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Output from Community Falls Leads Meeting Hosted by Ann Murray

Output from Community Falls Leads Meeting

I.E.T Teacher Building, Glasgow

14th December 2017

Prepared by Fiona MacNeill Associates

DISCOVER

DREAM

DESIGN

DESTINY/

DELIVER

STORIES HOPES PLANS ACTIONS &

IMPACT

MEASURES


The following document is a summary of 4 Appreciative Inquiry conversations that took place at the

I.E.T Teacher Building, Glasgow on the 14th December 2017. This has the purpose of:

Sharing ideas

Capturing themes in terms of the best of now

Identifying hopes for the future

Seeing ideas about what could change

Summarising personal commitments for all attendees to enable them to follow through

Summarising recommendations into the wider system to inform operational/strategic actions moving forward

The Appreciative Inquiry’s covered 3 areas concerned with developing new ways of working

connected to evidence based falls prevention:

Supporting people (with a range of needs and preferences) to participate I evidence based exercise

Working collaboratively and creatively with partner organisations

Working collaboratively and creatively with older people, families, carers, and the wider community

The appreciative Inquiries took place in 4 groups:

GROUP ONE: Facilitated by: James Brown

GROUP TWO: Facilitated by: Lianne McInally

GROUP THREE: Facilitated by: Mark Hamilton

GROUP FOUR: Facilitated by: Grier McGhee


GROUP 1 - DISCOVERY – THE STORIES AND THEMES What is your best story of working collaboratively with others, to support older people, to participate in evidence based exercise?

In the best experience I:

Provide personalised solutions for individual patients

Work positively and collaborate with the 3rd sector to create opportunities

Go the extra mile

Help people to have fun and build their confidence

Have conversations to create links with the appropriate people

Learn from others

Work together with others to provide the best outcome for all

In the best experience we are focused on: Support, Fun, and Collaboration

DREAM – THE HOPES What if this best was every day?

In the dream for the future we are focused on: Choice, Connectedness, and Personalised Goals


DESIGN – THE PLAN

Stand in that future, what is happening that is embedded/different/measureable?

Supporting people (with a range of needs and preferences) to participate in evidence based exercise

We have meaningful conversations with every older person about their needs, preferences, choices and goals

We co-create a tailored goal oriented activity passport, revisited at transactional stages, (outcomes/sector/functional change) and supported by a key worker to enhance adherence and support self management

We train and facilitate sufficient staff in our 3rd sector organisations to provide evidence based exercise at different levels of functional capacity to ensure immediate access when needed


We provide a personalised multi agency service that is responsive and accessible to the population when the need is identified

We use technology to enable seamless transitions to drive improvement and to support rehab recovery

We train our workforce to co-create evidence based pathways within the community which are personalised and outcome focussed


We have person centred meaningful, goal setting conversations with service users and their families

We provide a range of support, activities and services which enables the individual to achieve their goals with the use of local assets available to all

We monthly sample services users for data on experience, impact of interventions, quality of life and participation

DESTINY – THE ACTIONS AND IMPACT MEASURES


The idea I personally commit to is:

Gail Tripney

Activity passport – how mapping has been done in local community classes. Could look at introducing a

Forth Valley one through strategic group?

Have meaning conversations with older people about their needs, preferences, choices and goals. How –

measure impact by documenting initial conversations, regularly revisiting outcomes/needs

Craig Ross

Implement sit to stand exercise, rated on evidence base, for all resident rehab patients across all physio

and support working staff, by end of January 2018

Shona Findlater

Promote the use of meaningful conversations with patients and families re goals

Rosie Cooper

Challenging the direction at before development regarding level 2 screening to ensure we are achieving

supported S & B ex delivery for our domiciliary patients (Physiotherapy service) by 31/12/17

Sheena Wight

Evidence based pathways (transitions)

Val Redpath

Promote and support engagement with EBE


Dawn Skelton

Increasing training opportunities (EB) for 3rd sector organisations (GCU/LLT/NO. trained)

Influence policy of minimum effective numbers for ‘treatment’ – change of policy’

Helping to create a template ‘activity passport’ (tailorable!) Uptake use of passport can be

recorded/documented

Sarah Mitchell

Work with Ann and Dawn to develop a nutritional activity passport.



Ruth Muir

Improve data collection to drive improvement

Shona Findlater

Facilitate evidence based pathway in communication

Craig Ross

I will agree a formulised partnership for evidence based exercise delivery by jointly agreeing a service

level agreement by end of January 2018, measured by joint staff delivery of classes

Ruth Muir

Ongoing training (multi agency) across the pathway – stakeholders are confident and focussed on

individual outcomes

Sarah Mitchell

I will work in the TEC team to identify what tech could support us

Support progressing the whole IT system for wider AHP services



Val Redpath

Having person centred conversation with every older person and families about their goals, needs,

choices

Sheena Wight

Collect data and analyse the impact of intervention Q02 and participance

Trained workforce (multi agency)

Craig Ross

Collate and share across res rehab staff a map/directory/menu of all available home exercise options for

currently housebound people, working with a range of wider supports /community and coproduce by

end of February 2018

Ruth Muir

Supporting people – Lanarkshire has a falls register. Could this help in development of activity passport

(likely a natural project) but we may be able to contribute?

Rosie Cooper

Explore using activity passports with sport – with sport Aberdeen white we revisit the whole referral

process by February 2018

Having impact measure following level 2 interventions G/12 post referral

Val Redpath

Reporting and promoting work with 3rd sector

Shona Findlater

Map activities available to Inverclyde to increase participation


GROUP 2 - DISCOVERY – THE STORIES AND THEMES What is your best story of working collaboratively with others, to support older people, to participate in evidence based exercise? In the best experience I:

Facilitate collaboration with stakeholders

Take a person centred approach to deliver tailored interventions

Create a range of opportunities for sharing and learning to raise awareness of community assets

Work out with my traditional boundaries to deliver person centred care In the best experience we are focused on: Collaboration, Person Centeredness, and Community Engagement


In the dream for the future we are focused on: Inclusive, Encompassing and Community


DESIGN – THE PLAN



We are providing exercise for all in different locations at a time to meet everyone’s needs

We offer exercise opportunities which are easily joined by all individuals

We share information with partners on individual progress on their exercise journey


We have access to one system/database which allows access for all stakeholders including the person at centre of care to record care plans/interventions and participation in exercise e.g. My Account

We ensure every older person has access to a named person (life coach) who supports them to participate in evidence based exercise appropriate to them/their needs

We monitor and evaluate the impact of implementation in terms such as participation, adherence and confirmation of attending evidence based exercise


We have a community planning partnership that’s supports health and wellbeing by designing

accessible places and infrastructure that supports evidence based exercise

We work with communities to define opportunities for intergenerational working by embedding

PSI training/delivery in a variety of settings

We promote exercise as a way of life working for communities starting from early years through

later life by means of education information and resources




Kirstie Stenhouse I will work with community otago providers to explore what barriers there are to people accessing otago programme and seek to reduce these Elaine Reid Improve communication between acute care (inpatient falls) and community to help facilitate awards rehabilitation and strength balance exercises Rebekah Wilson Exploring opportunities to provide evidence based exercise in different settings and by different people Wendy Nimmo Ensure I let everyone in my family and social circle know about the importance of mobility and balance Rachel Mills Do training with stakeholders re importance of evidence based training and how to encourage and sign post individuals/service users to exercise programmes Nicola Lauchlan Pilot follow up telephone calls to programme participants to enquire if they have continued exercising and encouraging them to Hazel Webb Exploring with our partners how we can increase exercise provision to different locations and time across the city


Angela Create opportunities for sharing of information to ensure person centred care Mary Angela McKenna Undertake survey of staff skills to identify skills and training needs in delivering E.B.P Roz Barclay Work with my partners in Active Fife etc. to tailor information to encourage people to take up exercise opportunities to reduce the 40% of people referred and don’t access classes Ann Education/awareness raising of exercise “National Campaign” exercise for everyone



Wendy Nimmo Ensuring that I try and explore individual’s journeys from Acute hospital to home Angela Work collaboratively with all stakeholders to ensure everyone is supported enough to access exercise groups Kirsty Stenhouse Developing a space on health record system to record community physical activity adherence/participation Mary Angela McKenna Work with 3rd sector to support working practice in delivering PSI training – utilising local schools and universities Elaine Reid Work towards a single system/database to record care plans. Intervention from hospital to home or home to hospital Hazel Webb Work with partners in city to improve opportunities for different types of provision Nicola Lauchlan Altering discharge letters to reflect evidence based nature of the exercise completed and desired continuation – informing GP’s Rachel Mills Work with local stakeholders to develop evidence based exercise programmes in the community Roz Barclay Persuade the chair of the community falls group that we need to widen the membership/contact list to share awareness and develop a learning network Rebekah Wilson Work with the volunteers to support Falls App and supporting continued exercise Ann Influence universities around provision of exercise opportunity placements. Volunteering opportunities to support local areas. Health and wellbeing part of community safety includes prevention/health promotion Working collaboratively and creatively with older people, families, carers, and the wider community


Wendy Nimmo Carry out education, patient stories to share with the wider community Claudine Brindle Work with AHP teams to increase their awareness of the carers centre services to increase referrals Hazel Webb How we could explore/monitor individual’s progress along their exercise journey


Angela Promote exercise from early years to later life Mary Angela McKenna Explore options for increasing use of technology to support home based evidence based exercise programme. Pilot use and explore funding. Elaine Reid Support the teams promoting exercise as a way of life Nicola Lauchlan Increase engagement with other teams and community partners to deliver education about evidence based exercise e.g. carer centres/senior forums Rebekah Wilson Working with Active school partnerships to promote exercise for all ages Rachel Mills Discuss feasibility of allowing carers/family to attend/participate in classes with service users Kirsty Stenhouse Promote benefits of physical activity for bone health and falls through ensuring the information available locally - leaflets – on line information – face to face education Ann National campaign exercise as a way of life. Carers being involved in falls classes (Risk Myth Buster)



• Am creative in finding the approaches that would work in order for people to participate • Created an environment in which people could come together, to share experiences and be

motivated • Had conversations with people about what mattered to them

In the best experience we are focused on: Engagement, Camaraderie and Conversations


In the dream for the future we are focused on: Connectivity, Creativity and Co-production


DESIGN – THE PLAN



We have evidence based exercise provision which meets individual goals

Our partnerships support people who require transport to access exercise

Everyone can access the information they need in a way that works for them


Our workplace culture embeds exercise into our daily working lives

Our partner organisations take responsibility for participation in evidence based exercise

Exercise resources will be deferred in ALL partners strategic plans


We follow the evidence base for duration and dose of exercise

We are proactive in all our approaches

We have people exercising 150/week minimum


Supporting people (with a range of needs and preferences) to participate in evidence based exercise The idea I personally commit to is:

Alison Clark Ensuring access to better balance classes for those in Angus by providing transport provision for those who require Elaine Marsh Ensure RSWs in my service have the up to data knowledge and skills to provide and support evidence based ex in appropriate dosage etc. Sandra Lawler Supporting people with their exercise choices – allowing follow up and regular support – 3/6/9 months Anne Mitchell Ensure that exercise is the core component part of the working practices and ethos of my team Carolyn Wilson Leisure working in sheltered housing complex providing group exercise and S & B exercise and also one to one exercise for people unable to/not wanting group Sandra Lawrie Transport will be continued for those patients requiring it to be able to attend class for frail fallers Lorna Brown Seek to have more staff trained in otago and benefits Deirdre Moss Have the right conversation ‘what matters to you?’ with individuals Ann Moss Pilot healthy villages (like Lorne in Oban) Stop talking about older people – involve everyone Take assessment and exercise to remote neighbourhoods National public health campaign – positive experience of enjoying exercise and benefits Margaret Anderson

Check that our current interventions are meeting the evidence base


Deirdre Moss In January 2018 in Aberdeen I will undertake community profile to map community exercise provision



Elaine Marsh Ensure falls group are all engaged to the extent required in the design statement – more action feedback at EDFOG Anne Mitchell Promote E/Based exercise and promote public health messages related to this within our falls strategy Carolyn Wilson Planning a partnership event for all agencies to raise exercise agenda on partnerships Alison Clark Ensuring all AHPs are aware of the correct dosage of recommended exercise Sandra Lawrie The single leg balance challenge will be incorporated into all HSCP meetings Lorna Brown Limited referral criteria Sandra Lawler Providing education and training about active ageing and evidence based exercise Deirdre Moss Work collaboratively with partner agencies to support exercise in right dosage Margaret Anderson Discuss with staff how we open meaningful conversations on how to promote exercise Working collaboratively and creatively with older people, families, carers, and the wider community


Elaine Marsh Continue to build on evidence based community engagement to bring partnership to point where key messages are embedded Anne Mitchell Taking every opportunity to get out amongst the public and start the conversation about falls and exercise Carolyn Wilson Through CAPA and supported by training from main care home staff to deliver S & B exercise Alison Clark To find out about current up to date technological resources available within the partnership to support exercise provision in the community Sandra Lawrie Review and share the evidence base for duration and dose of exercise with those providing evidence based exercise Sandra Lawler To instil and develop evidenced exercise resources to families/carers – balance challenge/ex advice Margaret Anderson Meet with patient/carers groups to promote physical activity Deirdre Moss In January 2018 in Aberdeen – undertaking community profile to map community exercise provision



Engage others in realising the benefits to them

Notice that people are supported every step of the way

Notice that communities are capable of delivering evidence based exercise In the best experience we are focused on: Motivation, Connectiveness, and Empowerment


In the dream for the future we are focused on: Energising, Dynamic (choices) and Encompassing


DESIGN – THE PLAN



We encourage people to choose support for exercise participation as part of their self-directed support package

We provide, for people living in sheltered housing and assisted living complexes, the opportunity to participate in regular, ongoing evidence based exercise for falls prevention

We use all opportunities to promote and encourage uptake of a wide range of options for participating in evidence based exercise for falls prevention


We use the same measureable outcomes across sectors

We use technology to create opportunities in housing, for individuals to undertake evidence based exercise

We have changed behaviour resulting in increased uptake of evidence based exercise


We are undertaking more level 2 conversations within our primary care teams

We are delivering information/education sessions across the community to increase knowledge and understanding of calls

We are increasing opportunities for individuals to have local access to exercise by working with communities in a co-productive way


Supporting people (with a range of needs and preferences) to participate in evidence based exercise The idea I personally commit to is:

Ged Quirk Contact OD in my local authority and ask for leisure services to distribute ‘activity brochures’ to care homes/sheltered housing Irene Corcoran I will have conversations with families/patients on opportunities/lack of exercise/activity Joan Pollard

I will work with sync group to develop active ageing opportunities

Lynne Siddiqui

Spreading East Ren Pathway for falls to promote opportunities to encourage uptake of exercise options

Ann Murray

I will improve my knowledge and understanding of self-directed support

Shauna Stockan

I will liaise with 3 groups to educate on the outcome measures we could all use

Shona Strachan

I will explore choosing exercise as an option

Mascha Tauro

Come up with different way to support people to do exercise at home via DVD/video link

Christine McArthur

Agree outcomes across sectors testing single leg stand. 6 minute test and partners




Mascha Tauro To work in leisure to provide more directed exercise for frail people across the whole city Christine McArthur Working with leisure across Highland to develop evidence based exercise for falls prevention Joan Pollard I will meet with Scottish Care around falls prevention activities in care homes in Dumfries and Galloway Ann Murray I will link with the TEC programme/SCTT and the housing sector to identify current and future technology solutions for supporting evidence based exercise Lynne Siddiqui Embedding level 1/level 2/measureable and consistent outcomes across Eat Ren HSCP and partner organisations Shauna Stockan I will use all opportunities to promote the uptake of exercise and falls prevention Irene Corcoran Look at exercise numbers and of patient’s activity Working collaboratively and creatively with older people, families, carers, and the wider community


Christine McArthur

Take the balance challenge

Irene Corcoran

I will work closely with my local community colleagues to identify most appropriate

education/information services

Ann Murray

I will ensure learning and development guidance and associated resources are produced that support

people to have effective level conversations

Mascha Tauro

I will organise more information dates in communities (church halls, coffee morning etc.) to encourage

exercise/falls prevention

Shauna Stockan

I will deliver 3 information education sessions to community groups in the next 6 months

Lynne Siddiqui

Ongoing training (development and delivery) of falls awareness/risk factors/importance of exercise

across East Ren Community

Joan Pollard

As board lead I will ensure NHS D & G will finalise and roll out its falls training

Shona Strachan

I will continue to work in GCRA i.e. sport and physical activity to develop options for communities

National Action Working collaboratively and creatively with partner organisations


Raise awareness of EBE and National publicity campaign




Link to colleges – HND/HNC etc. Working collaboratively and creatively with older people, families, carers, and the wider community


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