‘The Tuesday Coffee Meeting’

1. ‘The Tuesday Coffee Meeting’ Planning and delivering continuous improvement for dementia service provision. Julia Pitkin Dementia Care Trainer & Care Assessor for 360 Forward Ltd www.360fwd.com T: 01483 275555

2. Proof of the pudding! A Philosophy - Person Centred Care Culture – “Well great, but what does that mean exactly?” You need to demonstrate and speak your values at 3 levels. “What the person wants to experience”(Outcomes) “the actions we will take” (Processes) “how we are going to behave” (Structures) www.360fwd.com T: 01483 275555

3. The drivers for service improvements are the people living with dementia. Their feelings and views of their own needs and wants are centralto the work carried out in a care organisation. The way they want to live their lives become our service objectives. “How are things done around here?”“Just the way the residents’ want!” www.360fwd.com T: 01483 275555

4. 360 Forward have developed a Standard Framework that incorporates the voices of people living with dementia (Duff & Hurtley 2011). www.360fwd.com T: 01483 275555

5. A Specialise Communication Group The Team at Ireland Lodge a Social Service run Care Home, Sussex used the ‘Validation Group’ structure (Feil 1993). Our Service Improvement grew out of the desire to develop more meaningful relationships between people with dementia who live together, with the aim to create a genuine community within the care home environment. • Six residents were invited to join the group, who chose to call it the ‘Tuesday Coffee Meeting’.+ a facilitator and co facilitator. • Same members with roles that complimented their strengths • Same time, 30 minutes every Tuesdays, • same place, same seating arrangement • Same routine and flow, no task or agenda, no failure • 24 consecutive weeks, although the meeting continue for many months after. www.360fwd.com T: 01483 275555

6. Embracing Individuality • Firstly, it involves an understanding of the person, their life story, personality, their remaining skills and strengths. • Secondly, bringing people with complimentary needs together in a small structured group that over time becomes a trusting and safe place to share and support each other. • Finally, the opportunity to explore feelings and experiences that arise living in the care home, by using sensitive communication techniques such as rephrasing, mirroring, matching emotions and tone verbal polarity, touch, reminiscing and music . www.360fwd.com T: 01483 275555

7. Outcomes- what we saw and heard • Conversations centred on universal themes heard every day in our care homes; need for affection, getting old, missing our mothers, loosing loved ones, waiting to go home, living with strangers • Strong personalities emerged that previously had gone un-noticed. • The meetings identified other unmet needs, which could be met in other programmes and friendships outside of the group. • Conversations could be heard among members after the meetings were closed. • Members welcome the opportunity to express themselves and share experiences. • Members demonstrated resourcefulness and wisdom in meeting their own emotional needs and in supporting others. • Articulation , expression, movement, all improved www.360fwd.com T: 01483 275555

8. Communication skills and personal attributes needed by staff • A clearly spoken and understanding of the language familiar to the person living with dementia. • Therapeutic conversational skills to help recognise the deeper need and responding sensitively, acknowledging and validating feelings. • Emotional intelligence and confidence to take opportunities as they happen and to go with the feelings that arise. • Non threatening and confrontational prompts set in the ‘here and now’ e.g. “How do you feel about the food here?” and not cognitive, e.g. “What is your opinion of the meals you receive at Ireland Lodge?” • Confidence to act on what we they have heard and to feedback to the team. • Where communication training leads to improvements in quality of social interactions between staff and older people- leads to improvements in older peoples quality of life and wellbeing (SCIE 2012). www.360fwd.com T: 01483 275555

9. Planning a Change • The project maybe instigated by the resident, but the drive to change is powered by the whole staff team. • Right at the beginning relatives&friends are involved. • Start with a daily routine, a way of doing things for the better “How do residents feel about mealtimes?” How does Mrs Smith feel about gets up in the morning?” • It must be inter-departmental. • It has a commitment that demonstrates encouragement, positive language and attitude. There must be ‘we can do’ attitude as opposed ‘it’ll never work, I told you so’ attitude. • Mistakes and appropriate risk taking are welcome and are essential to the learning process. • Reflection and evaluation of the project with its success & developments discussed daily. • Changes in the residents’ wellbeing and the process that made this happen are recorded daily. www.360fwd.com T: 01483 275555

10. Tips for Success • Staff have reported that when a positive change clearly results in residents’ wellbeing it gives them greater job satisfaction (Duff & Hurtley 2011). • Staff feel that when their personal contribution is heard, valued and acted on, this gives them a sense of ownership and commitment to the project. (Duff & Hurtley 2011). • A feeling of team spirit, commitment, working toward the greater good and common goal. Nursing staff, housekeepers, maintenance person, Kitchen staff and dietary staff, carers and activity co-ordinators, visiting professionals and management and proprietor • Interdepartmental collaboration is an essential ingredient. • Involvement of families is an important part of the team, planned changes in routine must be explained in terms of the benefits on the resident (Duff & Hurtley 2011). Otherwise they can feel excluded and under-valued , this can jeopardise the whole project. • Team skills, therapeutic conversational skills, project management, communication skills, observational skills, leadership skills. www.360fwd.com T: 01483 275555

11. Be imaginative with ways to encourage people to express themselves Art, Poetry & Music Observation Dementia Care Mapping Prompts & aids Picture, word, an emotion Specialised communication groups Talking Mats ™ www.360fwd.com T: 01483 275555

12. Continuous Improvement www.360fwd.com T: 01483 275555

13. References and reading: Allan, K. (2001) Communication and Consultation: Exploring ways for staff to involve people with dementia in developing services. Bristol: Policy Press. Feil, N (2003) Validation The Feil Method How to help the disoriented old old part 4 pg 108 Feil Productions, Cleveland Litherland R. (2008) Involving people with dementia in service development and evaluation. Production, Mcgraw−hill. www.innovationsindementia.org.uk/rachael.htm Duff P & Hurtley R (2011) The 360 Standard Framework (360 SF)™, The 360 Foundation. www.360fwd.com National ‘Living with Dementia’ programme was launched by the Alzheimer’s Society (2000) in response to people with dementia who had their voice heard in an organization that represented their interests: ‘Listen to us, hear us, we are here.’ Talking Mats™ Talking Mats Centre, Stirling University Innovation Park, Scotland. www.talkingmats.com www.360fwd.com T: 01483 275555