Using a decision tree to start conversations and share decisions

“As I’ve been going through the My Home Life Leadership Support programme, I’ve been looking at how we can be doing more to share decision making in our care home.

We’ve already tried a few different things in the past, like asking the residents to pick the design for the invitation card we made for Care Home Open Day.

We love the idea of a decision tree so we arranged to have one painted in our main hallway – right opposite where residents get their hair and nails done so it was a talking point straight away. It’s great to see the opinions build over time.

We used to just ask people face to face about things, but this way the residents can see where a decision came from.

We usually leave the voting open for quite a while – sometimes people aren’t in the mood to make a decision, or aren’t well for a while and there’s no pressure for people to make a decision if they don’t want to.

Our staff have also been talking about different ways we can use the tree – we’ve got our cook asking to use it to hear about what kind of special Christmas food our residents would like.

We recently used the tree to decide where we would go on a bus outing. We had a list of options that were practical (like having wheelchair access), and then people voted for their favourites. We had a great outing, and we’ve now opened up the voting for our Christmas party entertainer – chosen from the favourites across the year.

I want the tree to stay really meaningful and not fade into the background, so we’re only using for big decisions like trips and special events.

One surprise we’ve had is how much interest the tree has got from people visiting the home – family members have loved it and added in their thoughts on the things we’ve been asking about. It’s also gone down really well with people looking around the home to see if they want to move in – they really like that you can see we care about sharing decisions.”

John Green is the manager of Edgewater Nursing Home in Derry/Londonderry.


See pictures of the decision tree at Edgewater


Photos of the tree, the home and the Care Home Open Day postcard design chosen by Edgewater residents.