My Home Life is a new UK programme led by Help the Aged, National Care Forum and City University, aimed at improving quality of life for those living, dying, visiting and working in care homes for older people.

My Home Life (MHL) has adopted a m ulti-level, multi-agency approach to disseminating a vision and creating a positive culture for change to enable transformational practice development within the care home sector and wider health and care system. It is about working in true partnership with care homes to engage them with the messages while also influences the external environment within which the sector operates so that the evidence base for quality of life in care homes is embedded in the mainstream.

The vision

At the heart of the MHL programme is an evidence-based vision for care homes that was developed as a result of a literature review commissioned by Help the Aged and National Care Forum, to identify the positive practices that contribute to quality of life in care homes. The review brought together 60 academic researchers, members of the National Care Home Research and Development Forum (of which many are also members of the BSG), key stakeholders from the practice community and care home residents. The data gathered from this exercise identified eight best practice themes which together offer a vision for quality of life in care homes. These eight themes are summarised in Table 1.

Table 1: The My Home Life Evidence-based Vision

The vision is underpinned by ‘Relationship-centred Care’ that recognises the importance of seeing the care home as a community where the quality of life of staff, family, friends and residents are all crucial to improvements in practice. It suggests that everyone in a care home needs to have a sense of security, sense of continuity, sense of belonging, sense of purpose, sense of achievement and sense of significance (Six Senses Framework – developed by Professor Mike Nolan and colleagues at the University of Sheffield).

Getting research into practice: the challenge

There is clear evidence that much research appears to have little or no impact on practice (Davies, Nutley, & Smith, 2000). Getting research into practice is particularly challenging for social care provision within the independent sector. The sector often feels weary, overburdened with regulation and defensive in response to the negative media profile that they receive. Funding for educational programmes is sporadic at best, and in many care homes, a culture of professional training and development may be absent.

Ownership of expertise within the care home sector

Crucial to its early success has been the importance of allowing the sector ‘to own’ the programme. For decades, the sector has had to react to the requirements of regulators, commissioners and politicians, rather than owning the agenda themselves. The evidence base for MHL was undertaken using an ‘appreciative inquiry’ approach which emphasises examples of ‘what works?’ rather than ‘what doesn’t work?’. As a result MHL is profiling the positive examples of practice and the expertise that is already out there in care homes. It is about communicating back to the sector that this is their expertise and their programme.

The response from the care home sector to date has been very positive indeed with many care home providers wishing to associate with the programme and welcoming the stance of celebrating the good rather than dwelling on the bad examples of care home practice. Care home managers value the MHL vision because it offers them:

• Evidence of what customers (residents) want
• A sense of what practice could look like
• An evidence base from which care homes can articulate decision-making
• A framework for identifying evidence of good practice for self-regulation
• An evidence base for inspectors / commissioners to assess practice
• Accentuating positive (disassociating from bad press)

Current activities of My Home Life

A key value for My Home Life is to work collaboratively with all stakeholders to help us think creatively about how we can best support the care home sector to get research messages into practice. As a consequence we have:

• A steering group comprising key representatives from the care home sector and the involvement of residents to help shape the direction of the programme
• An advisory group of educational facilitators / training managers from the sector who advise on the content of resouces going out to the sector
• Academic theme leads who support and advise on the evidence base and on examples of positive practice
• Regional workshops across the UK to explore best practice with care home staff, commissioners, inspectors, residents and relatives

As a result of this collaboration we are working on 4 areas of activity: creating resources, developing networks, supporting change, and maintaining momentum.

Creating Resources

MHL have worked with the sector to explore what types of resources will actually help them in their practice. It became clear that many care home managers do not have time to read lengthy reports, and that any spare time they do have is seen as best spent working on the floor with the care-staff. As a result we have developed a range of resources tailored to different needs and with different levels of detail.

We have found that by embedding research messages into stories of practice we are really able to engage with care-staff. One of the resources that we are developing is a series of MHL bulletins which are targeted at care-assistants and include stories that they have written about the positive work they are doing. The bulletin goes out to 18,000 care homes across the UK and the feedback is that care-staff are picking up the bulletin and reading it.

Developing Networks

A number of care home managers have often told us that they feel very isolated in the work that they are doing. Many do not get opportunities to share ideas, anxieties or good practice. As a result, MHL is working in a number of regional areas to develop networks of care homes who come together to discuss the evidence base for My Home Life and share new ideas with us. The network is owned by the care homes themselves who set the agenda. We have had fantastic support from some of our theme leads who have been facilitating the local networks.

Supporting Change

The MHL team are conscious that resources alone are not enough to change practice and so are engaged in other activities to ensure that the vision is embedded in mainstream thinking and practice. MHL are working with regulators, commissioners and policy-makers to ensure that the requirements placed upon the care home sector reflect the evidence base for quality of life: The Commission for Social Care Inspection (CSCI) in England and the Care Commission in Scotland are both supporting the programme. MHL materials have been sent out to all inspectors in England and work is being undertaken to ensure that the regulatory framework reflects the My Home Life vision. Work with Local Social Services Commissioners is also underway. By engaging with the wider system, care home providers can see the relevance of the MHL vision in meeting their objectives.

Maintaining Momentum

MHL is constantly identifying opportunties to do mutually beneficial work with key people (care home providers, commissioners, inspectors etc.) with a shared interest in the sector. For instance, we heard from Scotland that commissioners knew they should be working with care homes, but did not always know how best to do this. In England, an opportunity arose to put on a joint event between My Home Life and the Care Services Improvement Partnership (Deparment of Health, England) to explore Partnership Working between Care Homes and the NHS. Colleagues from Scotland helped shape the event and findings from the event will now be shared across the Nations, as the issues raised and solutions highlighted are relevant to all.

Other work focuses on challenging the poor press that care homes so often have to endure. We are continually seeking to work with journalists to showcase the good work that is developing in the care home sector.

My Home Life Spirit

We are grateful to BUPA Giving for our initial funding and appreciate the way they have given us the freedom to work with the care home sector to decide the agenda for change. My Home Life spirit is all about:

• Building upon energy, enthusiasm and best practice out there
• Collaborating, sharing, and realising a vision for change

To join the My Home Life Network and obtain a copy of the report, please contact Jo Edler on joanna.edler@helptheaged.org.uk or 020 7239 1881.

An executive summary, short report and full literature review on which MHL is based, together with briefing papers on each of the eight best practice themes, is available at www.myhomelife.org.uk together with a growing number of linked resources.

Reference

Davies, H.T.O., Nutley, S.M., & Smith, P.C. (eds) (2000). What works? Evidence-based policy and practice in public services. Bristol: The Policy Press.