A range of presentations have been described although the area is still at a primarily descriptive stage. We discuss intervention structures and approaches that require further research.

Background: Day centres can enable people with mild-to-moderate physical and mental health conditions to continue living at home, delaying their move into residential care. ‘Access to Wellbeing’ is a programme designed to help day centres improve service users’ health and participation in meaningful physical, mental and social activities. This paper documents the programme and people's experiences of its implementation. Methods: This study used a retrospective observational design, and studied a day centre that caters for 40 disabled and/or frail adults daily. The Access to Wellbeing programme development started with a structured assessment of the day centre to identify aspects of the environment and working practices that impeded physical activity. Service users were interviewed to understand their needs, abilities and interests, and establish meaningful activities to improve their health and wellbeing. Alterations to organisational structures, the physical environment and work practices were instigated to increase opportunities for physical activity and involvement. Shortly after implementation of the Access to Wellbeing programme in a day centre, semi-structured interviews were conducted with three day centre staff and three members of the community rehabilitation team exploring their experiences of the programme and its implementation. Findings: Despite staff's initial scepticism about the programme and concerns about their increased workload, and its effect on their relationship and interaction with service users, the programme was successfully implemented. The programme increased service users’ physical health and wellbeing, and satisfaction with the service, and improved staff motivation and job satisfaction. A committed team working together was the most important factor determining successful implementation. Few additional resources were required. Conclusions: A holistic programme that aims to improve meaningful activities can be implemented in day centres. These programmes can bring wide-ranging benefits to service users health, wellbeing and participation, and staff motivation job satisfaction and productivity.

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