Taking intergenerational practice to the next level

Laura Haggarty, Care about Physical Activity (CAPA) Improvement Adviser takes us through her award winning intergenerational project which won ‘Most inspiring or innovative project’ at the 2018 Scottish Government and Healthcare Improvement Scotland’s Quality Improvement Awards.

Laura explains: “I developed this project because of my work on the CAPA Programme where I was looking for different opportunities for older people experiencing care to be more active and improve their quality of life. I knew there was some intergenerational work happening but felt there were opportunities to improve the sessions. Being on the Scottish Improvement Leader (ScIL) Programme was a great way to focus on a project with one care home and nursery to see if changes could be made which would make the sessions more beneficial for both the residents and the children.

“At the beginning, I got a group of residents, parents and staff from the care home and nursery together to discuss what we wanted to get out of the project and ideas about what changes we could make to sessions to benefit both generations.

This was really important to make sure we were clear about the outcomes we wanted to achieve.

“To measure the impact each session had on the children, I used the Leuven Wellbeing and Involvement scales. These are two scales that are commonly used in early years and achieving high scores means children are content and engaged in activities, which is essential to effective learning. By tracking children’s scores, I was able to work with early years staff to identify which sessions and activities provided the best opportunities for learning, explore where there were learning opportunities and try out new ideas. We did this through a Plan, Do, Study, Act (PDSA) approach where we planned what change we would make to the session, for example, having a set theme for an arts and crafts activity at a table with residents and predicting the outcome for both the children and the residents. We then tried it out and recorded the scores, getting feedback from everyone and studied the results together as a team. Bringing the team together regularly to discuss what was good and not so good about the change we had made allowed us to make further changes for improvement and try out the next idea, ensuring the impact on both generations was positive.”

  • Here are some of the key changes which led to improvements for everyone.
    Changing the environment and activity half way through the session – starting with arts and crafts around tables for example then moving to a more active activity such as balloon games and parachute games with everyone actively participating.
  • Utilising resident’s skills, experiences and preferences to lead an activity, for example, preparing and handing out the snacks and drinks, leading nursery rhymes or a sensory activity.
  • Having a set theme for an activity around tables with an equal ratio of residents to children, for example, ‘food’ as a theme where residents help children complete a paper plate with their favourite foods from sticking on pictures from magazines, food packaging or drawings all stimulating discussion around likes, dislikes, colours, shapes and experiences.
  • Residents visiting the nursery for a session every few weeks.

Laura said: “By gradually making small changes over time, the results showed that 80% of the children were scoring high on both the scales and therefore effective learning was taking place.

“The resident’s and children’s enjoyment of each session was recorded using a 1-5 smiley face chart to track the impact of the changes. The average experience rating was 4.6 which showed it was really positive.

“We saw positive relationships begin to form, perceptions of care homes and older people changed and intergenerational practice became embedded into the culture of the nursery and care home.”

Here are some examples of how children’s language and perceptions changed over time,

Laura continued: “The children walk one mile to the care home and back to the nursery and therefore are improving their physical activity levels and also experience of road safety, discussions around this and all the things they see on the way. Over time, the walk has become quicker as the children adapt to the routine and increase their fitness.

“I measured the resident’s activity levels each session using an activity tracker which showed me how long they were standing or moving around for or sitting not being active at all. Results showed an increase in physical activity over time which also impacted on their overall health and wellbeing. Resident’s anxiety, happiness and confidence all improved along with their hand grip strength, which means their ability to carry out day to day activities was improved.

“Once we had enough information to show the changes we were making were positive for both generations, we held a networking session which brought together local care homes and nurseries to learn from our project, share their experiences and make their own improvement plans. This led to 14 care homes and nurseries across the partnership area participating in regular intergenerational practice which is ongoing.”