Debbie Westhead, Deputy Inspector of the CQC Blog Post

For this month’s message I am not going to repeat any of the key messages you will already have received.  What I am going to do is concentrate on one day in October when I joined a T’ai Chi exercise session at Prior Bank Care Home in Sheffield; and this is when I began to feel old and it spurred me on to get fitter.  You will recall from previous messages that I have been on a bit of a journey over the last six months looking at how we can encourage and stimulate excellence in the care sector (it is a strategic priority) and encourage improvement. You may recall that I have previously mentioned my work with Comic Relief and The Reader which is a national charitable enterprise working to connect people with great literature and with each other and they received one of the grants.  Action for Elders Trust also received one of the grants and it was my privilege to meet the CEO, business development manager and physical mobility practitioner and learn more about the Trusts work.

Action for Elders Trust was established in 2012 and their vision is to co-create a society where older people can live with as much independence and happiness as possible.  The Trust currently delivers this through its flagship programme, Balanced Lives, which has supported more than 1,000 older people living in the following locations across England and Wales: The Vale of Glamorgan, Cambridgeshire,Sheffield, Herefordshire and York.  The programme is delivered in community settings – typically, community centres, day centres and care homes – for local residents, many of whom are referred by their GP or another healthcare provider.

The original Balanced Lives model was the product of nearly six years of research and development by the Sheffield Institute of Studies on Ageing (SISA) at Sheffield University; and the extensive academic and operational research showed that whilst longevity was increasing, the average ‘healthy age’ was still only 63.  SISA identified a gap in health care provision, particularly for those aged 75 and over and Action for Elders aims to fill this gap.  There are three programmes delivered and I attended the gentle movement and exercise programme based on T’ai Chi practice run by David Lipka, a Physical Mobility Practitioner.  The weekly hour long session focusses on the five evidence elements for improved mobility in older people – balance, flexibility, endurance and sustainability (Cochrane, 2009).

Prior Bank Care Home is operated by Anchor Trust and at its last inspection in April 2015 the service was awarded an overall rating of Good.  David has been meeting with a core group of residents for just over 12 months and during this time he and the staff at the home have noted a measurable difference in people’s confidence, strength and mobility.  The care home has also reported a reduction in falls and an independent evaluation report produced by NHS consultants, WPCS, shows that the Balanced Lives programme:

• Reduced prescriptive drug intake amongst beneficiaries by an average of 30%
• Achieved a six fold increase in balance, suggesting a substantial saving on the cost of falls to the NHS which at its current rates is £2.3 billion per year
• Increased overall wellbeing by 16%

The session starts with a gentle reminder of the exercises and although people had different physical and mental abilities, as the session progressed people remembered the movements and I could visibly see people’s confidence improving.  A couple of people started off very shaky and wanted the comfort of their walking aid.  At the end of the session, and as can be seen from the photos above, they were siting, standing and dancing without any aids.  Some people’s concentration wavered but as David had got to know the people he was working with he was very skilled at gaining their attention and offering praise in a gentle and clam manner; it was really quite inspiring.  The work of the Trust has certainly made a difference to the people living at Prior Bank Care Home and although the grant is no longer available the Trust has made a commitment to continue to deliver these sessions.  Having taken part in a session I think this is fantastic.

We have widely reported in the State of Care Report ‘that most people are still getting good care – but the health and care system is ‘straining at the seams’ – making future quality precarious.  However, as people’s health and care needs change and become more complex, a model of care designed for the 20th century is at full stretch and struggling to cope with 21st century problems. If services are to deliver consistently for people, there must be better coordination of care to create a sustainable and effective health and care system’.

Many times I have said we can no longer continue to deliver what we have delivered and commission services that are not fit for the 21stcentury.  Neither can health and social care continue to work in isolation.   We need to look to the future and provide people with the best possible outcomes to help them to lead fulfilling and meaningful lives.  The solution is not necessarily a new drug, but keeping healthy and feeling well and these models of social prescribing can be successful.   Did anyone watch the recent programme ‘Life at 100’?  What struck me about this programme is that physical exercise was one of the most important ingredients in people keeping healthy and in turn this helped to reduce social isolation.  Action for Elders Trust is to be commended for the work it is doing and I look forward to seeing how it can help challenge some of those misconceptions that exercise is only for the young as it is clear their work is making a difference