This is the second ALE project I have been involved in and although the team continue to face some of the same challenges as last time, this ALE 'feels different'.
The initial process was been well planned and the team agree that keeping the speakers 'in-house' (as opposed to having external consultants) made the experience much more 'real', with a sense of support and commitment from Eldercare. It was good to work with a ‘coach’ who kept us all on track when we inevitably started to digress to other areas, trying to solve all our perceived problems at the first meeting!
The issue identified by the staff team at Oxford and translated by the ALE team was:
"Residents lack personalised and appropriate stimulation or activity at specific times". Those times are identified as ‘sundowners’ (after 2.30pm), weekends and evenings.
This ALE has been identified by the people working on 'the floor' and who are ultimately responsible for making it work, for improving their working environment and improving the lives of the residents they support. The process has been much more consultative and staff have been willing to share their thoughts, feelings and ideas. Of course there are always those who come to the party kicking and screaming and for them the ALE just brings 'more work', but we are lucky to have a good ALE team with various skill mixes who are passionate about trying to make a difference.
After much thought and group discussion our group aim is:
To ensure residents have the opportunity to be engaged in personalised, appropriate stimulation or activity at all times. By March 2014 all staff involved in resident care will be provided with education and knowledge about what constitutes 'activity' and how staff can be a part of contributing to resident stimulation and wellbeing.
We will do this by:
- Educating staff
- Improving communication processes between staff members
- Improving communication processes and enhancing communication skills (with residents and families)
- Encouraging teamwork
- Providing staff with the knowledge to provide person-centered activities and stimulation
- Provide staff with the equipment to provide person-centered activities and stimulation
Even with the challenges, this year’s ALE project has already proven to be a success. Staff thought long and hard about the needs of the residents and how we can improve their quality of life and reduce some of the behaviours of concern (BOC) identified.
A Personal Care Assistant involved in the project has spoken to the staff at care staff meetings and has given them some insight into how the changes we have introduced have made a positive impact on both resident behaviours and staff workload. In an ideal world, by March 2014 (the date we have set to complete our ALE), behaviours of concern will have vanished, staff incidents greatly reduced, and falls at an all-time low. In reality we will be happy to see behaviours of concern reduced, staff incidents relating to behaviours reduced, and falls reduced.
We have now put a number of continuous improvements initiatives in place to help meet the issue identified. One of the key changes includes the introduction of a personalised 'Resident Interest Sheet' to capture residents' individual preferences 'in brief', as well as interests and the personal aids needed to enhance their lives. This simple initiative has already proven to be successful with residents engaging more with staff who appear to be more knowledgeable about the interests of the residents in their care.
Work started on the identification of the ALE in May 2013 but the associated continuous improvements were not identified until July. However there is already a marked improvement in BOC. We are looking forward to the evaluation of this project in March 2014 to get a clearer picture.
Our ALE compliments Eldercare's Vision Statement and falls in line with the expectations of Accreditation.
The most recent accreditation visit held on September 3 concentrated on Module 9 Improvements and Feedback. The assessor noted:
"The home is proactive in seeking improvements and monitoring performance with the Accreditation Standards. Residents, representatives, staff and others have opportunities for input into the continuous improvement system, the implementation of improvements is monitored, the results evaluated and feedback provided".
Being part of the ALE program has not only helped our residents, it has also assisted with our Accreditation process. It feels like we are heading in the right direction!