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Quality improvement through the paradigm of learning

Trish Hafford-Letchfield (Professor of Social Care, Department of Mental Health, Social Work and Integrative Medicine, School of Health and Education, Middlesex University, London, UK)
Peter Lavender (Professor of Education, University of Wolverhampton, Wolverhampton, UK AND Senior Research Fellow, National Institute of Adult Continuing Education (NIACE), Leicester, UK)

Quality in Ageing and Older Adults

ISSN: 1471-7794

Article publication date: 14 December 2015




Achieving meaningful participation and co-production for older people in care requires radical approaches. The purpose of this paper is to explore an innovation where learning interventions were introduced into care settings and older people matched to community-based learning mentors to develop partnerships. The authors explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship-based approach to promote wellbeing.


A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement.


Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support.


Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes.



The Authors wish to acknowledge and thank Learning for The Fourth Age who commissioned this research and Big Lottery Silver Dreams Fund who funded the evaluation. Also to all those participants who gave their valuable time and support to help us do the work.


Hafford-Letchfield, T. and Lavender, P. (2015), "Quality improvement through the paradigm of learning", Quality in Ageing and Older Adults, Vol. 16 No. 4, pp. 195-207.



Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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