Impact case study database

During 2016-2020 the research has engaged with residents and staff in a total of six care homes across Angus and Tayside, leading directly to social, physical, and emotional benefits for residents; it has changed the ways in which care homes understand and use film, as well as their management of associated resources. The project has generated impacts from its earliest phase as a pilot study, with subsequent expansion through support from national regulatory bodies The Scottish Social Services Council, and the Care Inspectorate.

In 2016 The Scottish Social Services Council published an interview with Drs. Salzberg and Breckenridge, as well as distributing their project summary leaflet to all care homes in Scotland via an online newsletter. This enabled researchers to establish a collaboration with the Care Inspectorate, which sponsored a series of improvement workshops based on the research.

Benefits to Residents

The project has changed the ways in which care homes use film. Prior to the research, homes typically adopted a variable definition of the ‘film’ (using it to refer to anything from YouTube clips of animals and musical concerts to episodes from television sitcoms) rather than a feature-length narrative production: “ What we usually do is half an hour then we’ll stop and do something else” [E1]. Our research countered this norm by exploring the importance of running narrative films in their entirety, an approach which has led to immediate physical, emotional, and social benefits for participating residents.

In response to music and dance numbers, residents clapped their hands, swayed to the music, tapped their feet, sang along, and some even got up to dance. According to one resident “ It takes all your will power to stay in the armchair and not jump up” [E2]. In another home, a staff member noted “ we have one lady who has a terrible time trying to sleep and managed to get a sleep [during] the film… [Another] lady with very advanced dementia was singing” [E7] while watching the movie.

These physical benefits were complemented by emotional shifts, with staff commenting on the ability of film to change the mood of the individual: “ I’ve seen that just now, because… with [X], we’ve had a few issues with her behaviour this week and I’m seeing [she is] back to being [herself] just through the power of [film]” [E3]. Staff in the Care Inspectorate-sponsored workshops also spoke of behavioural changes: one “ resident can be quite aggressive due to their dementia, and we noticed that they were calm and smiling during the course of the film… This was an unusual thing for them” [E7]. Similarly, another manager found “ a pattern of reduced restlessness and agitation” for residents [E6].

Staff were equally struck by the increased intergenerational social engagement that was facilitated by screening films in their entirety, with some visiting relatives choosing to join their loved ones in watching the films [E7], and others giving “ pointers for meaningful films” [E6].

During 2020 there were also COVID-related benefits for residents. One home noted that our research “ prompted [them] to use film as a meaningful activity” [E6] during the crisis. Another commented in an email, “ I am pleased to say residents have continued to enjoy a lot of movies [in] their own suites due to social distancing… Residents continue to have input and choices of movie and viewing times” [E9].

Benefits to Staff and Changes in Practice

The positive impact on residents helped change frontline staff perception of film screenings. Initially several staff had voiced reservations, concerned that the screenings would not make a difference, however managers have noted that these perceptions have since changed: “ Staff… had initial reservations or worries, however now they can all see the benefits… [staff] are not so worried about what's going on in the rest of the unit… as residents are more relaxed and settled watching the film” [E6].

Participating homes have also changed practice in terms of presenting films, and in the use of associated resources. With one manager noting that the way the home presented movies had “changed dramatically” [E4]. This manager represented one of two homes that established a dedicated cinema room following on from the success of the pilot-study screenings [E4, E5]. Similarly, a manager participating in the improvement workshops noted, “ Taking part in this project has taught me to look outside the box… Staff are more aware of the residents' choices around movies and could add this into their support plans” [E6].

This project led to broader benefits for staff via their roles as participant researchers in the co-creation of the Film in Care resource. They acknowledged feelings of increased agency; as the Care Inspectorate improvement advisor noted, “[Staff] felt empowered by being directly involved in the project from the beginning and the design of the project was open enough that they were able to modify and test changes in a way that suited the individuality of each home… [Care home staff] visibly improv[ed] their confidence and potential for innovation as the project progressed” [E8].

Improving Standards of Care

Such benefits to residents and staff have helped expand the scope of impact to include changing how regulatory figures view the use of film in care homes. The improvement advisor reflected, “ Before becoming involved… I shared a common view that watching film was a passive activity only” [E8]. Following the completion of the workshops, however, she found that the project had significant implications for the homes’ standards of care: “ *As is evident in the [Film in Care] resource and the quoted Health and Social Care Standards, the homes are all improving their standards of care due to this.*” She also noted, “ The Film in Care project ethos directly matched the Care Inspectorate’s vision for collaboration and improvements alongside those in the front line of services and those being cared for” [E8].

The partnership with the Care Inspectorate has resulted in a resource on Film in Care co-created with participating homes. Though delayed by the COVID-19 pandemic, this resource will be published by the Care Inspectorate in 2021 for all 817 care homes across Scotland and will include the importance of screenings as a COVID-friendly activity [E8].