Balancing infection control with wellbeing

Care homes and supported living: Learning and sharing following the COVID-19 lockdown

Care providers, managers and care staff have told us about the innovation and dedication of care home and supported living staff, from care staff to the kitchen staff, in trying to support the wellbeing of those they care for at the same time as continuing to implement distancing and PPE rules. Below are examples of some of the changes care homes and supported living staff have made that they found worked well and examples of wider community support. In addition, there are links to guides and resources which have been particularly helpful in supporting these activities.

Practice examples are focused around four areas:

  • Particularly relevant to supporting adults with autism and/or learning disability, was the recreation of their everyday visits to shops and cafes within the care setting. This has enabled both a ‘new normal’ for people who find changes to routine more stressful and supported skills development.
  • Making food and meals special both as an activity and to support those not eating well.
  • Arts, crafts and games, with homes balancing social distancing with meaningful activities that may connect those living in a care home and also their families.
  • Keeping people connected with the community, highlighting that communities and local authorities have an important role to play in supporting care homes.

We’ve heard so much about how people have died in care homes – now we need to focus on how they’re going to live.

Anne Child MBE, Royal Masonic Benevolent Institution Care Company

Note: SCIE would be interested to hear of any resources you found particularly helpful and examples activities to support wellbeing that you have started or expanded. If there was anything that did not work so well, do share that as well! People living in care homes and supported living are hugely diverse, and we welcome examples that would be of interest to specific groups as well as more general ones. Please contact us.

Practice examples

Recreating shops and cafes

Woodleigh House, a care home for 12 adults with learning disabilities, physical and sensory disabilities and autism, set up a ‘Tuc & Tat Shop’ during lockdown. Residents helped in ordering stock, pricing up and running the shop. This provided an opportunity to build skills around finances, IT, communication and general monitory awareness. Any profits from the shop have been used to buy new stock and to fund projects like improving the garden area.

At Kent Autistic Trust, staff were aware of how much people’s routines had been disrupted and how distressing that could be. To support favourite activities and routines around food and drink, staff contacted McDonald’s to request packaging and have provided coffee machines, capsules, toppings, flavour shots, whipped cream and Costa cups so that people can 'go for a coffee'. Staff arranged with their local shops for magazines, newspapers and bottles of coke to be delivered each day.

The Accomplish Group supports adults with autism and found that no longer being able to go out for coffee to a favourite coffee shop has been challenging. This has been replaced with a drive to a bench in a remote area and for coffee to be created whilst sat on the bench using the right kind of coffee and the right kind of coffee cup. Whilst still different, the taste and certain important visual things were the same. By doing this at the same time each day, a new, enjoyable routine has developed.

One of the people the Accomplish Group supports loves to go shopping for CDs to the local charity shops and then to have a bacon sandwich in a local café. Staff donated old CDs and set up a shop for him to arrive, keeping it as real as possible. He spent time sorting the CDs and paid for those he wanted. Staff took his order for a bacon sandwich and served him at a different table.

Useful learning

The recreation of everyday visits to shops and cafes within the care setting can help establish new, supportive routines, and help maintain contact with the community. Focusing on challenging and ultimately rewarding jobs like setting up and running a shop or café can enable residents to learn new skills and provide a sense of achievement for positive wellbeing.

Making food and meals special

At Milkwood Care Limited, one lady was not eating well in isolation. At lunch time, staff took her outside and served her meal, and made a pre-planned Zoom call to her daughter so they could have their lunch ‘together’. It gave her a sense of eating with her family and as a result she ate better. This more social lunchtime experience was repeated as frequently as possible, particularly with this woman and her daughter.

Other examples include:

  • movie and popcorn nights
  • sherry or port evenings with cheese and nibbles
  • afternoon teas
  • creating individual menus for people to order from.

BBQs have been popular for making meals more of an event, and allowing social distanced outdoor meals when the weather allows.

Useful learning

Special or fun mealtimes can help promote a sense of community within the home and support for individuals who struggle to eat and drink well in isolation. They can be enjoyable occasions for care staff as well.

Arts, crafts and games

There have been many examples of care staff using arts and crafts activities to support the wellbeing of people living in care homes and supported living. These have included:

  • making planters from old tyres
  • Zoom bingo
  • hunt the teddy (including notes and small prizes)
  • making fat balls for the birds
  • making and sending card to families, including photographs inside.

Examples and feedback from care homes and supported living managers have highlighted the wider ranging, and often previously unknown, talents of staff. For example, as skilled bakers, musicians and artists. Managers have reported wishing to continue to discover and promote staff talents for the wellbeing of those living in, working in and visiting care settings going forwards.

Norfolk Integrated Housing and Community Support Service (NIHCSS) organised social distancing bingo which took place outside of Boudicca Court residential service. Seven of the residents took part and staff said they kept asking for more games and are looking forward to repeating the activity again. The Locality Manager at the service explained how the activity had been a comfort and welcome distraction from the way the support some of the service users received had been disrupted and commented that ’was great and the staff enjoyed it too!’.

Useful learning

There are many socially distanced arts and crafts activities as well as games that can support creativity, expression and community for people living in care homes and supported living. Find out more about what you can try in SCIE’s Arts in care homes.

Keeping connected: Support from councils and the wider community

Following engagement with providers about technology needs, Dudley Council has purchased a number of tablet devices for nursing and residential care providers. The 10-inch tablets are SIM-enabled which means that locations with poor or no broadband can still get connected. The council has been working in partnership with My Improvement Network to deploy the devices and this includes remote onboarding, training and technical support if required. To date, over 45 devices have been rolled-out. As well as supporting improved communication between local system partners during the pandemic, the devices are being used to enable residents stay connected to family, friends and faith groups.

At Boudicca Court residential service, part of Norfolk Integrated Housing and Community Support Service (NIHCSS) staff had the idea of holding an outdoor social distancing movie night. To achieve this, they needed a projector and screen and put out a Facebook message to the local community to see if anyone could help. Members of the public enthusiastically responded and generously provided both items brand new, allowing the show to go ahead.

Image copyright of TLC Care – shared with permission

A number of care homes, including TLC Care have highlighted that the introduction of, or increased use of video calling with team members supporting residents to contact their families, had for some, increased their ‘world’ and their connections. This was particularly so for those who had friends and family living across the globe. Both team members and residents are keen for video calls to continue to be supported in the future.

Useful learning

Care homes and supported living providers have been enabling residents to stay connected with the outside world – especially with family and friends. The wider community can be an essential in supporting access to technology and can help meet specific needs.

Guides and resources

  • Top tips for tricky times (NIHR, Applied Research Collaboration, East of England) Open

    Region: UK

    Care setting: Care homes (older adults)

    Audience: Care home managers, frontline staff

    Format: pdf/poster available via webpage (requires simple registration to download all 8 Top Tips)

    These are three of eight ‘Top tips for tricky times’ by a group of care home researchers from two NIHR Applied Research Collaborations. Each topic is presented on a simple single page poster. The Top Tips are evidence based and aimed to support managers in how they can respond to their staff.

    Top tips for tricky times: Providing physical comfort and reassurance to care home residents during COVID-19; Using music to provide comfort and reassurance to care homes residents living with dementia; helping care homes residents with dementia to use a video to communicate with their families.

  • Free wellbeing resources for care homes (Oomph!) Open

    Region: UK

    Care setting: Care homes (older adults) but much would apply to supported living

    Audience: Care home managers, frontline staff, older people living in a care home

    Format: Webpage, pdf/posters

    Posters with ideas for activities to cover a range of interests. There are also printouts for exercise sessions which include photographs for each movement. These resources have been designed with people living in a care home in mind thinking about the best use of indoors and outdoors space.

    Oomph! webpage

  • Inspiring care home residents to be creative (SCIE) Open

    Region: UK

    Care setting: Care Homes (older adults) but much would apply to supported living

    Audience: Care home managers, frontline staff, older people living in a care home, families

    Format: Webpages. pdfs, videos

    Ideas and examples about involving people who live in care homes in creative arts. Written in association with the National Activity Providers Association (NAPA), the guide includes dance, drawing and painting, gardening, making things, music and singing, puppets, reading and writing, sculpture and pottery, benefits of using arts and digital. This is not COVID-19 specific, but is a comprehensive set of activities guides and links to resources.

    Arts in care homes webpage

  • Impact of PPE on individuals with dementia (NHS Lothian) Open

    Region: Scotland but applies UK wide

    Care setting: Any care setting for people living with dementia

    Audience: Care home and supported living managers and care staff working with adults with dementia or cognitive impairment

    Format: pdf

    Single page guide with helpful ideas for reducing anxiety in those living with dementia when wearing PPE, although many tips would be helpful for any adults who may feel anxious, not only those living with dementia.

    Impact of PPE PDF

  • Relatives & Residents Association Helpline Open

    National charity for older people needing care and the relatives and friends who help them cope. They support and inform residents, families and friends to find out all they need to know about care and to help them if things go wrong.

    Relatives & Residents webpage

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