Working together to make all our lives better: Collaborative care in residential homes

Altogether Better has developed a pioneering way to bring citizens together with health and care services in a more collaborative form of care provision. Since 2008, over 25,000 citizens have gifted their time as ‘health champions’, working in a range of health care settings, including GP surgeries, hospitals and other community services.

Building on Altogether Better’s work, a new collaborative initiative in North Tyneside, funded by the Health Foundation, will take the approach into care home settings for the first time. The initiative brings together people working in Collingwood Surgery, Collingwood Court Care Home, and Holmlea Care Home with local residents in North Shields. Core to the approach is closer collaboration between the health care professionals involved in caring for the residents and an invitation to local citizens, residents and families to develop new ideas, offers and activities that will improve people’s health, wellbeing and the quality of their care and their lives.  

We spoke to Alyson McGregor, the Director of Altogether Better, to find out about this collaborative approach to care. In common with many of the team, she also has personal experience of being the family member of someone living in a care home.

Building relationships to improve care

Around 400,000 older people live in care homes in England and as the average age of the UK population is increasing, the number of older people in need of care is also likely to increase.

‘Research from the US has shown that if you improve the relationships between people working in the care home, then quality of care improves’, says Alyson. ‘And we’re not only going to do that, we’re also going to improve relationships between care home staff, the citizens, the families, the general practice, the local pharmacists and the district nurses. One of the things that’s been the most fun in this project so far has been seeing that lovely blossoming of relationships between the different people who are part of it.’

In addition to engaging residents, families and local people, the project works to deepen relationships between the professionals involved in providing care. Creating space and time for discussion is already enhancing their understanding of each other’s roles and identifying the potential for improving working practices and care for residents. An important part of the approach is testing new ways of working together, and learning through a process of rapid prototyping.

Care homes need communities

A report from the Institute for Public Policy Research (IPPR) found low levels of reported life satisfaction and wellbeing and rising levels of loneliness and depression among older people, particularly those living in care homes.

‘My dad has dementia. My parents have been together for 60 years – just because he’s no longer living at home, doesn’t mean that my mum doesn’t want to spend her life with him. She visits my dad every day and she is part of his life in the care home. But she’s an “insider-outsider”. There’s no mechanism for her to be involved in the care home, so she’s not actually invited to share the things that would make a difference.’

Alyson says, ‘What we need to do is to make people’s lives normal for longer. This means drawing on the resourcefulness of everyone – citizens, visitors, the residents themselves and their families, the district nurses, the pharmacists, the GPs, the care home staff – to make everyone’s lives better.’

Inviting health champions into care homes

Almost 200 local people took up Altogether Better’s invitation to get involved with the project in North Tyneside. The first group of 21 health champions are already planning activities and approaches that will improve daily life for both people working in care homes and residents. Early ideas range from gardening, arts and day trips, to telling people’s life stories and having conversations.

Alyson says, ‘My dad was a dancer. It’s difficult for dancing to happen in his care home, for all sorts of reasons. But organising some dancing is an easy thing to do if you’ve got a group of people who are up for making a difference and having some fun – dancing in the corridors, dancing instead of the TV being on. My dad doesn’t always know who I am anymore, but he can remember how to dance a quickstep. So when I dance with my dad, he leads and he becomes my dad again, and I can’t tell you what a difference that makes.

‘That’s just one example of the kind of impact we hope to have with the care homes we are working with. Simple offers that really do make life better for everyone, not just the residents.’

Keeping older people healthy and happy for longer

Alyson is clear that there needs to be a dramatic change in the social care landscape.

‘One of our main motivations to do this work is that, in England, one care home goes out of business every week. If that keeps happening, we’re going to lose the NHS. Because the only place for people like my dad to go when the care home doesn’t have a place for them is a hospital bed and that costs three times as much as a care home bed would cost.

‘Instead we want to focus on keeping older people healthy and happy for longer, supported to be in their own homes, assisted housing, or in residential care, and living as normal a life as possible.’