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Supporting older people with learning disabilities and their families
Supporting older people with learning disabilities and their families

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3 Revisiting the Quilt of Excellence

In this final part of the course you will have an opportunity to revisit the Quilt of Excellence – the components of excellent care for older people with learning disabilities that you first encountered in Session 1.

Here it is as a reminder:

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NARRATOR
Our research showed that there are three key aspects involved when providing excellent care to older people with learning disabilities and their family carers. Each aspect is made up of its own unique elements. The result is really good support. We talked about how we could show what this support might look like in a visual way. Our team came up with the idea of a patchwork quilt. We call it the quilt of excellence. A patchwork quilt can be added to and changed over time, developing just like our lives do. A patchwork quilt also shows us how lots of smaller elements work together to make the whole. So our quilt of excellence for older people with learning disabilities and their family carers has three main parts, each with many different patches.
The first is about supporting people to live well as they get older. Through our research, we found that living well when people get older means having a good home, being able to get out and about in the fresh air, enjoying nature and being supported to do the things you really love. Enabling people to sustain relationships with their friends, family members, and support workers as they get older is also really important.
The second key element is supporting people to age well. This is about supporting people with the physical, mental, social and emotional changes related to ageing. It's also about planning ahead. This means really thinking about what happens as people age, paying close attention to their health and well-being and any changes they may be experiencing. It's also about ensuring people are in a home that they can grow older in, and supporting people around issues of death, dying and bereavement.
The third aspect of the quilt is about creating a caring environment for everyone. This involves looking after staff, enabling them to be confident and well trained to provide excellent care as people get older. It's also about helping staff to feel happy and well supported in their work. This is also about looking after family carers, supporting them, really listening to them, and keeping them involved in decisions, and being aware of their changing needs as they too get older. And very importantly, it means making sure the person is in a nurturing environment that respects their human rights, enables people to be supported by people that they like, and by people who like them.
When this patchwork of good practice comes together, we get the quilt of excellence, the best ways to support people with learning disabilities and their family carers as they get older.
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Activity 3 Living well, ageing well and creating a nurturing environment

Timing: Allow about 10 minutes

Now watch members of the panel discussing their views on the factors needed to create a caring and nurturing environment for older people with learning disabilities.

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DAWN: Having the right support.

LISA: Yeah. And you’re happy with that support?

DAWN: Yeah.

LISA: I guess, how they support you and who supports you.

DAWN: Yeah.

LISA: Definitely, that’s a big one.

PAM: Having your health checks regularly.

LISA: Yeah, so I guess thinking about--

PAM: --very important.

LISA: --your health, definitely. Linked to that there’s also keeping healthy, isn’t there, so thinking about what you’re eating--

DAWN: And exercise.

LISA: --exercising, too, definitely. What other things make a caring environment for you guys?

PAM: Making it as homely as possible with pictures and comforts.

LISA: Yeah, and lots of stuff that you love, really. And having your own space, your privacy, I think that’s so important. Dawn, can you think of any other things?

DAWN: Yeah, hanging out with our friends.

LISA: Yeah, and spending that time with other people, because I think you really enjoy that, don't you.

DAWN: Yeah.

LISA: You have so many friends, Dawn. What kind of things do you do with your friends?

DAWN: We play cards, we play dominoes, we cook for one another.

BEN: Effective leadership, present leadership, leading with values and confidence, I think, is really, really important. Being present so that both your staff, the people you support and their families see you-- I don’t necessarily mean you’re on the ward or in the home, but just being there, being available. And it filters down, people see that, and they think, yeah, this is the way to be.

All too often where services provide poor care-- And, again, I do not believe that people go to work to provide poor care at all. I think there’s sometimes-- if you’re not experienced, you go to work in care, and there’s maybe a level of indoctrination, you see things that aren’t right and think, oh, that’s the way to do it. Whereas, when things are done well, it’s because people are mirroring what they see from their seniors, from their managers, well, from the CEO down. And I think if your values as an organisation are right, that means that you’ll seek people with the right values, which will then mean that the services you provide are values-driven and individualised to meet people’s needs. So leadership, it would be my overarching kind of comment to that.

There is a converse to that, I would say. But not wanting to end on a negative. It’s not negative, I think it’s realistic in that sometimes that leadership is just one person, and they can maybe become a single point of failure. So what happens if that one person who provides that really authentic, values-led, personal, person-driven kind of leadership, what happens if they move on? Will it have been enough for the knowledge and skills that they’ve shared with their staff team and the people that are supported for that really positive outcome-focused service to carry on. So I think it’s important that leaders take the time to instill those values and those skills in their staff team and also check in that their staff team are practising what the organisation is preaching.

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Discussion

Pam and Dawn were keen to emphasise the aspects of the Quilt of Excellence that connected to people’s personal experiences: having good people to support you; being supported to pay attention to your health; being supported to do the things you enjoy, and maintain your relationships. Ben focused his response on the issue of leadership. He argues that effective leadership is critical to enabling staff to do the best job they can, creating a values-driven culture that permeates all the way through an organisation. He sees this as being a fundamental component in providing excellent support. But he also identified the risks associated with leadership – particularly if it is reliant upon the vision and actions of one person. Organisational values need to be put into action by everyone.