69
Activity Provision Benchmarking good practice in care homes College of Occupational Therapists Available for Download
Activity ProvisionBenchmarking good practice in care homes
College of Occupational Therapists
It is important to develop a culture in care homes where activity is integral to care and notseen as an optional extra. Activity provision: benchmarking good practice in care homes
promotes and encourages appropriate activity for older people that is delivered in a kindand pleasant environment, regardless of residents’ age and/or diagnosis, whilst stillrespecting their dignity and personal choice.
This publication: � Offers a framework of person-centred quality indicators and outcome measures for
activity provision.� Incorporates a benchmark tool to evaluate current practice and promote excellence.� Summarises relevant policy drivers and care standards for each country in the UK. � Includes supporting evidence for good quality activities in care homes.
This document is intended to inform, guide and encourage care home providers,managers and commissioners, and will also be helpful to residents, their families andfriends, and care home inspectors.
Activity provision: benchmarking good practice in care homes was jointly developed bythe College of Occupational Therapists and the National Association for Providers ofActivities for Older People.
Availablefor Download
ISBN 978-1-905944-05-7
Activity ProvisionBenchmarking good practice in care homes
College of Occupational Therapists106–114 Borough High StreetLondon SE1 1LBwww.cot.org.ukTel: 020 7357 6480 Fax: 020 7450 2299
© 2007 College of Occupational Therapists Ltd.
Reg. in England No. 1347374 Reg. Charity No. 275119
Cover image © NAPA, with thanks to Warwick de Winter.
For free distribution only.
Activity Provision covers:Layout 1 5/9/07 16:22 Page 1
The College of Occupational Therapists is a wholly owned
subsidiary of the British Association of Occupational Therapists
(BAOT) and operates as a registered charity. It represents the
profession nationally and internationally, and contributes widely
to policy consultations throughout the UK. The
College sets the professional and educational
standards for occupational therapy, providing
leadership, guidance and information relating to
research and development, education, practice
and lifelong learning. In addition, 11 accredited
specialist sections support expert clinical practice.
www.cot.org.uk
About the publisher
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The College of Occupational Therapists, 106–114 Borough High Street, Southwark, LondonSE1 1LB; www.cot.org.uk
Copyright © College of Occupational Therapists, London 2007
First published in Great Britain in 2007 by the College of Occupational Therapists
Author: College of Occupational Therapists
All rights reserved, including translation. No part of this publication may be reproduced,stored in a retrieval system or transmitted, by any form or any means, electronic, mechanical,photocopying recording, scanning or otherwise, without prior permission in writing of theCollege of Occupational Therapists, unless otherwise agreed or indicated. Copying is notpermitted except for personal and internal use, to the extent permitted by national copyrightlaw, or under the terms of a licence issued by the relevant national Reproduction RightsOrganisation (such as the Copyright Licensing Agency in the UK). Requests for permission forother kinds of copying, such as copying for general distribution, for advertising orpromotional purposes, for creating new collective works, or for resale, and other enquiries,should be addressed to the Publications Officer at the above address. Other enquiries aboutthis document should be addressed to the Professional Practice Group, College ofOccupational Therapists.
Whilst every effort is made to ensure accuracy, the College of Occupational Therapists shallnot be liable for any loss or damage, either directly or indirectly resulting from use of thispublication.
Typeset by Servis Filmsetting Ltd, ManchesterPrinted and bound in Great Britain
ISBN 978-1-905944-05-7
Acknowledgements
The College recognises the work of Julia Pitkin and Jennifer Wenborn as co-authors onbehalf of the College of Occupational Therapists.
The College also wishes to acknowledge:
Members of the Reference Group for their work and support:Tim Brooke, Jane Burgess, Sylvia Gaspar, Sue Heiser, Rosemary Hurtley, Sally Knocker, SimonLabbett, Tessa Perrin, Jackie Pool, Colin Sheeran, Sylvie Silver, Annie Stevenson, Jenny Stiles.
Keena Millar – Care Home Manager.
Members of the UK inspection agencies.
Warwick de Winter for the front-cover photograph.
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Contents
PagePreface ivForeword – Professor Ian Philp vi
1 Introduction 1
2 Background 2
3 Benchmark tool for activity provision in care homes 33.1 How to use this benchmark tool 4
3.1.1 Getting started 43.1.2 How to collect the evidence 43.1.3 Using the tool 5
3.2 The benchmark tool 5
Benchmark 1 – The activity culture within care homes 6
Benchmark 2 – Communication and relationships between people 10
Benchmark 3 – Activity, social and community participation 13
Benchmark 4 – Care planning to ensure a positive activity outcome for each resident 20
Quality indicators and action plan 25
4 References 33
AppendicesAppendix A Policy drivers 35Appendix B Care standards 46Appendix C Supporting evidence 54Appendix D College of Occupational Therapists 59Appendix E National Association for Providers of Activities for Older People 60
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Preface
This guidance is primarily concerned with the provision of activities for olderpeople in residential care homes, as indicated by the supporting evidence base inAppendix C.
The term ‘resident’ is used throughout this guidance to refer to a person in receipt ofcare, that is, a service user who is living in a care home. However, the term ‘serviceuser’ is used when a direct quote is provided or in relation to specific policy documents.
Many of the principles outlined can be applied to other care settings for olderpeople and adults, or to other care home residents.
For the purposes of this guidance, activity is described as follows.
Activity is essential to human existence, health and wellbeing. It has the potential torestore, maintain and improve physical and mental health. Our individual personality,life history, interests, values and beliefs influence our choice of activity. What we dohelps to define who we are. The urge to engage in purposeful and meaningfulactivity is a basic human drive. This in-built motivation does not diminish ordisappear as people age, but the common effects of ageing, such as reduced vision,poor hearing and the increased incidence of arthritis and dementia, can affect anindividual’s ability to participate in activities.
Care givers who identify care home residents’ special needs and personal preferenceswill provide appropriate activity choices regardless of age and/or diagnosis. In carehomes where there is an activity culture, residents will be seen participating in avariety of leisure and daily interests.
It is essential that there is mutual understanding, awareness and acceptance in thecare home between all staff and residents about the importance of activities and theunderlying principle that activity provision is vital to each resident’s health andwellbeing.
Activity needs to be integral to care and not seen as an optional extra.
Activities take many forms and the list of possible activities is endless. They mightinclude daily routines such as mealtimes or preparing a drink, or they might berecreational activities, such as listening to music, playing a game or going for a walk.They can be done alone, as in reading the newspaper, or they can be done in groupsor pairs, maybe just simply chatting with friends or other residents or visiting theshops or a local club. Activities might be linked to a resident’s political interests orreligious beliefs and values, such as voting or attending a local church. They mighttake place in communal settings, for example in the garden, or in the community,such as a trip to the local cinema. Leisure pastimes, daily activities, social experiencesand ‘quiet time’ are all important activities for many people.
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Activity provision is therefore about the ways in which residents are supported to doall of these things throughout the whole day, not just the structured groups intraditional activity programmes. It should also meet each individual’s activity needs ina range of areas, for example physical, intellectual, sensory, spiritual, social,emotional etc.
Activity Provision: Benchmarking good practice in care homes
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Preface
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Foreword
We want to ensure that older people have greater opportunities to enjoy oldage.
(Department of Health 2006)
Evidence shows that providing a range of activities within care homes can improveresidents’ quality of life. As the number of older people increases, and growingnumbers reside in care homes, the challenge becomes even more urgent.
The provision of meaningful activity at a level appropriate to the individual’s abilitiesand needs is a complex business. I believe this publication will assist in meeting thischallenge. It outlines and describes ‘good’ activity provision within care homes forolder people. The person-centred quality indicators that constitute the audit toolprovide a clear benchmark against which current service provision can be measuredand from which an appropriate action plan can be devised and implemented.
I was present at the launch of the strategic partnership between the College ofOccupational Therapists and the National Association for Providers of Activities forOlder People. Their combined expertise and experience within the field of activityprovision have produced an evidence-based and highly practical tool that will be ofimmense value to care home managers and staff, and commissioners, as well asbeing of interest to residents and their families, and inspectors. I am thereforedelighted to welcome this important outcome of their collaboration.
It will contribute to enhancing residents’ wellbeing and go some way towardsproviding all care home residents with greater opportunities to enjoy old age.
Professor Ian PhilpNational Director for Older PeopleDepartment of Health
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1 Introduction
This guidance outlines what constitutes ‘good’ activity provision within carehomes for older people. A benchmark tool is provided to evaluate currentpractice and promote excellence.
The guidance is aimed at care home providers and commissioners and isavailable to residents, their families and friends, and inspectors. It offers aframework of person-centred quality indicators and outcome measures toinform, guide and encourage those who are responsible for and take part inmanaging, developing, providing and purchasing activity provision within carehomes. It also provides a guide for inspectors on good practice in activityprovision.
The College of Occupational Therapists (COT) and the National Association forProviders of Activities for Older People (NAPA) launched a strategicpartnership in 2005 in order ‘to work together to make access to meaningfuloccupation a reality for older people’ (COT and NAPA 2005). This included theproduction of a benchmark document that relates to the ‘provision andinspection of meaningful occupation for older people’ (COT and NAPA 2005).
Further information about the aims, key objectives and organisationalstructures of the College of Occupational Therapists and NAPA can be found inAppendices D and E.
This guidance was commissioned by the College of Occupational Therapistsand produced in partnership with NAPA, supported by a Reference Group ofexperts from the following organisations:
• BUPA• College of Occupational Therapists Specialist Section – Older People• Help the Aged• National Association for Providers of Activities for Older People• Southern Cross Healthcare.
The group offered a combined wealth of personal experience in activityprovision and service development, staff training and development, inspection,operational management, and research within care homes for older people.The benchmark indicators were reviewed by members of the Reference Groupin partnership with care homes within the statutory and non-statutory sectors.
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2 Background
Care givers who enable residents’ continued participation in activities will helpto reduce difficulties as a result of depression, falls and dependency (Perrin2005). This is especially important because older people in care homes are atgreater risk of falling than those who remain in their own homes (Help theAged 2004). Furthermore, there is a wealth of evidence to support the ideathat engaging in activity has many other physical and psychological benefitsand is essential to everyone’s health and wellbeing. See Appendix C for moreinformation.
There are many factors that will influence whether care home residentsparticipate in different activities. These include, for example, the environment,opportunities to contribute to the local community and to participate inactivities that are within a person’s capabilities, and being able to choosewhich activities to do.
Current government policy focuses on wellbeing and inclusion, and for somecountries in the UK giving service users choice is becoming increasinglyimportant. People who are given a choice about the services they receive andhow they receive them, including activity provision in care homes, will findtheir needs are being met in more fulfilling ways. The opportunity to take partin activities is essential, irrespective of age, gender, sexual orientation,disability, cultural, religious or other needs. See Appendix A for moreinformation about key relevant policies and legislation.
The quality indicators and benchmarks in this guidance have been developedfrom a number of existing tools that measure aspects of wellbeing and qualityin services for older people, including those designed for older people withdementia.
The benchmark tool in the following pages would be useful for care homeproviders to assess their current level of service provision and to identify areasfor improvement in an action plan. If they wish, they could produce this asevidence during an inspection.
Section 3 of this publication has been designed to be photocopied forindividual use.
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3B
ench
mar
k to
ol f
or
acti
vity
pro
visi
on
in c
are
ho
mes
This
ben
chm
ark
too
l has
bee
n d
esig
ned
to
eva
luat
e p
ract
ice
and
per
form
ance
in c
are
ho
mes
. It
will
hel
p w
ith
th
ed
eliv
ery
of
resi
den
t-fo
cuse
d o
utc
om
es in
act
ivit
y p
rovi
sio
n b
y m
akin
g e
vid
ence
-bas
ed c
om
par
iso
ns.
An
act
ion
pla
n c
anb
e d
evel
op
ed a
nd
imp
lem
ente
d a
nd
th
e to
ol c
an a
lso
be
use
d t
o m
on
ito
r ch
ang
es a
nd
rev
iew
on
go
ing
per
form
ance
to d
evel
op
bes
t p
ract
ice.
Ther
e ar
e m
any
po
ten
tial
ben
efits
to
usi
ng
th
is t
oo
l, fo
r ex
amp
le:
•To
pro
vid
e ev
iden
ce o
f b
est
pra
ctic
e fo
r ac
tivi
ty p
rovi
sio
n w
ith
in t
he
care
ho
me.
•To
imp
rove
th
e q
ual
ity
and
per
form
ance
of
acti
vity
pro
visi
on
wit
hin
car
e h
om
es.
•To
rai
se a
war
enes
s am
on
g s
taff
ab
ou
t th
eir
ow
n a
nd
th
eir
colle
agu
es’ p
erfo
rman
ce.
•To
giv
e st
aff
and
res
iden
ts t
he
op
po
rtu
nit
y to
be
invo
lved
in t
he
ben
chm
arki
ng
pro
cess
, th
ereb
y im
pro
vin
gm
oti
vati
on
an
d d
evel
op
ing
co
nse
nsu
s to
mak
e ch
ang
es.
•To
giv
e a
bet
ter
un
der
stan
din
g o
f th
e w
ider
pic
ture
.•
To in
crea
se u
nd
erst
and
ing
an
d im
pro
ve w
ork
ing
pra
ctic
es b
etw
een
res
iden
ts, s
taff
an
d m
anag
emen
t.
Each
qu
alit
y in
dic
ato
r is
ou
tco
me
focu
sed
an
d s
up
po
rted
by
a se
ries
of
gra
ded
ben
chm
arks
:
AEx
celle
nt
A s
tan
dar
d o
f ex
celle
nce
an
d b
est
pra
ctic
e th
at h
as b
een
co
nti
nu
ally
sust
ain
ed o
ver
tim
e. S
taff
dem
on
stra
teim
agin
atio
n a
nd
enth
usi
asm
fo
r p
rovi
din
g a
n in
div
idu
alis
ed, p
erso
n-c
entr
ed a
pp
roac
h. W
ith
in t
he
org
anis
atio
nth
ere
is a
n a
ctiv
ity
cult
ure
wh
ere
acti
vity
is r
eco
gn
ised
as
vita
l to
hea
lth
an
d w
ellb
ein
g a
nd
isin
teg
ral t
o d
aily
care
, reg
ard
less
of
the
staf
f ro
les.
BG
oo
dA
go
od
sta
nd
ard
of
acti
vity
pro
visi
on
has
inte
gra
ted
mo
st a
ctiv
itie
s in
to d
aily
car
e, is
wo
rkin
g w
ith
in c
are
pla
ns,
use
s a
per
son
-cen
tred
ap
pro
ach
an
d id
enti
fies
wea
knes
ses
in o
rder
to
ad
dre
ss a
nd
imp
rove
the
resi
den
ts’ l
ivin
gex
per
ien
ce.
CA
deq
uat
eTh
e m
inim
um
acc
epta
ble
sta
nd
ard
. Mo
st p
oin
ts a
re a
deq
uat
ely
add
ress
ed, b
ut
con
sid
erab
le im
pro
vem
ent
cou
ldb
e m
ade
to im
pro
ve t
he
qu
alit
y o
f p
rovi
sio
n r
egar
din
g a
ctiv
itie
s an
d t
o e
nh
ance
th
e re
sid
ents
’ liv
ing
exp
erie
nce
by
inte
gra
tin
g a
ctiv
itie
s in
to d
aily
car
e.
DPo
or
Ther
e ar
e m
ajo
r g
aps
in a
ctiv
ity
pro
visi
on
. Act
ual
car
e is
no
t co
nsi
sten
t w
ith
th
at s
ug
ges
ted
wit
hin
th
e ac
tivi
tyca
re p
lan
or
ther
ear
e n
o id
enti
fied
act
ivit
y ca
re p
lan
s. A
sit
uat
ion
wh
ere
ther
e is
po
ten
tial
fo
r re
sid
ent
dis
sati
sfac
tio
n o
r ill
-bei
ng
. Th
ere
is li
ttle
or
no
att
emp
t to
inte
gra
te a
ctiv
ity
pro
visi
on
into
dai
ly c
are
and
littl
een
han
cem
ent
of
the
resi
den
ts’ l
ivin
g e
xper
ien
ce.
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3.1
Ho
w t
o u
se t
his
ben
chm
ark
too
lFo
r th
e p
urp
ose
s o
f th
is t
oo
l th
e fo
llow
ing
defi
nit
ion
s h
ave
bee
n u
sed
:
•St
aff
– in
clu
des
eve
ryb
od
y w
ork
ing
in t
he
care
ho
me,
incl
ud
ing
ow
ner
s an
d m
anag
ers.
•C
are
staf
f–
staf
f re
spo
nsi
ble
fo
r p
rovi
din
g c
are
on
a d
aily
bas
is, i
ncl
ud
ing
th
e ac
tivi
ty o
rgan
iser
s.
3.1.
1G
etti
ng
sta
rted
Bef
ore
sta
rtin
g t
o u
se t
he
ben
chm
ark
too
l, ta
ke fi
ve m
inu
tes
to r
ead
th
e n
ote
s b
elo
w.
The
focu
s o
f th
is t
oo
l is
the
resi
den
ts’ e
xper
ien
ces
of
acti
vity
. Ho
wev
er, i
nfo
rmat
ion
is c
olle
cted
usi
ng
dif
fere
nt
met
ho
ds
and
fro
m d
iffe
ren
t so
urc
es, w
hic
h in
clu
des
th
e re
sid
ents
th
emse
lves
, sta
ff, m
anag
ers,
fri
end
s an
d r
elat
ives
,an
d t
he
care
ho
me’
s d
ocu
men
tati
on
.
Wo
rkin
g w
ith
res
iden
ts w
ho
are
un
able
to
art
icu
late
th
eir
exp
erie
nce
s, f
or
inst
ance
th
ose
wh
o h
ave
dem
enti
a,re
qu
ires
th
e u
se o
f d
iffe
ren
t te
chn
iqu
es t
o c
olle
ct e
vid
ence
fro
m t
hem
. Ob
serv
ing
th
ese
resi
den
ts t
o a
sses
s, f
or
exam
ple
, th
eir
emo
tio
nal
wel
lbei
ng
, th
eir
eng
agem
ent
wit
h a
n a
ctiv
ity,
or
thei
r at
ten
tio
n is
on
e p
oss
ible
met
ho
d(K
itw
oo
d 1
997)
. Oth
er e
vid
ence
can
be
gai
ned
by
liste
nin
g t
o s
om
eon
e w
ho
kn
ow
s th
e re
sid
ent
wel
l, fo
r ex
amp
le a
spo
use
, par
tner
, fam
ily m
emb
er o
r cl
ose
fri
end
.
Som
e re
sid
ents
may
no
t b
e ab
le t
o a
rtic
ula
te t
hei
r ex
per
ien
ces
for
ph
ysic
al r
easo
ns.
Fo
r ex
amp
le, t
hey
hav
e h
ad a
stro
ke o
r h
ave
ano
ther
dis
abili
ty. A
lter
nat
ive
met
ho
ds
of
com
mu
nic
atio
n c
an b
e u
sed
, su
ch a
s p
en a
nd
pap
er o
ro
ther
co
mm
un
icat
ion
eq
uip
men
t an
d n
on
-ver
bal
ges
ture
s.
3.1.
2H
ow
to
co
llect
th
e ev
iden
ceIt
is n
eces
sary
to
co
llect
evi
den
ce in
a v
arie
ty o
f w
ays,
esp
ecia
lly w
hen
res
iden
ts a
re u
nab
le t
o v
erb
alis
e th
eir
view
s.Th
is c
an b
e d
on
e b
y:
•O
bse
rvin
g w
hat
is h
app
enin
g in
th
e ca
re h
om
e.•
List
enin
g t
o r
esid
ents
, rel
ativ
es, f
rien
ds,
sta
ff a
nd
man
ager
s ta
lk a
bo
ut
thei
r ex
per
ien
ces
wit
h r
egar
d t
o t
he
soci
allif
e o
f th
e h
om
e an
d a
ctiv
ity
pro
visi
on
.•
Rea
din
g s
up
po
rtin
g d
ocu
men
tati
on
.•
Ob
serv
ing
th
e b
ehav
iou
r an
d in
tera
ctio
ns
bet
wee
n r
esid
ents
, sta
ff, v
isit
ors
an
d m
anag
ers.
•O
bse
rvin
g r
esid
ents
’ att
enti
on
an
d e
ng
agem
ent
in a
ctiv
itie
s. D
o t
hey
loo
k co
nte
nt,
hap
py,
fru
stra
ted
, an
imat
ed,
wit
hd
raw
n o
r ag
itat
ed?
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3.1.
3U
sin
g t
he
too
lPl
ease
no
te –
th
e b
ench
mar
k to
ol a
nd
act
ion
pla
n f
orm
s co
nta
ined
in t
his
pu
blic
atio
n c
an b
e p
ho
toco
pie
d
1.C
olle
ct e
vid
ence
by
usi
ng
th
e d
iffe
ren
t m
eth
od
s d
escr
ibed
ab
ove
.
2.R
eco
rd t
he
evid
ence
yo
u s
ee, h
ear
or
hav
e re
ad in
th
e ev
iden
ce b
ox
agai
nst
th
e re
leva
nt
ben
chm
ark.
Yo
u m
ayfi
nd
yo
u h
ave
evid
ence
in s
ever
al o
f th
e b
oxe
s fo
r ea
ch q
ual
ity
ind
icat
or.
3.W
hen
yo
u h
ave
com
ple
ted
all
the
qu
alit
y in
dic
ato
rs, r
evie
w g
oo
d p
ract
ice
and
are
as w
her
e p
erfo
rman
ce c
an b
eim
pro
ved
.
4.It
is h
elp
ful a
t th
is s
tag
e to
sh
are
the
info
rmat
ion
yo
u h
ave
fou
nd
wit
h r
esid
ents
, co
lleag
ues
, sta
ff a
nd
man
ager
s.
5.U
sin
g t
he
evid
ence
, dec
ide
wh
at n
eed
s to
be
do
ne
to im
pro
ve a
ctiv
ity
pro
visi
on
an
d c
om
ple
te t
he
acti
on
s fo
rea
ch q
ual
ity
ind
icat
or.
6.Yo
u s
ho
uld
no
w h
ave
an a
ctio
n li
st t
hat
can
be
wo
rked
on
. Usi
ng
th
e ac
tio
n p
lan
fo
rms
(pag
es 2
5–32
), a
gre
e an
dre
cord
wh
o w
ill t
ake
resp
on
sib
ility
fo
r co
mp
leti
ng
eac
h a
ctio
n a
nd
a t
imet
able
fo
r im
ple
men
tin
g t
hes
e.
7.A
gre
e a
revi
ew d
ate
to r
epea
t th
e p
roce
ss. T
his
will
giv
e th
e o
pp
ort
un
ity
to m
easu
re a
nd
rec
ord
imp
rove
men
ts t
oac
tivi
ty p
rovi
sio
n w
ith
in t
he
care
ho
me.
3.2
The
ben
chm
ark
too
lTh
e b
ench
mar
k to
ol i
s d
esig
ned
to
hig
hlig
ht
area
s o
f w
eakn
ess
that
can
be
imp
rove
d u
po
n b
y d
evel
op
ing
an
act
ion
pla
n. I
t is
no
t ab
ou
t ac
hie
vin
g a
sco
re. T
he
too
l is
org
anis
ed a
rou
nd
fo
ur
key
area
s th
at a
re t
he
fou
nd
atio
ns
top
rovi
din
g m
ean
ing
ful a
ctiv
ity
to p
eop
le in
car
e h
om
es.
The
key
area
s ar
e:
1.Th
e ac
tivi
ty c
ult
ure
wit
hin
car
e h
om
es.
2.C
om
mu
nic
atio
n a
nd
rel
atio
nsh
ips
bet
wee
n p
eop
le.
3.A
ctiv
ity,
so
cial
an
d c
om
mu
nit
y p
arti
cip
atio
n.
4.C
are
pla
nn
ing
to
en
sure
a p
osi
tive
act
ivit
y o
utc
om
e fo
r ea
ch r
esid
ent.
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Ben
chm
ark
1 –
The
acti
vity
cu
ltu
re w
ith
in c
are
ho
mes
Car
e h
om
e o
wn
ers
and
man
ager
s ar
e re
spo
nsi
ble
fo
r en
suri
ng
th
ere
is a
cu
ltu
re t
hat
pro
mo
tes
and
incl
ud
es a
ctiv
ity
in a
llas
pec
ts o
f d
aily
life
fo
r th
e re
sid
ents
. An
act
ivit
y cu
ltu
re w
ill b
e fu
lly in
teg
rate
d in
to t
he
valu
es a
nd
act
ion
s o
f al
l sta
ff,
incl
ud
ing
man
ager
s, h
ou
seke
eper
s, c
ater
ers,
mai
nte
nan
ce a
nd
car
e st
aff.
Act
ivit
y w
ill a
lso
be
refl
ecte
d in
all
the
care
ho
me’
s d
ocu
men
tati
on
, in
clu
din
g t
he
po
licie
s an
d p
roce
du
res.
Staf
f w
ith
th
e re
leva
nt
kno
wle
dg
e an
d s
kills
to
pro
vid
e ap
pro
pri
ate
acti
viti
es c
an e
nri
ch t
he
rela
tio
nsh
ips
wit
hin
th
e h
om
eto
kee
p t
he
acti
vity
cu
ltu
re v
ibra
nt
and
aliv
e. In
a h
om
e g
rad
ed a
s ‘e
xcel
len
t’ t
his
will
be
all s
taff
bu
t at
a m
inim
um
sh
ou
ldb
e th
e ca
re s
taff
an
d a
ny
ded
icat
ed a
ctiv
ity
org
anis
ers.
A r
elev
ant
trai
nin
g p
rog
ram
me
for
staf
f w
ill b
e in
pla
ce t
o d
emo
nst
rate
th
e o
rgan
isat
ion
’s c
om
mit
men
t to
act
ivit
yp
rovi
sio
n f
or
its
resi
den
ts.
Qu
alit
y in
dic
ato
rs
1.1
The
care
ho
me
man
ager
dem
on
stra
tes
exte
nsi
ve k
no
wle
dg
e ab
ou
t h
is o
r h
er r
esid
ents
’ nee
ds,
inte
rest
s an
dp
refe
ren
ces,
irre
spec
tive
of
age
and
/or
dia
gn
osi
s, a
nd
ho
w t
hey
are
bei
ng
met
th
rou
gh
th
e p
rovi
sio
n o
f ac
tivi
ties
.1.
2A
ll st
aff
rece
ive
app
rop
riat
e tr
ain
ing
ab
ou
t th
e ef
fect
s o
f ag
ein
g, c
on
dit
ion
s o
f ag
ein
g, p
erso
n-c
entr
ed c
are,
com
mu
nic
atio
n s
kills
, an
d t
he
sele
ctio
n a
nd
pro
visi
on
of
app
rop
riat
e ac
tivi
ties
.1.
3R
esid
ents
are
fre
e to
en
gag
e in
per
son
al a
nd
so
cial
act
ivit
ies
of
thei
r ch
oic
e in
a r
elax
ed a
nd
fri
end
ly e
nvi
ron
men
tw
ith
in t
he
care
ho
me.
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1.1
Qu
alit
y in
dic
ato
rTh
e ca
re h
om
e m
anag
er d
emo
nst
rate
s ex
ten
sive
kn
ow
led
ge
abo
ut
his
or
her
res
iden
ts’ n
eed
s, in
tere
sts
and
pre
fere
nce
s, ir
resp
ecti
ve o
f ag
ean
d/o
r d
iag
no
sis,
an
d h
ow
th
ey a
re b
ein
g m
et t
hro
ug
h t
he
pro
visi
on
of
acti
viti
es.
A•
The
man
ager
co
mm
un
icat
es a
nd
dem
on
stra
tes
his
or
her
Ev
iden
ceco
mm
itm
ent
to t
he
acti
vity
cu
ltu
re w
ith
in t
he
ho
me’
s p
olic
ies,
pro
cess
es, t
rain
ing
an
d le
ader
ship
.•
Act
ivit
y ta
kes
pla
ce a
t an
y ti
me
of
day
an
d n
igh
t, a
nd
is fl
exib
leto
th
e re
sid
ents
’ nee
ds,
wis
hes
an
d p
erso
nal
ro
uti
nes
.•
The
man
ager
, all
staf
f an
d r
esid
ents
can
des
crib
e* h
ow
all
acti
viti
esan
d t
asks
can
be
seen
as
an o
pp
ort
un
ity
to b
uild
rel
atio
nsh
ips
and
en
han
ce t
he
resi
den
ts’ l
ivin
g e
xper
ien
ce.
B•
Ther
e is
co
mm
itm
ent
to t
he
acti
vity
cu
ltu
re b
ut
it is
on
ly p
artl
y Ev
iden
cere
flec
ted
in t
he
ho
me’
s p
olic
ies
and
pro
cess
es.
•A
ctiv
ity
take
s p
lace
at
mo
st t
imes
of
the
day
an
d e
ven
ing
an
dis
usu
ally
flex
ible
an
d p
erso
n c
entr
ed.
•Th
e ap
pro
ach
is p
erso
n-c
entr
ed f
or
mo
st r
esid
ents
. Man
ager
san
d c
are
staf
f ca
n d
escr
ibe
ho
w a
ctiv
itie
s ca
n b
e se
en a
s an
op
po
rtu
nit
y to
imp
rove
th
e re
sid
ents
’ liv
ing
exp
erie
nce
.
C•
Ther
e is
co
mm
itm
ent
to t
he
acti
vity
cu
ltu
re b
ut
it is
no
t re
flec
ted
Evid
ence
in t
he
ho
me’
s p
olic
ies
and
pro
cess
es.
•R
esp
on
sib
ility
fo
r ac
tivi
ty p
rovi
sio
n is
del
egat
ed t
o k
ey
mem
ber
s o
f st
aff
and
/or
acti
vity
org
anis
ers,
wh
o c
an d
escr
ibe
the
imp
ort
ance
of
acti
viti
es f
or
resi
den
ts.
•Th
e ap
pro
ach
is p
erso
n-c
entr
ed f
or
som
e re
sid
ents
, bu
t n
ot
all.
D•
Ther
e is
litt
le o
r n
o im
po
rtan
ce a
ttac
hed
to
act
ivit
y in
th
e ca
re
Evid
ence
ho
me
and
it is
no
t se
en a
s p
art
of
dai
ly li
fe o
r ro
uti
nes
by
man
ager
s an
d s
taff
.•
Ther
e m
igh
t b
e a
gen
eral
act
ivit
y ti
met
able
th
at is
no
t p
erso
n-
cen
tred
or
con
sist
entl
y fo
llow
ed.
•St
aff
are
seen
as
too
bu
sy t
o p
rovi
de
mea
nin
gfu
l act
ivit
y. T
hey
bel
ieve
th
e re
sid
ents
are
no
t in
tere
sted
, no
r d
o t
hey
vie
w
per
son
al o
r d
om
esti
c ca
re a
s an
op
po
rtu
nit
y fo
r ac
tivi
ty.
*Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
8 College of Occupational Therapists 2007
1.2
Qu
alit
y in
dic
ato
rA
ll st
aff
rece
ive
app
rop
riat
e tr
ain
ing
ab
ou
t th
e ef
fect
s o
f ag
ein
g, c
on
dit
ion
s o
f ag
ein
g, p
erso
n-c
entr
ed c
are,
co
mm
un
icat
ion
ski
lls, a
nd
th
ese
lect
ion
an
d p
rovi
sio
n o
f ap
pro
pri
ate
acti
viti
es.
A•
All
staf
f h
ave
rece
ived
ap
pro
pri
ate
trai
nin
g. T
hey
can
des
crib
e Ev
iden
ceh
ow
th
ey h
ave
hel
ped
res
iden
ts s
elec
t ac
tivi
ties
an
d e
nab
led
th
em t
o t
ake
par
t u
sin
g a
per
son
-cen
tred
ap
pro
ach
wh
ile
taki
ng
into
acc
ou
nt
any
age-
rela
ted
nee
ds,
dis
abili
ties
an
d
per
son
al c
ho
ices
.•
All
staf
f ca
n d
emo
nst
rate
or
des
crib
e h
ow
act
ivit
y p
rovi
sio
n is
ever
yon
e’s
resp
on
sib
ility
.•
All
staf
f co
mm
un
icat
e ef
fect
ivel
y w
ith
res
iden
ts t
o e
nsu
re t
hey
ar
e in
clu
ded
in a
ctiv
ity
pla
nn
ing
on
a r
egu
lar
and
on
go
ing
bas
is.
B•
Mo
st s
taff
hav
e re
ceiv
ed t
rain
ing
an
d c
an d
escr
ibe
ho
w t
hey
hav
eEv
iden
ceh
elp
ed s
om
e re
sid
ents
sel
ect
acti
viti
es, t
akin
g in
to a
cco
un
t an
yag
e-re
late
d n
eed
s, d
isab
iliti
es a
nd
per
son
al c
ho
ices
.•
Car
e st
aff
can
dem
on
stra
te o
r d
escr
ibe
ho
w a
ctiv
ity
pro
visi
on
is t
hei
r re
spo
nsi
bili
ty.
•M
ost
sta
ff c
om
mu
nic
ate
effe
ctiv
ely
wit
h r
esid
ents
, co
nsu
ltin
g w
ith
them
to
en
sure
th
ey a
re in
clu
ded
in a
ctiv
ity
pla
nn
ing
.
C•
Mo
st s
taff
are
ded
icat
ed t
o u
sin
g a
ctiv
ity
mea
nin
gfu
lly, b
ut
they
Ev
iden
cem
ay n
ot
hav
e h
ad t
rain
ing
.•
Car
e st
aff
hel
p r
esid
ents
sel
ect
acti
viti
es a
nd
en
able
th
em t
o t
ake
par
t.•
Res
iden
ts a
re c
on
sult
ed a
s an
d w
hen
it is
fel
t n
eces
sary
by
staf
f,fo
r ex
amp
le o
n a
dm
issi
on
to
th
e h
om
e. T
his
pro
ced
ure
is n
ot
fully
inte
gra
ted
into
th
e ac
tivi
ty p
lan
nin
g p
roce
ss.
D•
Ther
e is
no
evi
den
ce o
f tr
ain
ing
in m
ean
ing
ful a
ctiv
ity
at a
ny
leve
l.Ev
iden
ce•
Staf
f ca
nn
ot
des
crib
e th
e im
po
rtan
ce o
f ev
eryo
ne’
s ro
le in
p
rovi
din
g a
ctiv
itie
s, n
or
exp
lain
ho
w a
n a
ctiv
ity
cult
ure
has
im
plic
atio
ns
for
resi
den
ts’ h
ealt
h a
nd
wel
lbei
ng
.•
Res
iden
ts a
re n
ot
con
sult
ed r
egu
larl
y ab
ou
t a
cho
ice
of
do
mes
tic,
leis
ure
or
per
son
al a
ctiv
ity
and
so
me
acti
viti
es d
o n
ot
take
ac
cou
nt
of
thei
r ag
e-re
late
d n
eed
s.
For
alte
rnat
ive
met
ho
ds
of
colle
ctin
g e
vid
ence
see
pag
es 4
an
d 5
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1.3
Qu
alit
y in
dic
ato
rR
esid
ents
are
fre
e to
en
gag
e in
per
son
al a
nd
so
cial
act
ivit
ies
of
thei
r ch
oic
e in
a r
elax
ed a
nd
fri
end
ly e
nvi
ron
men
t w
ith
in t
he
care
ho
me.
A•
Res
iden
ts c
an b
e o
bse
rved
inte
ract
ing
wit
h e
ach
oth
er m
ost
of
Evid
ence
the
tim
e w
ith
ou
t n
eces
sari
ly b
ein
g e
ng
aged
in a
fu
nct
ion
al t
ask.
•R
esid
ents
rep
ort
* fr
ien
dly
an
d s
oci
al c
om
mu
nic
atio
n w
ith
all
staf
fat
all
tim
es a
nd
fee
l in
clu
ded
in t
he
com
mu
nit
y o
f th
e h
om
e.•
Res
iden
ts r
epo
rt*
that
th
ey a
re f
ree
to p
urs
ue
a ra
ng
e o
f p
erso
nal
or
soci
al a
ctiv
itie
s o
f th
eir
cho
ice
at a
ll ti
mes
.•
Res
iden
ts r
epo
rt*
that
all
staf
f re
spec
t th
eir
‘qu
iet’
tim
e i.e
. tim
e fo
r a
per
son
to
be
pri
vate
an
d e
njo
y q
uie
t re
flec
tio
n.
B•
Res
iden
ts c
an b
e o
bse
rved
inte
ract
ing
wit
h e
ach
oth
er s
om
e o
f Ev
iden
ceth
e ti
me.
•R
esid
ents
rep
ort
* th
at a
ll st
aff
com
mu
nic
ate
wit
h t
hem
in a
nap
pro
pri
ate
and
fri
end
ly m
ann
er m
ost
of
the
tim
e.•
Res
iden
ts r
epo
rt*
that
th
ey a
re a
ble
to
pu
rsu
e a
ran
ge
of
per
son
al o
r so
cial
act
ivit
ies
of
thei
r ch
oic
e m
ost
of
the
tim
e.•
Res
iden
ts r
epo
rt*
that
mo
st s
taff
res
pec
t th
eir
‘qu
iet’
tim
e.
C•
Res
iden
ts c
an b
e se
en in
tera
ctin
g w
ith
eac
h o
ther
.Ev
iden
ce•
Res
iden
ts r
epo
rt*
that
sta
ff c
om
mu
nic
ate
wit
h t
hem
wh
en
nec
essa
ry.
•R
esid
ents
rep
ort
* th
at t
hey
are
occ
asio
nal
ly a
ble
to
pu
rsu
e ac
tivi
ties
of
thei
r o
wn
ch
oic
e.•
Res
iden
ts r
epo
rt*
that
car
e st
aff
usu
ally
res
pec
t ‘q
uie
t’ t
ime.
D•
Res
iden
ts c
an b
e se
en s
itti
ng
alo
ne
and
rar
ely
com
mu
nic
atin
g w
ith
Ev
iden
ceea
ch o
ther
.•
Res
iden
ts r
epo
rt*
that
th
ere
is m
inim
al c
om
mu
nic
atio
n w
ith
sta
ff.
•R
esid
ents
rep
ort
* th
at t
hey
are
rar
ely,
if a
t al
l, ab
le t
o p
urs
ue
acti
viti
es o
f th
eir
ow
n c
ho
ice.
•R
esid
ents
rep
ort
* th
at t
hey
rar
ely
hav
e th
e o
pp
ort
un
ity
for
‘qu
iet’
ti
me.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 9 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
Ben
chm
ark
2 –
Co
mm
un
icat
ion
an
d r
elat
ion
ship
s b
etw
een
peo
ple
Co
mm
un
icat
ion
is m
uch
mo
re t
han
an
exc
han
ge
of
info
rmat
ion
. It
is t
he
mea
ns
by
wh
ich
we
exp
ress
ou
r th
ou
gh
ts,
feel
ing
s, h
op
es, f
ears
an
d a
spir
atio
ns.
It m
ay b
e a
gla
nce
, a t
ou
ch o
f th
e h
and
, a s
on
g o
r a
smile
th
at m
akes
a c
on
nec
tio
nw
ith
an
oth
er h
um
an b
ein
g. W
hen
an
ind
ivid
ual
can
no
lon
ger
use
wo
rds
to c
om
mu
nic
ate,
we
mu
st u
se n
on
-ver
bal
sig
nal
sto
dem
on
stra
te t
hat
we
are
liste
nin
g a
nd
th
at t
he
oth
er p
erso
n m
atte
rs t
o u
s.
Ad
mis
sio
n t
o a
car
e h
om
e ca
n r
esu
lt in
res
iden
ts f
eelin
g a
lon
e am
on
g s
tran
ger
s, b
erea
ved
of
fam
ily, f
rien
ds
and
fam
iliar
role
s, r
ou
tin
es a
nd
ob
ject
s. It
is e
ssen
tial
th
at c
are
ho
me
staf
f cr
eate
a s
ense
of
bel
on
gin
g w
ith
in w
hic
h r
esid
ents
fee
lp
hys
ical
ly a
nd
psy
cho
log
ical
ly s
afe,
wh
ere
rela
tio
nsh
ips
are
po
siti
ve a
nd
rew
ard
ing
, an
d w
her
e th
ey c
an f
reel
y ex
pre
ss t
hei
rfe
elin
gs
and
op
inio
ns,
tak
e p
art
in a
ctiv
itie
s an
d c
on
trib
ute
to
th
e co
mm
un
ity
wit
hin
th
e ca
re h
om
e.
Peo
ple
livi
ng
in a
car
e h
om
e sh
ou
ld b
e ab
le t
o e
xpec
t:
•A
pp
reci
atio
n, s
ensi
tivi
ty a
nd
ack
no
wle
dg
emen
t o
f th
eir
feel
ing
s an
d p
sych
olo
gic
al n
eed
s.•
Posi
tive
, rew
ard
ing
so
cial
rel
atio
nsh
ips.
•A
ckn
ow
led
gem
ent
as a
un
iqu
e in
div
idu
al w
ith
th
eir
ow
n id
enti
ty.
Qu
alit
y in
dic
ato
rs
2.1
Staf
f u
nd
erst
and
th
e va
lue
and
imp
ort
ance
of
effe
ctiv
e co
mm
un
icat
ion
an
d t
he
rela
tio
nsh
ips
they
bu
ild w
ith
resi
den
ts a
nd
ho
w t
hes
e d
irec
tly
affe
ct r
esid
ents
’ op
po
rtu
nit
ies
to t
ake
par
t in
act
ivit
ies.
2.2
Co
mm
un
icat
ion
bet
wee
n s
taff
an
d r
esid
ents
is e
ffec
tive
an
d s
ensi
tive
to
en
able
res
iden
ts t
o m
ake
info
rmed
ch
oic
esab
ou
t th
e ac
tivi
ties
th
ey d
o.
This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
10 College of Occupational Therapists 2007
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 10 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
This page may be photocopiedActivity Provision: Benchmarking good practice in care homesCollege of Occupational Therapists 2007 11
2.1
Qu
alit
y in
dic
ato
rSt
aff
un
der
stan
d t
he
valu
e an
d im
po
rtan
ce o
f ef
fect
ive
com
mu
nic
atio
n a
nd
th
e re
lati
on
ship
s th
ey b
uild
wit
h r
esid
ents
an
d h
ow
th
ese
dir
ectl
yaf
fect
res
iden
ts’ o
pp
ort
un
itie
s to
tak
e p
art
in a
ctiv
itie
s.
A•
All
staf
f ca
n d
escr
ibe
each
res
iden
t’s
com
mu
nic
atio
n n
eed
s an
d
Evid
ence
the
bar
rier
s to
su
cces
sfu
l co
mm
un
icat
ion
as
a re
sult
of
a re
sid
ent’
sd
isab
iliti
es, a
ge-
rela
ted
pro
ble
ms
and
lan
gu
age
dif
ficu
ltie
s.•
All
staf
f h
ave
rece
ived
tra
inin
g a
nd
kn
ow
ho
w t
o u
se r
esid
ents
’ co
mm
un
icat
ion
eq
uip
men
t an
d d
iffe
ren
t co
mm
un
icat
ion
m
eth
od
s. T
hey
des
crib
e h
ow
th
ey u
se d
iffe
ren
t ap
pro
ach
es t
o
mee
t re
sid
ents
’ nee
ds.
•A
ll st
aff
can
des
crib
e h
ow
th
ey d
evel
op
go
od
rel
atio
nsh
ips
wit
h
resi
den
ts a
nd
th
eir
rela
tive
s to
gai
n a
n u
nd
erst
and
ing
of
each
in
div
idu
al’s
act
ivit
y n
eed
s an
d w
ellb
ein
g.
B•
Mo
st s
taff
can
des
crib
e ea
ch r
esid
ent’
s co
mm
un
icat
ion
nee
ds
Evid
ence
and
th
e b
arri
ers
to s
ucc
essf
ul c
om
mu
nic
atio
n a
s a
resu
lt o
f a
resi
den
t’s
dis
abili
ties
an
d a
ge-
rela
ted
pro
ble
ms.
•St
aff
kno
w h
ow
to
use
res
iden
ts’ c
om
mu
nic
atio
n e
qu
ipm
ent
and
d
iffe
ren
t co
mm
un
icat
ion
met
ho
ds
and
mo
st h
ave
had
tra
inin
g.
•C
are
staf
f ca
n d
escr
ibe
ho
w t
hey
dev
elo
p g
oo
d r
elat
ion
ship
s w
ith
res
iden
ts t
o g
ain
an
un
der
stan
din
g o
f ea
ch in
div
idu
al’s
ac
tivi
ty n
eed
s.
C•
Car
e st
aff
can
des
crib
e m
ost
res
iden
ts’ c
om
mu
nic
atio
n n
eed
s th
atEv
iden
cear
e as
a r
esu
lt o
f th
eir
dis
abili
ties
an
d a
ge-
rela
ted
pro
ble
ms.
•C
om
mo
n c
om
mu
nic
atio
n e
qu
ipm
ent
and
bas
ic c
om
mu
nic
atio
n
met
ho
ds
are
use
d. S
taff
can
dem
on
stra
te t
hey
use
th
ese.
•G
oo
d r
elat
ion
ship
s b
etw
een
sta
ff a
nd
res
iden
ts c
an b
e se
en.
Staf
f ca
n d
escr
ibe
thes
e an
d h
ow
th
ey a
ffec
t re
sid
ents
’ p
arti
cip
atio
n in
dif
fere
nt
acti
viti
es.
D•
Staf
f ar
e u
nab
le t
o d
escr
ibe
resi
den
ts’ c
om
mu
nic
atio
n n
eed
s.Ev
iden
ce•
Bas
ic c
om
mu
nic
atio
n e
qu
ipm
ent
is a
vaila
ble
bu
t ra
rely
use
d.
Staf
f re
po
rt t
hey
hav
e n
ot
bee
n t
rain
ed t
o u
se t
his
eq
uip
men
t o
r al
tern
ativ
e m
eth
od
s o
f co
mm
un
icat
ion
.•
Staf
f m
ay c
arry
ou
t fu
nct
ion
al t
asks
wel
l bu
t ar
e u
nab
le t
o
des
crib
e h
ow
th
eir
rela
tio
nsh
ip w
ith
th
e re
sid
ents
mig
ht
affe
ct
thei
r p
arti
cip
atio
n in
an
y ac
tivi
ties
.
For
alte
rnat
ive
met
ho
ds
of
colle
ctin
g e
vid
ence
see
pag
es 4
an
d 5
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 11 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
12 College of Occupational Therapists 2007
2.2
Qu
alit
y in
dic
ato
rC
om
mu
nic
atio
n b
etw
een
sta
ff a
nd
res
iden
ts is
eff
ecti
ve a
nd
sen
siti
ve t
o e
nab
le r
esid
ents
to
mak
e in
form
ed c
ho
ices
ab
ou
t th
e ac
tivi
ties
they
do
.
A•
Res
iden
ts d
escr
ibe*
ho
w s
taff
ap
pea
r to
tak
e a
gen
uin
e Ev
iden
cein
tere
st in
live
s. T
hey
say
th
ey t
rust
th
e st
aff,
th
ey a
re
frie
nd
ly a
nd
can
be
app
roac
hed
at
any
tim
e.•
Go
od
rap
po
rt a
nd
eff
ecti
ve, s
ensi
tive
co
mm
un
icat
ion
b
etw
een
sta
ff a
nd
res
iden
ts c
an b
e se
en a
nd
hea
rd.
•St
aff
dem
on
stra
te u
nd
erst
and
ing
an
d p
atie
nce
wit
h
resi
den
ts w
ho
nee
d m
ore
hel
p a
nd
su
pp
ort
to
ch
oo
se
acti
viti
es.
B•
Res
iden
ts r
epo
rt*
they
are
set
tled
in t
he
ho
me
and
hav
e g
oo
d,
Evid
ence
tru
stin
g r
elat
ion
ship
s w
ith
th
e st
aff.
•G
oo
d r
app
ort
an
d e
ffec
tive
co
mm
un
icat
ion
bet
wee
n s
taff
an
dre
sid
ents
can
be
seen
an
d h
eard
.•
Staf
f d
emo
nst
rate
pat
ien
ce w
hen
hel
pin
g r
esid
ents
sel
ect
acti
viti
es.
C•
Res
iden
ts r
epo
rt*
they
are
set
tled
in t
he
ho
me
and
hav
e g
oo
d
Evid
ence
rela
tio
nsh
ips
wit
h t
he
staf
f.•
Staf
f en
gag
e in
ro
uti
ne
gre
etin
gs,
acc
ept
and
giv
e co
mp
limen
ts a
nd
po
siti
ve g
estu
res
of
ackn
ow
led
gem
ent.
•St
aff
are
war
m a
nd
car
ing
bu
t ar
e n
ot
alw
ays
able
to
hel
p
resi
den
ts s
elec
t ac
tivi
ties
.
D•
Res
iden
ts r
epo
rt*
they
so
met
imes
fin
d t
he
staf
f u
np
leas
ant
Evid
ence
and
un
cari
ng
an
d t
her
efo
re d
o n
ot
ask
abo
ut
acti
viti
es.
•St
aff
are
no
t o
ften
see
n g
reet
ing
or
talk
ing
wit
h r
esid
ents
.•
Staf
f ar
e m
ost
ly c
arin
g b
ut
giv
e lit
tle
tim
e to
tal
k w
ith
re
sid
ents
an
d s
ho
w li
ttle
un
der
stan
din
g o
f re
sid
ents
’ act
ivit
y ch
oic
es.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 12 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
Ben
chm
ark
3 –
Act
ivit
y, s
oci
al a
nd
co
mm
un
ity
par
tici
pat
ion
Rec
og
nis
ing
th
e im
po
rtan
ce o
f ac
tivi
ty a
nd
th
e n
eed
fo
r re
sid
ents
to
be
incl
ud
ed, r
egar
dle
ss o
f th
eir
imp
airm
ents
, is
esse
nti
al w
hen
en
cou
rag
ing
res
iden
ts’ p
arti
cip
atio
n a
nd
so
cial
inte
ract
ion
.
Car
e h
om
e st
aff
can
en
sure
a c
ho
ice
is a
vaila
ble
fo
r re
sid
ents
by
bei
ng
res
po
nsi
ve t
o n
ew id
eas,
by
resp
on
din
g t
o r
equ
ests
for
dif
fere
nt
acti
viti
es a
nd
by
dev
elo
pin
g d
iffe
ren
t w
ays
to h
elp
res
iden
ts t
ake
par
t.
Wh
en h
elp
ing
res
iden
ts s
elec
t an
d p
arti
cip
ate
in a
ctiv
itie
s it
is n
eces
sary
to
co
nsi
der
su
ch t
hin
gs
as:
•R
esid
ents
’ wis
hes
an
d in
tere
sts.
•M
ain
tain
ing
res
iden
ts’ d
ign
ity
wh
ile u
nd
erta
kin
g d
iffe
ren
t ac
tivi
ties
.•
Res
iden
ts’ a
bili
ty a
nd
th
e h
elp
th
ey m
igh
t n
eed
to
tak
e p
art
in a
n a
ctiv
ity,
irre
spec
tive
of
thei
r ag
e an
d/o
r d
isab
ility
.•
Tim
e o
f d
ay, m
on
th a
nd
yea
r.•
Res
iden
ts’ p
refe
rred
dai
ly r
ou
tin
e.•
The
pla
ce w
her
e th
e ac
tivi
ty w
ill t
ake
par
t an
d w
het
her
th
is is
insi
de,
ou
tsid
e o
r el
sew
her
e in
th
e lo
cal c
om
mu
nit
y.•
The
nu
mb
er o
f p
eop
le t
akin
g p
art
in t
he
acti
vity
, fo
r ex
amp
le, a
gro
up
of
peo
ple
, tw
o p
eop
le o
r w
het
her
th
ere
sid
ent
will
wo
rk a
lon
e.•
The
per
son
or
peo
ple
th
e re
sid
ent
cho
ose
s to
acc
om
pan
y th
em in
th
ese
acti
viti
es. T
hes
e m
igh
t b
e, f
or
exam
ple
,fr
ien
ds
or
fam
ily, a
mem
ber
of
staf
f, o
ther
res
iden
ts o
r so
meo
ne
fro
m t
he
loca
l co
mm
un
ity.
•R
esid
ents
pu
rsu
ing
co
nti
nu
ed in
tere
sts
eith
er w
ith
in t
he
ho
me
or
by
visi
tin
g t
hei
r u
sual
gro
up
s, c
lub
s, p
lace
s o
fw
ors
hip
, etc
.•
The
op
po
rtu
nit
y to
tak
e u
p n
ew a
ctiv
itie
s, in
tere
sts
or
ho
bb
ies.
•En
ablin
g c
om
mu
nit
y-b
ased
act
ivit
ies
to c
om
e in
to t
he
care
ho
me.
The
ph
ysic
al e
nvi
ron
men
t o
f th
e h
om
e, b
oth
insi
de
the
bu
ildin
g a
nd
in t
he
gar
den
, off
ers
op
po
rtu
nit
ies
for
soci
al c
on
tact
and
sen
sory
sti
mu
lati
on
.
Dai
ly li
vin
g t
asks
are
day
-to
-day
act
ivit
ies
man
y re
sid
ents
wis
h t
o c
on
tin
ue
to d
o w
hen
th
ey m
ove
into
a c
are
ho
me.
Th
ese
are
per
son
al t
asks
su
ch a
s g
etti
ng
up
an
d c
ho
osi
ng
wh
at a
nd
ho
w t
o d
ress
, tak
ing
a b
ath
or
was
hin
g, a
nd
eat
ing
a m
eal.
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‘Exc
elle
nt’
car
e h
om
es w
ill h
ave
app
rop
riat
e st
affi
ng
leve
ls t
hat
will
giv
e co
nsi
der
atio
n t
o t
he
resi
den
ts’ n
eed
s, r
ang
ing
fro
m a
ctiv
ity
pro
visi
on
to
em
erg
ency
car
e. C
on
sid
erat
ion
will
be
giv
en t
o e
mp
loyi
ng
sta
ff w
ith
rel
evan
t sk
ills,
fo
r ex
amp
leo
ccu
pat
ion
al t
her
apis
ts a
nd
act
ivit
y p
rovi
der
s.
Car
e h
om
es g
rad
ed a
s ‘e
xcel
len
t’ w
ill h
ave
suffi
cien
t b
ud
get
ary
reso
urc
es t
o m
eet
the
acti
vity
nee
ds
of
all t
hei
r re
sid
ents
.
Qu
alit
y in
dic
ato
rs
3.1
Incl
usi
ve a
ctiv
ity
pro
visi
on
en
able
s al
l car
e h
om
e re
sid
ents
to
tak
e p
art
in a
ctiv
itie
s o
f th
eir
cho
ice,
wit
h a
pp
rop
riat
ean
d s
ensi
tive
co
nsi
der
atio
n t
o c
ult
ure
, ag
e, g
end
er, h
ealt
h, s
exu
al o
rien
tati
on
, dis
abili
ties
an
d a
ge-
rela
ted
nee
ds.
3.2
The
ran
ge
of
acti
viti
es f
or
each
res
iden
t re
flec
ts t
hei
r ch
oic
e, t
hei
r so
cial
, cu
ltu
ral a
nd
rel
igio
us
pre
fere
nce
s, a
nd
isav
aila
ble
at
freq
uen
t an
d r
egu
lar
inte
rval
s th
rou
gh
ou
t th
e w
eek.
Th
e n
eed
fo
r ‘q
uie
t ti
me’
is r
eco
gn
ised
an
dre
spec
ted
.3.
3Th
e o
pp
ort
un
itie
s fo
r re
sid
ents
to
en
gag
e in
per
son
al d
aily
livi
ng
tas
ks a
re in
teg
rate
d in
to d
aily
car
e.3.
4M
ealt
imes
an
d t
he
soci
al a
spec
ts t
hes
e ev
eryd
ay e
ven
ts c
an o
ffer
are
rec
og
nis
ed a
s an
imp
ort
ant
acti
vity
.3.
5Th
ere
are
suffi
cien
t fi
nan
cial
an
d o
ther
res
ou
rces
, su
ch a
s eq
uip
men
t, m
ater
ials
, tra
inin
g a
nd
fac
iliti
es, a
nd
eff
ecti
veu
se o
f th
e av
aila
ble
en
viro
nm
ent
and
loca
l co
mm
un
ity,
to
pro
vid
e a
ran
ge
of
acti
viti
es.
This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
14 College of Occupational Therapists 2007
Benchmark 3 – Activity, social and community participation
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This page may be photocopiedActivity Provision: Benchmarking good practice in care homesCollege of Occupational Therapists 2007 15
3.1
Qu
alit
y in
dic
ato
rIn
clu
sive
act
ivit
y p
rovi
sio
n e
nab
les
all c
are
ho
me
resi
den
ts t
o t
ake
par
t in
act
ivit
ies
of
thei
r ch
oic
e, w
ith
ap
pro
pri
ate
and
sen
siti
ve c
on
sid
erat
ion
to
cu
ltu
re, a
ge,
gen
der
, hea
lth
, sex
ual
ori
enta
tio
n, d
isab
iliti
es a
nd
ag
e-re
late
d n
eed
s.
A•
All
staf
f ca
n d
emo
nst
rate
, by
ob
serv
atio
n o
r d
escr
ipti
on
, th
at
Evid
ence
they
un
der
stan
d t
he
spec
ific
acti
vity
nee
ds
of
all r
esid
ents
an
d
ensu
re in
clu
sive
act
ivit
y p
rovi
sio
n.
•A
ll st
aff
hav
e ap
pro
pri
ate
trai
nin
g a
nd
can
des
crib
e h
ow
th
ey c
om
ply
w
ith
rel
evan
t d
iscr
imin
atio
n le
gis
lati
on
an
d p
olic
y o
n s
oci
al in
clu
sio
n.
•A
ll re
sid
ents
can
des
crib
e* h
ow
th
ey p
arti
cip
ate
in a
ctiv
itie
s o
f th
eir
cho
ice,
taki
ng
into
acc
ou
nt
bu
t n
ot
excl
ud
ing
th
em o
n t
he
bas
is o
f th
eir
cult
ure
, ag
e, g
end
er, h
ealt
h, s
exu
al o
rien
tati
on
, dis
abili
ties
an
d a
ge-
rela
ted
nee
ds.
•A
ll ca
re h
om
e p
olic
ies
are
incl
usi
ve a
nd
sta
ff c
an b
e se
en t
o b
e im
ple
men
tin
g t
hem
.
B•
Mo
st s
taff
can
dem
on
stra
te, b
y o
bse
rvat
ion
or
des
crip
tio
n, t
hat
th
ey
Evid
ence
un
der
stan
d t
he
spec
ific
nee
ds
of
mo
st r
esid
ents
an
d e
nsu
re in
clu
sive
ac
tivi
ty p
rovi
sio
n.
•M
ost
sta
ff h
ave
app
rop
riat
e tr
ain
ing
an
d c
an d
escr
ibe
ho
w t
hey
co
mp
ly
wit
h r
elev
ant
dis
crim
inat
ion
leg
isla
tio
n a
nd
po
licy
on
so
cial
incl
usi
on
.•
Mo
st r
esid
ents
can
des
crib
e* h
ow
th
ey p
arti
cip
ate
in m
ost
act
ivit
ies
of
thei
r ch
oic
e ta
kin
g in
to a
cco
un
t b
ut
no
t ex
clu
din
g t
hei
r cu
ltu
re, a
ge,
g
end
er, h
ealt
h, d
isab
iliti
es a
nd
ag
e-re
late
d n
eed
s.•
All
care
ho
me
po
licie
s ar
e in
clu
sive
an
d m
ost
sta
ff c
an b
e se
en t
o b
e im
ple
men
tin
g t
hem
.
C•
Car
e st
aff
can
dem
on
stra
te t
hat
th
ey u
nd
erst
and
th
e n
eed
s o
f so
me
Evid
ence
resi
den
ts.
•C
are
staf
f h
ave
bas
ic t
rain
ing
ab
ou
t d
iscr
imin
atio
n le
gis
lati
on
an
d/o
rp
olic
y o
n s
oci
al in
clu
sio
n.
•So
me
resi
den
ts c
an d
escr
ibe*
ho
w t
hey
are
incl
ud
ed in
so
me
acti
viti
es o
f th
eir
cho
ice.
•So
me
care
ho
me
po
licie
s ar
e in
clu
sive
.
D•
Few
car
e st
aff
can
dem
on
stra
te t
hat
th
ey u
nd
erst
and
th
e sp
ecifi
c n
eed
s Ev
iden
ceo
f re
sid
ents
.•
Few
sta
ff, i
f an
y, h
ave
had
bas
ic t
rain
ing
ab
ou
t d
iscr
imin
atio
n le
gis
lati
on
.•
Few
, if
any,
res
iden
ts c
an d
escr
ibe*
ho
w t
hey
are
incl
ud
ed in
ac
tivi
ties
of
thei
r ch
oic
e.•
Few
, if
any,
car
e h
om
e p
olic
ies
are
incl
usi
ve.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
16 College of Occupational Therapists 2007
3.2
Qu
alit
y in
dic
ato
rTh
e ra
ng
e o
f ac
tivi
ties
fo
r ea
ch r
esid
ent
refl
ects
th
eir
cho
ice,
th
eir
soci
al, c
ult
ura
l an
d r
elig
iou
s p
refe
ren
ces,
an
d is
ava
ilab
le a
t fr
equ
ent
and
reg
ula
r in
terv
als
thro
ug
ho
ut
the
wee
k. T
he
nee
d f
or
‘qu
iet
tim
e’ is
rec
og
nis
ed a
nd
res
pec
ted
.
A•
Res
iden
ts a
nd
vis
ito
rs d
escr
ibe*
a v
arie
ty o
f ac
tivi
ties
th
at h
ave
Evid
ence
take
n p
lace
in t
he
last
mo
nth
th
at t
he
resi
den
ts h
ave
cho
sen
an
d
enjo
yed
.•
Res
iden
ts a
nd
vis
ito
rs r
epo
rt*
ther
e is
dai
ly a
cces
s to
co
mm
un
ity-
bas
ed a
ctiv
itie
s an
d a
ssis
tan
ce is
ava
ilab
le if
nee
ded
.•
Res
iden
ts a
nd
vis
ito
rs r
epo
rt*
that
sta
ff e
nco
ura
ge
app
rop
riat
e ty
pes
an
d q
uan
titi
es o
f ac
tivi
ty a
nd
tak
e in
to a
cco
un
t ev
ery
ind
ivid
ual
’s a
bili
ties
, ch
ang
ing
wis
hes
an
d r
equ
ests
fo
r ‘q
uie
t ti
me’
.•
Res
iden
ts w
ho
wis
h t
o a
re r
egu
larl
y in
volv
ed in
mak
ing
gro
up
d
ecis
ion
s an
d p
lan
nin
g w
eekl
y ac
tivi
ties
.
B•
Res
iden
ts a
nd
vis
ito
rs d
escr
ibe*
dif
fere
nt
acti
viti
es t
hat
hav
e ta
ken
Ev
iden
cep
lace
in t
he
last
mo
nth
th
at t
he
resi
den
ts h
ave
cho
sen
an
d e
njo
yed
.•
Res
iden
ts a
nd
vis
ito
rs r
epo
rt*
ther
e is
fre
qu
ent
acce
ss t
o
acti
viti
es in
th
e lo
cal c
om
mu
nit
y w
ith
ass
ista
nce
if n
eed
ed.
•R
esid
ents
an
d v
isit
ors
rep
ort
* th
at s
taff
en
cou
rag
e p
arti
cip
atio
n in
ac
tivi
ties
an
d t
his
usu
ally
tak
es in
to a
cco
un
t in
div
idu
als’
ab
iliti
es
and
req
ues
ts f
or
‘qu
iet
tim
e’.
•R
esid
ents
co
ntr
ibu
te t
o g
rou
p a
ctiv
ity
pla
nn
ing
if t
hey
wis
h.
C•
Res
iden
ts a
nd
vis
ito
rs c
an li
st*
a fe
w a
ctiv
itie
s th
ey h
ave
enjo
yed
Ev
iden
cein
th
e p
ast
mo
nth
.•
Acc
ess
to a
ctiv
itie
s w
ith
in t
he
loca
l co
mm
un
ity
is li
mit
ed a
nd
th
ere
are
few
lin
ks w
ith
peo
ple
ou
tsid
e th
e h
om
e.•
Res
iden
ts a
nd
vis
ito
rs r
epo
rt*
that
sta
ff e
nco
ura
ge
them
to
tak
e p
art
in a
ctiv
itie
s b
ut
som
e o
f th
ese
do
no
t m
eet
thei
r ca
pab
iliti
es
or
wis
hes
.
D•
Ther
e ar
e o
ccas
ion
al s
oci
al o
pp
ort
un
itie
s d
epen
din
g o
n w
hic
h
Evid
ence
staf
f ar
e av
aila
ble
.•
Ther
e ar
e fe
w s
oci
al o
pp
ort
un
itie
s o
r tr
ips
to/v
isit
s fr
om
th
e lo
cal
com
mu
nit
y.•
Res
iden
ts a
re e
nco
ura
ged
to
try
act
ivit
ies
for
wh
ich
th
ey d
o n
ot
alw
ays
hav
e th
e n
eces
sary
ski
lls a
nd
ab
iliti
es.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 14:02 Page 16 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
This page may be photocopiedActivity Provision: Benchmarking good practice in care homesCollege of Occupational Therapists 2007 17
3.3
Qu
alit
y in
dic
ato
rTh
e o
pp
ort
un
itie
s fo
r re
sid
ents
to
en
gag
e in
per
son
al d
aily
livi
ng
tas
ks a
re in
teg
rate
d in
to d
aily
car
e.
A•
Res
iden
ts a
nd
sta
ff w
ork
in p
artn
ersh
ip w
hen
un
der
taki
ng
Ev
iden
cep
erso
nal
dai
ly li
vin
g t
asks
an
d a
dap
t th
em w
her
e n
eces
sary
.•
Staf
f ca
n d
escr
ibe
ho
w c
om
ple
tin
g d
aily
livi
ng
tas
ks a
re a
ctiv
itie
s th
at a
re r
ewar
din
g a
nd
fu
lfilli
ng
fo
r in
div
idu
al r
esid
ents
.•
Res
iden
ts r
epo
rt*
that
th
ey c
ho
ose
th
eir
dai
ly r
ou
tin
e an
d
the
hel
p t
hey
rec
eive
an
d a
re e
nco
ura
ged
to
mak
e ch
ang
es t
hat
su
it t
hei
r st
ren
gth
s an
d p
refe
ren
ces.
B•
Staf
f in
volv
e re
sid
ents
wh
en u
nd
erta
kin
g p
erso
nal
dai
ly li
vin
g t
asks
.Ev
iden
ce•
Mo
st s
taff
can
des
crib
e h
ow
dai
ly li
vin
g t
asks
are
act
ivit
ies
that
ca
n b
e re
war
din
g f
or
ind
ivid
ual
res
iden
ts.
•R
esid
ents
rep
ort
* th
ey c
ho
ose
th
eir
dai
ly r
ou
tin
e an
d t
he
amo
un
t o
f h
elp
th
ey r
ecei
ve.
C•
Staf
f ar
e ca
rin
g, b
ut
resi
den
ts a
re n
ot
acti
vely
en
cou
rag
ed t
o t
ake
Evid
ence
par
t in
th
eir
per
son
al d
aily
livi
ng
tas
ks.
•So
me
care
sta
ff c
an d
escr
ibe
ho
w c
om
ple
tin
g d
aily
livi
ng
tas
ks a
re
acti
viti
es t
hat
can
be
rew
ard
ing
an
d f
ulfi
llin
g f
or
resi
den
ts.
•R
esid
ents
rep
ort
* th
ey c
an d
eter
min
e th
eir
dai
ly li
vin
g r
ou
tin
es
and
tas
ks, b
ut
this
is n
ot
alw
ays
con
sist
ent
and
can
dep
end
on
w
hic
h s
taff
are
on
du
ty.
D•
Staf
f d
emo
nst
rate
a ’d
oin
g t
o’ r
ath
er t
han
‘wo
rkin
g w
ith
’ Ev
iden
ceap
pro
ach
to
per
son
al d
aily
livi
ng
tas
ks.
•St
aff
are
no
t ab
le t
o d
escr
ibe
ho
w d
aily
livi
ng
tas
ks h
ave
mea
nin
g
for
som
e re
sid
ents
.•
Res
iden
ts r
epo
rt*
they
wo
uld
like
to
hav
e m
ore
say
in t
hei
r d
aily
liv
ing
ro
uti
ne
and
tas
ks o
r sh
ow
sig
ns
of
fru
stra
tio
n o
r an
ger
w
hen
rec
eivi
ng
pra
ctic
al h
elp
.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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18 College of Occupational Therapists 2007
3.4
Qu
alit
y in
dic
ato
rM
ealt
imes
an
d t
he
soci
al a
spec
ts t
hes
e ev
eryd
ay e
ven
ts c
an o
ffer
are
rec
og
nis
ed a
s an
imp
ort
ant
acti
vity
.
A•
The
din
ing
ro
om
is c
lean
an
d p
leas
ant
and
th
e ta
ble
s an
d s
eati
ng
Ev
iden
cear
e ar
ran
ged
in a
way
to
en
cou
rag
e so
cial
co
nta
ct. H
ow
ever
, re
sid
ents
can
eat
in t
hei
r o
wn
ro
om
s if
th
ey w
ish
.•
Res
iden
ts d
escr
ibe*
mea
ltim
es a
s a
ple
asan
t so
cial
act
ivit
y. T
hey
ar
e g
iven
a c
ho
ice
of
seat
ing
, fo
od
an
d d
rin
k, t
akin
g in
to a
cco
un
td
ieta
ry a
nd
oth
er n
eed
s.•
Rel
ativ
es a
re a
ctiv
ely
enco
ura
ged
to
acc
om
pan
y o
r as
sist
res
iden
tsas
ap
pro
pri
ate.
•St
aff
can
be
seen
tal
kin
g w
ith
res
iden
ts a
t th
e m
eal t
able
s. M
eals
are
serv
ed in
an
un
hu
rrie
d b
ut
effi
cien
t m
ann
er a
nd
ass
ista
nce
is
skilf
ully
giv
en t
o t
ho
se w
ho
nee
d h
elp
.
B•
The
din
ing
ro
om
is c
lean
an
d p
leas
ant,
an
d a
tten
tio
n is
pai
d t
o
Evid
ence
wh
ere
peo
ple
are
sea
ted
to
en
cou
rag
e so
cial
co
nta
ct.
•R
esid
ents
des
crib
e* m
ealt
imes
as
ple
asu
rab
le. T
hey
usu
ally
hav
e a
cho
ice
of
seat
ing
, fo
od
an
d d
rin
k, t
akin
g in
to a
cco
un
t th
eir
nee
ds.
•R
elat
ives
are
ab
le t
o a
cco
mp
any
or
assi
st r
esid
ents
at
mea
ltim
es a
s re
qu
este
d b
y th
e re
sid
ents
.•
Staf
f ca
n b
e se
en t
alki
ng
wit
h r
esid
ents
at
the
mea
l tab
les.
Mea
ls
are
serv
ed e
ffici
entl
y an
d a
ssis
tan
ce is
giv
en t
o t
ho
se w
ho
nee
d h
elp
.
C•
The
din
ing
ro
om
an
d t
able
s ar
e cl
ean
.Ev
iden
ce•
Res
iden
ts s
ay*
they
loo
k fo
rwar
d t
o m
ealt
imes
, bu
t th
ink
they
co
uld
be
mo
re e
njo
yab
le.
•R
elat
ives
are
aw
are
they
can
acc
om
pan
y an
d a
ssis
t th
e re
sid
ents
b
ut
few
are
en
cou
rag
ed t
o d
o s
o.
•St
aff
assi
st t
ho
se w
ho
nee
d h
elp
.
D•
The
din
ing
ro
om
is u
nin
viti
ng
an
d t
he
tab
les
are
no
t la
id.
Evid
ence
•R
esid
ents
des
crib
e* m
ealt
imes
as
rou
tin
e an
d s
taff
oft
en t
ell t
hem
w
her
e to
sit
.•
Vis
itin
g r
elat
ives
rar
ely
atte
nd
at
mea
ltim
es.
•St
aff
sho
w li
ttle
ski
ll an
d a
war
enes
s o
f re
sid
ents
’ nee
ds
for
hel
p
and
fo
r en
joyi
ng
mea
ltim
es.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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3.5
Qu
alit
y in
dic
ato
rTh
ere
are
suffi
cien
t fi
nan
cial
an
d o
ther
res
ou
rces
, su
ch a
s eq
uip
men
t, m
ater
ials
, tra
inin
g a
nd
fac
iliti
es, a
nd
eff
ecti
ve u
se o
f th
e av
aila
ble
envi
ron
men
t an
d lo
cal c
om
mu
nit
y, t
o p
rovi
de
a ra
ng
e o
f ac
tivi
ties
.
A•
The
acti
vity
po
licy,
dev
elo
ped
in c
on
sult
atio
n w
ith
res
iden
ts a
nd
sta
ff,
Evid
ence
is r
egu
larl
y re
view
ed a
nd
up
to
dat
e. It
incl
ud
es a
cces
s to
a v
arie
tyo
f re
sou
rces
th
at a
re s
uffi
cien
t fo
r th
e re
sid
ents
’ act
ivit
y n
eed
s.•
Ther
e is
a m
ix o
f p
riva
te, q
uie
t an
d s
har
ed a
reas
wh
ere
dif
fere
nt
acti
viti
es a
nd
so
cial
eve
nts
can
be
un
der
take
n.
•Th
ere
is a
wid
e se
lect
ion
of
mat
eria
ls r
ead
ily a
vaila
ble
to
res
iden
ts,
taki
ng
into
acc
ou
nt
a ra
ng
e o
f ab
iliti
es.
•St
aff
can
des
crib
e h
ow
th
ey u
se o
pp
ort
un
itie
s w
ith
in a
vaila
ble
re
sou
rces
in im
agin
ativ
e an
d p
ract
ical
way
s. T
hey
see
k o
ut
new
m
ater
ials
, id
eas
and
lin
ks w
ith
th
e lo
cal c
om
mu
nit
y.
B•
An
act
ivit
y p
olic
y h
as b
een
dev
elo
ped
in c
on
sult
atio
n w
ith
Ev
iden
cere
sid
ents
an
d s
taff
an
d in
clu
des
acc
ess
to a
var
iety
of
reso
urc
es.
•A
reas
hav
e b
een
set
asi
de
for
ind
ivid
ual
an
d g
rou
p a
ctiv
itie
s.•
Ther
e is
a s
elec
tio
n o
f m
ater
ials
rea
dily
ava
ilab
le t
o r
esid
ents
.•
Staf
f u
se t
he
reso
urc
es e
ffec
tive
ly a
nd
see
k o
ut
new
idea
s an
d
links
wit
h t
he
loca
l co
mm
un
ity.
C•
An
act
ivit
y p
olic
y is
in p
lace
, bu
t n
eed
s u
pd
atin
g. T
her
e h
as b
een
Ev
iden
celim
ited
co
nsu
ltat
ion
wit
h r
esid
ents
an
d s
taff
.•
Are
as f
or
qu
iet
and
gro
up
act
ivit
ies
are
avai
lab
le b
ut
limit
ed.
•So
me
acti
vity
mat
eria
ls a
re r
ead
ily a
vaila
ble
fo
r u
se, b
ut
thes
e ar
e n
ot
all e
asily
ava
ilab
le t
o r
esid
ents
.•
Staf
f u
se t
he
reso
urc
es a
vaila
ble
to
th
em b
ut
are
no
t in
no
vati
ve in
se
ekin
g o
ut
new
mat
eria
ls a
nd
idea
s.
D•
Ther
e is
no
act
ivit
y p
olic
y in
pla
ce a
nd
litt
le o
r n
o r
eso
urc
es f
or
Evid
ence
acti
viti
es.
•Th
ere
is li
ttle
sp
ace
iden
tifi
ed a
s su
itab
le f
or
the
vari
ou
s ac
tivi
ties
o
r so
cial
eve
nts
th
at c
ou
ld t
ake
pla
ce.
•A
ctiv
ity
mat
eria
ls a
re n
ot
read
ily a
vaila
ble
fo
r u
se.
•St
aff
do
no
t u
se/h
ave
acce
ss t
o r
eso
urc
es a
nd
do
no
t in
itia
te a
ctiv
ity.
For
alte
rnat
ive
met
ho
ds
of
colle
ctin
g e
vid
ence
see
pag
es 4
an
d 5
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 19 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
Ben
chm
ark
4 –
Car
e p
lan
nin
g t
o e
nsu
re a
po
siti
ve a
ctiv
ity
ou
tco
me
for
each
res
iden
t
Rec
ord
ing
an
d u
sin
g in
form
atio
n a
bo
ut
a re
sid
ent’
s lif
e h
isto
ry is
ess
enti
al w
hen
incl
ud
ing
act
ivit
y in
th
e ca
re p
lan
nin
gp
roce
ss. T
o e
nsu
re a
po
siti
ve a
ctiv
ity
ou
tco
me,
bio
gra
ph
ical
kn
ow
led
ge
com
bin
ed w
ith
info
rmat
ion
ab
ou
t th
e re
sid
ent’
scu
rren
t st
ren
gth
s, e
xpec
tati
on
s, w
ish
es a
nd
nee
ds
is r
equ
ired
. Str
eng
ths
will
incl
ud
e w
hat
th
e re
sid
ent
can
do
, wh
at t
hey
like
to d
o, a
nd
th
e p
eop
le w
ho
are
will
ing
to
hel
p t
hem
.
A g
oo
d c
are
pla
n is
a li
vin
g d
ocu
men
t i.e
. it
will
be
effe
ctiv
e o
nly
if p
eop
le r
eco
rd it
, fo
llow
it, r
evie
w it
an
d t
hen
red
o it
,so
it g
row
s an
d d
evel
op
s w
ith
th
e re
sid
ent.
Rev
iew
ing
an
d m
eeti
ng
th
e ac
tivi
ty a
nd
so
cial
nee
ds
of
resi
den
ts is
wit
hin
th
en
atio
nal
min
imu
m s
tan
dar
ds
(Dep
artm
ent
of
Hea
lth
200
3 –
see
Ap
pen
dix
B).
As
wel
l as
revi
ewin
g in
div
idu
al a
ctiv
ity
nee
ds
it is
imp
ort
ant
to c
olle
ct in
form
atio
n a
bo
ut
resi
den
ts’ s
atis
fact
ion
wit
h r
egar
d t
o a
ctiv
ity
pro
visi
on
. Th
is c
an b
e co
llect
edu
sin
g a
ran
ge
of
met
ho
ds,
su
ch a
s q
ues
tio
nn
aire
s, s
ug
ges
tio
n b
oxe
s, r
esid
ents
’ mee
tin
gs,
tal
kin
g t
o in
div
idu
als
and
mo
nit
ori
ng
th
eir
wel
lbei
ng
. It
is im
po
rtan
t th
at t
he
acti
vity
pla
n is
an
inte
gra
l par
t o
f th
e re
sid
ent’
s in
div
idu
alis
ed c
are
pla
n.
Wh
ile p
arti
cip
atio
n in
act
ivit
y is
vit
al f
or
resi
den
ts’ h
ealt
h a
nd
wel
lbei
ng
, an
y p
ote
nti
al r
isk
of
inju
ry m
ust
be
ackn
ow
led
ged
, par
ticu
larl
y if
th
ere
are
any
ph
ysic
al, c
og
nit
ive
or
sen
sory
imp
airm
ents
. Car
e p
lan
nin
g n
eed
s to
incl
ud
e ri
skas
sess
men
ts f
or
rele
van
t ac
tivi
ties
an
d c
ircu
mst
ance
s. H
ow
ever
, to
en
able
res
iden
ts t
o t
ake
par
t in
th
eir
cho
sen
or
pre
ferr
edac
tivi
ties
, a b
alan
ce n
eed
s to
be
stru
ck b
etw
een
man
agin
g r
isks
an
d h
elp
ing
res
iden
ts t
o p
arti
cip
ate.
Th
is m
ay a
lso
mea
nac
kno
wle
dg
ing
th
ose
act
ivit
ies
wh
ich
hav
e as
soci
ated
hea
lth
an
d fi
nan
cial
ris
ks, s
uch
as
smo
kin
g, d
rin
kin
g a
lco
ho
l,g
amb
ling
etc
. Th
e st
arti
ng
po
int
sho
uld
alw
ays
be,
‘Ho
w c
an t
his
per
son
be
sup
po
rted
to
do
th
e th
ing
s th
ey w
ou
ld li
ke t
od
o?’
The
succ
essf
ul a
ctiv
ity
co-o
rdin
ato
r(H
urt
ley
and
Wen
bo
rn 2
005)
sta
tes
that
it is
imp
ort
ant
to c
olle
ct r
elev
ant
info
rmat
ion
abo
ut
a re
sid
ent.
Th
is in
form
atio
n w
ill in
form
th
e ac
tivi
ty p
art
of
the
care
pla
n a
nd
sh
ou
ld in
clu
de:
•R
elev
ant
med
ical
his
tory
, in
clu
din
g m
enta
l hea
lth
an
d c
urr
ent
wel
lbei
ng
.•
Phys
ical
ab
ility
an
d m
ob
ility
, su
ch a
s ra
ng
e o
f m
ove
men
t an
d s
tren
gth
of
up
per
an
d lo
wer
lim
bs,
dex
teri
ty, h
and
–eye
co-o
rdin
atio
n, b
alan
ce a
nd
an
y eq
uip
men
t n
eed
s.•
Co
mm
un
icat
ion
, co
mp
reh
ensi
on
an
d s
pee
ch.
•Se
nso
ry a
bili
ties
, in
clu
din
g e
yesi
gh
t an
d h
eari
ng
.•
Co
gn
itiv
e ab
iliti
es, f
or
exam
ple
sh
ort
-ter
m a
nd
lon
g-t
erm
mem
ory
, co
nce
ntr
atio
n, p
rob
lem
so
lvin
g, l
og
ical
th
inki
ng
and
seq
uen
cin
g.
This page may be photocopiedActivity Provision: Benchmarking good practice in care homes
20 College of Occupational Therapists 2007
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•Pa
st a
nd
pre
sen
t w
ork
an
d f
amily
ro
les,
act
ivit
y an
d le
isu
re p
urs
uit
s.•
Past
an
d p
rese
nt
frie
nd
s an
d r
elat
ives
.•
Cu
ltu
ral p
refe
ren
ces.
•Po
ten
tial
ris
ks t
o r
esid
ents
, rel
ativ
es, s
taff
or
oth
ers
wh
en p
arti
cip
atin
g in
act
ivit
ies.
Qu
alit
y in
dic
ato
rs
4.1
Bio
gra
ph
ical
info
rmat
ion
is r
eco
rded
wit
h c
on
sen
t fr
om
th
e re
sid
ent
and
kep
t u
p t
o d
ate
to in
form
th
e ca
re p
lan
an
dac
tivi
ty p
rovi
sio
n.
4.2
Res
iden
ts’ c
urr
ent
acti
vity
pre
fere
nce
s, in
tere
sts
and
ab
iliti
es a
re r
egu
larl
y re
view
ed, a
nd
ou
tco
mes
an
d u
ser
sati
sfac
tio
n a
re r
eco
rded
in t
he
care
pla
nan
d a
re e
vid
ent
in p
ract
ice.
4.3
The
acti
vity
pla
nn
ing
pro
cess
an
d d
ocu
men
tati
on
incl
ud
es r
elev
ant
risk
ass
essm
ents
.
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Benchmark 4 – Care planning to ensure a positive activity outcome for each resident
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22 College of Occupational Therapists 2007
4.1
Qu
alit
y in
dic
ato
rB
iog
rap
hic
al in
form
atio
n is
rec
ord
ed w
ith
co
nse
nt
fro
m t
he
resi
den
t an
d k
ept
up
to
dat
e to
info
rm t
he
care
pla
n a
nd
act
ivit
y p
rovi
sio
n.
A•
The
care
ho
me’
s p
olic
ies
incl
ud
e re
fere
nce
to
ind
ivid
ual
ised
Ev
iden
ceac
tivi
ty p
rovi
sio
n a
nd
gai
nin
g c
on
sen
t w
ith
in t
he
care
pla
nn
ing
d
ocu
men
tati
on
.•
To c
om
ply
wit
h c
are
ho
me
po
licie
s ab
ou
t ch
oic
e an
d c
on
sen
t,
resi
dent
s an
d re
lati
ves
give
a b
iogr
aphy
/life
sto
ry w
here
app
ropr
iate
.•
Ther
e is
rec
ord
ed e
vid
ence
in t
he
care
pla
n t
hat
th
is in
form
atio
n is
u
sed
to
dev
elo
p a
pp
rop
riat
e ac
tivi
ties
wit
h r
esid
ents
.•
Res
iden
ts’ a
ctiv
ity
pre
fere
nce
s ar
e kn
ow
n, u
nd
erst
oo
d a
nd
met
by
staf
f w
ho
reg
ula
rly
up
dat
e th
e ca
re p
lan
s.
B•
The
care
ho
me’
s p
olic
ies
incl
ud
e ac
tivi
ty p
rovi
sio
n a
nd
gai
nin
g
Evid
ence
con
sen
t w
ith
in t
he
care
pla
nn
ing
do
cum
enta
tio
n.
•A
bio
gra
ph
y/lif
e st
ory
is o
bta
ined
fro
m r
esid
ents
an
d r
elat
ives
.•
Ther
e is
rec
ord
ed e
vid
ence
th
at t
his
info
rmat
ion
is u
sed
to
dev
elo
pac
tivi
ties
wit
h r
esid
ents
.•
Res
iden
ts’ a
ctiv
ity
pre
fere
nce
s ar
e kn
ow
n, u
nd
erst
oo
d a
nd
met
b
y st
aff.
C•
Ou
tlin
es o
f th
e m
ajo
r ev
ents
in t
he
resi
den
ts’ l
ives
hav
e b
een
Ev
iden
cere
cord
ed a
nd
are
use
d w
hen
pla
nn
ing
an
d p
rovi
din
g a
ctiv
itie
s.•
A b
rief
life
sto
ry is
ob
tain
ed f
rom
res
iden
ts a
nd
rel
ativ
es.
•St
aff
are
enth
usi
asti
c, b
ut
ther
e is
inco
nsi
sten
t ev
iden
ce t
hat
in
form
atio
n is
reg
ula
rly
use
d t
o d
evel
op
act
ivit
ies
wit
h r
esid
ents
.•
Res
iden
ts’ a
ctiv
ity
pre
fere
nce
s ar
e kn
ow
n b
y st
aff,
bu
t th
ey u
se
this
info
rmat
ion
inco
nsi
sten
tly
wh
en a
gre
ein
g s
uit
able
act
ivit
ies.
D•
Litt
le o
r n
o b
iog
rap
hic
al in
form
atio
n h
as b
een
ob
tain
ed f
rom
Ev
iden
cere
sid
ents
an
d r
eco
rded
.•
Staf
f re
po
rt t
hey
do
no
t co
llect
life
sto
ries
an
d a
re n
ot
awar
e o
f re
leva
nt
care
ho
me
po
licie
s.•
Ther
e is
insu
ffici
ent
info
rmat
ion
to
off
er r
esid
ents
ap
pro
pri
ate
acti
viti
es.
•R
esid
ents
’ act
ivit
y p
refe
ren
ces
are
no
t kn
ow
n b
y st
aff.
For
alte
rnat
ive
met
ho
ds
of
colle
ctin
g e
vid
ence
see
pag
es 4
an
d 5
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4.2
Qu
alit
y in
dic
ato
r R
esid
ents
’ cu
rren
t ac
tivi
ty p
refe
ren
ces,
inte
rest
s an
d a
bili
ties
are
reg
ula
rly
revi
ewed
, an
d o
utc
om
es a
nd
use
r sa
tisf
acti
on
are
rec
ord
ed in
th
e ca
rep
lan
an
d a
re e
vid
ent
in p
ract
ice.
A•
The
care
pla
n is
dra
wn
up
wit
h in
volv
emen
t fr
om
th
e re
sid
ent,
Ev
iden
cere
cord
ed in
a s
tyle
acc
essi
ble
to
th
e re
sid
ent,
an
d a
gre
ed a
nd
si
gn
ed b
y th
e re
sid
ent
and
/or
rela
tive
.•
Res
iden
ts’ s
atis
fact
ion
is c
olle
cted
* an
d r
eco
rded
usi
ng
dif
fere
nt
m
eth
od
s th
at r
eflec
t th
eir
abili
ties
an
d n
eed
s.
•Ea
ch r
esid
ent’
s ac
tivi
ty n
eed
s an
d w
ellb
ein
g a
re r
eco
rded
6–1
2 w
eeks
aft
er a
dm
issi
on
wh
en t
he
resi
den
t h
as s
ettl
ed in
. Th
ese
are
revi
ewed
wit
h r
esid
ents
an
d c
are
pla
ns
are
up
dat
ed a
s ch
ang
es
occ
ur
or
at a
min
imu
m a
nn
ual
ly.
•C
are
staf
f ca
n d
escr
ibe
the
acti
vity
aim
s, o
bje
ctiv
es a
nd
ou
tco
mes
fo
r al
l th
e re
sid
ents
an
d t
hes
e ar
e ev
iden
t in
pra
ctic
e.
B•
The
care
pla
n is
dra
wn
up
wit
h t
he
resi
den
t, r
eco
rded
an
d a
gre
ed
Evid
ence
and
sig
ned
by
the
resi
den
t an
d/o
r re
lati
ve.
•R
esid
ents
’ sat
isfa
ctio
n is
co
llect
ed*
in d
iffe
ren
t w
ays
to r
eflec
t th
eir
abili
ties
an
d n
eed
s.
•Ea
ch r
esid
ent’
s ac
tivi
ty n
eed
s an
d w
ellb
ein
g a
re r
eco
rded
an
d
revi
ewed
an
nu
ally
. Car
e p
lan
s ar
e u
pd
ated
.•
Car
e st
aff
can
des
crib
e th
e ac
tivi
ty a
ims,
ob
ject
ives
an
d o
utc
om
es
for
all t
he
resi
den
ts a
nd
pu
t th
ese
into
pra
ctic
e.
C•
The
care
pla
n is
dra
wn
up
wit
h t
he
resi
den
ts a
nd
rec
ord
ed.
Evid
ence
•R
esid
ents
’ sat
isfa
ctio
n is
co
llect
ed*
in a
n a
d h
oc
way
.•
Res
iden
ts’ a
ctiv
ity
nee
ds
are
reco
rded
.•
Car
e st
aff
can
des
crib
e th
eir
invo
lvem
ent
in d
evel
op
ing
act
ivit
y ai
ms,
ob
ject
ives
an
d o
utc
om
es b
ut
are
inco
nsi
sten
t ab
ou
t re
cord
ing
, up
dat
ing
an
d u
sin
g t
his
info
rmat
ion
.
D•
Litt
le im
po
rtan
ce is
att
ach
ed t
o c
are
pla
ns.
Evid
ence
•R
esid
ents
’ sat
isfa
ctio
n is
rar
ely
colle
cted
*, if
at
all.
•A
ctiv
ity
nee
ds
and
ch
oic
es a
re p
oo
rly
reco
rded
.•
Act
ivit
y ai
ms,
ob
ject
ives
an
d o
utc
om
es a
re n
ot
avai
lab
le f
or
ove
r h
alf
of
the
resi
den
ts a
nd
sta
ff a
re u
nab
le t
o li
nk
acti
vity
pla
ns
wit
h d
aily
op
erat
ion
s.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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24 College of Occupational Therapists 2007
4.3
Qu
alit
y in
dic
ato
rTh
e ac
tivi
ty p
lan
nin
g p
roce
ss a
nd
do
cum
enta
tio
n in
clu
des
rel
evan
t ri
sk a
sses
smen
ts.
A•
Pers
on
-cen
tred
ris
k as
sess
men
ts h
ave
bee
n c
arri
ed o
ut,
rec
ord
ed
Evid
ence
and
are
reg
ula
rly
revi
ewed
reg
ard
ing
res
iden
ts’ a
bili
ties
to
p
arti
cip
ate
in a
ctiv
itie
s o
f th
eir
cho
ice.
•R
isk
asse
ssm
ents
pro
mo
te r
esid
ents
’ fre
edo
m, w
elfa
re a
nd
th
eir
rig
ht
to c
ho
ose
, reg
ard
less
of
thei
r d
isab
iliti
es a
nd
oth
er n
eed
s.
Ther
e is
evi
den
ce t
hat
alt
ern
ativ
e ac
tivi
ties
an
d s
up
po
rt m
easu
res
hav
e b
een
fu
lly e
xplo
red
.•
Wh
ere
app
rop
riat
e, r
esid
ents
an
d r
elat
ives
rep
ort
* th
ey a
re
invo
lved
an
d jo
int
dec
isio
ns
are
reac
hed
ab
ou
t an
y ac
tio
ns.
B•
Ris
k as
sess
men
ts h
ave
bee
n c
arri
ed o
ut
and
rec
ord
ed r
egar
din
g
Evid
ence
resi
den
ts’ a
bili
ties
to
par
tici
pat
e in
act
ivit
ies
of
thei
r ch
oic
e.
•R
isk
asse
ssm
ents
pro
mo
te r
esid
ents
’ fre
edo
m, w
elfa
re a
nd
th
eir
rig
ht
to c
ho
ose
. Th
ere
is e
vid
ence
th
at a
lter
nat
ive
acti
viti
es a
nd
su
pp
ort
mea
sure
s h
ave
bee
n f
ully
exp
lore
d.
•R
esid
ents
an
d r
elat
ives
rep
ort
* jo
int
dec
isio
ns
are
usu
ally
rea
ched
ab
ou
t an
y ac
tio
ns.
C•
Ris
k as
sess
men
ts a
re c
om
ple
ted
an
d r
eco
rded
.Ev
iden
ce•
Ris
k as
sess
men
ts p
rom
ote
th
e w
elfa
re o
f th
e re
sid
ents
bu
t ro
uti
ne
safe
ty p
reva
ils o
ver
resi
den
ts’ c
ho
ice.
Ass
essm
ents
sh
ow
so
me
evid
ence
th
at a
lter
nat
ive
acti
viti
es a
nd
su
pp
ort
mea
sure
s h
ave
bee
n c
on
sid
ered
.•
Rel
ativ
es a
nd
res
iden
ts r
epo
rt*
they
wo
uld
like
mo
re in
volv
emen
t in
th
e ri
sk a
sses
smen
t p
roce
ss.
D•
Ind
ivid
ual
ris
k as
sess
men
ts a
re r
arel
y, if
at
all,
carr
ied
ou
t to
en
able
Ev
iden
cere
sid
ents
to
par
tici
pat
e in
act
ivit
ies
of
thei
r ch
oic
e.•
Ris
k as
sess
men
ts d
o n
ot
take
into
acc
ou
nt
the
resi
den
ts’ a
bili
ties
an
d r
igh
t to
ch
oo
se a
ctiv
itie
s.
•R
isk
asse
ssm
ents
are
car
ried
ou
t an
d d
ecis
ion
s m
ade
on
beh
alf
of
resi
den
ts a
nd
rel
ativ
es r
ath
er t
han
join
tly.
* Fo
r al
tern
ativ
e m
eth
od
s o
f co
llect
ing
evi
den
ce s
ee p
ages
4 a
nd
5
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Qu
alit
y in
dic
ato
rs a
nd
act
ion
pla
n
The
follo
win
g p
ages
can
be
ph
oto
cop
ied
to
rec
ord
wh
o w
ill t
ake
resp
on
sib
ility
fo
r co
mp
leti
ng
eac
h a
ctio
n, w
hen
th
eysh
ou
ld b
e im
ple
men
ted
by
and
an
ag
reed
dat
e to
rev
iew
th
e p
roce
ss.
1.Th
e ac
tivi
ty c
ult
ure
wit
hin
car
e h
om
es
1.1
The
care
ho
me
man
ager
dem
on
stra
tes
exte
nsi
ve k
no
wle
dg
e ab
ou
t h
is o
r h
er r
esid
ents
’ nee
ds,
irre
spec
tive
of
age
and
/or
dia
gn
osi
s, a
nd
ho
w t
hey
are
bei
ng
met
th
rou
gh
th
e p
rovi
sio
n o
f ac
tivi
ties
.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
1.2
All
staf
f re
ceiv
e tr
ain
ing
ab
ou
t th
e ef
fect
s o
f ag
ein
g, c
on
dit
ion
s o
f ag
ein
g, p
erso
n-c
entr
ed c
are,
co
mm
un
icat
ion
ski
lls, a
nd
the
sele
ctio
n a
nd
pro
visi
on
of
app
rop
riat
e ac
tivi
ties
.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
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26 College of Occupational Therapists 2007
1.3
Res
iden
ts a
re f
ree
to e
ng
age
in p
erso
nal
an
d s
oci
al a
ctiv
itie
s o
f th
eir
cho
ice
in a
rel
axed
an
d f
rien
dly
en
viro
nm
ent
wit
hin
the
care
ho
me.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
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2.C
om
mu
nic
atio
n a
nd
rel
atio
nsh
ips
bet
wee
n p
eop
le
2.1
Staf
f u
nd
erst
and
th
e va
lue
and
imp
ort
ance
of
effe
ctiv
e co
mm
un
icat
ion
an
d t
he
rela
tio
nsh
ips
they
bu
ild w
ith
res
iden
tsan
d h
ow
th
ese
dir
ectl
y af
fect
res
iden
ts’ o
pp
ort
un
itie
s to
tak
e p
art
in a
ctiv
itie
s.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
2.2
Co
mm
un
icat
ion
bet
wee
n s
taff
an
d r
esid
ents
is e
ffec
tive
an
d s
ensi
tive
to
en
able
res
iden
ts t
o m
ake
info
rmed
ch
oic
es a
bo
ut
the
acti
viti
es t
hey
do
.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
M1085 - ACTIVITY ENGLISH.qxd 3/9/07 11:18 Page 27 WAYNE'S G3 WAYNE'S G3: WAYNE'S JOBS:10742 - COT - ACTIVITY:
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28 College of Occupational Therapists 2007
3.A
ctiv
ity,
so
cial
an
d c
om
mu
nit
y p
arti
cip
atio
n
3.1
Incl
usi
ve a
ctiv
ity
pro
visi
on
en
able
s al
l car
e h
om
e re
sid
ents
to
tak
e p
art
in a
ctiv
itie
s o
f th
eir
cho
ice,
wit
h a
pp
rop
riat
e an
dse
nsi
tive
co
nsi
der
atio
n t
o c
ult
ure
, ag
e, g
end
er, h
ealt
h, s
exu
al o
rien
tati
on
, dis
abili
ties
an
d a
ge-
rela
ted
nee
ds.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
3.2
The
ran
ge
of
acti
viti
es f
or
each
res
iden
t re
flec
ts t
hei
r ch
oic
e, t
hei
r so
cial
, cu
ltu
ral a
nd
rel
igio
us
pre
fere
nce
s, a
nd
isav
aila
ble
at
freq
uen
t an
d r
egu
lar
inte
rval
s th
rou
gh
ou
t th
e w
eek.
Th
e n
eed
fo
r ‘q
uie
t ti
me’
is r
eco
gn
ised
an
d r
esp
ecte
d.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
w d
ate:
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3.3
The
op
po
rtu
nit
ies
for
resi
den
ts t
o e
ng
age
in p
erso
nal
dai
ly li
vin
g t
asks
are
inte
gra
ted
into
dai
ly c
are.
Act
ion
s
To b
e ac
tio
ned
by:
Dat
e:R
evie
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30 College of Occupational Therapists 2007
3.5
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fin
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4.C
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32 College of Occupational Therapists 2007
4.3
The
acti
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4 References
Bradford Dementia Group (2005) DCM 8 user’s manual. Bradford: University ofBradford. (Available only as part of attending a Learning to Use DCM training course.)
College of Occupational Therapists, the National Association for Providers of Activitiesfor Older People (2005) Occupation matters for older people (leaflet). London: COT.
Commission for Social Care Inspection (2006) Key lines of regulatory assessment(KLORA): care homes for older people (consultation document). London: CSCI.Available at: www.csci.org.uk/Docs/klora_care_homes_260606.doc Accessed on13.06.07.
Commission for Social Care Inspection (2007) Annual quality assurance assessment:care homes for older people. London: CSCI. Available at:http://www.csci.org.uk/professional/care_providers/all_services/inspection/aqaa/aqaa_care_homes_for_older_peo.aspx Accessed on 14.06.07.
Department of Health (2003) Care homes for older people: national minimumstandards: care homes regulations 2001. 3rd ed. London: Stationery Office.
Department of Health (2006) A new ambition for old age: next steps in implementingthe national service framework for older people. London: DoH.
Great Britain. Parliament (2005) Disability Discrimination Act 2005. London: StationeryOffice.
Help the Aged (2004) Preventing falls: managing the risk and the effect of fallsamong older people in care homes. London: Help the Aged. Available at:http://www.helptheaged.org.uk/NR/rdonlyres/673C5002-596F-476D-B2DF-DB6F09C37D9A/0/managing_risk_and_effect_of_falls.pdf Accessed on 28.02.07.
Hurtley R, Wenborn J (2005) The successful activity co-ordinator: a learning resourcefor activity and care staff engaged in developing an active care home. 2nd ed.London: Age Concern England.
Kitwood T (1997) Dementia reconsidered: the person comes first. Buckingham: OpenUniversity Press.
Perrin T ed (2005) The good practice guide to therapeutic activities with older peoplein care settings. Bicester: Speechmark.
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Appendix A: Policy drivers
Though there are many similarities, the policies, legislation and regulatoryframeworks governing the provision of services such as care homes for older peoplediffer in each of the four countries within the UK.
This section summarises some of the policy drivers most relevant to activity provisionwithin care homes. Readers are advised to refer to the relevant regulations,standards and policies for the most up-to-date information.
England
National Service Framework for older people(Department of Health 2001)The National Service Framework (NSF) for older people aims to promote the healthand wellbeing of older people through better co-ordinated services of the NHS andlocal authorities.
Standard 8 focuses on the promotion of health and active life in older age andmakes specific reference to increasing physical activity (p. 110) and promotingcertain strategies for preventing falls and their consequences in care home settings(p. 80).
A new ambition for old age: next steps in implementing the national serviceframework for older people(Department of Health 2006)Ten programmes of activity will be delivered covering the following three majorthemes:
1. Dignity in care, which aims to improve and upgrade the environment of in-patient wards and care homes and assure quality by working closely withinspectorates and regulators. It will ensure dignity is central to the provision ofcare for older people, including those with mental health problems and those atthe end of life.
2. Joined-up care, which outlines a system reform for stroke, falls, mentalhealth, complex needs and urgent care services and the development ofthe Common Assessment Framework, to ‘ensure that comprehensiveassessment is undertaken prior to long-term or residential nursing homecare’ (p. 14).
3. Healthy ageing, whose aims include improving physical fitness and overcomingbarriers to active life by improving access to equipment, foot-care, oral health,continence care, low-vision and hearing services, healthcare and healthpromotion services.
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Everybody’s business: integrated mental health services for older adults: a servicedevelopment guide(Department of Health, Care Services Improvement Partnership 2005)Many older people with mental health problems live in non-specialist care homes. Itis estimated that 60–70% of care home residents have dementia and 40% havedepression (p. 36). This guide highlights that ‘staff should seek to know more abouttheir [residents’] biographies and previous lifestyles so that they can providepersonalised care and encourage the maintenance of interests and skills. Activityprogrammes will help reduce depression’ (p. 37).
Our health, our care, our say: a new direction for community services(Department of Health 2006)The key themes in Our health, our care, our say are to promote independence,wellbeing and choice through services that are provided around individuals andtheir personal needs and preferences.
The aims are to:
• Provide person-centred, tailored, seamless services that give positive outcomes forclients.
• Provide good customer care.• Provide dignity in care.• Promote health, wellbeing and prevention of ill-health.
Dignity in carePractice guide 09(Social Care Institute for Excellence 2006)This guide has been developed to improve standards of dignity in care. It providesinformation for service users on what they can expect from health and social careservices. It gives practical guidance to service providers and practitioners to helpdevelop their practice, with the aim of ensuring that all people receiving health andsocial care services are treated with dignity and respect.
The guide covers:
• The meanings and aspects of Dignity in care.• Information and guidance on how to tackle poor standards of service, for
practitioners, service users and carers.• Key pointers to improving the dignity of older people.• Examples of ways in which dignity can be incorporated into care.• The policy context and key research and policy findings, with references.• Relevant guidance and standards.
The guide includes the Dignity challenge, which is a clear statement of what peoplecan expect from a service that respects dignity. It is supported by ten tests that canbe used by providers, commissioners and people who use services to see how theirlocal services are performing. Dignity challenge number ten is to ‘act to alleviatepeople’s loneliness and isolation’. This is defined as follows: ‘People receiving services
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are offered enjoyable, stimulating and challenging activities that are compatiblewith individual interests, needs and abilities’ (SCIE 2006).
Inspecting for better lives: delivering change(Commission for Social Care Inspection 2005)Inspecting for better lives is a programme of change and modernisation that focuseson the experiences of people who use services, such as care homes, and how theproviders, such as care home owners and managers, are improving the quality ofcare they provide.
Regulations for care homes have changed following the introduction of a self-assessment scheme, called Annual Quality Assurance Assessments (AQAA). The keylines of regulatory assessment (KLORA) will guide people over what aspects of theirservice will be reviewed in relation to assessing the quality of the service they areproviding (CSCI 2006).
England and Wales
Dementia: supporting people with dementia and their carers in health and socialcareNational Clinical Practice Guideline Number CG 042.(National Institute for Health and Clinical Excellence, Social Care Institute forExcellence 2006)This is the first joint guideline produced by the Social Care Institute for Excellence(SCIE) and the National Institute for Health and Clinical Excellence (NICE). It coversthe identification, treatment and care of people with dementia, and support forcarers within health and social care in England and Wales.
Key priorities for implementation include: non-discrimination; consent; carerassessment and support; co-ordination and integration of health and social care;memory assessment services; structural imaging for diagnosis; assessment ofbehaviour that challenges (to establish an individual care plan); provision ofdementia-care training to all staff working with older people in health, social careand voluntary sectors; and meeting mental health needs within acute hospitalservices.
Implementation advice for social care and health professionals is available from NICEand SCIE.
Northern Ireland
Department of Health, Social Services and Public Safety business plan 2007–2008(Department of Health, Social Services and Public Safety 2007)The Department of Health, Social Services and Public Safety (DHSSPS) was createdin 1999 and its mission is ‘to improve the health and social well-being of thepeople of Northern Ireland. It endeavours to do so by ensuring the provision ofappropriate health and social care services, both in clinical settings and in thecommunity’.
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The DHSSPS supports a range of programmes including health promotion andencouraging people to adopt activities and attitudes that will lead to better healthand wellbeing.
A healthier future: a twenty year vision for health and wellbeing in NorthernIreland 2005–2025(Department of Health, Social Services and Public Safety 2004)The regional strategy for health and wellbeing, A healthier future is a vision forhealth and wellbeing in Northern Ireland for the 20 years up to 2025. It is intendedto give the direction of travel for health and social services and focuses on:
• Promoting public health.• Engagement with people and communities to improve health and wellbeing.• The development of responsive and integrated services which will aim to treat
people in communities rather than in hospital.• New, more effective and efficient ways of working through multi-disciplinary
teams.• Measures to improve the quality of services.• Flexible plans, appropriate organisational structures and effective, efficient
processes to support implementation of the strategy.
The Elderly and Community Care Unit at DHSSPS has developed objectives which aimto support an increasing number of people to live independent lives, preferably intheir own homes, and to develop effective alternatives to hospital care, which aredesigned to reduce inappropriate admissions and unnecessary lengths of stay. Itsobjectives include developing a range of housing and care options and expandingthe respite and support services for carers. In co-operation with the independentsector, it also plans to expand the use of such things as supported living and daycare.
The Bamford review of mental health and learning disability (N. Ireland)The Bamford review of mental health and learning disability comprises severalreviews that encompass policy, services and legislation. One of these, Living fullerlives, is a service report relevant to older people with dementia and other mentalhealth problems.
Living fuller lives(Dementia and Mental Health Issues of Older People Expert Working Committee2006)The draft report for consultation Living fuller lives (2006) makes a range ofrecommendations about services for older people with dementia and other mentalhealth problems. For example, a range of models of respite care should be deliveredand these models should be responsive and beneficial to older people with mentalhealth problems and their carers. Care homes should promote ‘a positive andenjoyable quality of life, including appropriate activities, enjoyable and appropriatefood and promotion of independence’ (p. 106).
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Older people’s strategy: ageing in an inclusive society(Office of the First Minister and Deputy First Minister Northern Ireland 2006)The vision for this strategy is ‘to ensure that age related policies and practices createan enabling environment, which offers everyone the opportunity to make informedchoices so that they may pursue healthy, active and positive aging’ (p. 9).
The strategy has six objectives, as follows:
1. To ensure that older people have access to financial and economic resources tolift them out of exclusion and isolation.
2. To deliver integrated services that improve health and quality of life for olderpeople.
3. To ensure older people have a decent and secure life in their home andcommunity.
4. To ensure that older people have access to services and facilities to meet theirneeds and priorities.
5. To promote equality of opportunity and full participation in civic life and tochallenge ageism wherever it is found.
6. To ensure government works in a co-ordinated way interdepartmentally and withsocial partners to deliver effective services for older people.
The 2005–2006 report on progress against departmental actions to achieve thestrategic objectives was published in January 2007.
Investing for health 2002(Department of Health, Social Services and Public Safety 2002)The Investing for health strategy is built around two goals and seven objectives, witha number of measurable, illustrative targets linked to these objectives. These includeinformation on promoting independent living for older people through a communitydevelopment approach (pp. 24–25).
Priorities for action: planning framework for the HPSS 2006–2008(Department of Health, Social Services and Public Safety 2006)This framework outlines the key priorities for health and social services for NorthernIreland for 2006–2008. It sets out the actions to be taken forward to deliver high-quality, safe and accessible services that meet the needs of the people of NorthernIreland.
Scotland
Co-ordinated, integrated and fit for purpose: a delivery framework for adultrehabilitation in Scotland(Scottish Executive 2007)Launched in February 2007 this new model of service delivery gives strategicdirection and support to all health and social care services and practitioners whodeliver rehabilitation services to individuals and communities.
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The document focuses on core principles of rehabilitation specifically as they relateto older people, adults with long-term conditions and people returning from workabsence and/or aiming to stay in employment.
The new vision calls for a fundamental shift in the way the NHS works, from anacute, hospital-driven service to one that is embedded within the community, ispatient focused on a philosophy that moves from ‘care’ to ‘enablement’ andrehabilitation. The focus is on meeting the twin challenges of an ageing populationand the rising incidence of long-term conditions.
The ethos is about enabling physical, psychological, emotional, social andoccupational potential of the individual and improving quality of life. It recognisesthat social engagement and purposeful occupation are key to self-worth andwellbeing.
Better outcomes for older people: framework for joint servicesExecutive summaryPart 1: Implementing and evaluating joint servicesPart 2: Joint services and the journey of care(Scottish Executive 2005)
This framework has three functions:
1. To promote the implementation and mainstreaming of joint and integratedservices by local partnerships.
2. To set out the requirements and timescales which the local partnerships ofNHS boards and councils should meet in developing joint and integrated services.
3. To act as a tool to assist in the implementation of joint and integrated services.
Changing lives: report of the 21st century social work review(21st Century Social Review Group, Scottish Executive 2006)Changing lives reports on the recommendations made by the 21st Century SocialWork Review Group for the future of social services in Scotland.
It promotes the idea that services should meet people’s needs rather than peoplefitting the available services. It recognises that social work services make an essentialcontribution to the promotion and development of a society that is healthy,prosperous, safe, fair and inclusive.
The recommendations include designing and delivering services around the needs ofthe people who use the services and their carers and providing effective, integratedservices to support vulnerable people and promote social wellbeing.
Draft standards: healthcare services used by older people in NHSScotland(NHS Quality Improvement Scotland 2004)This document introduces the NHS Quality Improvement Scotland (NHS QIS) draftstandards for healthcare services used by older people in NHSScotland. The standardsfollow four key parts of the patient journey and are identified as:
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1. Avoiding admission – to ensure there are services in place that can respondquickly to provide health promotion, assessment, care and rehabilitation forolder people regardless of their current residential setting.
2. Admission and rehabilitation – to focus on assessment, acute care, care planningand rehabilitation.
3. Transfer and discharge – to facilitate safe discharge home and support peopleafter discharge.
4. Supporting services – to focus on multi-agency planning of services used by olderpeople.
These standards are used by NHS QIS to assess performance in areas throughoutNHSScotland where services are used by older people. These will include care homesfor older people.
Wales
Fundamentals of care: guidance for health and social care staff(Welsh Assembly Government 2003)This initiative is included in the Plan for Wales (National Assembly for Wales 2001) aspart of ‘Improving Health and Care Services’ and aims to improve the quality ofaspects of health and social care for adults. The document provides guidance andpromotes good practice by describing and presenting practice indicators for use asbenchmarks. The areas of practice include communication, relationships, respectingpeople, promoting independence, ensuring comfort and safety, eating and drinking.
National minimum standards for domiciliary care agencies in Wales(Welsh Assembly Government 2004)This document sets out the national minimum standards for domiciliary care agenciesin Wales. The purpose of these standards is to ensure a reasonable level of personalcare and support which people receive while living in their own home in thecommunity. The standards will be applied to agencies providing personal care to awide range of people, such as older people, who need care and support while livingin their own home.
The strategy for older people in Wales(Welsh Assembly Government 2003)
The five key aims of this strategy can be summarised as:
1. Tackling discrimination against older people.2. Promoting and developing older people’s capacity to continue to work, learn and
make an active contribution for as long as they wish.3. Promoting and improving the health and wellbeing of older people.4. Providing high-quality services and support to enable older people to live as
independently as possible in a suitable and safe environment and to ensureservices are organised around their needs.
5. To implement The strategy for older people in Wales to ensure that it is a catalystfor change and innovation across all sectors, improving services for older people.
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Healthy ageing action plan for Wales(Welsh Assembly Government 2005)This plan provides guidance for use at local level on evidence-based healthpromotion interventions for older people. It is structured around the priorities withinthe various National Service Frameworks and health gain targets, and highlights therole of national and local statutory, voluntary and independent agencies.
The health promotion action plan for older people in Wales(Welsh Assembly Government 2004)Consultation documentThe plan is structured around the main target areas, including physical activity andemotional health and wellbeing, for action to promote the health of older people. Ithighlights the role of national and local statutory, voluntary and independent agencies.
National Service Framework for older people in Wales(Welsh Assembly Government 2006)The National Service Framework (NSF) sets national, evidence-based standards forthe health and social care of older people, thereby helping to ensure that a goodlevel of service is available everywhere in Wales. The NSF sets out a three-stageprogramme to bring all services up to a minimum good standard in the shorter term,and to share and spread good practice to continually improve services and strivetowards excellence.
The NSF consists of ten key standards, which set out the rationale and evidence base,followed by the key actions required. There are six cross-cutting themes whichunderpin all of the standards:
1. Equity.2. Person-centred care.3. Engaging older people and carers.4. Whole systems working.5. Promoting wellbeing and independence.6. Management capacity.
The Welsh Assembly Government regards the National Service Framework for olderpeople in Wales as providing the main policy drive for dignity in care in Wales. Anyinitiatives with respect to older people’s care will be driven through implementationof the NSF.
Making the connections plan(Welsh Assembly Government 2004)Making the connections outlines four main principles:
1. Citizens at the centre – services are to be more responsive to users, with peopleand communities involved in designing the way services are delivered.
2. Equality and social justice – every person is to have the opportunity to contributeand services must work to connect with the hardest-to-reach members of thepopulation.
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3. Working together as the Welsh Public Service – more co-ordination betweenproviders to deliver sustainable, quality and responsive services.
4. Value for money – making the most of our resources.
This relates to the way services are commissioned and delivered and impacts on allareas of health and social care, indeed all public services. This is the agenda thatpromotes collaborative rather than competitive working in Wales.
References
21st Century Social Work Review Group (2006) Changing lives: report of the 21st CenturySocial Work Review. Edinburgh: Scottish Executive. Available at: www.scotland.gov.uk/Resource/Doc/91931/0021949.pdf Accessed on 13.06.07.
Commission for Social Care Inspection (2005) Inspecting for better lives: delivering change.London: CSCI. Available at: www.csci.org.uk/PDF/ibl_2.pdf Accessed on 13.06.07.
Commission for Social Care Inspection (2006) Key lines of regulatory assessment (KLORA):care homes for older people (consultation document). London: CSCI. Available at: www.csci.org.uk/Docs/klora_care_homes_260606.doc Accessed on 13.06.07.
Dementia and Mental Health Issues of Older People Expert Working Committee (2006) Livingfuller lives: draft report for consultation. Available at: www.rmhldni.gov.uk/dementia-consultation-july06.pdf Accessed on 13.06.07.
Department of Health (2001) National Service Framework for older people. London: DoH.
Department of Health (2006) A new ambition for old age: next steps in implementing thenational service framework for older people. London: DoH.
Department of Health (2006) Our health, our care, our say: a new direction for communityservices. (Command Paper 6737). London: DoH.
Department of Health, Care Services Improvement Partnership (2005) Everybody’s business:integrated mental health services for older adults: a service development guide. London:DoH. Available at: http://kc.csip.org.uk/upload/everybodysbusiness.pdf Accessed on 13.06.07.
National Institute for Health and Clinical Excellence, Social Care Institute for Excellence(2006) Dementia: supporting people with dementia and their carers in health and social care.(NICE clinical guideline 42). London: NICE.
NHS Quality Improvement Scotland (2004) Draft standards: healthcare services used by olderpeople in NHSScotland. Edinburgh: NHS QIS. Available at: www.nhshealthquality.org/nhsqis/files/DS%20Healthcare%20for%20Older.pdf Accessed on 13.06.07.
Northern Ireland. Department of Health, Social Services and Public Safety (2004) A healthierfuture: a twenty year vision for health and wellbeing in Northern Ireland 2005–2025.Available at: www.dhsspsni.gov.uk/healthyfuture-main.pdf Accessed on 13.06.07.
Northern Ireland. Department of Health, Social Services and Public Safety [ca.2007] DHSSPSbusiness plan. Available at: www.dhsspsni.gov.uk/business_plan_0708.pdf Accessed on13.06.07.
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Northern Ireland. Department of Health, Social Services and Public Safety (2006) Priorities foraction: planning framework for the HPSS 2006–2008. Available at: www.dhsspsni.gov.uk/pfa_2006–08��.pdf Accessed on 11.06.07.
Northern Ireland. Department of Health, Social Services and Public Safety, Belfast (2002)Investing for health 2002. Available at: www.dhsspsni.gov.uk/show_publications?txtid=10415Accessed on 11.06.07.
Office of the First Minister and Deputy First Minister Northern Ireland (2006) Older people’sstrategy: ageing in an inclusive society. Available at: www.ofmdfmni.gov.uk/ageingreport-2.pdf Accessed on 20.03.07.
Philp I (2006) A new ambition for old age: next steps in implementing the national serviceframework for older people. London: Department of Health.
Scottish Executive (2005) Better outcomes for older people: framework for joint services:executive summary. Edinburgh: Scottish Executive. Available at: www.scotland.gov.uk/Resource/Doc/1244/0011892.pdf Accessed on 12.02.07.
Scottish Executive (2007) Co-ordinated, integrated and fit for purpose: a delivery frameworkfor adult rehabilitation in Scotland. Edinburgh: Scottish Executive. Available at:www.scotland.gov.uk/Resource/Doc/166617/0045435.pdf Accessed on 31.05.07.
Social Care Institute for Excellence (2006) Dignity in care. (Adults’ Services Practice Guide 09).London: SCIE. Available at: www.scie.org.uk/publications/practiceguides/practiceguide09/files/pg09.pdf Accessed on 22.02.07.
The Bamford Review of Mental Health and Learning Disability (N. Ireland). Available at:www.rmhldni.gov.uk/index.htm Accessed on 20.03.07.
Wales. National Assembly (2001) Plan for Wales 2001. Cardiff: National Assembly. Availableat: http://www.planforwales.wales.gov.uk/pdf/plan_for_wales_English.pdf Accessed on10.08.07.
Welsh Assembly Government (2003) Fundamentals of care: guidance for health and socialcare staff: improving the quality of fundamental aspects of health and social care foradults. Cardiff: WAG. Available at: www.wales.nhs.uk/documents/booklet-e.pdf Accessed on12.03.07.
Welsh Assembly Government (2003) The strategy for older people in Wales. Cardiff: WAG.Available at: http://new.wales.gov.uk/topics/olderpeople/publications/strategy?lang=enAccessed on 12.02.07.
Welsh Assembly Government (2004) Making the connections: delivering better services forWales: the Welsh Assembly Government vision for public services. Cardiff: WAG. Available at:http://new.wales.gov.uk/docrepos/40382/403823121/40382213/403822133/mtc-document-e1.pdf?lang=en Accessed on 27.02.07.
Welsh Assembly Government (2004) National minimum standards for domiciliary careagencies in Wales. Cardiff: WAG. Available at: www.csiw.wales.gov.uk/docs/Standards_Domiciliary_Care_e.pdf Accessed on 27.02.07.
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Welsh Assembly Government (2004) The health promotion action plan for older people inWales. Cardiff: WAG. Available at: www.eagagroup.com/downloads/pdf/action_plan_consultation_e.pdf Accessed on 12.02.07.
Welsh Assembly Government (2005) Healthy ageing action plan for Wales: a response tohealth challenge Wales. Cardiff: WAG.Available at: new.wales.gov.uk/docrepos/40382/40382311111/reports/pre-06/ageing?lang=enand http://new.wales.gov.uk/docrepos/40382/40382311111/reports/pre-06/ageing2?lang=enAccessed on 12.02.07.
Welsh Assembly Government (2006) National Service Framework for older people in Wales.Cardiff: WAG. Available at: www.wales.nhs.uk/sites3/documents/439/NSFforOlderPeopleInWalesEnglish.pdf Accessed on 27.02.07.
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Appendix B: Care standards
Like the policy drivers, each of the four countries in the UK has producedits own care standards and inspection processes, which are constantly reviewed. Mostof these focus on service users and achieving high-quality outcomes.
Readers are advised to refer to the relevant standards and inspection processesfor the most up-to-date information. This section summarises some of the keyinformation about care standards for each country.
England
Legislation: Care Standards Act 2000
Regulatory bodyand inspectorate: Commission for Social Care Inspection
Regulations: Care Home Regulations
Standards: National minimum standards for care homes for older people(Department of Health 2003)
Inspection:Three types:
1. Key inspection – a thorough look at how well the service is doing, taking intoaccount detailed information provided by the owner or manager.
2. Random inspection – short, targeted inspection either focused on the specificissue, or to check on improvements that should have been made, or to investigatea complaint, or for no reason at all.
3. Thematic inspection – focused on a specific issue, or a specific region, in order tolook at trends.
The main cross-cutting themes are:
• focus on service users• fitness for purpose• comprehensiveness• meeting assessed needs• quality services• quality workforce.
Standards relevant to activity provision:Standard 7 – Service user planOutcome: the service user’s health, personal and social care needs are set out in anindividual plan of care.
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• 7.2The service user’s plan sets out in detail the action to be taken by care staff toensure that all aspects of the health, personal and social care needs of the serviceuser are met.
Standard 12 – Social contact and activitiesOutcome: service users find the lifestyle experienced in the home matches theirexpectations and preferences, and satisfies their social, cultural, religious andrecreational interests and needs.
• 12.1The routines of daily living and activities made available are flexible and variedto suit service users’ expectations, preferences and capacities.
• 12.2Service users have the opportunity to exercise their choice in relation to:
– Leisure and social activities and cultural interests.– Food, meals and mealtimes.– Routines of daily living.– Personal and social relationships.– Religious observance.
• 12.3Service users’ interests are recorded and they are given opportunities forstimulation through leisure and recreational activities in and outside the homethat suit their needs, preferences and capacities. Particular consideration is givento people with dementia and other cognitive impairments, those with visual,hearing or dual sensory impairments, and those with physical disabilities orlearning disabilities.
• 12.4Up-to-date information about activities is circulated to all service users in formatssuited to their capacities.
Standard 13 – Community contactOutcome: service users maintain contact with family, friends, representatives and thelocal community as they wish.
• 13.1Service users are able to have visitors at any reasonable time and links with thelocal community are developed and/or maintained in accordance with serviceusers’ preferences.
Northern Ireland
Legislation: The Health and Personal Social Services (Quality, Improvementand Regulation) (Northern Ireland) Order 2003
Regulatory bodyand inspectorate: The Regulation and Quality Improvement Authority
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Regulations: The nursing homes regulations (Northern Ireland) 2005The residential care homes regulations (Northern Ireland) 2005
Standards: Care standards for residential and nursing homes (in draft format the time of going to press)
Inspection:
Announced inspections – these inspection visits are planned and the serviceprovider knows when the inspection staff will arrive to conduct them. Theseinspections can be performed by care, pharmacy, estates and financial inspectors.
Unannounced inspections – these inspection visits are planned without the serviceprovider receiving advance notice. These inspections can be performed by care,pharmacy, estates and financial inspectors.
Unannounced inspections can be performed during working hours, early mornings,late evenings and weekends. The distribution of these inspections is important toprovide assurance as to the care provided at different stages of the day and night. Itis also a method for identifying poor practices.
A new methodology for the inspection process is being piloted and it is hoped thiswill be implemented during 2007–2008.
Scotland
Legislation: Regulation of Care (Scotland) Act 2001
Regulatory body: The Scottish Commission for the Regulation of Care(established April 2002)/The Care Commission
Standards: National care standards (Scottish Executive 2005)National care standards: care homes for older people (ScottishExecutive 2005)
Inspectorate: Care CommissionThe Care Standards and Sponsorship Branch
Inspection:All care services are required to self-evaluate their service against the National carestandards. Services are inspected at least once a year, on either an announced or anunannounced basis, based on five core standards and a number of themes.Information about the current core standards and themes is available on the CareCommission website.
Main principles:
• Dignity – your right to:– Be treated with dignity and respect at all times.– Enjoy a full range of social relationships.
• Privacy – your right to:– Have your privacy properly respected.– be free from unnecessary intrusion.
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• Choice – your right to:– Make informed choices, while recognising the rights of other people to do
the same.– Know about the range of choices.
• Safety – your right to:– Feel safe and secure in all aspects of life, including health and wellbeing.– Enjoy safety but not be over-protected.– Be free from exploitation and abuse.
• Realising potential – your right to have the opportunity to:– Achieve all you can.– Make full use of the resources that are available to you.– Make the most of your life.
• Equality and diversity – your right to:– Live an independent life, rich in purpose, meaning and personal fulfilment.– Be valued for your ethnic background, language, culture and faith.– Be treated equally and be cared for in an environment which is free from
bullying, harassment and discrimination.– Be able to complain effectively without fear of victimisation.
Standards relevant to activity provision:Standard 6 – Support arrangementsYou can be confident before moving in that the home will meet your support andcare needs and personal preferences. Staff will develop with you a personal plan thatdetails your needs and preferences and sets out how they will be met, in a way thatyou find acceptable.
• 6.1Your personal plan will include:
– Social, cultural and spiritual preferences.– Leisure interests.– Any special furniture, equipment and adaptations you may need.– Any special communication needs you may have.
Standard 12 – Lifestyle: social, cultural and religious belief or faithYour social, cultural and religious belief or faith are known and respected. You areable to live your life in keeping with these beliefs.
• 12.4The social events, entertainment and activities provided by the care home will beorganised so that you can join in if you want to.
Standard 14 – Keeping well: healthcareYou are confident that the staff know your healthcare needs and arrange to meetthem in a way that suits you best.
• 14.7You will have opportunities to take part in physical activities in, or outside, thehome. If you cannot go out of the home, you will be able to take part in physical
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activities arranged by the staff that aim to help you maintain your physicalindependence and activity.
Standard 17 – Daily lifeYou make choices and decisions about day-to-day aspects of your life and about howyou spend your time.
• 17.1The social events, entertainment and activities provided by the care home will beorganised so that you can join in if you want to.
• 17.2You know that the staff will explain, justify and record any limits on yourindependence in your personal plan and know that these will be reviewed regularly.
• 17.3You know that the staff are trained to listen to people living in the care home.
• 17.4You can keep up relationships with friends, relatives and carers and links withyour own community. If you want, the staff will support you to do this.
• 17.5You are free to come and go as you please, unless there are specific legalrequirements which prevent this.
• 17.6You have no restrictions placed on the time you get up or go to bed.
• 17.7You are supported and encouraged to use local services such as hairdressers,shops and banks.
• 17.8You have access to information about local events, facilities and activities.
• 17.9Staff can help you to arrange meetings with visitors and help any disabled friendsand relatives into and around the building.
Wales
Legislation: Care Standards Act 2000
Regulatory bodyand inspectorate: Care Standards Inspectorate for Wales
Regulations: Care homes (Wales) regulations 2002The care homes (Wales) (amendment) 2003The care homes (Wales) (amendment no. 2) regulations 2003
Standards: National minimum standards for care homes for older people (Welsh Assembly Government 2004)
Supplementary guidance for older people with dementia (Care Standards Inspectorate for Wales 2003)
Inspection:The inspection process was reformed as of April 2006. Providers complete a self-assessment form, including details of policies and procedures. The inspection plan is
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linked to key needs of the service and sent to the provider outlining the inspectionmethodology to be used. Normally this includes case tracking to enable all aspects ofcare to be inspected through the service user’s experience. An annual inspectionreport is compiled.
Standards relevant to activity provision:Standard 6 – Service user planOutcome: each service user’s health, personal and social care needs are set out in anindividual plan of care.
• 6.2The service user’s plan sets out in detail the action which needs to be taken bycare staff to ensure that all aspects of health, personal and social care needs ofthe service user are met.
Standard 9 – Social contact and opportunitiesOutcome: service users find that their lifestyle in the home matches theirexpectations and preferences, and satisfies their social, cultural, religious andrecreational interests and needs.
• 9.1The opportunities made available and the routines of daily living areflexible and varied to suit service users’ expectations, preferences and capacities.
• 9.3Service users have the opportunity to exercise choice in relation to:
– Leisure and social activities and cultural interests.– Food, meals and mealtimes.– Routines of daily living.– Personal and social relationships.– Religious observance.
• 9.4Service users’ interests are recorded and they are given opportunities forstimulation through leisure and recreational activities in and outside the homethat suit their needs, preferences and capacities. Particular consideration is givento people with dementia and other cognitive impairments, those with visual,hearing or dual sensory impairments, and those with physical disabilities orlearning disabilities.
• 9.5Up-to-date information about activities is circulated to all service users in formatssuited to their capacities.
Standard 10 – Community contactOutcome: service users maintain contact with family, friends, representatives and thelocal community as they wish.
Standard 15 – Health careOutcome: service users’ healthcare needs are fully met.
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• 15.8Opportunities are given for appropriate exercise and physical activity: appropriateinterventions are carried out for service users identified as at risk of falling.
Supplementary guidance for older people with dementia
• 8.7A setting which aims to promote fulfilment will:
– Know about the things that individuals have done in earlier life and identify and encourage the skills and interests they retain.
– Build on the individual’s positive attributes and what they are still able to do, rather than just manage negative features such as their confusion.
– Help individuals to use their physical and mental faculties within the limit of their abilities and wishes, but recognise and care for those who have no wish to be active or sociable.
– Recognise and care for the emotional and spiritual needs of service users.– Create a stimulating environment.– Ensure that staff understand the importance of activity for people with
dementia and of the specific activities which are available.– Ensure that care staff offer support to the service users in making choices
and about activities.
References
Care Standards Inspectorate for Wales (2003) Supplementary guidance for older people withdementia. London: Stationery Office.
Department of Health (2003) National minimum standards for care homes for older people.London: Stationery Office.
Great Britain. Parliament (2000) Care Standards Act 2000. London: Stationery Office.
Great Britain. Parliament (2001) Regulation of Care (Scotland) Act 2001. London: StationeryOffice.
Great Britain. Parliament (2002) The Care Homes (Wales) regulations 2002. Welsh StatutoryInstrument 2002 No. 324 (W37). London: Stationery Office.
Great Britain. Parliament (2003) The Care Homes (Wales) (Amendment No. 2) regulations2003. London: Stationery Office.
Great Britain. Parliament (2003) The Care Homes (Wales) (Amendment) 2003. London:Stationery Office.
Great Britain. Parliament (2003) The Health and Personal Social Services (Quality,Improvement and Regulation) (Northern Ireland) Order 2003. London: Stationery Office.
Northern Ireland. Northern Ireland Assembly (2005) The Nursing Homes regulations(Northern Ireland) 2005. London: Stationery Office.
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Northern Ireland. Northern Ireland Assembly (2005) The Residential Care Homes regulations(Northern Ireland) 2005. London: Stationery Office.
Scottish Executive (2005) National care standards. Edinburgh: Scottish Executive. Available at:www.scotland.gov.uk/Topics/Health/care/17652/9325 Accessed on 12.02.07.
Scottish Executive (2005) National care standards: care homes for older people. Edinburgh:Scottish Executive. Available at: www.scotland.gov.uk/Resource/Doc/37432/0010384.pdfAccessed on 12.02.07.
Welsh Assembly Government (2004) National minimum standards for care homes for olderpeople. Cardiff: WAG.
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Appendix C: Supporting evidence
C.1 The importance of activity for older peopleA number of physical and psychological changes occur when someone stopsengaging in activity, for example reduced muscle strength and postural stabilitywhich will increase the risk of falling, decreased respiratory, cardiac and intestinalfunction, disorientation, sense of loss, anxiety and ill-being.
• Perrin T ed (2005) The good practice guide to therapeutic activities with olderpeople in care settings. Bicester: Speechmark.
Engaging in activity results in physical and psychological benefits.
• British Heart Foundation (2003) Active for later life. London: BHF.• British Heart Foundation (2005) Moving more often: a programme to promote
physical activity with frailer, older people. London: BHF. Available at:http://changeagentteam.org.uk/_library/docs/BetterCommissioning/moving_more_often.pdf Accessed on 13.06.07.
• Skelton D (2001) Effects of physical activity on postural stability. Age & Ageing,30(Supplement 4), S33–39.
• Skelton D (2002) Exercise for healthy ageing. 2nd ed. London: Research intoAgeing.
C.2 The importance of activity for older people in care homesParticipating in activity can reduce the levels of: depression; behaviour thatchallenges; falls; and dependency in care homes, thus improving wellbeing.
• Ames D (1990) Depression among elderly residents of local-authority residentialhomes: its nature and the efficacy of intervention. British Journal of Psychiatry,156(5), 667–675.
• Mann A, Schneider J, Mozley C, Levin E, Blizard R, Netten A, Kharica K, EgelstaffR, Abbey A, Todd C (2000) Depression and the response of residential homes tophysical health needs. International Journal of Geriatric Psychiatry, 15(12),1105–1112.
• Mozley CG (2001) Exploring connections between occupation and mentalhealth in care homes for older people. Journal of Occupational Science, 8(3),14–19.
• Rovner BW, German P, Burton LC, Clark RD (1994) A longitudinal study ofparticipation in nursing home activity programs. American Journal of GeriatricPsychiatry, 2(2), 169–174.
• Rovner BW, Steele CD, Shmuely Y, Folstein MF (1996) A randomised trial ofdementia care in nursing homes. Journal of the American Geriatrics Society, 44(1),7–13.
Purposeful activity for care home residents is acknowledged as an essentialcomponent of health, wellbeing and quality of life.
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• Bradford Dementia Group, ExtraCare Charitable Trust (2006) Enrichingopportunities: unlocking potential: searching for the keys. Bradford: BradfordDementia Group.
• Brooker D (2007) Person-centred dementia care: making services better. London:Jessica Kingsley Publishers.
• Green S, Acheson Cooper B (2000) Occupation as a quality of life constituent: anursing home perspective. British Journal of Occupational Therapy, 63(1), 17–24.
• Mozley C, Sutcliffe C, Bagley H, Cordingley L, Challis D, Yuxley P, Burns A (2004)Towards quality care: outcomes for older people in care homes. Aldershot:Ashgate Publishing.
• Mozley CG (2001) Exploring connections between occupation and mental healthin care homes for older people. Journal of Occupational Science, 8(3), 14–19.
• Mozley CG, Schneider J, Cordingley L, Molineux M, Duggan S, Hart C, Stoker B,Williamson R, Lovegrove R, Cruickshank A (2007) The care home activity project:does introducing an occupational therapy programme reduce depression in carehomes? Aging & Mental Health, 11(1), 99–107.
• Schneider J, Mann AH, Levin E, Netten A, Mozley C, Abbey A, Egelstaff R,Kharicha K, Todd C, Blizard B, Topan C (1997) Quality of care: testing somemeasures in homes for elderly people. (Discussion Paper 1245). Canterbury:University of Kent at Canterbury, Personal Social Services Research Unit.
C.3 The level of activity in care homesHistorically the level of inactivity within care homes for older people has been high.
• British Heart Foundation (2005) Moving more often: a programme to promotephysical activity with frailer, older people. London: BHF. Available at:http://changeagentteam.org.uk/_library/docs/BetterCommissioning/moving_more_often.pdf Accessed on 13.06.07.
• Challis D, Godlove C, Mozley C, Sutcliffe C, Bagley H, Price L, Burns A, Huxley P,Cordingley L (2000) Dependency in older people recently admitted to care homes.Age & Ageing, 29(3), 255–260.
• Godlove C, Richard L, Rodwell G (1982) Time for action: an observation study ofelderly people in four different care environments. (Social services monographs:research in practice. Community Care). Sheffield: Joint Unit for Social ServicesResearch.
• Help the Aged, National Care Forum, National Care Homes Research andDevelopment Forum (2006) My home life: quality of life in care homes. London:Help the Aged.
• Mozley CG (2001) Exploring connections between occupation and mental healthin care homes for older people. Journal of Occupational Science, 8(3), 14–19.
• Nolan M, Grant G, Nolan J (1995) Busy doing nothing: activity and interactionlevels amongst differing populations of elderly patients. Journal of AdvancedNursing, 2(3), 528–538.
• Schneider J, Mann AH, Levin E, Netten A, Mozley C, Abbey A, EgelstaffR, Kharicha K, Todd C, Blizard B, Topan C (1997) Quality of care: testingsome measures in homes for elderly people. (Discussion Paper 1245).Canterbury: University of Kent at Canterbury, Personal Social Services ResearchUnit.
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• Townsend PB (1962) The last refuge: a survey of residential institutions andhomes for the aged in England and Wales. London: Routledge & Keegan Paul.
• Willcocks D, Peace S, Kellaher LA (1987) Private lives in public places: a research-based critique of residential life in local authority old people’s homes. London:Tavistock.
More recently a multi-centre randomised controlled trial examined the unmet needsof residents with dementia living in care homes. Daytime activity was an unmet needfor 76% of the sample of 238. This level of unmet need rose to 84% for thoseresidents who were also depressed and to 90% for those who were also anxious.
• Hancock GA, Woods B, Challis D, Orrell M (2006) The needs of older people withdementia in residential care. International Journal of Geriatric Psychiatry, 21(1),43–49.
The state of social care in England 2004–05 (CSCI 2005) provides an overview ofprivate, voluntary and statutory social care services in England. Data collected fromthe assessments of services against the national minimum standards have been usedto inform this report, which includes information about care homes for older people.The data measure quality, but, as the report suggests, they do not necessarily captureimportant ideas, facts or outcomes and are ‘at best “proxy” indicators for the thingsthat matter to most people’ (p. 94).
The report states that the quality of residential services is generally improving.However, it also highlights that there is ‘a need to focus more directly on thosethings that matter to individuals and enhance their quality of life’ (p. 111). It alsofound that activities offered in homes for younger adults were more stimulatingthan those in homes for older people and these were usually group rather thanindividual activities.
• Commission for Social Care Inspection (2005) The state of social care in England2004–05. London: CSCI.
C.4 Organisational cultureThe manager is key to encouraging a culture of activity and to enable and empowercare staff to make the necessary organisational changes.
• Beck C (2001) Identification and assessment of effective services andinterventions: the nursing home perspective. Aging and Mental Health,5(Supplement 1), S99–111.
• Green S, Acheson Cooper B (2000) Occupation as a quality of life constituent: anursing home perspective. British Journal of Occupational Therapy, 63(1), 17–24.
C.5 Physical environmentAs care home premises need to be ‘fit for purpose’, the facilities and equipment toencourage residents to be as independent as possible must be readily available. Pooraccess and lack of appropriate walking aids can impede or prevent mobilisationthroughout the home, thus lowering levels of physical activity and the potential for
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stimulation and social interaction. A lack of colour contrast between different levelsand surfaces and poor lighting can make it difficult for residents with visual orperceptual impairments to find their way around. Certain design principles areaccepted as beneficial within care homes for people with dementia.
• Brawley EC (2001) Environmental design for Alzheimer’s disease: a quality of lifeissue. Aging and Mental Health, 5(1), S79–83.
• Powell Lawton M (2001) The physical environment of the person with Alzheimer’sdisease. Aging & Mental Health, 5(Supplement 1), S56–64.
Further information is available from:
• Rees L, Lewis C (2004) Adapting homes: a guide to adapting existing homes forpeople with sight loss. Cardiff: JMU Access Partnership.
• RNID www.rnid.org.uk• Royal National Institute of the Blind (RNIB) www.rnib.org.uk• The Alzheimer’s Society (2006) The Alzheimer’s Society guide to the dementia
care environment. London: The Alzheimer’s Society.• The Dementia Services Development Centre, University of Stirling
www.dementia.stir.ac.uk
C.6 ActivitiesIt is beyond the remit of this document to advise on ‘how’ to provide effectiveactivities. The potential scope is endless. However, the essential elements are gettingto know the person in terms of their individual life history, experiences, interests andvalues, and understanding their current level of physical, sensory, cognitive andpsychological ability. This knowledge then informs the selection of personallymeaningful activities and their provision at an appropriate level of challenge or ‘fit’.We all know how frustrating it can be to be confronted by something that is beyondour capabilities, or indeed that is too simple. So it is vital to get the right degree of‘fit’. The importance of gathering life history information cannot be overestimated,not just in relation to activity provision but to assist care givers in understandingbehavioural patterns and habits.
• Gibson F (2005) Fit for life: the contribution of life story work. In: M Marshall, ed.Perspectives on rehabilitation in dementia. London: Jessica Kingsley. 75–179.
• Hurtley R, Wenborn J (2005) The successful activity co-ordinator: for activity andcare staff engaged in developing an active care home. 2nd ed. London: AgeConcern England.
• Knocker S (2002) The Alzheimer’s Society book of activities. London: TheAlzheimer’s Society.
• Knocker S, Gaspar S (2007) Starting out and keeping it up: a guide foractivity providers. London: National Association for Providers of Activities forOlder People.
• Murphy C (2004) The critical importance of biographical knowledge. In: T Perrin,ed. The new culture of therapeutic activity with older people. Bicester:Speechmark. 88–103.
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• Osborn C (1993) The reminiscence handbook: ideas for creative activities witholder people. London: Age Exchange.
• Owen T ed, National Care Homes Research & Development Forum (2006) Myhome life: quality of life in care homes. London: Help the Aged.
• Pool J (2002) The Pool Activity Level (PAL) instrument for occupational profiling: apractical resource for carers of people with cognitive impairment. 2nd ed.London: Jessica Kingsley.
• SHAP Working Party on World Religions in Education publishes an annualcalendar of festivals for 12 major religions. Available at: www.shap.org
• Wenborn J, Challis D, Pool J, Burgess J, Elliott N, Orrell M (in press) Assessing thevalidity and reliability of the Pool Activity Level (PAL): checklist for use with olderpeople with dementia. Aging and Mental Health.
C.7 Falls preventionAlongside strategies to keep residents mobile comes the increased risk of falling.Care home residents are three times more likely to fall than community-living olderpeople. Forty per cent of care home admissions follow a previous fall and 40% ofhospital admissions from care homes follow a fall (Help the Aged 2004).Comprehensive risk assessments need to be completed and a range of strategiesimplemented to prevent falls (NICE 2004). However, this should not be at theexpense of limiting the individual’s potential level of independence or participationin activities.
• Help the Aged (2004) Preventing falls: managing the risk and effect of fallsamong older people in care homes. London: Help the Aged.
• National Institute for Clinical Excellence (2004) Falls: the assessment andprevention of falls in older people. (Clinical Guideline 21). London: NICE.
C.8 Useful reading/resources
• Feil N (2002) The validation breakthrough: simple techniques for communicatingwith people with Alzheimer’s-type dementia. 2nd ed. Baltimore, MD: HealthProfessions Press.
• Perrin T ed (2004) The new culture of therapeutic activity with older people.Bicester: Speechmark.
• Perrin T, May H (2000) Wellbeing in dementia: an occupational approach fortherapists and carers. Edinburgh: Churchill Livingstone.
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Appendix D: College of Occupational Therapists
The College of Occupational Therapists sets the professional and educationalstandards for occupational therapy. It provides leadership, guidance and informationrelating to research and development, education, practice and lifelong learning. Inaddition, 11 accredited specialist sections support expert practice in key areas.
The College of Occupational Therapists Specialist Section – Older People aims toimprove older people’s quality of life by promoting the development and provisionof high-quality, evidence-based occupational therapy services. Members work in bothphysical and mental health and in social care services for older people in a variety ofsettings, including care homes.
Key objectives
• To be a thriving organisation that is indispensable to the profession.• To promote the importance of occupation for the health and wellbeing of the
population.• To lead innovation in occupational therapy theory, practice, research and
education.• To have a positive influence in the development and support of a workforce that
meets changing needs.• To continue to have an input to wider debate and work to have an influence on
national policies.
StructureThe British Association of Occupational Therapists (BAOT) is the professional bodyand trade union for occupational therapy staff in the UK. Eight English regions, fourScottish regions and the four countries are represented within its membership.
The College of Occupational Therapists is a wholly owned subsidiary of BAOT andoperates as a registered charity. It represents the profession nationally andinternationally, and contributes widely to policy consultations throughout the UK.
ContactBritish Association/College of Occupational Therapists106–114 Borough High StreetLondon SE1 1LBTel: 020 7357 6480www.cot.org.uk
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Appendix E: National Association for Providers of Activities for OlderPeople (NAPA)
NAPA is a registered charity and membership organisation for all those interested inincreasing activity opportunities for older people in care settings. NAPA offers directservices to its members, including an information line, publications and trainingcourses. It also has a strategic and campaigning role in order to put activity at theheart of care.
Values
• The uniqueness of each older person.• Raising awareness of activities.• Understanding the care world.• Better practice.
Key aimsDeveloping expertise in activity provision for older people and sharing this through:
• Delivering best practice, training and support.• Disseminating useful information.• Promoting, encouraging and researching best practice.• Raising the status of activity providers.
StructureNAPA is a registered charity and a limited company with a small permanent staffteam. It is administered by a board of trustees made up of volunteers with a keenand active interest in promoting high-quality activity provision for older people.
NAPA has established working partnerships with most of the leading organisationsinvolved with the wellbeing of older people, both voluntary and privately funded, inorder to promote its aims.
ContactNAPA5th Floor – Unit 5.1271 BondwayLondon SW8 1SQTel: 020 7078 9375www.napa-activities.co.uk
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Activity ProvisionBenchmarking good practice in care homes
College of Occupational Therapists
It is important to develop a culture in care homes where activity is integral to care and notseen as an optional extra. Activity provision: benchmarking good practice in care homes
promotes and encourages appropriate activity for older people that is delivered in a kindand pleasant environment, regardless of residents’ age and/or diagnosis, whilst stillrespecting their dignity and personal choice.
This publication: � Offers a framework of person-centred quality indicators and outcome measures for
activity provision.� Incorporates a benchmark tool to evaluate current practice and promote excellence.� Summarises relevant policy drivers and care standards for each country in the UK. � Includes supporting evidence for good quality activities in care homes.
This document is intended to inform, guide and encourage care home providers,managers and commissioners, and will also be helpful to residents, their families andfriends, and care home inspectors.
Activity provision: benchmarking good practice in care homes was jointly developed bythe College of Occupational Therapists and the National Association for Providers ofActivities for Older People.
Availablefor Download
ISBN 978-1-905944-05-7
Activity ProvisionBenchmarking good practice in care homes
College of Occupational Therapists106–114 Borough High StreetLondon SE1 1LBwww.cot.org.ukTel: 020 7357 6480 Fax: 020 7450 2299
© 2007 College of Occupational Therapists Ltd.
Reg. in England No. 1347374 Reg. Charity No. 275119
Cover image © NAPA, with thanks to Warwick de Winter.
For free distribution only.
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