PR 00170 - Design and Develop

Description of the project and the local area

(Including needs assessment or/and, other data sources available for your target population and area.) Is there a history in your area of social innovation or collaborative action with communities? The projects involve La Ritournelle, a retirement home created in 2014 and located in Villeneuve d’Ascq (59). The establishment is in a recent residential neighbourhood. La Ritournelle is an establishment belonging to the AFEJI association. AFEJI manages a large number of social and medico social services for elderly people and demonstrates its continued ambition to daily pursue its “fight against all forms of exclusion. AFEJI specialized establishments are living labs to elaborate, develop, test and evaluate innovative methods to support the elderly autonomy. The establishment hosts full-time 73 residents needing help for everyday life activities, 22 of them living in sheltered units due to cognitive disorders. The average age of the resident is 83 and the average duration of the stay is about 2 years, mostly interrupted by the death of the resident. 60 professionals work in La Ritournelle, including:

• A director,
• 2 managers (one in charge of the sanitary and medical aspects, one in charge of housing and leisure activities),
• 1 animator and 1 to 2 part-time volunteers (24 hours a week),
• 1 psychomotor therapist, full time,
• 1 psychologist, part time,
• Nurses
• Professional caregivers with various statuses taking care of the residents in the everyday activities.

La Ritournelle is involved in WP1 (soft gym and trail on the coast) and WP2 (animal mediation) and plans on testing various pilots in this frame. It is not usual at all for such a retirement home, especially as the residents are mostly very old and handicapped (only a few able to walk with or without assistance, many with advanced cognitive disorders). The association AFEJI core value is to “fight against all forms of exclusion.” It reflects in the strong will from direction and professionals to be very careful not to exclude anyone from the activities. It has two implications:

1. The activities must be designed for all residents to be able to participate if willing to. Some adjustment will be made, especially for the WP1 activity (focused on physical activity and walking) to involve the residents unable to walk as well as to offer an opportunity to those who can walk to preserve this capacity by training regularly.
2. The cost must not be a limitation to participate to the activities.

Activities of WP2 look at how animals can be incorporated in a wider care concept for elderly people. So far animals are used in care only in a domestic setting and often only when people are already not able anymore to leave their home or are confined to bed. It may be promising to use animals also in a preventive care concept. Leisure farms that are now mainly targeting children as well as normal farms may thus also extend their commercial and social activities. Target population involves:

• The residents of the establishment, indifferent to their health condition.
• The caregivers (family and friends of the residents)
• The local population especially the elderly living in the neighbourhood.

We do not exclude the eventuality of widening the target population if there were any opportunity along the project. These 2 work packages create a coherent set of activities so as to stimulate active ageing and longer independent living among the targeted population. It is to be noticed that the residents’ caregivers are often over 60 themselves and thus in the scope of the SAIL targeted population. Needs assessment includes:

• Study of the University Picardie Jules Verne (partner 11) about the elderly leisure activity, containing a field study run by 2 interns (psychologists to be) inside the establishment to assess their needs regarding leisure activities regarding possibilities for WP1 and WP2.
• A study from the CCAS (communal social welfare centre) about the elderly in the city of Villeneuve d’Ascq and their needs 
• Statistics established by the French National Institute for Statistics and Economic Research ;
• The professionals of La Ritournelle because they have a very accurate knowledge of the residents needs and preferences;
• Questionnaires distributed to the residents (especially about animal mediation).

There is no known history of social innovation within the establishment or the area.  However, collaborative actions of the establishment with community include:

• Regular visits for shared activities from the children of the day care centre all year round.
• Weekly visits and shared activities with teenagers from a Centre for Psychologically or Emotionally Disturbed Youth, during school year,
• Visits and shared activities with residents from La Source, residence for ageing persons with disabilities several times a year,
• Visits from the TA1AMI association’s volunteers (1 volunteer visits on a regular basis 1 residents and share activities with him/her),
• Some shared activities with elderlies of the city organised by the department for senior citizens (including another retirement home).

Assets and resources

What assets or resources including expertise has your team got that helped you get started with this project? AFEJI has a strong local anchorage and implication, which has been an asset in approaching unexpected partners and soliciting to meet them. AFEJI reputation and contacts has been of great help. Another asset has been the project management led by the international department of AFEJI, which has acquired a strong experience in European projects management. Dedicated human resources from this department include:

• an experimented project manager dedicating 40% of his time to this project,
• a project coordinator hired in April 2018 working full-time on this project.

Internally, AFEJI has an important amount of experienced professionals with technical competencies such as accountability and other supporting functions. The professionals of La Ritournelle are highly qualified, dedicated and motivated. They are key resources of this project and an asset to develop and set up durable, audacious and relevant pilots. They bring a sharp knowledge of elderly in general and of the residents in particular as they get to spend an important amount of time with them on an everyday basis. They were willing to set up new innovative activities even before the SAIL project was granted. Social innovation process experimented through SAIL has been an opportunity to impulse some new energy and methodology so as to renew processes and everyday work. 

Geographical setting

Please describe where your project is based, is your project based in a rural or urban area, area of catchment for participants, is it on single or multiple sites? The project mainly takes place in a retirement home, La Ritournelle, located in Villeneuve d’Ascq, Hauts-de-France region, France. Villeneuve d’Ascq is a peripheral city of Lille, Nord and counts 63 000 inhabitants. It is an important spot at many levels:

• One of the main economic spots of the Hauts-de-France region, various kinds of businesses, both French and international, have their headquarters in the city;
• An academic pole with 42,000 students and 2,5000 researchers;
• A hub for sports and culture.

Nonetheless, it has about 10km² of greenspace, lakes, forests, hence its nickname of ‘green technopole’. Villeneuve d’Ascq belongs to the Lille European Metropolitan community, an intercommunal structure (90 communes) centred on the city of Lille and bordering Belgium. Its population is about 1, 150,000 in 2014. Learn more about Villeneuve d’Ascq : https://en.wikipedia.org/wiki/Villeneuve-d%27Ascq Learn more about the Métropole Européenne de Lille : https://en.wikipedia.org/wiki/M%C3%A9tropole_Europ%C3%A9enne_de_Lille La Ritournelle was built in 2014 in a newly constituted neighbourhood. It is located in front of a private hospital and surrounded by detached houses, large pavements and quiet streets. It is located about 3 km from the Parc du Héron, a famous green space of Villeneuve d’Ascq.

Current situation

`What currently happens` in relation to your project problem or issue, is your project new or are you building on an existing project? As a SAIL project partner, AFEJI engaged in WP1 and WP2. Due to the team enthusiasm, hiring of a project coordinator in April 2018 and new opportunities, many activities have thus been developed than announced, answering elderlies’ needs through innovative settings with leisure industry. Regarding WP2, AFEJI was interested in experimenting how animals can be incorporated in a wider care concept for elderly people. So far animals are used in care only in a domestic setting and often only when people are already not able anymore to leave their home or are confined to bed. It may be promising to use animals also in a preventive care concept. Leisure farms that are now mainly targeting children as well as normal farms may thus also extend their commercial and social activities. During the design and develop phase, new innovative opportunities were discovered, especially with animal cafés. We plan on testing the following activities, which is broader than what we enrolled in.

WP	Pilot	In a few words	Degree of novelty and how it incorporates into the establishment activities.
WP2	Leisure farms	Outing to 2 leisure farms and a donkey farm.	There were a will to incorporate some animal mediation in the care and leisure program of the establishment as the impact seems very encouraging, especially with persons suffering from cognitive disorders. The first inclination was rather medico-social oriented (a companion, guard dog). SAIL has been an opportunity to direct this activity toward some more leisure-oriented and innovative solutions, furthermore offering the chance to include more animal types than just dogs.

AIL has been an opportunity to direct this activity toward some more leisure-oriented and innovative solutions, furthermore offering the chance to include more animal types than just dogs. |- |WP2 |Animals cafés |Outings to 2 animals’ café, one with cats and one with dogs. |} We are currently fine-tuning the pilots and formalising the engagements with the partners. Please remember this lists are still provisional. Both work package AFEJI is engaged in (movement and sport; wellbeing) are already monitored and at the heart of attention as they are highly linked to quality of life, a major concern in retirement homes. Broadly speaking, SAIL has been an opportunity to set up in a social innovation process and unexpected partnerships tendencies that would have been established in a medico-social way with usual partners otherwise. The social innovation process has renewed the interest of the professionals for the job and made up for the fatigue and difficult work conditions as in any retirement home. The main challenges and identified risks are:

1. The project refers to very old persons (the average age is 83, most of the residents only stay up to 2 years in the establishment before they leave or die ) with major handicaps (physical or cognitive disorders, frequently both). It makes any outing really complex to set up as it requires a perfectly adapted organisation. The other identified risk is not to address only to the same few residents and make sure it benefits to a wider audience.
2. Lack of resources. The establishment does not have any financial resource to allocate to the project, which means most of the activities are being funded by the participants themselves. Finding a proper economic model that would be a long-term solution, affordable for the participants and allowing maintaining the activities in the long run is still a challenge.
3. Retirement homes are not some attractive places which makes it complex to create and maintain some dynamics not to mention encourage exterior visitors to get inside the home for leisure activities.
4. For this project, the professionals are key resources and the skills and competencies are not interchangeable and do not overlap. If there were some professionals to leave, the project would be considerably slowed down. A special attention is paid to this point.
5. Usually, in the projects run by the establishment, there is a minor use of evaluation compared to the needs of the SAIL project.  

Demand

What would you anticipate the demand might be for your proposed project at this stage and what are you basing that forecast on? We anticipate the demand will be as high as the activities capacities (usually up to 10-15 persons except for the walks that are up to 6-7). Regarding the residents, the main limit is the size of the transportation mean and the impossibility for them to use another mean (public transportation would not be adapted for instance). Usually, demand is higher than offer for outings. We expect about 4 caregivers to each session and some participants from the neighbourhood. We do expect all activities to be at full capacity at the beginning and hope for the interest of the participants to be constant.

Expansion

Are you planning to expand an already-successful project with a different population or in a different setting? Please describe your reasons for this and what information you used to inform your decision? AFEJI specialised establishments are living labs to elaborate, develop, test and evaluate innovative methods to support the elderly autonomy. If the activities were a success, they could be extended to the other AFEJI establishments and promoted to a different scale especially through prizes and participating to specialised programmes in the active ageing field.  Furthermore, the SAIL project initiated a culture of social innovation among the professionals. This social innovation process is bringing new opportunities to the establishment to go beyond the classic limitations and habits of professionals and create win-win leisure-oriented dynamics leaning on innovative partnerships, in order to answer best the needs of the residents. It has been an efficient mean to give back some creativity and meaning to the everyday professional life routine. For instance, following the social innovation method, a new project was initiated: a therapeutic garden inside the establishment. During the exploration phrase, the reflexion on both work packages led to the need for developing a place that would host such activities inside the retirement house. The teams engaged in a process for creating a therapeutic garden, which is a garden inside the establishment with therapeutic purposes:

• It encourages physical activity (such as walking inside the garden to explore it, gardening, walk trails to train etc.);
• Gardens have a proved impact on persons suffering from cognitive disorders as senses and emotions can bring up some memories (limbic memory);
• There are a place where elderlies are not only taken care of but can take care of some living plants. This is the same aspects we were interested in testing in WP2 (animal mediation). The residents can also teach how to take care of some plants as most of them come from countryside and have taken care of a garden along their lives. 
• It is a place for sharing quality-time with caregivers.
• It increases the wellbeing.

For this new activity, innovative partnerships are initiated or pursued such as tourism office, local sports company etc.

Information capture for your project

Please make a plan and decide what strategies you are going to use and when. As a minimum everyone needs to keep their meeting minutes/notes and attendance details. Other ideas are photos/videos/diaries/attendance numbers/participant feedback/log book. In relation to the SAIL feasibility study you will need to be able to say who attended your project and when also including the participants age and gender if possible. The information capture will be made through different strategies:

1. Minutes and notes from each activity organised if relevant;
2. Attendance details collected through an attendance sheet so as to get the following information:
   1. Number of participant
   2. Name, age & gender
   3. How they got to know the activity
   4. How many workshops they attended
   5. Satisfaction collected with questionnaires & interviews
   6. Maybe some basic data on health condition

Photos will be taken.

Acceptability

How was the project proposal recieved by a) your team members/organisational partners b) your target community/potential participants? Evidence would include: participant observation at initial project meetings, qualitative interviews with participants and project staff or correspondence related to the proposal ie emails exchanges? The international department of AFEJI is headed by an experienced project manager and runs various European projects. The project manager dedicates 40% of his time to the SAIL project. AFEJI participation has been welcomed by the executive board. The establishment runs various projects, most of them ambitious and demanding. For instance, all professionals are trained to the Montessori methodology; there are many outings, intergenerational partnerships.  The team is usually eager to set up any meaningful project or programme that benefits the quality of life of the residents, especially in a preventive care setting. The project was considered an opportunity to set up new pilots and benefit the residents. However, it took some time before the teams could identify clearly the SAIL project among the other projects. The residents considered the project for what it brings them: an offer for new activities. Despite the world café session, most of them do not make any difference yet between the establishment animation programme and the SAIL activities. Not all resident are usually willing to participate to activities and there is a core group more enthusiastic than the others for various reasons. The stakeholders all considered the project was innovative and generated significant interest. The data was mostly collected through participant observation.

Adaptation

Have you made any changes to your original plans, why did you make the change and what information did you base your new plans on? AFEJI originally enrolled in testing 1 WP2 activity: Animal mediation in leisure farms (WP2) In addition to the experienced project manager working 40% of his time on the project, a project coordinator was recruited in April 2018 for the design and develop phase, working full-time on the project. As a consequence of this human resources addition (more time to develop activities), some new activities have been contemplated, such as a donkey farm but could not be realised due to complexity.    We did not make any change on the activities AFEJI originally enrolled for, however many minor adaptations were often made during the project on the activities “extension”. They were due to challenges met or to new opportunity (for instance an opportunity for a new innovative partnership). While developing, some adjustments were made, mostly due to the need to be realistic regarding some outings (logistic complexity).  Some adaptations were also made due to the change in the contact person for some innovative partnership that caused significant delays and sometimes loss of opportunity.

Key stakeholders and relations

Are there key individuals, (including participants) organisations or relationships who are central to your project, and in what way do they benefit your project?

Key stakeholders / actors	Description	Expected benefit from the activities
The residents living in La Ritournelle	73 elderly persons all of them in need for help for the everyday life activities. Out of them: 22 residents living in 2 sheltered units and suffering from cognitive disorders.	- Wider range of activities offered - New prevention care setting experimented - Wellbeing improved
The caregivers	Mainly family of the residents (children, grandchildren), they visit occasionally or regularly, some of them every day. For some of them: a high emotional burden linked to their relative health situation and/or the life in the Ritournelle. They benefit from the activities directly (participating) or indirectly (because their relative is participating and benefits from the activities).	- Share some quality time with their relative during SAIL activities - Wellbeing improvement experimented and offered to their relative. - New prevention care setting experimented and offered to their relative.
The professionals	60 professionals working 1 animator + 1 or 2 volunteers depending of the time of the year 1 psychologist 1 psychomotor therapist	- New activities to take care of the residents. - New solutions to offer and new preventive care settings. - Renewed interest in their profession due to attractiveness and innovation. - Attractiveness of the residence due to dynamism.
New local partnerships	- Tourist office - Club des aînés - Association des jardiniers de Villeneuve d’Ascq - Decathlon	- Increase partners network - Increase recorded activities - Can offer to participate to some innovative activities.
Innovative and unexpected partnerships forged during SAIL explore phase.	- Decathlon - Leisure farms - Cafés with dogs / cat	- Extend their activities to new audience - Increase the cost-effectiveness of the facilities and services during off-peak period. - Advertisement through communication about the activities. - Involvement of the employees - Sponsorship.