Transcript

SPEAKER:

First of all, we're going to look at a short case study describing a care home, Fairview House. This case study is actually made up from a number of real homes that we visited and draws together some of their most important features. You've got the description and I'm going to read it out.

Fairview House is in an English market town on the Scottish borders and has around 40 residents, about half of whom are living with dementia. Originally a very large old vicarage, it was converted to its current role in the 1970s and has since been fully repurposed and redecorated by a large care group in the voluntary sector which bought it in the early 1990's. It still has quite a quirky interior with nooks and crannies rather than straight corridors and a variety of accessible bedrooms for individual occupancy.

Good natural light is evident all around and the repurposing of the building, which included the addition of a conservatory, has brought much more light into the dining room. There's also a separate room for staff to relax in and have as their own private space. The square entrance hall is furnished with sofas, which are similar in style to that which residents may have been used to before they moved in. It also has a large noticeboard with information about activities and requests for residents' views.

To the right of the entrance hall, a door stands open to the manager's office. A resident is comfortably settled on a small sofa. He greets visitors with a welcoming smile. The manager Jean has worked here for over 30 years, having joined as a care attendant and then been supported through a journey of formal and informal learning to reach her current post.

The retention and longevity of Fairview staff is something of which they are proud. The home's place in its community has played a role in this. It benefits from being able to recruit from nearby because it's known and respected. Additionally, staff may have friends or family already working here. Some residents know the staff from previous lives too, having been their teachers, parents, friends and so on. The philosophy is that it's important to include all the relationships that surround a resident.

Fairview House aims to be part of its locality in every sense by opening its doors and large garden to people nearby who may enjoy the facilities. Residents can also help to maintain the garden if they wish. Similarly, it's easy for residents to go into the town for shopping, to see friends, or to go to a place of worship. Some may need to be accompanied, in which case the view is that this should be a shared pleasure for them and the carer who goes with them.

The two large lounges have been split into four distinctive areas with chairs and coffee tables that are easy to move and arrange into different groups. The TV is contained in one area such that it doesn't dominate. Another of the areas has tea and coffee making facilities so residents can sit there with their guests. Whilst the whole arrangement encourages interaction, conversation, and small group activities, the areas can be rearranged to create a big, more open space for music or watching the TV together for a special programme. Just off one of the lounges is a small alcove where there's a collection of laptops and iPads for those residents who want to use them with or without help of a member of the staff team.

Another feature of Fairview House is its personalisation residents photos, pictures, and ornaments are part of the communal spaces and the decor so everywhere reflects the family that lives there. Like the sofas in the entrance hall, the decor and furniture has been chosen to reflect residents' tastes rather than the bland luxury of a hotel. This is achieved in part by consulting all concerned when changes are made, residents and staff, and also by understanding the local culture. The well-used garden, with carefully laid paths, various resting points, and a covered gazebo for the summer, is accessed through a conservatory designed to bring the outside in. The conservatory is warm, light, comfortable place, giving views over the open country in which many of the residents would have been brought up and some would have farmed.

Marie, the activities champion, aims to get residents and staff alike involved in craft groups, music, talks, celebrations, and outings. All the activities are planned together as a community so everyone can look forward to them. She helps steering groups of residents to put on celebrations for national and sporting events.

Time is built on-- I'll start that again. Time is built into staff rotas to allow for some staff participation and to give as much flexibility as possible to accommodate residents' hobbies. In Marie's words, an example of the latter is, if there's something they want to bake, we'd bring everything out to them into the dining room if they were making a cake or something like that. Similarly, residents are able to contribute to their care home community as they wish to and can. For instance, by gardening, sorting the books and puzzles, and so on.

Meals are an important part of the day, with lunch in particular bringing most people together. Those living with dementia are helped by the staff and also by their fellow diners. The meal arrangements and variety of the rooms give a choice of environment, privacy, quiet, or company. Access to objects, not only of emotional but also of practical significance, is also very important to autonomy and to forming relationships. The staff at Fairview House are given the flexibility and time to recognise these individual needs.

As with all care homes or community facilities, Fairview House has to deal with loss and the inevitability that members of their family will pass away. Staff are supported in bereavement and family members are helped to be with their loved ones by rearranging rooms, adding a small bed, bringing their meals in, and providing solace if it is wanted. Staff are also enabled to go to funerals.

Now, please think about the various ways in which Fairview care home is enabling and sustaining relational care. Complete the table below, writing in one thing about Fairview in each column. One thing they do that helps to nurture trust, one way in which they purposefully focus on relationships, and one aspect of the environment that helps relationships to flourish.