What was the issue you were addressing or working on?
This Example of Practice focuses on a range of initiatives within one specialist older person’s housing complex which included straight forward design enhancements and provision of respite accommodation. There were two overarching issues:
- the design and accessibility of specialist older person’s housing common areas and the impact this has on older people’s capacity to be involved in social interaction opportunities; and
- the aim to improve the range of respite options available to older people and their carers.
It was identified that participation from tenants and older people from the wider community was significantly hampered by the design and layout of specialist older person’s housing common areas. The accessibility issues to access the common room coupled with the design of the actual common areas had resulted in some instances that tenants were unable to gain access to the common areas unaided and when using the common areas were particularly limited in their capacity to engage in activities safely.
The common areas were accessed via traditional fire doors and the design although a relatively new build purpose built specialist development presented challenges for older people who had a memory problem, physical disability or frailty or visual impairment.
Access to social opportunities and engagement in meaningful activities is crucial in maintaining and improving health and wellbeing and is of particular importance within specialist older persons housing in helping older people feel socially included and connected within their communities.
Improving support for carers was also identified as a priority and the development of new respite provision within the specialist older person’s housing complex was also an objective.
What you did?
Resources: Change fund allocation for both ‘developing and enhancing housing’ and ‘respite project’.
Action: A joint assessment was carried out by NHSL and NLC occupational therapists to identify design improvements for the common areas which would improve accessibility and enhance the environment to enable participation from older people in a range of social opportunities.
Respite flat furnished and procedural guidance and processes developed; managed and planned through locality planning groups.
Implementation: A number of accessibility improvements were completed. This included:
- Installation of automated (sensor opening) doors
- Design enhancements to the common areas incorporating ‘dementia friendly design’ principles, contrasting seating and flooring, improved signage, improved lighting, provision of furniture to meet varying needs and to support engagement in activities for people with physical disabilities
Involvement and Consultation: This case study emphasises a co-production approach which capitalises on the expertise and knowledge held across specialist professionals and tenants to identify barriers and obstacles to participation and solutions to address these. Participation meetings were held with tenants and staff to capture feedback on priorities for action. Follow up focus groups were held with tenants and staff following improvements to measure impact on shifting the balance and the outcomes the project contributed to.
In respect of respite project, active involvement of tenants in proposals and the third sector have played a key role in the promotion and development of the model with a particular emphasis on promotion for carers in North Lanarkshire.
What were the outcomes - benefits or otherwise?
Outcomes: A number of positive outcomes were achieved for older people as a direct result of this project. This included:
- reduced social isolation
- improved health and wellbeing
- increased independence achieved through improved accessibility which has enable older people to participate in activities without or with reduced support
- reduced reliance on formal supports and services
- reduced reliance on informal supports
- improved support for carers
- more older people feeling connected to their community
- anticipated reduced admissions to hospital related to environmental incidents (falls)
- older people with more complex needs supported within the community as opposed to acute settings
- improved housing infrastructure which better meets the needs of older people with complex needs and is more sustainable in meeting the needs of an increasing older population
- a model of practice/practical guide for re-design for future cyclical and refurbishment programmes in other sheltered housing complexes
The majority of the benefits associated with improved design have been realised relatively close to completion of work and this has been communicated directly through tenants and other older people who use the common areas via focus groups held. The outcomes of the respite project have yet to be fully explored as this model is evolving as learning is being shared across other localities which also provide respite accommodation to improve usage and targeting of resource.
The timeline for this case study spans 2012-2014, with potential exploration of extending respite project until the end of the change fund programme.
Following ongoing review of the projects and this particular case study the respite project would have benefitted from:
- clearer criteria for usage (in terms of carers and older people and circumstances) at the outset
- more focussed and driven promotion of resource across carers groups to maximise usage
In terms of the design enhancements, this work would have been improved through extending accessibility measures to other communal areas within the complex, i.e. corridors and other areas used by the public to improve accessibility further.
Contacts - to find out more
Margaret Kelly, firstname.lastname@example.org 01698 274154