The ROAM II Study: Realistic rehabilitation for Outdoor Activities and Mobility in care homes

20^th November 2018

Realistic rehabilitation for Outdoor Activities and Mobility in care homes is an exciting new research study which aims to increase residents’ opportunities to use care home gardens and outdoor spaces. Sponsored by Nottinghamshire Healthcare NHS Foundation Trust and funded by the Abbeyfield Research Foundation, the first phase of the study will involve refining the research protocol and an outline outdoor programme with care home stakeholders. Details of these will be presented in due course, but for now, please see below for some background to the study.

Background: Care home residents should be supported to take part in meaningful activities in their preferred places. Getting out into care home gardens and outdoor spaces can involve meaningful activities, such as, walking, enjoying sunlight, gardening and doing domestic jobs, and be important for quality of life. Supporting individualised outdoor opportunities is one way that care homes can deliver and demonstrate holistic, relationship-centred care – provision that recognises residents’ needs for occupation, social participation and control over daily life. The health and wellbeing benefits of spending time in outdoor environments are well-evidenced, however, many residents’ continue to lack opportunities to use care home outdoor spaces. Whilst there is an increasing array of outdoor design recommendations to draw upon, there have been few attempts to understand the challenges from the care home perspective.

The previous study (ROAM), which took place in three East Midlands care homes of different sizes, found that most residents needed staff support to move from inside to outside and once there, to take part in activities and move around. Weather, staffing levels/time, access and the outdoor spaces varied but overall, were barriers to residents’ outdoor use for much of the year. Nonetheless, there were occasions when some care staff - those who shared person-centred values and believed outdoor use was beneficial for residents - worked together to overcome these challenges. Furthermore, the presence of a researcher exploring residents’ outdoor use appeared to encourage some staff to reflect on small-scale, practical changes that might increase outdoor use.

Using principles from realist evaluation and appreciative action research, the ROAM II study aims to draw on the particular expertise and enthusiasm of care home staff, residents and family carers to refine, implement and evaluate the outline outdoor programme identified in the earlier study. The process will be facilitated by a research occupational therapist who will co-produce the programme in a tailored way in each care home for roll out. Our vision is to be able to build capacity and capability amongst care home activity coordinators and care staff, not only to increase residents’ outdoor use, but also to improve skills in delivering meaningful activities and relationship-centred care.

What’s happening next? ROAM II is a 22-month project which started on 01.10.18. We are currently in the process of identifying a care home in Nottinghamshire with a robust culture of outdoor use to consult with about the research protocol and the outline outdoor programme. An update will be provided in the next quarterly blog – with permission, we will include some stakeholder comments about the consultation process and/or outdoor use in general.

Whatever your role, please join in the discussion about working with UK care homes to increase residents’ outdoor opportunities via our twitter feed: @ROAM IIStudy

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