What was the Care Home Quality Improvement Project?
In collaboration with NHS Shropshire, Telford & Wrekin Integrated Care Board, this project offered a new approach to quality improvement in care homes, whereby homes identified the areas where they wanted to make changes, and support was tailored by the project staff accordingly.
Our Vision
The project used Appreciative Inquiry, to work in partnership with 17 care homes in Shropshire, Telford & Wrekin on quality improvement initiatives that supported the wellbeing of their residents. In the context of this project, wellbeing included:
- Maintaining independence, choice and control
- Optimal fluid and nutritional intake
- Being involved in meaningful activities
- Being valued as an individual
- Feeling safe
- Staying active
- Feeling calm and relaxed
- Sleeping well
- Maintaining relationships and social contacts
- Avoiding hospital admissions
Why was the Project developed?
The project was developed in recognition of the many factors influencing wellbeing in care homes. Increasing numbers of care home residents have dementia, along with symptoms such as:
- Poor night-time sleep
- Daytime sleepiness
- Restlessness
- Agitation
- Apathy and depression
- Poor appetite
- Poor fluid intake
Any of the above may potentially lead to increased frailty and poor health outcomes including hospital admission. Every one of the project care homes was different and so the support they needed to meet the needs of their residents in the best possible way was unique to each one.
What was the approach?
This was a preventing/reversing frailty approach, aiming to support residents to stay well for longer. This was not a one-size-fits-all project but one that aimed to support homes to build on their existing strengths to become even better at what they do.
Impact of the Project
Many of the quality improvement initiatives identified by care homes involved in the project related to dementia, including a focus on reducing the sensory overload in people with advanced dementia, more activities that met their psychosocial and emotional needs, and initiatives that involved carers more in carrying out activities. Examples included:
- Setting up a quiet sensory room, and more one-to-one sessions for bed-bound residents.
- Activity boxes for carers to use at the weekends.
- Changes to mealtimes so that the bigger meal is in the evening, improved evening snack options, and producing ‘show plates’ at mealtimes to support personal choice.
- Bedtime preparation (turning down the lighting, etc).
- Staff using distraction techniques effectively to de-escalate challenging behaviours.
For more information:
If you would like to find out more about the project please contact