‘Living life to the full’: How do activities facilitated by care homes for older people in North Tyneside promote wellbeing?

Healthwatch North Tyneside carried out an Enter and View programme across 31 care homes for older people in North Tyneside (resulting in 32 reports because one home received two visits). The study examined how care homes provide meaningful activities and how these activities contribute to residents’ mental wellbeing. Volunteers spoke with 195 residents, 158 staff members and 65 visitors, alongside survey responses from relatives and members of the public. 

The report found that most care homes met basic expectations for providing activities, but relatively few demonstrated the higher standards recommended by NICE guidance on wellbeing in care homes. While there were examples of good practice, many homes needed to improve how they planned, personalised, evaluated and delivered activities. 

Most homes gathered information about residents’ personal histories, interests and preferences through assessments and tools such as Life Story books and “This is Me” profiles. However, these approaches were often newly introduced and not yet consistently completed for all residents. The report found that homes did not always use the information collected to create personalised activity plans or adapt activities to changing needs. 

Most homes planned activity programmes and advertised them through noticeboards, newsletters or other communication methods. Nevertheless, activity planning tended to focus on activities for the whole home rather than tailored plans for individuals or smaller groups. Homes that planned activities in advance and incorporated resident feedback were generally able to offer a wider and more responsive range of opportunities. 

Evaluation of activities was identified as a significant weakness. Although some homes collected feedback and monitored participation, most lacked systematic methods for assessing whether activities met residents’ needs. Feedback processes often focused only on residents who already took part in activities and rarely included those who chose not to participate or residents with communication difficulties.

The report found that homes used a variety of methods to involve residents and relatives in decisions about activities, including meetings, individual discussions and care planning. However, resident meetings were often poorly attended and did not always include people with dementia or those needing additional support. Healthwatch concluded that homes would benefit from using multiple methods to gather views and ensure all residents can participate in decision-making. 

Many homes encouraged residents to participate in activities through informal prompts and one-to-one conversations. However, there was limited evidence of systematic approaches to identifying and supporting residents at risk of loneliness or social isolation. The report highlighted the need for regular assessment of isolation risks and targeted interventions to maintain wellbeing.

Provision for residents confined to their rooms varied considerably. Some homes offered structured one-to-one activities such as reminiscence work, hand massage or technology-based activities, while others relied mainly on informal visits and chats. The report concluded that homes need more consistent monitoring and provision of meaningful activities for people unable to leave their rooms. 

Most homes made some effort to ensure activities were accessible, particularly for people with mobility difficulties. However, there was less evidence of adaptations for residents with hearing impairments, visual impairments, mental health conditions or dementia. The report recommended more systematic planning to overcome these barriers. 

The Enter and View teams found that care homes generally offered a good range of group activities, including arts and crafts, music, games, entertainment and outings. One-to-one activities were highly valued by residents, but their availability varied and was often dependent on staff capacity. Social activities were common, although more could be done to support relationships and friendships between residents. 

Many homes had links with schools, churches and community groups, and some regularly supported residents to attend community events, shopping trips or social clubs. However, opportunities for residents to leave the home were not always monitored or available consistently across all homes.

Most homes provided some form of physical activity, such as chair exercises, gardening and outdoor walks. Nevertheless, opportunities for residents who were bedbound or highly dependent were more limited, and there was little evidence of collaboration with physiotherapists or occupational therapists to support activity programmes. 

Daily living tasks, such as setting tables, preparing vegetables, dusting or helping with household activities, were one of the weakest areas identified. Although some homes encouraged these activities, they were generally ad hoc and available to only a small number of residents. The report argued that supporting residents to maintain independence through everyday tasks should become a routine part of care. 

A major theme throughout the report was the difference between homes that adopted a “whole-home” approach to meaningful activity and those that relied largely on an activities coordinator. In many homes, activity provision depended heavily on a single staff member rather than being seen as the responsibility of all staff. Healthwatch concluded that meaningful activity should be embedded throughout daily care and supported by adequate staffing, training and resources. 

The report recommended that care homes develop a whole-home culture of activity, create individual activity plans for every resident, improve evaluation systems, reduce social isolation, increase opportunities for daily living tasks, and ensure that all staff receive training in facilitating meaningful activity. It also recommended that commissioners strengthen requirements around activity provision and that the Care Quality Commission place greater emphasis on meaningful activity and wellbeing during inspections.