Text size: a | a | a

Activities care planning and participation

 

Why we are interested in care planning and participation.

Recognising the importance of activity and the need for individuals to be included, regardless of their impairments, is essential when encouraging individuals' participation and social interaction.

Recording and using information about an individual's life history is important when including activity in the care planning process.To achieve a positive outcome with planned activity, biographical knowledge combined with information about the individual's current strengths, expectations, wishes and needs is required.

The aim is always to assist the person to function as independently as possible

What we would expect to find

We would expect a good activity plan to be created, followed, reviewed and updated to accurately reflect the individual's needs.As well as reviewing the suitability and adaptability of activities, we would expect important information to be collected about the individual's satisfaction with regard to activity provision.Most importantly we would expect to see the activity plan integrated into the individual's care plan.

What we found

From examining individual's case files and observing the activity culture, the visitors found wide variations in the quality and quantity of recorded information about the activity and social needs of individuals.At one end of the spectrum this comprised no involvement of the individual, relatives or carers, no record of individual's likes/dislikes, hobbies and interests and therefore no mention of how activities could be used in addressing identified needs in the care plan.One carer stated he had never been consulted by any member of staff about his wife's interests or preferred activities, or even just about her in general.The visitor noted,

"There is no documented evidence to show that meaningful activities are embedded in this lady's daily routines and how they could be used to treat her anxiety and depression."

A son told a visitor that in his opinion, his mother was still experiencing a huge sense of loss following the death of her husband a few years previous.The loss had had a significant impact on her wellbeing and day to day functioning yet no-one seemed to be offering her counselling, or indeed any activities, which might help her to cope prior to and since her admission.

At the other end of the spectrum we saw care planning informed by personal history profiling with input from family and carers to identify the individual's activity choices and preferences.

We found examples of individual's activity preferences being recorded, we witnessed staff consistently engaging with individuals through the use of activity, asking individuals how the activity affected them, varying the levels of support offered to maximise participation but found little of this valuable interaction recorded in case files.

Good practice examples

Example 1

"There is documented evidence of the daughter's concern about the need for her father to be involved in a range of activities to minimise his tendency to withdraw into himself.The occupational therapist has completed an initial interview form on which his self care, domestic and leisure activity preferences are clearly recorded.The nursing plan records the need for this gentleman to participate in a range of daily activities to improve his low mood and reduce his anxiety.The physiotherapist has assessed this gentleman's mobility by taking him for a short walk outdoors and is now involving him in an exercise group to improve his fitness and to provide an opportunity for social interaction.Dental and optician appointments have been scheduled.

Example 2

A visitor found helpful documented examples of a person with dementia's personal preferences with sensitive and practical advice for all staff involved in his care on how to build rapport and maximise his engagement in everyday activities.

Dislikes having his hands held, do not ask direct questions as he will abandon the activity. Likes to listen to conversation rather than join in. He particularly enjoys being read to.

Example 3

An Asian man was experiencing delusions and was socially withdrawn when he was admitted to the ward. His wife spoke no English. An interpreter facilitated communication between the staff and the wife to identify his hobbies and interests. This resulted in the staff sourcing his favourite Indian music. It also helped staff to identify people who were good friends of her husband. One friend lived elsewhere in the UK and another lived abroad. The staff arranged telephone conference facilities between the three friends to nurture support and meaningful communication.

Action needed

  • Biographical information about the individual must be recorded and kept up to date to inform the care plan and activity provision.
  • The individual's activity preferences, interests and abilities must be regularly reviewed, and outcomes and satisfaction recorded in the care plan and evident in practice.
  • Care planning should be person centred, use a range of therapeutic interventions and reflect changes in physical and mental health.
  • Care plans should be regularly audited to ensure that preferences, interests and abilities are assessed, monitored and reviewed.