Karen Davies, Registered Home Manager, Rose Court
Who says you can’t? This is our ‘go to’ response when we meet resistance in Rose Court, an HC-One care home offering residential care, nursing care and dementia care. How often do you hear ‘she can’t take part in that activity, she’s on a puree diet’ or ‘he can’t go on that trip, he’s got dementia’. There are many reasons why people living in a care setting are not involved or included in planning and taking part in activities.
As a Home Manager I wanted to free up residents and staff to think differently about the provision of activities. The idea emerged a few years ago when we (the Home Manager and Well-being Coordinator) struck on the idea of adapting The Seven Rights of Medication (an international safe practice standard) and using our existing philosophy to activities provision to produce The Six Rights of Activity. Unfortunately this idea didn’t come to fruition at that time, but this year, the team at Rose Court have been lucky enough to be involved in the Skills for Care graduate programme. As part of the programme, our graduate Lucy, has led a project to develop and pilot the use of the Six Rights of Activities, making reference to current CQC requirements, and the company policy and procedures around activities provision.
The Six Rights of Activities are as follows:
- The right activity
Is this the best outing/activity to match the resident’s assessed needs, wishes and choices? This should include real time choices and reflect the individual’s life story. It should include an assessment of the location of the external activity or any specific activities or tasks which may occur which pose a risk. Is this appropriate for the resident? Take into account the stage of dementia the resident may be at as to whether the activity is appropriate and how to make it appropriate.
- The right resident
Is the right resident attending the right activity to match the resident’s expectations and abilities? Take into account the stage of dementia the resident may be at, as to whether the activity is appropriate for their abilities, or consider altering the way the resident can participate to make it appropriate.
- The right time
Is the trip/activity at the right time of day and the right length/duration to best match the resident’s expectations and abilities?
- The right documentation
Have you completed the right assessment of need and risk for the resident? Have risk assessments been conducted, health and safety procedures followed, capacity to consent reviewed and safeguarding considered? This may also include resident mix, transport, medication (does medication need to be taken?), communication (mobile phone?), social skills, equipment needed and the right food and fluids. If a modified diet is required, liaise with the kitchen to organize this. You should then evaluate and evidence the experience to develop individual planned care.
- The right support
Will there be the right level of support? Have you got the appropriate staff/relative to resident ratio? Arrange additional staff with the Home Manager and staff team to meet the assessed needs of the planned activity (potentially staff training as first aiders). Has enough support been provided to the resident to help decide on participation in the activity? Are staff aware and available to give the right level of support to the resident depending on their abilities and the stage of dementia they may currently be experiencing? Who else can you involve in the process to ensure the right support is available? E.g. do you need to consult with a nurse, or do you need the assistance of maintenance or kitchen staff?
- The right reason
Is the right resident participating for the right reason? Has there been as assessment of who needs and wants the activity, to evidence choices offered to all and ensure inclusivity?
Rose Court are participants in the Teaching Care Homes Programme, a partnership programme between Care England, the Foundation of Nursing Studies and the Burdett Trust for Nursing. See: https://www.fons.org/programmes/teaching-care-homes.
NSG 1101 – The “7 rights” of medication. Available from: http://nursing-care.co.uk/BabyNursing/nursing-7-medication-rights. Last accessed 5th August 2019.