A question of quality

Caroline D’Souza explores what constitutes quality within arts and health practice?

Since having moved on from my role as Arts Development Manager at Jewish Care a couple of months ago, I have had some time to reflect on some of the issues that arose throughout my 5 years in the role.

In this position I had the opportunity to recruit a pool of experienced skilled participatory artists to work as freelancers within the charity’s 11 care homes. The result was a group of participatory artists spanning the creative arts, who were highly experienced in working in care settings with vulnerable adults. Many of them had been working within the field of arts and health for many years. Central to their work was the ability to literally ‘reach’ people who others had defined ‘unreachable’ – people living with advanced dementia, some who no longer had verbal capacity, some who were isolated, depressed or slept a lot.

I witnessed many moments of ‘ magic’ that happened in these interactions, where residents who rarely engaged in activities or life, come to life, fill with joy, sing, dance, express themselves, interact with others, eat better, become calmer. These moments are different for everyone and sometimes the subtlest of movements or glint of an eye can be as significant as a more obvious response.

What is this ‘magic’? What is happening?

The importance of ‘quality’ in arts and health practice is a frequent point of discussion  but what are the key attributes of a participatory artist, that constitutes quality? In writing a brochure to introduce the concepts and ethos of participatory arts to my social/health care colleagues at Jewish Care, I started to really explore this issue. I needed to outline best practice in this area. After all, I was introducing a new programme of participatory arts activity throughout the care homes and I needed to explain how it was relevant and of value.

I focused on what happens in the dynamic between participatory artist and participant/s. I described best practice as including:

  • The importance of the quality of contact and attention given to an individual
  • The ability to able to step into someone else’s world and enter into a moment together
  • The ability to use creative activity as a bridge to communication
  • Providing choice at an appropriate level for the participant
  • Focusing on the person and their strengths rather than illness

This definition works but there are more nuanced things that these points didn’t quite encompass…

At the last arts forum for our participatory artist pool in June, we spent the day exploring the processes, strategies and skills that were central to the artists’ practice.  One of our experienced artists presented her work sharing how she is able to affect/ change the care home environment as part of her immersive storymaking sessions. In describing what happens in the sessions, she talked of ‘holding the magic’, taking people on a journey during which she is tuned into each person, present, reading participants responses and needs, in order that all are included as well as keeping people on board and not let anything disrupt the process.

She says of the process of storymaking with the group, “I must relinquish control, then juggle, create -whatever comes from them; they provide the content for the session.” This example, of one artist’s process, shows a combination of artistry and highly developed interpersonal skills. This begins to unpack what is happening within the dynamic between artist and participant.

Creating context

The importance of understanding the context of where you are working and building relationships throughout the care home community is key to delivering quality participatory arts work. Often arts practitonors are seen as ‘other’ in care settings and are perceived to be providing something that is not relevant to the care team’s work. However, by working in a person-centered way with the staff, encouraging them to share their own interests with the residents, value their own attributes and inherent skills, our artists were able to win their trust. Also important, was the fact that artists had knowledge and understanding of the daily structure of the home, the challenging issues facing the staff and thus were able to show empathy, support and understanding as well as offering a flexible approach.

There is one more essential point to make and that is, only a supported and supervised workforce can provide sustainable quality work. What I’m referring to here is the fact that traditionally, participatory artists do not receive supervision (unlike arts therapists, psychotherapists, social workers, care teams etc.)  As I hope I have illustrated in this piece, the work of participatory artists can involve the same extent of complexity and sensitivity as the professions outlined above, yet often a chance to reflect, address challenges receive support, doesn’t exist for them.

There is a huge gap here, this is a growing field with an all party parliamentary inquiry that’s evidenced multiple research studies proving the worth of this work, and with the government putting £4.5m into social prescribing schemes across the country. If we do really value this work, and are concerned with issues such as quality and best practice, why are we not providing support for the artists that are leading the way in the field?

Today, LAHF is hosting an event addressing this issue, a really encouraging move. I will be there and look forward to sharing views on a way to move forward to provide the support and supervision that participatory artists deserve. The best practice surely deserves the best support.

Caroline D’SouzaCaroline D’Souza
Consultant Arts Management



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