Care Home Cwtch Peer Support – supporting care home managers across Wales

Care Home Cymru is a national improvement programme for older people living in care homes in Wales. We work with care homes who are passionate about improving the quality of life and the care for their residents.  With the outbreak of the pandemic our work in the programme has focussed on how we can work with this sector as seek to adapt to dealing with Covid-19.

Our journey began in 2019 where we worked with the sector to demonstrate how ‘improvement science’ can play an important role in supporting care homes. Working alongside a small number homes across Wales, we wanted to see how the principles of quality improvement could work in the care home setting.  We know that their staff make improvements in the way they carry out their work every single day – for their colleagues and the residents they care for. However, the majority didn’t have experience of recording what changes they had made and what difference it had made. This is where improvement science comes in. By experimenting with changes that start small and test out new ways of working, recording what has happened (for the better or worse) and either adopting those changes or adapting those changes has been an approach that has been well received. By creating an atmosphere where no learning should be seen as a failure, it is valuable in showing what can (and does) go wrong.

In the early stages of our programme, we focused on building capability and capacity through quality improvement methodology and ongoing coaching and mentoring.  Our goal was to nurture care staff to ‘think differently’ so that their approach to their working day was through an improvement lens. Several studies have shown that ultimately, this will result in not only ongoing improvement in quality of care, but also increased staff engagement and satisfaction. It is for this reason that engaging with care home staff in improving care during unprecedented times and service pressures is an issue of the highest priority. COVID-19 has had a devastating impact on this population group and has brought about many challenges, not only for care home staff but also for residents and families.

Throughout the pandemic, we engaged with care homes to better understand what support was (and still is) required.  We partnered with Age Cymru, Social Care Wales and Digital Community Wales to develop a platform that offers peer support to care home managers. 147 care homes were able to engage with us and 86% of these thought a network for sharing and supporting different ways of working during the pandemic was needed. Subsequently the Care Home Cwtch (a series of virtual regular support sessions) was launched in May.

Programme Lead Rosalyn Davies welcomes care home managers on a fortnightly basis and the key objectives are to:

  • share practical day to day solutions
  • problem solve to support improvements and innovations
  • support and offer peer supervision for staff within the sector; and
  • support care and better outcomes for vulnerable residents, including those living with dementia

In the very first session we asked care home mangers to describe their working week to give us all a greater understanding of the complexities they were facing. The outcome of this will stay with us for a long time to come. The common feelings reported were: ‘frustrated’, ‘scary’, ‘unknown’ and ‘awful’. The Care Home Cwtch is led by care home managers and is a safe space for them to build relationships with each other and to build resilience for the whole team.  We’ve had feedback from care home managers who attend the ‘Cwtch’ and they’ve said they find the sessions ‘supportive because they allow to me discuss common issues with my peers’.

Ensuring that care home managers have good health and wellbeing is paramount so that they can provide leadership and management and the ‘Cwtch’ also supports this.

To date the majority of activities have been delivered to support the manager within care homes.  Reflecting on the activities, we recognise there is a need for it to be developed for the well-being of all care home staff. We’ve also been developing a mobile app that is an accessible up-to-date platform for a wide range of resources. We hope to share further news on its development, launch date coming soon.

To find out more or to get involved, please contact