Quality standard
Quality statement 1: Participation in meaningful activity
Quality statement 1: Participation in meaningful activity
Quality statement
Older people in care homes are offered opportunities during their day to participate in meaningful activity that promotes their health and mental wellbeing.
Rationale
It is important that older people in care homes have the opportunity to take part in activity, including activities of daily living, that helps to maintain or improve their health and mental wellbeing. They should be encouraged to take an active role in choosing and defining activities that are meaningful to them. Whenever possible, and if the person wishes, family, friends and carers should be involved in these activities. This will help to ensure that activity is meaningful and that relationships are developed and maintained.
Quality measures
Structure
Evidence of local arrangements to ensure that older people in care homes are offered opportunities during their day to participate in meaningful activity that promotes their health and mental wellbeing.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from care protocols.
Outcome
a) Feedback from older people in care homes that they are offered opportunities to take part in activity during their day.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. The following documents from the Adult Social Care Outcomes Toolkit (University of Kent) include questions about choice and control, social participation and involvement, occupation and dignity: CHINT3 care home interview schedule and CHOBS3 care home observation schedule.
NHS Digital Personal Social Services Adult Social Care Survey (England) collects data on service users' views and opinions over a range of outcome areas, including satisfaction with social care and support and quality of life.
b) Feedback from older people in care homes that they have taken part in activity during their day that is meaningful to them.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. The following documents from the Adult Social Care Outcomes Toolkit (University of Kent) include questions about choice and control, social participation and involvement, occupation and dignity: CHINT3 care home interview schedule and CHOBS3 care home observation schedule.
NHS Digital Personal Social Services Adult Social Care Survey (England) collects data on service users' views and opinions over a range of outcome areas, including satisfaction with social care and support and quality of life.
What the quality statement means for different audiences
Organisations providing care ensure that opportunities for activity are available and that staff are trained to offer spontaneous and planned opportunities for older people in care homes to participate in activity that is meaningful to them and that promotes their health and mental wellbeing.
Social care, health and public health practitioners ensure that they offer older people in care homes opportunities during their day to participate in spontaneous and planned activity that is meaningful to them and that promotes their health and mental wellbeing.
Local authorities and other commissioning services ensure that they commission services from providers that can produce evidence of activities that are undertaken within the care home and can demonstrate that staff are trained to offer spontaneous and planned opportunities for older people in care homes to participate in activity that is meaningful to them.
Older people in care homes have opportunities during their day to take part in activities of their choice that help them stay well and feel satisfied with life. Their family, friends and carers have opportunities to be involved in activities with them when the older person wishes.
Source guidance
Personalisation: a rough guide. Social Care Institute for Excellence (SCIE) guide 47 (2012)
Mental wellbeing in over 65s: occupational therapy and physical activity interventions. NICE guidance PH16 (2008), recommendation 1
Dignity in care. SCIE (2006, updated 2020), Involvement and inclusion
Definitions of terms used in this quality statement
Care homes
This refers to all care home settings, including residential and nursing accommodation, and includes people accessing day care and respite care. [Expert opinion]
Meaningful activity
Meaningful activity includes physical, social and leisure activities that are tailored to the person's needs and preferences. Activity can range from activities of daily living such as dressing, eating and washing, to leisure activities such as reading, gardening, arts and crafts, conversation, and singing. It can be structured or spontaneous, for groups or for individuals, and may involve family, friends and carers, or the wider community. Activity may provide emotional, creative, intellectual and spiritual stimulation. It should take place in an environment that is appropriate to the person's needs and preferences, which may include using outdoor spaces or making adaptations to the person's environment. [Adapted from SCIE's support on dignity in care and freedom to choose, Royal College of Occupational Therapists' Living well in care homes and expert opinion]
Mental wellbeing
Emotional and psychological wellbeing. This includes self-esteem and the ability to socialise and cope in the face of adversity. It also includes being able to develop potential, work productively and creatively, build strong and positive relationships with others and contribute to the community. [NICE's guideline on older people: independence and mental wellbeing, terms used in this guideline]
Equality and diversity considerations
Staff working with older people in care homes should identify and address the specific needs of older people arising from diversity, including gender and gender identity, sexuality, ethnicity, age and religion.
When tailoring activities to the needs and preferences of older people, staff should be aware of any learning disabilities, acquired cognitive impairments, communication and language barriers, and cultural differences. Staff should have the necessary skills to include people with cognitive or communication difficulties in decision making (from SCIE's support on dignity in care, Information and communication). Staff should ensure that they are aware of the needs and preferences of older people who are approaching the end of their life.
When collecting feedback from older people about whether they have been offered opportunities for meaningful activity, staff should consider using alternative methods for older people who find it difficult to provide feedback. For example, tools such as the University of Bradford's Dementia care mapping can be used, and/or feedback from people who are considered suitable to represent the views of the older person, such as family members, carers, or an advocate.