At Apple House care homes we strive to support residents to lead a healthy lifestyle and to be as independent as possible. We provide access to a programme promoting healthy living and wellbeing, with home cooked fresh food, regular exercise, and creative activities. This article outlines why it is important to give people with autism the opportunity to take part in creative activities and regular exercise.

Challenges for people with Autism

For people with autism, you may notice that they can have challenges in interacting in social situations as it can be overwhelming at times with direct verbal communication. We may not get a direct response or eye contact and we can wonder if we have been understood. So it may also be a struggle to build a relationship with them through words alone.

At times people with autism can have rigid mindsets as this may be their way of making sense of the world around them. So, therefore, change can be difficult as they feel reassured by a routine that gives them a sense of control. They may not always understand that a change in routine may be something beyond their carer’s or parents’ control. Such as the illness of a friend or a change in who supports them due to outside factors.  They may need help in regulating their emotions in response to these situations.

Sensory experiences

Jackie Edwards (2017) describes how people with autism may have difficulty making connections between their tactile, vestibular and proprioceptive sensory systems where they may be overactive or not active enough with how they interact with their environment.  For example, they may have a hypersensitivity to loud noise or bright light, may also be de-sensitised to tactile experiences. So, therefore, they would benefit from a sensory diet to improve sensory integration.

She advocates giving people with autism access to different sensory experiences to help improve concentration and attention. This in turn may help them to be able to regulate awareness of their surroundings more effectively as well as to help them relax and not feel overwhelmed, leading to increased socialisation and interaction, promoting less rigid thinking, creativity, and motor skills.

Benefits of exercise

At Summerwood we recognise the importance of exercise by helping our residents access their community, take part in physical exercises such as the gym and swimming, and helping with gardening, tending the vegetable patch etc.

According to Healy S, et al. (2018) research shows that for people with autism exercise can have a number of benefits:

• Reducing stereotypical behaviours or self-stimulating behaviours
• Improving social skills with sports that promote teamwork
• Helps to reduce weight gain or obesity
• Can increase a person’s attention as repetitive behaviours can decrease
• Exercise can reduce anxiety and improve the ability to regulate emotions, build resilience to anxiety-triggering situations
• Exercise can improve motor skills and coordination for people with autism

Benefits of creative activities

The creative arts is another important activity and we support individuals to participate in regular arts and music classes in the community and within Summerwood, their home.

Art can give a person a sense of control as they learn to adapt to the task in their own way. Drawing and painting can also help to improve and maintain fine motor skills. Creative arts can be an effective way to engage with the person in a non-pressurised way. Tactile art forms such as paint and clay also provide a sensory experience to fulfill the needs of the person to be able to balance their sensory experiences more effectively. Music can elicit interactive emotional responses and melodic rhythms can help them engage.

Arts and wellbeing

People with disabilities can be more vulnerable to mental health issues so we are aware that it is important to provide a way for people to communicate their emotions appropriately. Behaviours on the surface may arise due to an inability to verbally communicate how they feel. Behaviours thus can have a function so this highlights the importance of non-verbal communication and communication aids to help people communicate their needs.

For further assistance, creative arts therapy with a trained art therapist can be a way for a person to be able to express and/or regulate their emotions when words are difficult. It can also help to improve cognition and emotional regulation where the aim is to use the art materials or creative activity to access emotional wellbeing and to help a person learn to regulate their emotions and understand themselves within a safe and facilitating environment.

— By Andrew Wright, Support Worker, Summerwood Care Home, Hants (Previously Rated ‘Outstanding’ by CQC).

References and further reading

Draycot, C. (2013) Educating Autism – Art and Creativity to Engage an Autistic Child in the Classroom. The Art of Autism: Connecting through the Arts. https://the-art-of-autism.com/educating-autism-art-and-creativity-to-engage-an-autistic-child-in-the-classroom/

Edwards, J. (2017) The benefits of multi-sensory environments. Autism Journey Blog.

Healy S (2018) The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Review article. Autism Research. 11(2) · April 2018.

Rudy, L.J (2017) How Does Art Therapy Help People With Autism? Very Well Health. https://www.verywellhealth.com/art-therapy-for-autism-260054

“Apple House Ltd believes that its employees represent its greatest asset.  By providing opportunities, facilities and financial support for training, the service aims to ensure that all of its employees are in possession of the knowledge, skills and experience necessary to perform their jobs to the highest standard.  To this end, the service is committed to functioning as a learning organisation, providing all of its employees with the opportunity for training and re-training in accordance with their own needs and that of our homes.

Without a skilled, committed and well-trained staff team, the service cannot possibly succeed in its aim to provide high-quality care.

Training should not only motivate staff, but also encourage their co-operation, imagination and personal development.  Without being stimulated by new learning, staff can become bored, take shortcuts, lapse into bad habits or feel undervalued.

A planned programme for the training and development of staff is essential to ensure good practice and the provision of a quality service for service users.  This is why we have 25 core training courses available to our staff with more being available if there is an individual speciality being undertaken.

If you would like to be part of our team and enjoy this environment of learning and fulfilment, please get in touch through our careers or contacts pages.  We’d love to hear from you.”

––Romaine Lawson, Director of Operations

• Care home policies on oral health and providing people with support to access dental services
• Oral health assessment and mouth care plans
• Daily mouth care
• Care staff knowledge and skills

CQC, during their discussions at the Regulation of Dental Services Programme Board and with other stakeholders across adult social care and primary care, highlighted that awareness and take-up of the NICE guidelines were still low.

CQCs review included dental inspectors attending 100 routine planned inspections of care homes alongside inspectors from their adult social care team. They spoke with managers and senior staff members as well as people who use services, and their relatives, to find out about their experiences of care.
Smiling Matters is a report of what was found in those homes, conclusions and recommendations for action.

In Apple House care homes, we have used the report to raise awareness of the importance of clear guidance within our own homes to ensure that access to regular dental check ups, care plan guidance and daily mouth care is and continues to be an important part of a person’s person-centred support. We have found that staff training is crucial and this goes hand in hand with the understanding of creative support plans which reduce barriers to people receiving oral healthcare. An area of action will be to include how people find this experience within our annual service user survey to gain the views of the people we support. An area of excellence was found to be specialised training received by members of staff which has been rolled out to the teams. The report has been discussed and communicated throughout the organisation at senior, team and service user meetings.
One of the recommendations from the CQC report is:
That NHS England and local commissioners:

• Work with the care home sector to avoid lengthy waiting times for appointments and treatment and provide emergency appointment times. 

• Work with GP practices and other primary care contractors, such as community pharmacists, to establish local arrangements to signpost people to dental provision. 

• Provide adequate capacity to provide routine and emergency treatment to people in care homes. This should be linked to a clear, measurable outcome around avoidance of GP appointments and A&E attendances resulting from dental crises.

You can read the full CQC report ‘Smiling Matters: Oral health care in care homes’ here.

Romaine Lawson, Director of Operations, Apple House care home group.

Importance of creative activities and exercise for people with autism

Introduction

At Apple House care homes we strive to advocate a healthy lifestyle and to be as independent as possible. We provide access to a programme promoting healthy living and wellbeing, with home cooked fresh food, regular exercise, and creative activities. This article outlines why it is important to give people with autism the opportunity to take part in creative activities and regular exercise.

Challenges for people with Autism

For people with autism, you may notice that they can have challenges in interacting in social situations as it can be overwhelming at times with direct verbal communication. We may not get a direct response or eye contact and we can wonder if we have been understood. So it may also be a struggle to build a relationship through words alone.

Often people with autism can have rigid mindsets at times as this can be their way of making sense of the world around them. So, therefore, they can find change difficult as they feel reassured by a routine that gives them a sense of control. They might not always understand that a change in routine may be something beyond their carer’s or parents’ control such as an illness of a friend, or a change in who supports them due to outside factors; Covid restrictions have been an exceptional challenge for many. Help and support may be needed in regulating  emotions in response to these situations.

Sensory experiences

Jackie Edwards (2017) describes how people with autism may have difficulty making connections between their tactile, vestibular and proprioceptive sensory systems where they may be overactive or not active enough with how they interact with their environment.  For example, they may have a hypersensitivity to loud noise or bright light, may also be de-sensitised to tactile experiences. So, therefore, they would benefit from a sensory diet to improve sensory integration.

She advocates giving people with autism access to different sensory experiences to help improve concentration and attention. In order to help them to be able to regulate awareness to the surroundings more effectively as well as helping them to relax and not feel overwhelmed, leading to increased socialisation and interaction. Promoting less rigid thinking, creativity, and motor skills.

Benefits of exercise

At Apple House care homes we recognise this importance by supporting and encouraging residents to access their community, taking part in physical exercises such as the gym (when safe to return) and swimming, and to help with gardening, tending the vegetable patch, and cycling.

According to Healy S, et al. (2018) research people with autism exercise can have a number of benefits:

• Reducing stereotypical behaviours or self-stimulating behaviours
• Improving social skills with sports that promote teamwork
• Helps to reduce weight gain or obesity
• Can increase a person’s attention as repetitive behaviours can decrease.
• Exercise can reduce anxiety and improve the ability to regulate emotions, build resilience to anxiety-triggering situations
• Exercise can improve motor skills and coordination for people with autism

Benefits of creative activities

The creative arts is another important activity and we support residents to actively participate in regular arts and music classes in the community and in the home.

Art can give a person a sense of control as they learn to adapt to the task in their own way. Drawing and painting can also help to improve and maintain fine motor skills. Creative arts can be an effective way to engage with the person in a non-pressurised way. Tactile art forms such as paint and clay also provide a sensory experience to fulfill the needs of the person to be able to balance their sensory experiences more effectively. Music can elicit interactive emotional responses and melodic rhythms can help individuals to engage.

Arts and wellbeing

People with disabilities can be more vulnerable to mental health issues so we are aware that it is important to provide a way for people to communicate their emotions appropriately. Behaviours on the surface may arise due to an inability to verbally communicate how they feel. Behaviours thus can have a function so this highlights the importance of non-verbal communication and communication aids to help people communicate their needs.

For further assistance, creative arts therapy with a trained art therapist can be a way for a person to be able to express or regulate their emotions when words are difficult, helping to improve cognition and emotional regulation. Where the aim is to use the art materials or creative activity to access emotional wellbeing and to help a person learn to regulate their emotions and understand themselves within a safe and facilitating environment.

— Andrew Wright, Senior Support Worker and Trained Art Therapist, Little Amberwood care home.

🔊 Listen to this

References and further reading:

Draycot, C. (2013) Educating Autism – Art and Creativity to Engage an Autistic Child in the Classroom. The Art of Autism: Connecting through the Arts. https://the-art-of-autism.com/educating-autism-art-and-creativity-to-engage-an-autistic-child-in-the-classroom/

Edwards, J. (2017) The benefits of multi-sensory environments. Autism Journey Blog.

Healy S (2018) The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Review article. Autism Research. 11(2) · April 2018.

Rudy, L.J (2017) How Does Art Therapy Help People With Autism? Very Well Health. https://www.verywellhealth.com/art-therapy-for-autism-260054

Our teams are working hard to ensure a safe and peaceful Christmas can and will be enjoyed for all the people we support.

We have seen the introduction of Lateral Flow Device tests (LFD) and our staff are busy attending the webinars and training to ensure that these can be delivered in a timely manner. You can see more information regarding these tests here https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-of-visitors-in-care-homes

Our teams have gone over and above this year in their commitment to our company and we can’t thank everyone enough for the extra effort we know the pandemic has made everyone make. We have all had to adapt how we think, what we do and how we see our family and friends. Frontline workers have been recognised for the work they do and this is long overdue. We want to see the celebration of our wonderful carers and managers applauded by the country as much as we do each and every day.

We have been keeping our readers up to date with the latest Governement guidance where possible. Please bear in mind that this is fluid and changes to meet the latest decisions taken centrally. For the latest guidance please go to the gov.uk site.

— Romaine Lawson, Director of Operations, Apple House Care Homes.

“After a break from working on the nature garden to assist other team members with their exciting projects, we once again turned our attention to the nature garden. In particular the solving of the one glaring issue since work on the garden began. At present the nature garden could be accessed either side of the Cabin; these access points are fine for those who are able-bodied and confident on their feet. However to be truly accessible for everyone there needed to be an access suitable for everyone. This had been a problem that the team could not seem to solve and had been a stumbling point. However, whilst working on projects for other team members, it had dawned on the Team that there was an area big enough behind the rockery to create such a path so eureka! problem solved and the team were raring to go.

This was what faced the team and after a quick clear up of all the loose foliage the team went round the other side to clear the loose bricks and were ready to clear a path through. Nice and easy until…disaster struck!

The quick clearance job suddenly turned into seemingly mission impossible. The team, determined not to be beaten, dug around the stones to see if any further surprises were waiting and…

It seemed that the team had stumbled across an old wall buried by time and mother nature. The team felt their hearts drop to their stomachs. However, spurred on by encouragement and curiosity from the residents and staff members, they perceived to see exactly what they were faced with.

As if by magic or pure good fortune, the “wall” turned out to be lumps of ore and debris buried and compacted together through time. Piece by piece the team managed to remove the obstructions including:

This little ‘boulder’ the team named Hercules, which weighs in at a rather impressive 78kg (yes the team actually weighed it!)

The team managed to remove all the obstructions except for one rather large rock that was entwined with tree roots. The team christened that particular rock ‘Father time’ as it looked like it had been next to the tree since forever.

The team then set about burying the exposed roots and laying a dirt path down. Luckily they had recently participated in another project (more about that at a later date) which meant there was plenty of dirt to use.

So after all the hard work and effort…

The Team can proudly present the new path and access point to the nature garden.” — David Dellow, Senior Team Leader, Redcroft Care Home.

Please read our letter to families by clicking the download link below.

We are continuing to review our current practices and adapting our approach where appropriate; for example, how or if we can begin to facilitate single family contact in a safe way in outdoor public space. As the Government’s rules change we will change too if it’s safe to do so and if Public Health England (PHE) tell us this is okay.

It’s also essential that we continuously appraise the guidance we and our managers give our teams, that it is consistent and updated, compliant with latest law and underpinned by Health and Safety legislation. Yesterday the Government issued fresh advice on ensuring employees are safe at work and we are already digesting this information as a management team. Work is already underway on updating risk assessments as well as putting in place brand new measures to enhance even further the safety of our team in our collective fight against COVID-19.

Thank you for your continued support and stay safe!

Here is our ‘Staying Safe’ POSTER:

— Jane Montrose, Managing Director, Apple House Care Homes.