Highly Commended Evidence of Outstanding Activities Competition Entry Acknowledgment

Each quarter, we receive many detailed and considered entries to our Evidence of Outstanding Activities Competition. Whilst the cold realities of the competition allow for only one ‘winner’, in instances where another Home or Activities Coordinator has demonstrated exceptional transformation, connection or inspiration, we like to further acknowledge this by awarding certificates of High Commendation. For our winter round, we awarded one of these acknowledgments and certificates to…

…Gemma Smith (The Grange, Forest Healthcare). Her entry was Highly Commended for involving colleagues and building the home community. Her submission wonderfully demonstrated her skilful ability to build curiosity and anticipation, to inspire and enable participation - both planned and spontaneous - and her foresight and capacity for considered follow-up.

She used specific Rebel box dress-items to pique interest: the tattoo sleeves being used and worn by resident Teresa causing such joyful laughter that ‘everyone who happened to be in the area at the time was dragged into the action.’ Staff dressed up and posed for pictures with residents, which really ‘helped them to see the value of the boxes,’ with residents taking on ‘new personalities’ and feeling ‘young, vibrant and involved.’ Following this successful interaction, the home developed their own mobile photo booth and created a photo album, which now welcomingly greets visitors at reception. Family members can also use the album to request copies of photos of their loved ones.  

A great outcome and a clear demonstration of how materials can be adapted to evolve and extend an activity and interaction.

Great work guys!

Elliott Grigg - Administrator & Project Officer

A Game is not just for Christmas ……

Jude Sweeting, Director of Quality & Enjoyment

‘The room was filled with laughter and everybody embraced the project so now we’re going to do something like this every month!’

It’s great this month to hear the new possibilities emerging from the senior team at Halliwell, in Tunbridge Wells.  They had a go at exploring playfulness by playing a game together. At Ladder to the Moon games are not just for Christmas and not just for children either. A game is something where people invest their time fully together in a process of ‘doing’ without – for once – being concerned about the outcome.

They allow for some ‘messing about’ by creating false purpose. Messing about is not just a great pastime it allows people to ‘re-create’ themselves as individuals and we strongly recommend it.

So why might all this be particularly important in a care? Well we notice, and people tell us, that actions and conversations in homes tend very often to focus on the achievement of specific outcomes.

While these conversations can still be creative in nature the outcome focus can constrain the thinking to doing the things that we know will work. Nothing wrong with that but often there is no newness, inspiration is missing and there is no space for discovery.

As part of the support we give to companies developing their culture of creativity, we ask leaders in homes to try out new approaches with their teams that open up playfulness. We ask people to try out some ‘games’ together because ‘games’ provide fresh opportunity to build openness, acceptance and relationships.

Games allow a world where the outcome doesn’t really matter – even though we may feel the edge of competitiveness in the playing.  We have found that to improve relationships and trust the most productive games are often those that have the most impossible outcomes to achieve. And they usually cause the most laughter, which allows for openness and connection.

Such was the case at Halliwell when the Heads of Department, who meet every month, were split in to 3 groups and asked to build the tallest tower in 30 minutes, out of sellotape, marshmallows, string and spaghetti (uncooked!).

Each team member was assigned a role e.g. time-keeper. They discovered their ingenuity more as the materials ran out, in the case of the sellotape, or simply didn’t comply as when spaghetti snapped and marshmallows melted.

I am told that the results rival the famous towers of Blackpool and Paris – and the leaning tower in Pisa and the team were talking about their efforts for days afterwards.

Congratulations Halliwell for bold creative leadership and encouraging the heart of the senior team!


How watching TV ‘soaps’ can encourage the heart of care ....

It’s always worth noticing what kindles the seed of an idea to flourish into a vision worth pursuing ….

‘Holby City’ was the inspiration for a Home Manager I spoke to recently. She had watched an episode in which a dying man had expressed a wish to feel the sun on his face. She easily made the creative connection between this heartfelt request and the situation that people at the end of their life in her home might find themselves in.

Her home is deep in the Gloucestershire countryside and has great outdoor space with many mature trees. Residents already have great social times and relaxation in the garden but often these do not include those who are the most frail. But thanks to Holby City two thoughts combined afresh (the feel of the sun and the thought of her home’s beautiful garden) to produce a new and compassionate possibility.

The manager has set a goal for next year, which is to have a summerhouse – ‘a place where many things can happen and where people at the end of life, if they wish it, can come out in a protected chair to “feel the sun on their face”.

3 tips on Inspiration:

·      It often comes from unexpected places

·      It makes you want to act to change something

·      It will wear off so best get started!


Jude Sweeting, Director of Quality & Enjoyment 

The Outstanding Activities Competition Winter Winner is ….. [drum roll] ........

Amy Roberts – Maidstone Care Centre (Ranc Care)

Amy’s entry impressed the selection panel, specifically for:

  • Leadership and openness – showing a responsive approach to the icons Photo Shoot box
  • Noticing further potential and her ability to deliver impact - personalising her approach in responding to residents
  • Transforming crises into opportunities 
  • Embedding her practice

The Evidence:

During the home’s first session using the evocative Icons Photo Shoot activities box, a resident began to discuss his time in the army and the different uniforms worn. Seeing the opportunity present in this engagement, Amy and the activities team decided to extend the ‘dressing up’ aspect of the box. They sourced additional armed forces uniforms – both Navy and Army – from the local theatre’s wardrobe department and gave residents another opportunity to not only ‘dress up and have their pictures taken’, but also, invaluably, another opportunity to connect.

Amy elicited interest and aroused curiosity in the uniforms and event by donning first the Red Cap uniform and then the Wren’s uniform and enjoyed her own multiple ‘tours of duty’ around the home.

Residents were both surprised and amazed, with some commenting that the event was ‘better than Christmas’, with the original resident whose memories sparked this new opportunity thoroughly enjoying dressing up as an army officer. He had his picture taken and has it framed and proudly on show in his bedroom.

To further broaden the impact of the activity, Amy wrote a report, replete with photos, and disseminated it amongst interested parties: staff, relatives and visitors. And perfectly summarised the moving impact the occasion had on the activities staff with the heart-warming quote: ‘None of us were quite prepared for the reaction of some of our residents…and the emotion in their eyes that left us all with a lump in our throats.’

Congratulations Amy and well done to all the staff and residents of Maidstone Care Centre!

Elliott Grigg, Project Officer



The home that moved Christmas .......

What a joy to be on a Centre for Creativity & Innovation in Care webinar recently with a home manager from Harrogate.  2016 had not been the greatest of years for this manager, who had experienced a CQC inspection just a few months after coming into post and before the home had fully realised the benefits of all her work for change.

The inspection report had been hard to embrace and had left the home team low.  Further bad news arrived with the cold December winds when nasty infectious viruses forced the home to close to visitors right across the Christmas period. So Christmas became a moderate affair unshared by residents with their loved ones.

The manager chose her attitude. Having dealt with the ‘crisis’ she looked for the ‘breakthrough opportunity’ hidden in the ‘breakdown’. She and the team decided to ‘redo’ Christmas. So on January 11th the home was doing all its rituals for Christmas eve. January 12th, Christmas Day, saw the post man come in especially to wish the residents a happy Christmas, the staff wore their Christmas jumpers and Christmas dinner and games were enjoyed by families and staff in great spirits.

Finally, January 13th was confidently declared Boxing Day by one and all and the buzz has lived on well into February.

Crisis? What crisis?


Jude Sweeting, Director of Quality & Enjoyment


Post inspection blues – and outstanding habits ....

Jude Sweeting, Director of Quality & Enjoyment 

It is disheartening for homes to hear post inspection that they are at the upper end of Good when they have spent months of personal investment to achieve Outstanding. And of course it is joyful to achieve an Outstanding rating where, in the exposure of an inspection, nothing seems guaranteed. In both cases however there is the aftermath of the inspection and some kind of rallying and refocusing.

Two weeks ago I had my first coaching call of the year with a home which achieved a CQC rating of Outstanding late last year. I left the call even more convinced that Outstanding is a leadership mindset, which produces behaviours that once ‘turned on’ become as natural as breathing.

The CQC rating is an important validation with powerful business consequences and we all need to understand what is needed to achieve this. There is much learning to be done as we seek to share an understanding of creativity and innovation in care services.

Arguably, authentically outstanding homes won’t need to ‘bounce back’ post inspection. They won’t need to spend lots of time ‘managing’ being unsuccessful or successful (after the final result and even if it seems unfair) as they already have a higher investment in the process of innovation and creativity than the outcomes these produce.  They just will continue to be innovative in their behaviors because they have lots of evidence that pleasing outcomes will follow in abundance. Stretching is not just for inspections (or even Christmas) it is a habit of success.

Where there is a post inspection sense of‘returning to business as usual’ or even ‘its now time to refocus’ it is important to get back to ‘clean slate’ thinking.

So what was it about the post inspection Outstanding home on this call with their home manager and activity leader that gladdened my heart? It was a sense of unstoppable creative confidence with tangible indications that innovative behaviours are routinely automatic:

  • Natural future focus: ‘yes we had the (CQC) celebration party before Xmas, it was lovely, but that was ages ago’


  • Noticing impact and feedback:  ‘our new electronic care records mean that I had 4 staff attending an afternoon social event last week – that is unheard of!’


  • Willingness to learn, exploit, hoan, combine and build: ‘I’m seeing that if we do more work matching staff with residents we can use the ‘new’ time for more outings and ‘in home special times’.”


  • Commitment to relationship building using the whole team: ‘we used the tool you sent us and 20 of the staff have done their relationship circles – I’ve been really amazed that some of the residents who I had on my outer circle (less energizing relationships) were in the centre circle for a number of staff – there’s a lot we can use here’


  • Inclusion and curiosity underpin investment in enquiring: ‘I will complete the tool with all the staff so we can see it all’


  • Risk–taking and working to be leader proof: ‘we had to resuscitate a resident recently and I stood back to allow other staff to put their learning into practice. Often the home manager is expected to do the CPR. I’m doing this to encourage staff problem solving too by saying‘I haven’t got time – come back and tell me what you have done’


  • Playfulness that encourages the heart of positive relationships: ‘I asked staff to share a proud achievement in their lives and created a game for the residents to guess which member of staff had done this thing. They loved it – when the residents weren’t sure who we were talking about I re-introduced the member of staff to them’


To the Moon!!

Ladder to the Moon's - No. 1 Tip for Christmas and beyond - settle back and find some Hygge ....

December 20th 2016

For those of you well on the path to Christmas you may have noticed that books about ‘Hygge’ (pronounced hue – gah) the Danish word for a feeling that most of us know but find hard to define, have been ‘the thing’ this year. If you work in a care home its still worth putting them on your Xmas wish list to Santa, or spending your Christmas present book vouchers on as they have many hints and tips applicable to boosting well-being for those living in care homes. And they will be thought provoking about the meaning of home, chores and the mundane in your own life too.

Hygge is variously defined as a quality of presence, an experience of togetherness and it’s a feeling of being warm safe comforted and sheltered. It’s about feelings of relatedness and contentment, that the self and belonging to the moment matters – and that these things are worth our regular attention in every day life.

The Danes as a nation score very highly for national well-being and so a book on Hygge will likely give you plenty of ideas of how to create inclusion and comfort for individuals and for groups of people. At its heart Hygge is usually about savouring a very simple sensual experience of ordinary life, often shared with others, and where something is enjoyed for the comfort and/or connection it brings.

The winter season abounds with such opportunities. Real fires and candlelight feature very strongly for Danes throughout the long months winter and although these are usually not do-able things in nursing homes there are plenty of other simple offers where Hygge moments can be created and shared e.g. a warming hot chocolate served in a favourite mug and in a peaceful corner, a special cosy blanket, a plate of mince pies specially presented in subdued lighting to share with a friend or in a small group, perhaps with a glass of sherry.

Combining these small ideas with another aspect of Hygge which is to enjoy contrasts, like hot and cold, dark and light means that small chunks of time can be quickly upgraded from mundane to special. None of this is rocket science but the important rule of Hygge is that people are mindful about creating enjoying simple moments together and everyone in the group works hard to have others be accepted, included and supported to be themselves. And that a ‘comforting home’ is an act of creation wherever you are.

Seasons greetings one and all!

Jude Sweeting, Director of Quality & Enjoyment

Wait a minute Mr Postman ……

Ashley Gardens recently took delivery of a creative resource box from Ladder to the Moon called “The Post Box” this is the story of what happened next ….

They got creative of course!

The first step – who do we want to get in touch with and why? The outcome of this thinking has not only resulted in strengthening connections with the local community, but also an international flurry of contact, which has brought delight and a few surprises to everyone involved.

Postcards have been sent to residents’ friends and family in Russia, Greece, Italy and France, to funeral directors, local schools, the WI, other local care homes and …… they are beginning to receive replies!

This amazing and otherwise untapped level of contact and connection, sparked off the idea to create a visual journey for the home – they now have a large wall map of the UK and another of the World – every postcard received is displayed on the wall with a piece of cord running from the postcard to its location on one of the two maps.

Resident Penny Jones has been nominated “post lady” - she dons the post cap every morning and goes to check the Post Box made by residents for any new arrivals.

Penny Jones collects the post at Ashley Gardens

Penny Jones collects the post at Ashley Gardens


Ladder to the Moon supports WCS Care Achieve Outstanding Overall - 5 Outstanding overall

"The work we embarked on with Ladder to the Moon helped us to understand the journey we were on which was to develop creative practice and creative leadership" - Christine Asbury - CEO WCS Care

National Care Forum Executive Director Vic Rayner interviews WCS Care Chief Executive Christine Asbury about the Warwickshire-based care home provider's fifth 'Outstanding' from the Care Quality Commission.

Christine, also a Founder Member of the Centre for Creativity & Innovation in Care - www.creativityandinnovation.care -  speaks about the role Ladder to the Moon has played in supporting their success.

Ladder to the Moon has, over the last 18 months, supported 3 providers and a total of 9 care homes to achieve Outstanding Overall .... 9 homes and counting!

On capturing imps and scribbles (and why post-its were invented)

Mary Oliver in her essay on ‘Power and Time’ writes about how creativity sometimes needs concentration without interruptions ‘– a place apart – to pace, to chew pencils, to scribble and erase and scribble again’.

She talks too of how easy it is for your mind to distract you with some other seemingly more pressing issue like phoning the dentist or buying mustard. And how we always react and when we return ‘the imps of the ideas have fled back into the mist’……..

Jude Sweeting - Director of Quality & Enjoyment