cARTrefu – arts in care settings


In April 2015, Age Cymru began delivering a new project, cARTrefu, across care homes in Wales. The project is jointly funded by the Baring Foundation and Arts Council Wales.

‘cARTrefu’ means to reside in Welsh and is being run through Age Cymru’s Gwanwyn programme which celebrates creativity in older age.  The two-year project aims to improve the quality of care home residents’ experience of participatory arts activities and to their well-being in general.  It’s hoped that care home staff acquire new skills and the confidence to share them, and that the artist practitioners develop their professional practice.

cARTrefu is a Wales wide programme and care homes are selected to encompass geographical spread and the Welsh language.  
cARTrefu was inspired by the Courtyard Theatre’s ( Hereford) project Making Me and operates in Wales with support from Age Cymru’s My Home Life Cymru, celebrating existing best practice in care homes.

Description of the arts activity

Four lead mentors from the following art forms have been recruited: Performing Arts (Dance/Drama), Music, Visual Arts, Words (Poetry/Prose). These four mentors are supporting a further four practitioners within each art form;  meaning a total of 16 artists will receive mentoring and deliver art sessions in care homes. Each of the 16 artists deliver weekly two-hour sessions over a period of eight weeks meaning residents and staff in each residency will receive a total of 16 hours of tuition. Each artist practitioner will lead eight residencies, meaning over the lifespan of the project, 128 art residencies are being provided across Wales.

cARTrefu offers residents and staff new experiences and access to art forms they may have never tried before.

Details of the project participants

Mentors and artist practitioners were recruited by Age Cymru following an application and interview stage.
Potential care homes are invited to submit an expression of interest expressing their motivation for taking part and then selected by Age Cymru. Residents and staff from the selected care homes are invited to take part in the sessions. Some practitioners work with residents one-to-one and others work with larger groups.

Project management

Age Cymru’s Arts and Creativity Programme Manager has overall responsibility for the project and the project coordinator is responsible for the day to day management.  The independent evaluation of cARTrefu is being led by Dr Katherine Algar from the Dementia Services Development Centre (DSDC) Wales, Bangor University.

Ethical approval was granted by the NHS Research Ethics Committee for the evaluation. Evaluation participants were required to give written consent before they could be included in the evaluation. Following guidance of the Mental Capacity Act 2005 (Department of Health, 2005), a consultee’s opinion was sought if a resident was judged as not having capacity. All residents were assured that deciding not to take part in the evaluation would not affect their participation in the art activities.
There is no cost for the residencies.

Evaluation methods and findings

The objectives for the evaluation are:

  1. To investigate the mentoring process;
  2. To explore the impact of the art residencies on all those involved (e.g. Care home residents, staff, artists, and the wider community).

A Year 1 evaluation report was produced in May2016 and a final report is expected in May 2017.
Measures were developed by the evaluation team in consultation with the cARTrefu team. Residency 1 was an evaluation pilot-phase to test the application of the measures in the setting and these were refined following feedback from participants for the main evaluation (Residency 2 onwards).

Measures include:

  • Practitioners Reflective Journal: to capture what happens in the sessions and the experience of the residents. Also enables the practitioners to evidence their professional development and reflect on their practice.
  • Approaches to Dementia Questionnaire (ADQ; Lintern 1996): A widely-used 19 item scale that asses a person’s attitudes to residents with dementia, including sub-scales of person-centred and hopeful attitudes. [practitioners and Care staff complete]
  • Smiley Faces Assessment Scale: a self-report rating scale using pictures of five smiley faces ranging from very unhappy to very happy. Used by residents to rate how they’re feeling before and after each session.
  • Care staff questionnaires: exploring previous experience of art and expectations before the residency and whether care staff acquired new skills and the confidence to share them afterwards.  
  • Preliminary findings from year 1 include:
  • An increase in average score in the Smiley Faces Assessment Scale after the session indicating an increase in the residents’ general well-being after attending a session.
  • An increase in staff average total scores and average scores of both subscales after the residency in the ADQ, indicating that staff had a more optimistic outlook and identified more with a person-centred approach than before the residency.
  • Reports of a positive impact on residents, staff, the artist practitioners, and the wider community

cARTrefu is the largest project of its kind in Wales. In the first three residencies, the project has reached 759 residents in 48 homes. Up to 128 homes will have engaged with cARTrefu by the end of the project meaning nearly 2000 residents will have attended one or more sessions (assuming average number of residents remains at 15 per residency).  Important implications have been learned for future projects and preliminary results indicate an extremely positive impact on care home residents, care staff, practitioners and the wider community. As the project continues, evidence for their benefit and examples will be gathered to enable the sharing of best-practice for large-scale projects in care homes. This has important implications for the 23,000 older people living in care homes in Wales (National Assembly for Wales, 2011) and it is hoped that the results from the main evaluation project can be used to inform policy to improve the wellbeing of care home residents and staff alike.


Supported using public funding by the Arts Council England