Places to Flourish - A pattern-based approach to foster change in residential care.

Background
Name of your initiative: 
Places to Flourish - A pattern-based approach to foster change in residential care.
Short name (acronym): 
Places to Flourish
Website title and address: 
Places to Flourish web site
Which organization is submitting this initiative?: 
Louth Age-Friendly County Alliance
Please specify in which regions/provinces: 
IRELANDIRELANDBorder, Midland and WesternBorder
City: 
Dundalk
Where is this organization located?: 
Iceland
Please enter the name of the contact person for this initiative: 
Dr Lucia Carragher
Please enter the email of the contact for this initiative: 
Lucia.Carragher@Netwellcentre.org
Part of larger strategy or programme: 
National
If you answered "other", please specify: 
Please provide us with more details of this programme or strategy: 
‘Places to Flourish’ has been prepared to support organisations embarking on change programmes in residential care settings. It comprises a rich knowledge resource providing guidelines, case- studies, scenarios, patterns and developmental tools and techniques that can be used in-situ to support residential care organisations on their change journeys. The resource is set within the context of a HSE- led service innovation programme shaping a framework for cultural change in residential services for older people. The programme addresses an integrated approach to innovation and leadership, person-centred practice, resident empowerment, and spatial reconfiguration. Together these interwoven strands can provide a healthier and life-enhancing place for older people and their carers to live and to work – to flourish. The need for the programme and the supporting resource, has grown from several parallel and reinforcing seams of activity which include: • the HIQA National Standards for Residential Care • the MNPDU sponsored ‘person-centred practice’ project • training and practice development for allied health workers • community models such as the Nestling Project in Dundalk • Teaghlach and related household-oriented initiatives • the Hospice Friendly Hospitals programme • The National Advocacy Programme
The status of the initiative: 
Completed
Please give a summary of your initiative (in English): 
There are a myriad of issues that enable or hinder culture change in residential care settings. For transformational change to occur learning needs to be: • Meaningful to the practice context of the learner • Challenging of taken-for-granted assumptions • Adult oriented • Soulful - learning that engages the learner emotionally • Creative and engaging • Targeted on key issues that inspire personal change Whilst these issues are essential to changing practice, learners need to be helped to ‘see them through their own eyes’ and not through the judgemental eyes of others. To this end, ‘Places to Flourish’ uses a framework derived from the work of McCormack, Walsh and Manley (2008) The unique approach is that of ‘patterns’ in workplaces. It is these patterns that have the greatest impact on workplace cultures and practice effectiveness. Patterns describe problems which occur over and over again in an environment or operational context and they describe the core of a solution to that problem in such a way that it can be used a million times over – without ever doing it the same way twice. As such, patterns can be very generalised at a conceptual level while they are absolutely unique at a local implementation level. ‘Places to Flourish’ has used a ‘pattern based’ approach to describe a connected and self- reinforcing web of repeating place-sensitive experiences that are at the heart of everyday life in long term care settings. These patterns are tied to each other in the form of a language, where the bonds between them help to complete the patterns, to fill them out. Together the patterns form an initial, yet coherent picture of life in a long term care setting, capable of generating solutions for unique contexts in an infinite number of forms, with infinite variety.
The geographical scope: 
National
Type of initiative: 
Public-private-partnership
Environment or setting of the initiative: 
Urban
The economic environment or setting of the initiative: 
Moderate
The most important source of funding for your initiative: 
Regional funding
If other, please specify your source of funding: 
What triggered this initiative?: 
The vision in the HSE Innovation Fund Award is – ‘to create a framework for changing the culture of Irish residential care settings for older people which respects their right to home and a meaningful life connected to their families and friends’. It’s a cultural shift from a task-oriented institutional model to one which supports older people to continue to direct their own lives ‘at home’ supported by consistent and valued teams of healthcare staff. ‘Places to Flourish’ has been prepared to support organisations embarking on change programmes in residential care settings. It comprises a rich knowledge resource providing guidelines, case- studies, scenarios, patterns and developmental tools and techniques that can be used in-situ to support residential care organisations on their change journeys. The resource is set within the context of a HSE- led service innovation programme shaping a framework for cultural change in residential services for older people. The programme addresses an integrated approach to innovation and leadership, person-centred practice, resident empowerment, and spatial reconfiguration. Together these interwoven strands can provide a healthier and life-enhancing place for older people and their carers to live and to work – to flourish.
Objectives
What are the main objectives of your initiative? Choose a maximum of 3 objectives.: 
Housing: increase the number of older people living independentlyRespect and social inclusion: increase in number of policies/strategies targeted at older peopleCommunity support and health services: increase in client-oriented and -centered made to measure health and social care and services
Please describe any subgoals of your initiative: 
Target group
Does your initiative target people with a specific impairment or disease?: 
Frailty, chronic diseases, dementia or social isolation with no or weak informal and/or formal care networks warranting the need to relocate to residential care.
How many people have you reached or do you expect to reach with your initiative?: 
1000 - 10.000
Does your initiative target a specific age group?: 
65 - 7980+
Does your initiative target men or women?: 
Irrelevant
Approach
Please indicate what best describes your initiative: 
ImplementationOtherImplementationPhysical adaptationsKnowledge transferOtherPolicyResearchInnovation/action/applied
What type of intervention strategy is used in your initiative?: 
AdvocacyUser-empowerment and participation
Please indicate the Technology Readiness Level (TRL) of your initiative: 
Not applicable
Who executes the initiative: 
Health service contractersPublic authorityOtherPrimary health care providersNursePrimary health care providersOtherResidential long-term care facilities
What is the relevant physical scale of your initiative?: 
BuildingIn a care settingBuildingIn a residential settingCity/municipalityNeighbourhoodCare settingNeighbourhoodResidential settingRegional levelRoomIn a care settingRoomIn a residential setting
Please indicate how you think your initiative could be scaled up (made to reach more people): 
Promoted through national and international associations of long-term residential care providers in the public, private and NGO sectors.
Please indicate the type of stakeholders concerned with your initiative.: 
Advocacy organisationCultural institutionEnd-usersHealth service contractersPublic authorityNon-governmental organisationPrimary health care providersNursePrimary health care providersOtherResidential long-term care facilities
Please describe how you think your initiative could be transferred to other regions or contexts: 
Through publication, policy development, training and mentoring.
Is your initiative economically sustainable and does it contribute to economic development?: 
YES
If you selected "other" neighbourhood, please specify:: 
Impact & outcome
Will you collect or have you collected outcome data for this initiative?: 
Yes
What do you consider the key success factors of your initiative? If your initiative has not yet started, please indicate what you expect the key success factors to be: 
Enhancing empowerment and personal choice for older people in long term care settings. Positively impacting on the quality of life of older persons in long term care settings. Strengthening the rights and dignity of both older people, and those who care for them. Providing life-enriching and homely physical environments that promote and foster human dignity.
What do you consider the main barriers to overcome in your initiative? If your initiative has not yet started, please indicate what you expect the main barriers to be.: 
Cultural transformation toward more person-centred practice, transferring control and encouraging greater empowerment and personalisation within these settings is difficult and challenges more traditional task oriented approaches. It requires leadership and commitment.
What instruments will you use/have used to collect data?: 
If you selected "other" instrument to collect data, please specify: 
If yes, how will you/have you collected those data?: 
Observational studies
Will you collect or have collected socio-economic impact data for this initiative?: 
No
Will or are the collected data in the initiative publicly available?: 
No