Look Who’s Talking: Prioritising Wellbeing for Care Services

Article | Hilary Woodhead, National Activity Providers Association (NAPA)

The National Activity Providers Association (NAPA) is a national charity and membership organisation with 3000 care home members.

NAPA supports care services to prioritise wellbeing by promoting activity, arts and engagement. We provide support services that give Activity Providers the knowledge, skills and resources required to provide person-centred, meaningful connections. During the COVID-19 pandemic, we responded quickly, adapting our services to make them available digitally.

In March 2020, the government recommended that people over 70 should be particularly stringent about following social distancing measures. People living in care homes were unable to see family and friends, informal carers, or healthcare professionals due to ‘no visitors’ policies. Group activities and communal dining were suspended to reduce the risk of coronavirus transmission, adding to the isolation that people experienced.

Over the following 18 months, care homes experienced an extraordinary period of challenge and change. Applying social distancing in care homes challenged staff in many ways, and it became clear that new approaches to supporting wellbeing were needed.

At the forefront was the incredible effort and commitment shown by Activity Providers, who rapidly adapted their approaches to improve residents’ wellbeing’. The most notable development was the greater use of digital approaches and tech-based activities, which meant more use of established platforms, more phone and video interactions, and a wider use of devices and apps to enable creative engagement.

It is fair to say that there were initial barriers to digital connection. Some NAPA members reported practical challenges, such as poor internet connection in rooms that were too far from the router, while others faced resistance to buying equipment or providing training.

At the start of the pandemic, several Activity Providers told us that they were using their own phones and tablets to enable residents to connect with family and friends. NAPA members reported that with the help of social media, local communities responded with donations of reconditioned electronic devices.

Without the support from wider communities, some care providers would have struggled to facilitate the social connections needed to maintain an individual’s wellbeing. Later, as the confidence of care homes grew, the government provided an iPad for every care home to enable digital connection.

COVID-19 was the catalyst for NAPA’s own digital transformation. To continue to offer our services, we also needed to be creative and innovative in our approach. In March 2020 we made the decision to digitalise all NAPA support services.

We suspended face-to-face training, audit and service reviews, conferences and support programmes, and we embarked on a period of transformation. After consulting our members, we developed the following digital solutions: eLearning and distance learning courses and qualifications, webinars, an online awards ceremony, and an online conference.

We transferred all our hard-copy resources to digital downloads, circulating free activity resources to care homes across the UK, and we extended our online presence across social media. This period of digital transformation was only possible thanks to the support of our members, partners and supporters; our entire focus was to be of use to our care home members at a time of crisis.

In April 2020, NAPA members called on us to publish our position on the importance of activity and engagement during lockdown. Following a period of rapid consultation and in line with government guidelines, we published our recommendations: a focus on the need for a ‘whole home’ approach, one-to-one connection, and the identification of key staff members responsible for maintaining contact between residents and their loved ones, facilitating digital connection through technology. In tandem, we published a series of resources encouraging socially distant activities and providing practical suggestions for one-to-one engagement and creative use of technology.

As the year progressed and we consulted with the sector, it became clear that there was a need for external support and advice for Activity Providers. In July 2020, with grant support from The Rayne Foundation, we extended the Helpline service to include a free phone line, email service and online support group.

To date, the helpline service has received approximately 2000 contacts. Before the pandemic, our responders received calls and emails from care and activity staff, arts practitioners and family members keen to talk through their ideas or dilemmas.

Many of our calls were from lonely Activity Providers – lone voices attempting to embed wellbeing into care practice – or family members seeking advice on ways to engage a relative.

During the pandemic, the nature of the calls changed. Approximately 90% of calls to the NAPA Helpline were about COVID-19 and the impact on activity provision. Approximately 70% were directly related to tech and digital connections, and 30% included an element of discourse around tech-based activity.

Our Helpline responders reported a high number of comments or queries acknowledging the essential nature of digital connection, as though it was being recognised for the very first time.

This has been the hardest of times, in the early months of the pandemic I couldn’t see my sister who lives in a care home. Thank you for encouraging me to use FaceTime. I know it sounds silly but seeing her face on a screen and her seeing mine kept us connected. It isn’t the same as giving her a hug, but not seeing her at all was unbearable.

- Family carer

There are many activities you can do with an Alexa, all by speaking to it. We do exercise to music – we start the day with some gentle exercise. To launch the programme, we just say ‘Alexa, start the 7-minute workout’ or ‘Alexa, start Engage workout’. Alexa talks us through the steps!

- Wellbeing practitioner

Using the Wii has been so much fun! You can get really involved and move around or play from the comfort of your chair. It is also fairly simple to use once you get going!

- Activities co-ordinator

Internet shopping has been a great way to enable the people we support to buy a gift or send a personalised card to a family member they have been unable to see.

- Activity assistant

We have really enjoyed visiting cities all over the world from the comfort of our armchairs! Virtual tours are such fun, enabling people to see places they have dreamed of visiting in person, it can be really powerful!

- Care home manager

As the restrictions begin to lift, family members and friends are starting to visit loved ones again and communal activities in small groups are slowly being reinstated. We are delighted to see how the arts are being used to help residents express their experience.

Thousands of care homes took part in the National Day of Arts in Care Homes on 24 September. The pandemic has forced us all to behave differently, and to connect digitally we had to embrace the technology that had previously baffled us. Care homes responded incredibly creatively to the countless challenges they faced.

We have all learned more about how to use technology, its benefits and its limitations.Technology is now used in care homes more frequently than ever before. It will never replace the importance of human connection, but it can support personalised and person-centred engagement and enhance the quality of life of people who live in care homes.

As we return to in-person interaction, NAPA will continue to support care homes to embrace technology beyond the COVID-19 pandemic. We must share the lessons we have learned and ensure that care homes and Activity Providers have the skills and resources to further embed technology into activity provision.

Each time we use a tech-based approach we have an opportunity to explore new ways to connect with an individual’s interests, background, culture and sense of self, allowing us to be inclusive, to learn more about the person we support, and to enable them to remain connected to the people they love and the things that matter to them most

To find out more about NAPA and NAPA membership, email membership@napa-activities.co.uk

To find out more about Arts in Care Homes, visit www.artsincarehomes.co.uk

To download our free resource, Getting Creative with tech, visit napa-activities.co.uk/ membership/free-resources

To contact the free NAPA Activity Support Service Helpline, phone 0800 1585503.

Hilary Woodhead

Executive Director, National Activity Providers Association (NAPA)

Hilary Woodhead is the Executive Director of the National Activity Providers Association (NAPA) and is responsible for all aspects of the association’s charities work.

Hilary first studied drama and later social care management, and her love of the arts and her commitment to providing arts-based activities for all has underpinned her career.

Before joining NAPA, Hilary led service improvement and workforce development programmes for health, housing and social care providers. She is passionate about dementia, engagement and practice development. She has worked in the sector for 30 years.