One consequence of the lack of opportunity to exchange knowledge, expertise and experiences in day care can be 'wheel reinvention' and missed opportunities for partnership and development. Case study examples usefully capture knowledge and experiences, enable learning from other organisations’ efforts and broaden understandings of day centres’ work and how they might be involved in mutually beneficial initiatives, for example. Day centre providers and their professional and community stakeholders can benefit from reading such examples.
This section highlights some case study examples and resources grouped into five headings:
⦁ Day centres supporting the NHS and social care
⦁ Enhancing service quality
⦁ Activities in day centres
⦁ Outreach, partnership working and bringing the community into day centres
⦁ Service expansion or re-design.
Full case studies may be found in the downloadable pdf of this section at the bottom of the page.
People with little background in day centres may wish to start by reading a King’s College London NIHR Policy Research Unit on Health and Social Care Workforce report: What happens in English generalist day centres for older people? Findings from case study research. It aims to further the understanding of these diverse, multi-faceted settings for potential collaborators and social care and health professionals. It reports a pre-Covid pandemic descriptive picture of four day centres covering aims, funding models, location, internal environments, staffing, day structure, charges and a typical day.
Day centres supporting the NHS and social care
- A day centre for people with advanced dementia in south London identified why a service user with dementia and diabetes frequently became unresponsive, leading to a reduction in ambulance call-outs, thus saving NHS expenditure.
- A local authority day centre opened up its building to social workers, occupational therapists and a falls clinic, during its temporary closure due to Covid. Teams have continued to use the building after it re-opened.
- A voluntary sector activity centre, that was in contact with many carers, supported the local authority to consult with carers about an update to its local Carers Strategy.
- A day centre worked with the NHS adult mental health service on a project to transform a storage room at the day centre into a reminiscence room. As well as creating a place for day centre clients, this project also benefits users of SLAM adult mental health services who were employed to work on it as part of their recovery programme.
- One day centre explained how day centres contribute to safeguarding, and safety in terms of not being alone and by supporting carers.
- Individual testimonials also provide valuable evidence and a useful perspective for understanding the impact of day centres. During the development of these resources, we spoke to Joan who shared how going to a day centre has changed her life. Her story/testimonial is written using the Most Significant Change approach which is covered in the ‘Understanding outcomes and impact’ section of the Resources Hub.
Read more about these case studies.
Enhancing service quality
- A positive risk management strategy was developed to ensure that people with early dementia were not excluded from but were enabled to attend an exercise programme without a carer.
- An Excel ‘time tool’ to monitor time requirements for individual and whole-group support needs was developed by the manager of a local authority day centre for people with dementia. It monitors time needed by staff to support people and prompts reflection about support techniques. The ‘time tool’ spreadsheet itself can be downloaded at the bottom of this page.
- In a day centre that is linked with a care home, handheld mobile devices used for handovers between shifts in the care home are used for gathering information about attenders’ days and to guide reflective conversations with staff.
Read more about these case studies
Resources
- Tools for measuring how person-centred services are appear in the 'Understanding outcomes and impact’ section of this website, for example, PERCCI and TLAP’s “I” statements.
- The Scottish Care Inspectorate’s guide to self-evaluation for improvement introduces the process of self-evaluation and provides suggestions for how care settings might reflect on what they are doing so they can get to know what they do well and identify what they need to do better.
Templates may help day centres to provide person-centred care and support and are useful for new staff and volunteers who need to get to know their day centre’s clients.
- One-page profiles capture what is important to them, what people appreciate about them, and how they want to be supported. Read more about them.
- Alzheimer Society’s ‘This is me’ is longer and includes background information about the person, important people/places/events in their lives and their preferences and routines.
- My Home Life’s ‘Insights into me’ is an online or printable booklet aiming to generate conversations about a person and includes a one-page overview, a family and friends tree, personal history, what makes a good day and other areas more relevant to a residential setting.
My Home Life’s two online, interactive games may support relationship building between day centre attenders, staff and volunteers if played as a group (using a tablet, for example):
- ‘Picture Knowing Me’ is a light-hearted, interactive way for people to share something about themselves and learn something about others. It involves clicking on a wheel that spins and stops on a topic (e.g. small things that annoy me, something small that makes a big difference to me, something about me that may surprise you). People can choose to share something about the topic or to spin again for a different one. Guidance is provided.
- ‘Key Cards’ aims to get people chatting and finding out new, surprising or moving insights about each other. There are 55 questions (downloadable). In the interactive version, you press the button to generate a question, answer it or press again to generate a new question. (Example questions: What, for you, is the most beautiful sound in the world? What has been the best change in the world over the last 50 years?) Guidance is provided.
The importance of a good welcome
During the development of these resources, an older person, a day centre attender’s daughter and a social worker emphasised how important it is for people to feel welcomed and at home as soon as they arrive. This contributes to a person feeling comfortable, demonstrates caring and allays worries they may have had about where to go and suchlike. Feeling that a day centre is responsive and the warmth of the manager and staff/volunteers – to older people, relatives and professionals - help social workers feel comfortable making referrals. Having a good relationship with a manager leading to a sense of trust is also important to social workers.
Activities in day centres
- A dementia day centre introduced cycling for day centre clients. Use of adapted bikes, bike storage and intergenerational support were all made possible through local collaborations with Wheels for Wellbeing and a local Pupil Referral Unit.
- One day centre for people living with dementia improved its offer by introducing technology in the form of iPads and static cycling with virtual scenery.
- Two south London day centres brought music in through local collaborations.
- Two local theatre groups and a secondary school perform for attenders of a voluntary sector activity centre, giving them access to the arts and fresh conversation material to take home.
Read more about these case studies
Resources
- The National Activity Providers Association (NAPA) publishes a series of free resources (e.g. monthly activity calendar, guidance on planning a community disco, creative quizzes booklet) and low-cost topical resource ideas.
- Health Innovation Network published a guide to online resources for staff running activities. It provides brief information about and links to activities on tablets, access to newspapers and magazines, physical activity and exercise, films, music and television, livestreamed concerts, nature and museums, and links to other useful activity resources.
- My Home Life’s two online, interactive games ‘Picture Knowing Me’ and ‘Key Cards’ help get people talking about themselves so that people can get to know each other better.
Outreach, involving and bringing in the community, and local partnership working
- Developing local links has brought music and theatre into several day centres. Through local collaborations two day centres brought music into their centres in different ways. Two local theatre groups and a secondary school perform for attenders of a voluntary sector activity centre, giving them access to the arts and fresh conversation material to take home.
- A dementia day centre introduced cycling for day centre clients. Use of adapted bikes, bike storage and intergenerational support were all made possible through local collaborations with Wheels for Wellbeing and a local Pupil Referral Unit.
- A day centre undertook outreach with its local Mosque that aimed to support and include its older female members.
- One day centre for people with moderate to advanced dementia developed one-off partnership working opportunities. It partnered with The National Citizen Service, resulting in the transformation of an unused locker room into a sensory room, fundraising for this and storytelling workshops. This formed part of the young people’s social action (volunteering and campaigning) programme. It also worked with the NHS adult mental health service on a project to transform a storage room at the day centre into a reminiscence room. This created a place for day centre clients and benefited users of South London and Maudsley's adult mental health services who were employed to work on it as part of their recovery programme for its clients.
- A voluntary sector activity centre worked with the local authority, the NHS and a local supermarket to put on celebrations for the annual International Day of Older Persons.
Day centres work collaboratively to share spaces:
- A large day centre in south London developed a partnership with a social enterprise that employs and trains adults with learning disabilities; this led to the day centre’s kitchen being used as the training setting.
- A dementia day centre introduced cycling for day centre clients. Use of adapted bikes, bike storage and intergenerational support were all made possible through local collaborations with Wheels for Wellbeing and a local Pupil Referral Unit.
- A local authority day centre opened up its building to social workers, occupational therapists and a falls clinic, during its temporary closure due to Covid. Teams have continued to use the building after it re-opened.
Read more about these case studies.
Day centre service expansion or re-design
- An in-depth case study shares experiences of providing a day centre for mixed service user groups. Age UK Wandsworth’s Gwynneth Morgan Day Centre supports older people, with and without dementia, and adults with physical disabilities, some of whom also have learning disabilities. As well as covering background, the case study details impact (including some individual case studies), day-to-day experiences of providing care for mixed groups, what helped and what was a hindrance and tips for others.
- An in-depth case study recounts the experiences of redesigning and modernising a traditional day service into an innovative, creative centre for wellbeing for older people. It covers challenges (internal and external) and details of developments and new partnerships.
- Devonshire Dementia Day Centre, which adjoins a care home, offers 1950s themed reminiscence experiences. It is a 1950s themed reminiscence day centre with a tea room (based on Lyons Tea Rooms), a pop-up market and a hairdresser. Equipment and paraphernalia were selected to match this theme.
Read more about these case studies.
Template
- Excel ‘Time Tool’ spreadsheet to monitor time needed by staff to support people and to prompt reflection about support techniques