Whiddon introduces MyLife and ASCOT in care planning 

Changing from a clinical needs to wellbeing care approach

Measuring wellbeing outcomes and the impact of aged care services on quality of life, consistently and systematically, is a challenge for most aged care providers. In 2015, Whiddon launched its new ‘MyLife’ model of care which is focused on a person’s wellbeing. A review of care planning practices had identified a gap around consistent evaluation, goal setting and structures in residents’ wellbeing. More importantly, some registered nurses (RNs) said they were not confident initiating and conducting conversations around emotional and social needs with residents. Across the residential care industry, care planning is typically focused on clinical needs. This has resulted in a lack of focus on evaluating the impact of services on wellbeing. Whiddon was committed to changing this, and as part of establishing an evaluation framework of MyLife introduced the Adult Social Care Outcomes Toolkit (ASCOT— an internationally recognised, robust tool that measures social care-related quality of life.

It links closely to the seven outcomes in Whiddon’s MyLife model of care by measuring quality of life against eight wellbeing domains. The eight domains of wellbeing cover four lower order needs (accommodation, food, safety and personal care) and four higher order needs (social interaction, occupation, control over daily life, and dignity). Integrating ASCOT into care planning in residential care, and the ‘circle of care’ interview methodology that allowed for participation of people with dementia, was an innovation in care planning.

Trialling and embedding the ASCOT tool

Whiddon partnered for the trial with ASCOT founders, the University of Kent in the United Kingdom. The ASCOT team was keen to assist with this new use of the tool, integrating it into care planning and in residential aged care. The 15-month trial took place across 2016 and 2017. The main goals were to test the value to care planning of using the ASCOT tool, as well as the sustainability and effectiveness of the methodology that we had designed.

This included:

• value to residents and improved quality of their care (including its alignment with our MyLife model and relationship-based care approach)
• user friendliness and effectiveness of the tool and ‘circle of care’ methodology for residents, families and RNs
• sustainability of conducting ASCOT conversations as part of care planning in terms of additional RN time and burden to residents and families
• the value to quality improvement of services at individual, service and system level.

Empowering residents and families

Conducting the ASCOT conversations—in a systematic way that was integrated with care planning for individual residents—had great benefits for residents, their families and Whiddon’s care approach. Residents, like ASCOT trial participant Doris Grainger (pictured), and family members reported feeling empowered by the conversations. The current generation in aged care is not used to talking about their emotional and social needs, however the formal structure of the conversations enabled them to talk more openly about these. The conversations were valuable to Whiddon’s relationship-based care approach.

Residents and families felt that staff really cared about them, particularly when they saw tailored initiatives that had been identified in the conversations being implemented and followed up. The ASCOT tool is now being implemented across Whiddon’s 19 aged care homes and eight community care services in alignment with the rollout of the MyLife model of care.

For more information whiddon.com.au/research-and-innovation