Nestled between the tourist hub of Bournemouth, the coastal harbour of Lymington, with the ancient priory town of Christchurch on our doorstep, the range of things to do here is diverse.  Horse riding, flying a light aircraft, cycling in the New Forest, water skiing, and horticulture–just some of the activities that people we support have experienced.

And that’s the most incredible aspect of living where we live.  There is something for everyone, activities both active and passive.  Oceanarium, tree canopy walks and zip lining, fun fairs, picnics at music festivals such as the annual jazzy Stompin’ on the Quomps, the Air Festival with planes old and new cutting through the skies above us.  Gentle strolls through deer-filled forest or along the beach.  From achieving dreams to simply enjoying time to be, to breathe sea air and sit a while looking out over the ocean to Old Harry’s Rocks and beyond.

Perhaps nothing reveals so much about individuals as how they choose to play – how they invest their time and energy for leisure time.  Leisure is that time free from demands or activities of daily living.  Everyone needs regular recreation that develops skills, promotes good health, relieves stress, facilitates social interactions, and provides a general joy for living. ––Regina Cicci, Ph.D. [Developing Recreational Skills in Persons with Learning Disabilities]

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

The Apple House Ltd Approach:

The world of management and strategic planning can be full of jargon-based terms and phrases, which can take the core meaning away from readers who want to see the direction and aims a company wants to work towards.

While it is crucial that our company has a clear strategic plan from directorship level, the methods which enable this plan to work through an operational route are key to achieving the common goal. This planning stage will assist the company forward through an ever-increasing demanding economy and climate.

For our Company, the aim is to protect the homes of the people we support and the jobs of the people whom we employ throughout our services.

An infographic is used to give an overview of our Operational Goal Planning.

–Romaine Lawson, Director of Operations, Apple House.

“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

“Access to gardens can enhance focus and attention, as well as reducing anxiety and boosting self-confidence. Additionally, the garden can be considered a dynamic environment offering diverse opportunities for learning.” –[‘Green Spaces – Outdoor Environments for Adults with Autism’ by Katie Gaudion and Chris McGinley.]

At Apple House care homes we know that our outdoor spaces are as vital as indoor space for those who reside at our services.  For many years we have actively encouraged residents to take ownership of their garden space, to use it in a way meaningful to them. Perhaps this year, even more than previously, we value our outdoor spaces, fresh air and the gentle exercise of gardening.

At Apple House care home, residents enjoy 100ft of garden and actively shop for plants, tend seasonal blooms, help with garden maintenance and enjoy sitting out with a cuppa to admire the results.  Redcroft, Little Amberwood and Summerwood care homes also rear and nurture their own hens, with Summerwood residents even designing and building a hen house.  Growing vegetables is the norm here: eating home grown organic veg and free range eggs is tremendously rewarding in itself as well as nutritiously beneficial.  

Results-based activities such as these also foster a sense of ownership and achievement.

Sensory gardens incorporate textures, actions and movement, sounds, smells, colour.  At Summerwood care home in Hampshire, our registered manager, John, and residents created a sensory garden that blends all of the above.  We also offer garden space that is restful and calming, without additional sensory stimulation.

All of our services now have log cabins in their grounds. Redcroft care home, in Bournemouth, has a fabulous activities cabin nestled beside the hen house. Instead of slicing a path through the lawn to reach it, residents and staff planted a sensory path including lavenders, herbs such as thyme, rosemary and mint. Imagine the scents released as fingertips brush along the heads of the blooms and leaves as you walk to and from the cabin which again is fragrant with the scent of pine wood.  Texture is as import as scent and so there are fleshy, course foliage and soft silken leaves and tickly grasses.

While seasons and nature will continually change garden space, it’s important to us that we facilitate enjoyment of what is a wonderful commodity all year round.  The cabin enables residents to connect with their garden and to feel part of their outdoor space even in the winter.

We are ready for Spring, are you?

The Mad Hatters Tea Party!

So, it was that after a conversation involving three very creative minds that the idea of the Mad Hatters Tea Party was born. Amanda Sinnick (Deputy Manager) put her considerable organisation skills to use and grabbed the event by the scruff of the neck and formed a Tea Party committee.

Amanda over saw the creation of the many wonderful decorations that would create the fabulous party vibe that was present on the day, as well as the one of a kind advertisement board.

Nora Grant (support worker) took full use of this opportunity to show off her formidable artistry skills to help create standalone pieces that were present on the day, as well as assisting individuals to make one-of-a-kind hats and outfits for the party.

Rebecca Blackmore (senior support worker) demonstrated her outstanding baking/culinary skills to create the wonderful themed buffet as well as a magnificent centrepiece cake.  

Amanda, in the role of Chairperson, oversaw the day itself and ensured that it went smoothly and was a great success. Judging by all the beaming smiles on faces it certainly was!

After the event had finished Amanda announced that she had already started the initial planning for “The Carnival Extravaganza” planned for the end of August 2020

So watch this space…” David Dellow, Senior Support Worker/Team Leader, Redcroft.

“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.