Care Opinion/Talking Mats

National project
Award: £97,622
Timescale: April 2016 – September 2017

Project aims

To develop a new online service which will help more people with dementia who have communication difficulties, communicate their thoughts, opinions and experiences of health and social care and the quality of care they are receiving.

They will be able to do so on Care Opinion’s online public feedback channel, through developing an online, digital version of Talking Mats specifically designed for this purpose.


Good communication is the foundation of effective health and social care. The development of communication difficulties is a feature of dementia that will occurs for all people with dementia. The severity and speed of that change will vary. It may be gradual, or it may be more sudden. Examples of the range of communication difficulties experienced are:

  • reduced vocabulary
  • word-finding difficulty
  • problems with reasoning
  • repetition of thoughts
  • lack of coherence
  • losing track of topic
  • distractibility 
  • loss of fluency 
  • deterioration of reading and writing skills

At all stages of dementia people can find it hard to express their views effectively. However, as the dementia progresses, it may become increasingly difficult to ensure that they are able to express their views. Non-verbal and visual methods of communication have proved to help the effectiveness of communication of people with dementia.

People at all stages of dementia face challenges when giving feedback to health and social care services e.g. in the early stages it may be that their secondary language skills of reading and writing are compromised.

Finding innovative and engaging ways of hearing the feedback of individuals with dementia is critical as poor communication is cited far too frequently in investigations into poor health care, and features as a common aspect of complaints made to service providers.

More Information

Care Opinion has already pioneered an online feedback platform to allow the general public to share their opinions and experiences, both positive and negative, of health and social care. This feedback is then sent to providers of care who respond publicly. 

Care Opinion specialises in supporting people with communication difficulties so they can express themselves using interactive visual storytelling and picture symbols.

This funding will be used to provide a new service which will combine both approaches.

Specific activities to include:

Discovery: the identification, design and piloting, with people with dementia living at home and in a care/residential setting, of the topics, options and visual images which will best enable people with dementia to tell their story and enable service providers to better understand people with dementia’s feedback about their services.

Design: the technical design and testing of two story workflows, including a simplified version, on Care Opinion’s online platform

Interpretation: the identification of the issues staff may experience and development of training and resources which will enable staff to better interpret, respond to and act on feedback from people with dementia using Talking Mats.

Build: the integration of Talking Mats into all stages of Care Opinion’s existing online platform, including the simplified story workflow for residential or group activity settings.

Acceptance/real world testing: the practical testing of the integrated system, involving people with dementia, carers and staff, and iterative system updates to address functional and usability issues identified

Evaluation: the identification of early adopter service user sites and evaluation - from the perspective of people with dementia, their carers and helpers, and staff - of the use, acceptability, value and impact of the system in these service settings and more widely, including what support may be needed to enable people with dementia to share their experiences

Adoption: engage with stakeholders to raise awareness about and encourage use of the new Talking Mats-based options on Care Opinion platforms amongst people with dementia, carers and service providers, developing awareness-raising tools and online resources to promote adoption

Work in the Discovery phase has already led to the development of a comprehensive symbol (picture) set to support people to give feedback on their experience of health and social care. A number of new symbols to the Talking Mats portfolio have been designed and produced and testing of the system has been carried out successfully. 

This innovative approach will enable more people with dementia to share their experiences of health and social services, so that they can say what works well for them and what does not.It will give them a voice that they otherwise may not have and will raise awareness about specific needs that may have gone unarticulated.This will give service providers an opportunity to respond to these needs.

Outcomes we'd like to see

  • Social inclusion: people with dementia whose voices often remain unheard will now have a powerful and innovative way to share their experiences and views
  • Service learning and insight: health and social care services are often unwilling or unable to engage with users with communications difficulties including people with dementia, so remain unaware of their experiences of care
  • Service improvement: our experience is that about 10% of concerns raised on Care Opinion lead to a service improvement. Often, improvements are simple and inexpensive to implement
  • Culture change: by bringing the stories of people with dementia onto the mainstream Care Opinion platform, alongside others, we expect to raise awareness of their needs and in turn, impact on staff and wider societal attitudes

Additional Information

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