The provision of activities in care homes has long been on CQC’s radar. With the ever-increasing focus on person-centred care provision, it is more important than ever that providers take appropriate steps to ensure person-centred activities are provided to their residents on a daily basis.
Whilst it is not explicitly mentioned in the Regulations, the provision of activities can be interpreted by CQC to fall under Regulation 9 of the Health and Social Care Act (Regulated Activities) Regulations 2014 which states that the care and treatment of service users must be appropriate, meet their needs and reflect their preferences.
CQC’s Key Lines of Enquiry (KLOEs) and associated prompts, which are followed by inspectors during inspections of registered services, specifically refer to how people are supported to follow their interests and take part in social activities. The KLOEs also refer to ensuring service users are protected against social isolation. These requirements are reflected in the Characteristics for ‘Good’ under the Responsive question which state a ‘Good’ service “protects people from the risks of social isolation and loneliness and recognises the importance of social contact and companionship” and “enables people to carry out person-centred activities within the service or in the community and encourages them to maintain hobbies and interests.” Inspectors are prompted to look at the choices offered to service users, the resources available at the service to make the carrying out of activities possible and whether they are person-centred. We have seen examples where services have been deemed by CQC to be in breach of Regulation 9 by not providing appropriate person-centred activities.
In order to comply with CQC’s expectations and requirements, providers should ensure that activities provided are determined by service users’ life histories and their personal preferences. Activities can comprise of a wide range of forms. For example, for service users with dementia, the Alzheimer’s Society has shown that even simple activities such as conversations, joint participation in games and personalised music can be effective activities. The types of activities on offer will depend on the personal preferences and abilities of the individual service users within your care.
Examples of ways services can demonstrate compliance include:
- keeping records of discussions with service users including personal preferences in relation to activities. These can be discussed as part of the services admissions process and updated through regular care plan reviews.
- Recording individual service users’ daily activities. This should include recording when activities have been offered but refused and whether any alternative options have been discussed. This helps demonstrate that choices have been offered and that the service is protecting against social isolation.
- Seeking feedback of activities from service users and others involved. This could be during resident and relative meetings which can be minuted or through formal feedback forms.
- Employing a dedicated Activities Coordinator. They should have the appropriate skills to implement effective activities programmes for the type of service users accommodated at the service. For example, if the service accommodates residents with dementia they should have appropriate training on effective activities in this area.
- Regular audits of the activities provision at the service.
Although many examples of good practice are seen daily throughout the care sector it is often the case that only the negative is highlighted and portrayed to the public. Providers should not become complacent with the provision of activities for their residents – it is vital that appropriate stimulation in a person-centred manner is continually encouraged throughout the sector.