My Home Life

1. Professor Julienne Meyer Tom Owen My Home Life

2. MHL Mission Promoting quality of life for those living, dying, visiting and working in care homes for older people.

3. MHL Support Age UK, City University, & Dementia UK Relatives & Residents Association National Care Forum (Co-Founder) English Community Care Association National Care Association Registered Nursing Home Association Care Forum Wales Scottish Care Independent Health & Care Providers National Care Home R&D Forum

4. Phases of My Home Life Phase One: Vision • (2005-7 – HtA) Phase 2: Dissemination • (2007-9 – BUPA) Phase 3: Implementation • (2009-12 – JRF, DH, LA, • City Bridge etc) Phase 4: Sustainability • Research & Development • Enterprise Activities (LS&CD) • Social action

5. MHL Social Movement • Evidence-based • Relationship-centred • Appreciative • Making a difference

6. “Islands of the old” The Government will support the work being led by My Home Life and national care provider organisations to work with their members to connect care homes to their local community.

7. Recommendation 10 Care home providers should invest in support and regular training for their managers. As commissioners of care, local authorities have an important role to play in facilitating this.

9. MHL Vision Personalisation • Maintaining identity • Sharing decision-making • Creating community Navigation • Managing transitions • Improving health & healthcare • Supporting good end-of-life Transformation • Keeping workforce fit for purpose • Promoting a positive culture

10. What older people really want ... See who I am! (Maintaining identity) Involve me! (Sharing decision-making) Connect with me! (Creating community) Bridges et al (2010) http://www.city.ac.uk/bpop/

11. 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 Nolan et al (2006) Positive relationships between residents, relatives and staff and between care homes and their local community and wider health and social care system

12. Activities Synthesising evidence Developing resources Creating networks Empowering leaders Supporting change Maintain momentum

13. Leadership Support & Community Development • Provide learning experience for a small number of care home managers (Leadership and Support) • Identify and reduce the barriers to QoL across the wider system (Community Development) • Create a supportive network for care homes in London to celebrate & share best practice, linked to MHL UK

14. Big Care Home Conversation “What makes life good in care homes now, what could make them better – and how might we get there?”

15. Quality of Life Indicators Domains 1 Quality of care 2 Quality of life 3 Leadership 4 Economic Performance • Context All QoL indicators for MHL were acceptedthrough the Delphi, except: “% of staff who feel positive about changingpractice” (Promoting positive culture) All QoL indicators for SF were acceptedexcept (staff): security, continuity, belonging, purpose and significance

16. Managing risk & Minimising restraint • Perceived overlap between ‘restraint’ and ‘abuse’ • Previous poor practice in the use of restraint • Manual restraint • Other forms of manual restraint • (Arrangement of furniture; Lap belts, wrist and vest restraints; Bedrails; Deprivation of walking aids or means to summon assistance; Locked doors; Over-medication) • Staff instructions, or institutional rules or practices • Other forms of restraint mentioned in the study (Alcohol, cigarettes, sex, Environmental restraints) • Negotiating and managing positive risk taking • Risk assessment tools and restraint policies • Training and practice development

17. Quest for Quality An inquiry into the quality of healthcare support for older people in care homes: A call for leadership, partnership and improvement BGS (2011)

18. Methods Review • Research in care homes is complex • Research partners: residents, relatives and staff as • Impact the of cognitive and physical frailty, staffing pressures and the unique environments of care homes • Well-being of participants and associated stakeholders in research design.

19. My Home Life: Promoting quality of life in care homes • Increasing role in supporting complex health and social needs • UK policy - voice, choice and control • How to make this happen?

20. Wales “The Committee commends the work of the My Home Life project which we believe makes a valuable contribution to improving quality of life in residential care.” p61

21. Scotland • Care Commission • Nurse Consultant for Care Homes • Connect in Care • Improving Care for Older People Shared Space • SOFI/ROLFI tool • LSCD programme

22. MHL Northern Ireland • Big Care Home Conversation • Raised £50K • Partners • Univ of Ulster • Age NI • IHCP

23. The future... • Vital part of care spectrum • Demand increasing (40,000 beds needed in next ten years) • Greater specialism • Reducing pressure on NHS • A sector that is emerging as having the potential to deliver quality for our frailest citizens in community and in care homes

24. My Home Life Spirit • Building upon energy, enthusiasm and best practice out there • Collaborating, sharing, realising a vision for change

25. Contact Details Professor Julienne Meyer & Tom Owen My Home Life City University London Adult Years Division School of Health Sciences Northampton SquareEC1V 0HB, London, UK Tel: +44 (0)20 7040 5776 Email: mhl@city.ac.uk mhl www.myhomelife.org.uk www.city.ac.uk/dignityincare www.city.ac.uk/bpop