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Inpatient neuro rehab

Maximising independence through community re-engagement

By creating opportunities for care home residents in local communities, Exemplar Health Care is enabling life-changing progress

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“Everybody is different and wants to do different things. At Exemplar Health Care, we want the people we support to live their lives with the independence that is possible for them – and we’ll do anything we can to enable that.”

And when Exemplar Health Care says ‘anything’, pretty much anything is on the table in terms of supporting their residents to experience life outside of their care home and in the local communities they’ve always lived in. 

Previously, service users have embarked on social activities ranging from a helicopter ride to a trip to see the Dreamboys – showing the lengths the provider will go to in making their care truly person-centred. 

For Sophia Feurtado, service user engagement manager at Exemplar Health Care, feeling part of the local community and having the opportunity to experience life within it, is vital for everyone. 

“Being involved in their local community is really important for our residents. It helps to empower them. It gives them a more personalised experience, promotes choices and independence. And it helps them to either continue or rediscover things they used to do, or to find new things and make new relationships,” she says. 

“It’s so important that people feel empowered, and that because they live in a care home they don’t feel cut off.

“We want people to feel like a valued part of our community. So right from the start, when they come to live in our homes, we will have conversations with them about the things that they want to do, about their choices, things that they’ve done in the past and things they’d like to try. That starts as soon as they’re ready.”

Creating opportunities

And from those conversations come the opportunities that Exemplar Health Care takes great pride in creating for its residents. From enabling a man to play in a local football team again – an activity he had done regularly pre-brain injury – to enabling a stroke survivor to regain confidence and independence by volunteering in the local community, community integration forms a central part of what the fast-growing provider’s care homes offer. 

“We’ll take it at their pace. We will start to introduce them slowly back into the community, but we also bring people in,” says Sophia. 

“It could be that someone isn’t able to go into the community initially, but we can bring organisations or individuals in to work with them, to help re-introduce them into the outside world. 

“Nothing is too difficult for us and we’ll always look at the personal choice of the individual. There might be somebody who has done something in their past, or they’ve worked in a certain profession in their past, and they’ve still got that interest or that skill. We would look to see what there is available locally that might help them to relearn those skills. 

“An example might be someone who had worked as a gardener. We might look to see if there are any community voluntary groups they could go to, or we could get community volunteers from gardening projects to come in. We could also seek for them to volunteer in a community project or a garden centre. 

“Or it could be that some of our residents want to learn something and we’ll find an opportunity for them in adult education. Some of the people we support have joined education groups alongside everybody else, and our staff will go with them to support them. 

“Everything is risk assessed and we like to take positive risks to enable our residents to live the very best lives possible.”

Alongside the fact that everyone’s circumstances are different, their progress can also vary, meaning our care is personalised to them. 

“Some people progress quicker than others. You will get some people who will be able to go off and do things on their own, they might go shopping on their own, for example. Some other residents feel confident getting on the bus or the train and use their money management, because they’ll be supported to get to that point,” says Sophia. 

“But for those who maybe aren’t at that level of community engagement, we have an initiative within our homes where they can volunteer to do different roles within the home. That’s a safe space for them to learn and to do things, ahead of where volunteering and going into the community is an option for them. 

“We will develop any role based on what they want to do. We’ve got people working in a tuck shop, working on reception, working in the laundry, helping in the gardens, a whole host of different things they can do within the community environment of our own care homes.”

Through taking part in his favourite hobbies, Andy is building everyday living skills outside of his Exemplar Health Care home

Support to achieve ambitions

While for some getting back into the community is something they have longed for, for others there can be more hesitation. But for Exemplar Health Care, the support is there at whatever level is needed. 

The team use the active support model, where service users are empowered to achieve the task they wish to complete. 

“There is a lot of support, to gradually introduce people to things,” says Sophia. 

“There is the risk of the fear factor, because with some individuals, when they were doing things out in the community before, they might not have had to live with the conditions that they’re living with now. There is the fear of how they will be received, how they will be perceived. 

“But we like to show that what might be seen as a negative can be turned around to a positive, and while people may be fearful, they know the staff are supporting and encouraging them, and that really helps. 

“Through active support, we would usually identify a task and then break it down into smaller chunks – so in this situation, you’d perhaps have more input from the staff towards the beginning of the process and at certain other stages. But as the person becomes more confident or more able, then interventions from staff would be less and less. 

“We also acknowledge that some people might always need support. We could take the scenario of supporting somebody to go to college. That person might never ever be able to get to college alone, so they will always need the support of staff to go along with them. Our care planning process and high staffing levels enable us to provide this support.”

The approach Exemplar Health Care takes to community engagement is also vital in building relationships with the local area, says Sophia.

“We have seen how positive it is that people in the community get to know our residents and build relationships. It helps to demystify people’s perceptions about what life is like in a care home,” she says. 

“We want to attract local people from the community to come and support our residents, it’s really important. And we want to build the relationships so they stay with us, because a lot of our residents like consistency, so that relationship building is very important, both within and outside the care home setting.”

The importance of community engagement

Sophia says there is no greater endorsement of the vital role community reintegration plays than through the endorsement of the people at the centre of everything – the people who are receiving this support.  

“I know it’s important because our residents have told me that. Whenever we ask them what they want to do, the highest thing on their priority list is that they want to go out. They want to go and do things that they would do if they were living in their own homes,” she says.

“It’s like myself – the whole me, the whole Sophia, is an extension of all the things that I love to do outside of my home. So knowing my neighbours, being able to wake up and say hello to them, knowing the local shopkeeper, being able to go to my local supermarket, knowing where the parks are; the everyday things. 

“It’s getting that fresh air, to feel the sun – or even feel the cold or the rain – on your face, just those things that sometimes you take for granted, and the fact that it builds their confidence so much.”

The personal progress being made is something Sophia is always delighted to see.

“I can see the incremental progress that people have made and are making,” she says. 

“This kind of work is not easy to measure, it’s more the fact you have to look at the personal stories and the impact it’s had on them. We could measure progress in somebody who hasn’t been able to get out of their wheelchair for a number of months. But then after certain interventions, they can stand, or they can take their first few steps.

“It’s about the softer measures rather than hard statistics – but they tell their own stories in a way that statistics couldn’t.”

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