Quality improvement through the paradigm of learning

Abstract

Purpose: If we are to achieve meaningful participation and co-production for older people using care, then more radical approaches are required. This project explores an innovation where older people using social care were matched to community based learning mentors to develop partnerships within which learning interventions were facilitated. We explore how the concept of learning underpinning this innovation might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship based approach to promote wellbeing in later life.Design/methodology/approach: A structured evaluation drew on qualitative data captured from individual interviews with older people (n=25) and their learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. The data was contextualised alongside interviews with relevant stakeholders (n=10) including a care home manager, social care and education commissioners, Trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement. Findings:Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, we suggest that a paradigm of learning offers an innovative framework for encouraging older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure through the mechanism of learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through the reciprocity generated and by using an asset based approach. There were benefits for care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support.Originality/Value: Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Engagement in learning activities can help to nourish and sustain membership of the community which is significant for marginalised populations such as older people living in care homes.

Dog‐assisted interventions and outcomes for older adults in residential long‐term care facilities: A systematic review and meta‐analysis

“…This is particularly important in the context of significant challenges for making further resources available and to develop tools and approaches to strengthen formal and informal caregivers’ relationships with older people living in hidden communities. This includes identifying interventions that foster capacity building in RLTCF that expand and encourage the use of broader social roles in the local community (Hafford‐Letchfield & Lavender, 2015). Some of the themes from the review captured the unexplored potential of partnerships with DAI provider agencies and local community members coming in with their pets and that there may be wider benefits for those involved.…”

Access to Learning Opportunities for Residents in Care Homes: Reviewing the challenges and possibilities

“…WHO [6] stress that in long term care, formal and informal carers have the duty to "ensure that a person who is not fully capable of selfcare can maintain the highest possible quality of life, according to his or her individual preferences, with the greatest possible degree of independence, autonomy, participation, personal fulfilment and human dignity". Providing learning opportunities for people in long term care, supported by existing community resources, has been carried out in some areas [7][8][9][10][11][12] and could be rolled out to infuse a culture of leaning in the nursing (care) home sector.…”

“…The focus of this paper centres on active learning for residents in nursing (care) homes, targeted to an individual's learning requirements, rather than leisure activities, decided by staff, in which people are either passive observers or recipients. This distinction is important to make [11,13,14], because learning embraces healthy ageing; it involves purpose, engagement, self-development, fulfilment and growth. It also serves to address the stereotypical assumptions that 'old' people have lost the capacity to learn.…”

Single women living alone in later life

“…Education is demonstrated as an important determinant for health and happiness among this group of women. The benefits of education and learning, particularly programmes and interventions which engage older people are beginning to be increasingly researched (McNair, 2009;Hafford-Letchfield, 2011;Hafford-Letchfield and Lavender, 2015;Hafford-Letchfield, 2016). These have made some…”