Teaching Care Homes: Inspiring and impacting

Last month, we started the next phase of our Teaching Care Homes (TCH) programme and began working with five new homes. The TCH programme was initially established by Care England and funded by the Department of Health in 2016. FoNS was privileged to be invited to be a partner in this pilot work and to lead the development of a programme to explore what it meant to be a ‘Teaching Care Home’. Whilst in principle, there was a view that they would be ‘flagship homes’, centres of excellence in person centred care and teaching and learning, the pilot was an opportunity to work with the homes who had this aspiration and to co-create a vision that could be shared and replicated.

As a result of the pilot, Care England and FoNS developed a proposal for taking forward the learning, to develop ongoing work to build a network or community of TCHs that would be ‘beacons or hubs’ of expertise. Homes that would support others by leading the way in creating positive learning environments whilst continuing to provide safe and caring homes for residents and support for relatives. We were delighted to receive funding from the Burdett Trust for Nursing to support 10 homes over the next two years, ultimately creating a community of 15 homes.

An advisory group was established, chaired by Professor Martin Green (Care England) to help guide the new programme of work. In reviewing the criteria for selection, the group agreed that in order to be beacons for others, the homes recruited needed to be stable and performing well.

A competitive application process was developed and ran during the winter 2017/18. After a shortlisting process, eight excellent applicants were shortlisted and visited by judges representing FoNS and the advisory group. The final five homes selected to join the TCH programme were:

• Hilltop House, Oakleaf Group in Northampton
• James Page House, Parkhaven Trust in Liverpool
• Landermeads, Independent in Nottingham
• Royal Star and Garter, Royal Star and Garter Homes in Solihull
• Wren Hall, Independent in Nottingham

Having spent time at the homes during the shortlisting visits, the tremendous expertise of the staff became apparent. We (FoNS) felt therefore, that rather than impose our ideas about how the homes should engage with the programme and take forward the vision for TCH, we should work collaboratively with the new participants to co-create how we would work together and identify the priorities for future activity.

During our first two days together, we agreed our ways of working and created space for participants to explore their hopes and aspirations for being part of a TCH community. Building on this, the participants went on to identify and agree three interlinked priority areas that they wanted to explore and develop as shown here:

As representatives of the TCH Programme, they believe they should be inspiring others – other homes, nurses and other professionals, students and communities in a way that would challenge the prevailing narrative regarding care homes. They want to raise awareness of excellent care home nursing and share experiences in a way that makes a difference to other homes. They talked about wanting to ‘push the boundaries’ as well as being open to new ideas and creative thinking. Ideas that they are working on include creating short videos that can be shared via social media, but also being more intentional about encouraging people to come into their homes e.g. inviting staff from other care homes, or local primary care or acute providers to join teaching and learning opportunities. As part of our co-created ways of working, one participant shared her experiences of developing her own advanced care plan. This stimulated a conversation about the opportunities for learning that could enhance end of life care. As a consequence, each of the homes have committed to undertake some activities related to this which we will share in a future blog to raise the profile of Dying Matters Awareness Week.

Promoting cross sector and interprofessional working is seen as a way of encouraging healthcare professionals and staff to look at what care home nursing can offer. Staff exchanges between homes, hospitals and communities was seen as one activity that could break down barriers and is currently being negotiated by one of the care homes and a local ward manager. Working more closely with education providers was also highlighted. Not just offering student placements but also going into educational institutions to talk to students about what care home nursing has to offer and also to influence the curriculum, so that care home nursing has a presence.

Intergenerational working and engagement is an important way in which homes can become a more visible and important part of communities. For example, one of the homes has recently opened a nursery on site and is enjoying the benefits of children being part of the home on a regular basis. Joint activities, such as cooking, are creating positive outcomes for the children and families, residents and families and staff. One of the nursing journals is going to write a feature article about this. Participants have come up with a raft of ways in which they can make stronger, more meaningful and more frequent connections with schools and other community groups.

In order to spread and share activity and learning, participants recognise the importance of communication and engagement. They acknowledge the value and reach that social media opportunities can offer for making connections and sharing experiences in more creative ways, including videos, podcasts, blogs and narratives. With many already using platforms such as Facebook, WhatsApp and Twitter, the scope for wider sharing could be tremendous.

With so many excellent ideas developing, one of the areas that we have particularly encouraged the homes to explore is understanding what they are doing well, how they are doing it and ways in which they can spread this too. We believe that by identifying strategies for spreading and sharing learning, the TCH programme can really begin to make a difference to other homes. This is something that we and all the homes involved (including the five homes from the pilot work) are very committed to achieving.

We continue to be inspired by the people we meet and working with in the care sector and want to make sure they receive greater acknowledgement and reward for the work they our doing in our communities. The TCH programme is one way in which we can contribute to them influencing the future of care sector nursing.