.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Caterham Dene Community Hospital. All their staff have been trained in occupational therapy and physiotherapy skills through an in-house programme developed by the therapists working on the ward.

  In addition, the healthcare assistants, supported by the therapists, are encouraged to take on a range of activities such as recreational therapies - quizzes, craft work and exercise groups, which include chair-based exercises. There is a close working relationship with the nearby local authority residential home, and activity coordinators from there visit to assist with activities.

  For further information contact Eileen Clark, Service Manager. Tel 01737 214846. Email eileen.clark@eastsurrey-pct.nhs.uk.

• Invite people who use services to contribute ideasOpen

  When things need to change, invite the people who use services to contribute their suggestions. Their ideas are often straightforward and practical.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by In Touch, a project run by Gloucestershire Rural Community Council to provide support and advice on services for older people in the county’s rural communities.

  When changes in social services criteria and closures of some day centres led to loss of services, In Touch worked with older people to identify what they would miss and need after services changed. The ideas of the older people were simpler, more cost effective and more acceptable to them than the original services and led to a range of social activities in a sheltered housing complex, informal lunch clubs, and a community minibus providing trips for regular shopping and lunches further afield.

  For further information see Gloucestershire Rural Community Council.

• Try drama techniques to benefit older people with dementiaOpen

  Develop drama-based activities for people with dementia, using dolls, puppets, music and dance to reach the people behind the disease.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by North Dorset Primary Care NHS Trust (now Dorset PCT). They used 'Drama as a powerful clinical tool: fun with a purpose’ (113kb PDF file) as a teaching tool for staff, who have since developed activities for people with dementia and expanded community links. The many improvements include

  • a very positive environment and workforce to promote a philosophy of independence, individuality and well-being
  • actively reaching the person behind the disease, communicating via drama, dolls as therapy, puppetry, music and dance
  • improvement in many people’s speech, confidence and self-esteem
  • using drama techniques/skills and diversion with constructive occupation rather than medication to help positive behaviour changes
  • an active promotion of person-focused care.

  The service has won many regional and national awards including The Queen’s Nursing Institute/Alzheimer’s Society Award for Excellence and Innovation in Dementia Care 2003.

  For further information contact Lesley Benham, Team Leader. Tel 01305 762508. Email Lesleybenham@dorset-pct.nhs.uk.

• Involve people in the improvement of servicesOpen

  Involve people in improving services in their communities, helping to make communities stronger and improving people’s lives.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Sheffield Council and the Home Office. The Unique Improvements project works with people who face some of the biggest challenges. For older people it provides interactive approaches to:

  • older people strategy development
  • developing Partnership for Older People’s Project (POPPs) bids
  • evaluating POPPs
  • care home development programmes
  • safeguarding adults programmes.

  The project has also developed a range of older people’s health and wellbeing projects focusing on surviving winter. This includes working with older people to raise awareness of the dangers of winter conditions. The ‘Keep Warm, Keep Well, Keep Safe’ programme includes ‘Snug as a Bug’ - keeping your home warm, getting all your benefits, keeping in good health, ‘buddying’ with another older person for safety and making provision for older life such as writing your will.

  For further information contact Linda Henry Tel 0151 480 2202 or email linda.henry@uni.gb.com.

• Run a workshop to involve the local communityOpen

  Run an ‘involvement workshop’ to raise the profile of your service and make links with the local community.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Mental Health Services for Older People at Ashfield Community Hospital. They ran an involvement workshop to:

  • Raise the profile of mental health services for older people by presenting the service in a positive and pro-active way.
  • Bring the wider community closer to the work carried out by the service and demonstrate how it works in partnership with agencies like the Alzheimer’s Society to fight for the dignity of older people with mental health issues.

  The workshop featured singers and small reminiscence displays, a poet and an organ grinder. People were asked to send in mementoes such as pictures, poems and coins to be mounted on giant jigsaw pieces and hung on the walls leading up to the inpatient wards.

  For further information contact Deborah Thompson, Modern Matron, Nottinghamshire Healthcare NHS Trust. Email Deborah.thompson@nottshc.nhs.uk.

• Give people who use services the chance to workOpen

  Enable people who use services to get work experience in a supportive environment – for example, on a voluntary basis. This can build confidence and even enable people to consider applying for paid employment.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice at the Local Care Centre, a new development in Plymouth that provides a range of health services for the local community. The building’s foyer houses a cafe, run by local people who use mental health services and coordinated by a local carer.

  The initiative is a joint venture between Plymouth PCT, users, carers and the voluntary sector, set up to enable people with long term mental health problems to gain access to paid employment. Within the first nine months of the scheme, two people found substantive employment.

  Reports from people who use services suggest that the opportunity to work voluntarily in a supported - yet real - work environment has improved their confidence and enabled them to consider work as a real option.

  For further information contact David Macauley, Plymouth PCT/Mental Health Partnership.

• Involve people who use services in running your serviceOpen

  Involve the people who use your services in shaping and running your service. Consider how people could contribute through an advisory group, for example.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by the Haven Project, which provides day and crisis services to people with severe personality disorders. Service users play a central role in shaping and running the project; in addition to forming an advisory group, 50 per cent of those on the Haven board of directors have used mental health services.

  The success of the service has been impressive. There has been an 85 per cent fall in the admission of Haven Project clients to hospital and the use of A&E services is down by 60 per cent.

  Hazel was diagnosed with a personality disorder and has been involved with the Haven Project for nine years. She says: 'The Haven has given me a future and a life, rather than an existence. I am finally in a position where I can see a happy and useful future. The Haven is the family I never had. It’s a place where I feel safe and able to explore my path to recovery.’

  For further information contact Benedict Knox, Strategic Communications Advisor, Department of Health. Email ben.knox@dh.gsi.gov.uk.

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