CHARM Care Home Research Study – A project to find out resident, visitor and staff preferences and suggestions for our new garden space and associated activities

Four care homes participated in the CHARM research project, conducting two mini-research projects each. This blog shares the experiences of Sanctuary Care’s Hastings Residential Care Home in Malvern, Worcestershire and their second mini-research study. Hastings is also part of Sanctuary Group and thanks go especially to Home Manager Sue Milward, Deputy Manager Dan Reeves, Activity Coordinators Kirsty Sinton, Jackie Sadler, April Walwyn, Hannah Barber, Jenny Douglas and Project Manager Elizabeth Johnston of Sanctuary Care for their work as part of the Hastings’ Research Working Group.

Stage 1: Find out, plan and prepare

The direction of the project was decided with the knowledge that landscaping work planned for the garden area was about to start following the build of “the orangery”, a new conservatory area to the care home, which had left the garden in a bit of a state!) In addition, Sanctuary Care – the Organisation that runs Hastings – had a “spring initiative” underway, which was focussed on helping residents access gardens and outside spaces, as a way to enhance their well-being. Both these factors meant that focussing on the garden space seemed appropriate and timely for their second research project within CHARM.

It was decided that the CHARM research could be used innovatively to inform the design and plans for the garden space by consulting with as many interested people as possible. This was with the aim to ensure that the new garden space met people’s wants and needs.

The project aimed to:

1. Enhance the lives of residents at Hastings by providing them with access to good, accessible and safe outdoor space at their home, with the knowledge that the natural world is known to improve well-being.
2. Ensure that everyone’s needs were considered, including residents, family members, visitors and staff.
3. To open up interest and opportunities for everyone to be involved in helping with the changes to the garden space and to make use of the space when it’s finished.

Stage 2: Act and make things happen

This project was an exploratory study to find out how three groups at Hastings (residents, staff and families/visitors) wanted to influence the plans for the garden and related activities. The team decided to use a different approach for consulting each group. The three approaches were:

Staff Group

Staff were invited to take part in a focus group run by two members of the care home research team.

Family/friends Group:

A questionnaire was created for family friends and visitors to complete, to provide Hastings with their preferences and ideas around the design, features and uses of the garden.

Resident Group:

Residents, including those living with dementia took part in a series of consultation groups facilitated by staff. The consultation groups took three different forms:

1. A group activity using ‘planning packs’, in which residents chose where to place certain items on a garden plan.
2. A group discussion about what would make a good garden.
3. A discussion group about favourite plants that prompted the senses of smell, sight and taste.

Planning packs activity

Stage 3: Study, watch and listen

The team at Hastings received:

• 18 responses from the friends, family and visitor questionnaire
• 5 members of staff participating in the staff focus group
• 6 residents took part in group discussions around what would make a good garden
• 6 took part in the garden planning activity pack
• 8 residents took part in selecting favourite plants

Once all the data was gathered it was time to find out what it told the care home and what they could learn from it. With the help of the CHARM researchers-in-residence from the Association for Dementia Studies, the team analysed the data and produced basic descriptive statistics.

You can read the full report of the findings here:

Link to report

See the poster of their findings here:

Link to poster

Findings from the resident consultation activities around landscaping and feature preferences

Stage 4: Reflect, think, discuss and change

Once the data was analysed, it was time to look at the findings and work out how these could influence the decision making about the garden. They came up with a list of common ideas from all three groups and these have been used to create an action plan for the next steps in building the garden.

Landscaping

Aspect	Suggested by
Space to move and walk This should be built-in and paid attention to with placement of furniture etc.	Residents, staff and families
Shaded seating areas Both permanent and portable Also think about some that also doubles as sheltered seating in poorer weather	Residents, staff and families
Interactive and sensory plants Pay attention to how it functions and looks all year round	Residents, staff and families
Accessible pathways with safe, level surfacing Think particularly about providing a pathway to follow around the garden for those who wish to walk	Staff and families
Routine Maintenance Ongoing maintenance should be incorporated into the action plan Cannot rely on staff voluntary work Watering is the most pressing problem, could a sprinkler system solve this?	Staff and families

Features

Aspect	Suggested by
Raised flower beds Providing opportunities for participation	Residents, staff and families
Focus on sensory planting Suggestions made: grasses for movement; lavender, herb garden, strong scents and colour Resident preferences as listed above	Residents, staff and families
Comfortable seating With shade and allowing group dining and socialising	Residents, staff and families
Water feature As a talking point Think about sound of water on stones/waterfall	Staff and residents
A greenhouse Accessible by residents to help with potting, planting and watching things grow	Staff and residents
Bird feeding stations, table and bird bath	Families

Activities

Aspect	Suggested by
Potting, planting and watching things grow Interacting with plants is really important	Residents, staff and families
Sensory engagement Smelling, tasting, touching as prompts for reminiscence and conversation	Residents, staff and families
Adding to the garden features Building wildlife area, bug/bee hotels Perhaps an area could be saved to be readily changeable or added to at a later date	Residents and staff
The use of the garden is what makes it special Helping with routine tasks Spending time outside and socialising	Residents and staff
Encourage families to socialise and use it Signage Events Invitations to participate in activities	Staff and families
Launch the new garden with an open day! To encourage use and possible volunteering from visitors	Overall
Listen and encourage residents to share their own ideas The consultations with residents created positive and enjoyable environments so that residents could take part. This is important for all activities	Overall

In addition, by sharing their project findings with others in the CHARM group, a care home with a specially designed dementia garden has been identified and the team at Hastings will be visiting to help with their own design: A great example of sharing learning across our CHARM care homes and one of the key intended outcomes of the CHARM project!