How many residents should I be left with on my own?
A guide to safe practice for activity staff.
I am frequently left open mouthed when, on training days for activity staff, students tell me that it is routine practice for them to be working in a room with large numbers of residents and no other staff present.
Only last week I heard from a lady who has worked in a care home for 8 months as an Activity Coordinator. She has no previous experience of care, has had no Induction Training and commonly finds herself alone in a lounge with 12 - 20 residents. She has dealt with 3 choking incidents in that time. On each occasion, she has had to shout for help causing distress to all those present whilst dealing with the poor resident who is choking. I would suggest that it was only luck that none of the 3 incidents turned into a major catastrophe.
At NAPA we feel strongly that no one should try and support more than 6 people in a room without additional staff support. It is just not safe for either the residents or that staff member. I don't know of any other role in care that would have this expectation of just one person for even a few minutes let alone the 90 minutes that this lady was trying to do.
So what do we advise people to do in this situation? I tell them to leave the room as soon as 6 residents are present, find the senior person in charge that day and say that they need another staff member to be present otherwise they will be embarking on unsafe practice. If another member of the team is not forthcoming they should return to the senior and advise that either the additional numbers of residents are removed from the room for their own safety or the Activity Coordinator should terminate the session and move on to one to one or small group work that is safe.
Of course, we would advise that this situation should never arise anyway. If an Activity Coordinator is working effectively they will be inviting particular residents to a group session. They will have assessed who will benefit from the group, matched the skills of the participants and tailored the activity so that all will benefit. This may mean that a craft based activity is run 3 or 4 times over the course of a morning working with small groups for about 40 minutes at a time. This approach means we are offering person-centred activity provision.
Sadly what we hear about more often is the group session involving anyone who happens to be in a given lounge. The published programme, for example, may say Quiz Time at 11am in the lounge. The care team may start bringing people along to the lounge once they are up and dressed and had breakfast. For some this will be way before 11am. More will be rounded up by the Activity Coordinator who hopefully knows who may enjoy a Quiz. By 11am the room is full, the care team have moved off to do other things and the Activity Coordinator is left to be a Butlins Redcoat style entertainer for a disparate group of residents in an unsafe environment. This version of activities is then praised by the Manager for having 20 people in the session. Quantity over quality rules!
So for lots of good reasons - most importantly on safety grounds - we hope that Activity Coordinators will no longer accept being put into this position and Managers will not expect it to happen.
*All information is correct at the time of publishing