Promote active support

Transcription

1 In Association With Learning work book to contribute to the achievement of the underpinning knowledge for unit: LD OP Promote active support Credit value 5 All rights reserved, no parts of this publication may be reproduced, copied, stored or transmitted without the prior permission of The Learning Company Ltd Version 1-01/06/11

2 Learner s Name: Learner s Signature: (Please sign inside the box) Employer s Name: Employer s Address: Start Date: Anticipated End Date: College Provider: Learner s Enrolment Number: Mentor s Name: Assessor s Name: Internal Verifier s Name: I V s Sampling Date: Page 2

3 INTRODUCTION This workbook provides the learning you need to help you to achieve a unit towards your qualification. Your qualification on the Qualification and Credit Framework (QCF) is made up of units, each with their own credit value; some units might be worth 3 credits, some might have 6 credits, and so on. Each credit represents 10 hours of learning and so gives you an idea of how long the unit will take to achieve. Qualification rules state how many credits you need to achieve and at what levels, but your assessor or tutor will help you with this. Awarding Organisation rules state that you need to gather evidence from a range of sources. This means that, in addition to completing this workbook, you should also find other ways to gather evidence for your tutor/assessor such as observed activity; again, your assessor will help you to plan this. To pass your qualification, you need to achieve all of the learning outcomes and/or performance criteria for each unit. Your qualification may contain essential units and optional units. You ll need to complete a certain amount of units with the correct credit value to achieve your qualification. Your tutor/assessor can talk to you more about this if you re worried and they ll let you know how you re doing as you progress. This workbook has been provided to your learning provider under licence by The Learning Company Ltd; your training provider is responsible for assessing this qualification. Both your provider and your Awarding Organisation are then responsible for validating it. THE STUDY PROGRAMME This unit is designed for individuals who are working in or wish to pursue a career in their chosen sector. It will provide a valuable, detailed and informative insight into that sector and is an interesting and enjoyable way to learn. Your study programme will increase your knowledge, understanding and abilities in your industry and help you to become more confident, by underpinning any practical experience you may have with sound theoretical knowledge. Page 3

4 WHERE TO STUDY The best way to complete this workbook is on your computer. That way you can type in your responses to each activity and go back and change it if you want to. Remember, you can study at home, work, your local library or wherever you have access to the internet. You can also print out this workbook and read through it in paper form if you prefer. If you choose to do this, you ll have to type up your answers onto the version saved on your computer before you send it to your tutor/assessor (or handwrite them and post the pages). WHEN TO STUDY It s best to study when you know you have time to yourself. Your tutor/assessor will help you to set some realistic targets for you to finish each unit, so you don t have to worry about rushing anything. Your tutor/assessor will also let you know when they ll next be visiting or assessing you. It s really important that you stick to the deadlines you ve agreed so that you can achieve your qualification on time. HOW TO STUDY Your tutor/assessor will agree with you the order for the workbooks to be completed; this should match up with the other assessments you are having. Your tutor/assessor will discuss each workbook with you before you start working on it, they will explain the book s content and how they will assess your workbook once you have completed it. Your Assessor will also advise you of the sort of evidence they will be expecting from you and how this will map to the knowledge and understanding of your chosen qualification. You may also have a mentor appointed to you. This will normally be a line manager who can support you in your tutor/assessor s absence; they will also confirm and sign off your evidence. Page 4

5 You should be happy that you have enough information, advice and guidance from your tutor/assessor before beginning a workbook. If you are experienced within your job and familiar with the qualification process, your tutor/assessor may agree that you can attempt workbooks without the detailed information, advice and guidance. THE UNITS We ll start by introducing the unit and clearly explaining the learning outcomes you ll have achieved by the end of the unit. There is a learner details page at the front of each workbook. Please ensure you fill all of the details in as this will help when your workbooks go through the verification process and ensure that they are returned to you safely. If you do not have all of the information, e.g. your learner number, ask your tutor/assessor. To begin with, just read through the workbook. You ll come across different activities for you to try. These activities won t count towards your qualification but they ll help you to check your learning. You ll also see small sections of text called did you know? These are short, interesting facts to keep you interested and to help you enjoy the workbook and your learning. At the end of this workbook you ll find a section called assessments. This section is for you to fill in so that you can prove you ve got the knowledge and evidence for your chosen qualification. They re designed to assess your learning, knowledge and understanding of the unit and will prove that you can complete all of the learning outcomes. Each Unit should take you about 3 to 4 hours to complete, although some will take longer than others. The important thing is that you understand, learn and work at your own pace. YOU WILL RECEIVE HELP AND SUPPORT If you find that you need a bit of help and guidance with your learning, then please get in touch with your tutor/assessor. If you know anyone else doing the same programme as you, then you might find it very useful to talk to them too. Page 5

6 Certification When you complete your workbook, your tutor/assessor will check your work. They will then sign off each unit before you move on to the next one. When you ve completed all of the required workbooks and associated evidence for each unit, your assessor will submit your work to the Internal Verifier for validation. If it is validated, your training provider will then apply for your certificate. Your centre will send your certificate to you when they receive it from your awarding organisation. Your tutor/assessor will be able to tell you how long this might take. Page 6

7 UNIT LD OP : Promote active support About this unit The purpose of this unit is to provide the learner with knowledge, understanding and skills to promote active support to increase an individual s participation in tasks and activities. It is aimed at those whose role includes planning, monitoring and providing direct support and assistance to individuals. Learning outcomes There are Four learning outcomes to this unit. The learner will be able to 1. Understand how active support translates values into person-centred practical action with an individual 2. Interact positively with individuals to promote participation 3. Develop and implement person-centred daily plans to promote participation 4. Use personcentred records to evaluate an individual s participation in activities What is active support? Active Support is a personcentred model of how to interact with people combined with a daily planning system that promotes participation and enhances quality of life. The Hotel model refers to institutional style settings organised mainly around staffing needs. They are not person-centred and offer a poor quality of life to individuals. For example, where carers undertake all the domestic tasks and do not provide opportunities for individuals to participate in constructive activities. Person-centred care is a way of providing care that is centred around the person, and not just their health or care needs. To explain this in simple terms, we are all individual, no two people are the same so it is not appropriate to say that because two people have dementia that they both have the same care and support needs. Person-centred values ensure a comprehensive understanding of individual needs and the development of appropriate individual care plans for all individuals. Page 7

8 Person centred values covers the total care of the person. To begin with the person is the centre of the plan i.e. to be consulted and their views always to come first. It should include all aspects of care both Social Services, Health, family and voluntary sector. Current developments in person-centred care should also consider the implications of self-directed support, and planning with people to develop the support plans for their individual budgets. Personcentred approaches are a core element of all good practice, and should be integral in all delivery of care and support. This practice should extend across all of adult social care, including commissioning. Recent examples of this are to be seen in services where self-directed support is the mechanism for the commissioning and funding of the service. Person centred planning is central to the White Paper Valuing People (Department of Health, 2001). One of the challenges this presents is how we can fully involve people with high support needs, who may not use words to speak, in person centred planning. Traditionally, when we have considered how we can involve people in planning we have concentrated on the planning meeting. The personalisation agenda is leading some of the changes happening in social care today. Personalisation has come about as a direct result of the modernisation of social care services that has been happening over the past several years. 'Putting people first', published in December 2007, contains the government's vision of how personalisation of social care services will allow people more control over their own lives and the services they choose. The use of individual budgets and resourcing put the people who are in receipt of a service at the centre of the funding for that service, moving away from a model of local authority assessment and placement. The White Paper Our health, our care, our say' confirms the vision of high quality support meeting people's aspirations for independence and greater control over their lives, making services flexible and responsive to individual needs. A useful guide on receiving direct payments is available from the Department of Health. To read the guide, visit the Department of Health website. Page 8

9 As personalisation is playing a key part in the transformation of the social care sector many issues are currently being worked through with the implementation of self-directed support. These will help to shape both the local policies and procedures that local government use, as well as informing the national policy direction. A crucial aspect of relationship building in your job role is making sure that people are able to make choices and take control over as much of their lives as possible, known as empowerment. This simply means doing everything you can to enable people to do this. Many people who receive care services are often not able to make choices about what happens in their lives. This might be due to many factors, for example their physical ability, where they live, who provides care and the way services are provided. Individuals who are unable to make choices and exercise control may also suffer from low self esteem and lose confidence in their own abilities. There are other factors which may impact on self esteem and these include the degree of encouragement and praise we are given from important people in our lives; the amount of satisfaction we get from our jobs and whether we have positive and happy relationships with friends and family. Self esteem has a major effect on people s health and well-being. Individuals who have a positive and more confident outlook are far more likely to be interested and active in the world around them, than those lacking confidence and belief in their own abilities. Therefore it is easy to see how this can affect an individual s quality of life and their overall health and well-being. You can take in daily working activities to give individuals more choice and more opportunities to make decisions about their own lives. There are some aspects of empowerment and participation which are common to many settings and most individuals. If self esteem is about how we value ourselves then self image is how we see ourselves and both are equally important. As part of empowering individuals you need to consider how you can promote individuals sense of their own identity. Page 9

10 This involves making sure you recognise the values, beliefs, likes and preferences individuals have and not ignoring or discounting them as they may not fit in with the care system. A little thought and consideration can ensure that people feel they are valued and respected as individuals. For example finding out how an individual likes to be addressed is important. Some older people, for example, like to be addressed by Mr or Mrs and this indicates respect as a result. You will also need to make sure that people have been asked about religious or cultural beliefs, particularly in relation to eating food, forms of dress which are acceptable and the provision of personal care. The National Standards Framework now requires that a single assessment process takes place involving multidisciplinary, interagency assessment of the needs of the service user. This results in a documented care plan. When individuals want to make choices about their lives, you must ensure that you are doing your best to help them identify any barriers they may meet and help them overcome them. When working with individuals in their own home, it is generally easier for them to make day to day choices for themselves. The introduction of the direct payment scheme has provided a far higher level of choice than previously. This system means that payments for the provision of services are made directly to the individuals, who then employ care workers, determining the level and type of service. The individual is then the employer and in a greater position to make choice and take decisions. Avoiding assumptions When it comes to people, everyone is different. But we can tend to make sweeping generalisations which we think applies to everyone in the same particular group. Therefore in order to provide quality, empowering care, we must take the time to find out about personal beliefs and values and consider all aspects of individuals lives. Page 10

11 Although you may hold a different set of values of beliefs to the individual you provide care for, you must not impose your beliefs on them. You may need to act as an advocate for their beliefs even if you do not personally agree with them. Value each person as an individual and be sure to be open to what others have to say. Recognising your own prejudices It is not easy to acknowledge your own prejudices and how they affect what you do. Prejudices are a result f your own beliefs and values, and may come into conflict with a work situation. There is nothing wrong with having your own beliefs and values, everyone has them. But it is important to be aware of the and how they may affect what you do at work. Consider the basic principles that apply in your life. For example you may have a basic belief that all people should be honest. Would you then find it hard to work with someone who lied extensively? You may believe that abortion is working so would you then find it difficult working with someone who had had an abortion? Exploring your own behaviour is never easy and you must have good support from your manager or close friends in order to do it. Once you are aware of your own beliefs and values you must then consider how to how to accept the beliefs and values of others. The individuals you work with are all different so it is important to recognise and accept that diversity. Many workplaces have policies about managing diversity rather than equal opportunities. This is due to the fact that it has been realised that until diversity is recognised and valued there is no realistic possibility of any policy about equal opportunities being totally effective. Ways to promote understanding and use of active participation First you must be sure that you give information in a way that can be understood by the individuals concerned. You must ensure that any specific communication needs are met. Page 11

12 For example people may require information in Braille, or to be communicated with using signing. You will need to find out how to change the format of the information, or how to access it in a suitable format. Promoting choice and empowerment is about identifying the practical steps you can take in daily working activities to give individuals more choice and more opportunities to make decisions about their own lives and the activities they wish become involved in. You will also need to consider the circumstances when you pass on information about a particular service or facility. You should take into account the situation of the individual at that particular time. An obvious example is that you would not pass on information about social clubs and outings to someone whose partner had just died. You also need to take into account an individual s state of health and any medical treatment that may affect the relevance or usefulness of the information. Make sure that the information is accessible by; Presenting it in the most useful format Making it available at the right time Taking all the circumstances into account. There are some aspects of empowerment and participation which are common to many settings and most individuals. If self esteem is about how we value ourselves then self image is how we see ourselves and both are equally important. As part of empowering individuals you need to consider how you can promote individuals sense of their own identity. This involves making sure you recognise the values, beliefs, likes and preferences individuals have and not ignoring or discounting them as they may not fit in with the care system. A little thought and consideration can ensure that people feel they are valued and respected as individuals. For example finding out how an individual likes to be addressed is important. Some older people, for example, like to be addressed by Mr or Mrs and this indicates respect as a result. You will also need to make sure that people have been asked about religious or cultural beliefs, particularly in relation to eating food, forms of dress and other activities which they may feel are accessible. The National Standards Framework now requires that a single assessment process takes place involving multidisciplinary, interagency assessment of the needs of the individual. This results in a documented care plan. Page 12

13 DID YOU KNOW? The muzzle of a lion is like a fingerprint - no two lions have the same pattern of whiskers. ACTIVITY ONE Circle the words or phrases you would associate with promoting understanding Empowerment Participation Eggs Bacon Care plan Beliefs Valued Respected Sausages Supporting choices When individuals want to make choices about their lives, you must ensure that you are doing your best to help them identify any barriers they may meet and help them overcome them. When working with individuals in their own home, it is generally easier for them to make day to day choices for themselves. The introduction of the direct payment scheme has provided a far higher level of choice than previously. This system means that payments for the provision of services are made directly to the individuals, who then employ care workers, determining the level and type of service. The individual is then the employer and in a greater position to make choice and take decisions. When it comes to people, everyone is different. But we can tend to make sweeping generalisations which we think applies to everyone in the same particular group. Therefore in order to provide quality, empowering care, we must take the time to find out about personal beliefs and values and consider all aspects of individuals lives. Page 13

14 Although you may hold a different set of values of beliefs to the individual you provide care for, you must not impose your beliefs on them. You may need to act as an advocate for their beliefs even if you do not personally agree with them. Value each person as an individual and be sure to be open to what others have to say. The range of services and facilities that individuals may want to use is large and varied. Once people have the information on what is available, the next stage is to support them to make use of it. This may involve completing application forms or other paperwork and you may need to support individuals to fill in any forms that are required to access their selected networks or services. People have to travel if they wish to participate in many activities and forms of entertainment. When you are encouraging individuals to make maximum use of services you may need to discuss or arrange travel arrangements. Information about travelling and access are important in order to identify any problems the individual may have. Many individuals may need to be encouraged to use services after finding enough information to make a properly considered choice. But you must be careful not to cross the boundary between encouraging them and pressurising them into using a particular service or activity. Similarly you must not prevent someone from participating in a network or activity because you think it is risky or unsuitable. Professional carers can be faced with difficult situations when individuals have obtained information about activities or potential relationships which may expose them to risks or other dangers. There is a fine line between neglecting your responsibilities for the individual s safety and imposing unfair restrictions. Most people working in health and social care are likely to be cautious, rather than careless. Although this concern for the safety of individuals is well intentioned it can result in restricting people s rights to enjoy the relationships or services available. Overcoming barriers There are many barriers which can restrict access or prevent people from using networks, participating in or developing relationships. Information is one of the keys to overcoming barriers. Page 14

15 An individual with plenty of accurate and current information is far more likely to be able to challenge or overcome difficulties than someone who feels anxious or uncertain because of lack of information and support. Barriers to access tend to fall into three key categories; environmental, communication and psychological. Environmental barriers- Lack of disabled facilities Narrow doorways No ramps No lifts No interpretation of signage for those with a sensory impairment Lack of transport Lack of ease of access Communication barriers- Lack of loop systems Poor quality communication skills Lack of translators or interpreters Lack of information about the network or facility Lack of information in an appropriate format Psychological barriers- Unfamiliarity Lack of confidence Fear or anxiety Unwillingness to accept help in order to access resources or networks. How to challenge and overcome barriers and ensure safety of individuals Start by checking that all possible information is available about the activity to be undertaken. Work with individuals to help plan ways to ensure their safety and to overcome challenges and any identified barriers. For example you may need to support someone to search for alternative facilities if the ones originally found do not have wheelchair access. If the identified social club or meeting place does not have wheelchair access, encourage the individual to make arrangements to meet somewhere that does. Page 15

16 If there are problems finding suitable transport then it may be necessary to find out about transport with the necessary provision. It is essential you never compromise the rights on the individual to choose their own means of access and to set boundaries as to what is acceptable in terms of personal space, choice and dignity. Implementing active support Person centred planning is a way of helping people to think about what they want now and in the future. It is about supporting people to plan their lives, work towards their goals and get the right support. It is a collection of tools and approaches based upon a set of shared values that can be used to plan with a person - not for them. Planning should build the person's circle of support and involve all the people who are important in that person's life. Person centred planning is built on the values of inclusion and looks at what support a person needs to be included and involved in their community. Person centred approaches offer an alternative to traditional types of planning which are based upon the medical model of disability and which are set up to assess need, allocate services and make decisions for people. Person centred approaches are ways organisations who support people use tools from person centred planning to ensure that they provide a service which focuses on what is important to the individual as well as the support they need. Person centred working involves a number of approaches which people who provide support can use to help them work in a more person centred way. How to sort what is important to a person from what is important for them How to address issues of health, safety and risk whilst supporting choice How to identify what the core responsibilities are for those who provide paid support How to consider what makes sense and what does not make sense about a person s life How to ensure effective support by matching characteristics of support staff to the person s needs Page 16

17 Person centred reviews are a way of facilitating reviews using person centred thinking tools. The person is involved throughout the whole process from start to finish (it s their review), family, friends and professionals support the person throughout. Person centred reviews look at all aspects of the person s life and their relationships. A person centred review should be a positive experience that focuses on the person s strengths, talents and their gifts and develops an action plan that focuses on making things happen. Person Centred Risk Assessment A twelve step process to manage risk in a more person centred way helps professionals involved in assessing risk to address significant issues of health and safety whilst supporting choice by also taking into account things that are important to people. Person Centred Teams Person centred approaches are not only for people who use services, they can also be very useful tools for enabling teams to work together effectively. Person Centred Team Plans help teams to be clear about their purpose, to understand what is important to each member and what support they need to do a good job Person centred planning can work for anyone. It is especially useful for people who may need help planning their future, or who find that services often do the planning for them. Lots of people feel like this, so person centred planning suits lots of different people. Some people have used person centred planning to help them with the following: Moving home Leaving traditional day services An individual budget Finding friends Direct Payments To tell support staff what is important to them Page 17

18 There are key features of person centred planning that will help anyone reviewing plans to ensure the person is at the centre and has their say. Key features are: 1) The person is at the centre. This means that the person has had genuine choice and involvement in the process, and in deciding who is involved, where, when and how the planning takes place. 2) Family members and friends are full partners. People will come together to work flexibly and creatively to ensure that the person is getting the supports they need to have a better life. 3) Person centred planning reflects the person s capacities, what is important to the person (now and for the future) and specifies the support they require to make a valued contribution to their community. The plan identifies choices about how the person wants to live and then demonstrates how the proper supports are provided. 4) Person centred planning builds a shared commitment to action that will uphold the person s rights and encourages their participation in community life. 5) Person centred planning leads to continual listening, learning and action, and helps the person to work towards getting what they want/need out of life. The plan is not focused only on services provided, but on what might be possible in the future. The person centred plans include negotiation so that resources and supports reflect what the individual wants and needs. The essence of being person-centred is that it is individual to, and owned by, the person being supported. There is no single approach that can be applied to working with someone in a person-centred way, and no approach that exclusively covers all of the process that may be needed in developing a person-centred plan. Current developments in person-centred approaches should also consider the implications of self-directed support, and planning with people to develop the support plans for their individual budgets. The use of care plans A care plan sets out in some detail the daily care and support that has been agreed should be provided to an individual. If you are employed as a carer, it acts as a guide to you in terms of what sorts of activities are expected of you. It does not stand still, of course. Page 18

19 There will be regular reviews, and the individual and you should be involved in discussion about how it is working and whether parts need changing. Person centred planning is much more than a meeting. It is a process of continually listening, and learning; focussed on what is important to the person now, and for the future; and acting upon this in alliance with their family and friends. It is vital that we think about how the person can be central throughout the process, from gathering information about their life, preparing for meetings, monitoring actions and on-going learning, to reflection and further action. There is a danger that efforts to develop person centred planning simply focus on having better meetings. Any planning without implementation leaves people feeling frustrated and cynical, which is often worse than not planning at all. Very often you will only be caring for and supporting people when they are in a vulnerable position. The quality of care that you can provide will be improved if you have knowledge of the whole person, not just the current circumstances: knowledge can help us for example to understand better why people behave in the way they do. A care plan, based on a person centred approach, will help in understanding some of this, but what else might help? Person centred planning, then, demands that you see the person whom you are supporting as the central concern. It means that we need to find ways to make care and support individual, not one size fits all. It means that the relationship moves from being one of carer and cared for towards one based on a partnership: you become a resource to the person who needs support. A care plan sets out in some detail the daily care and support that has been agreed should be provided to an individual. If you are employed as a carer, it acts as a guide to you in terms of what sorts of activities are expected of you. It does not stand still, of course. There will be regular reviews, and the service user and you should be involved in discussion about how it is working and whether need changing parts. Person-centred planning is a process of life planning with individuals using the principles of inclusion, and a social model rather than a medical model. Page 19

20 With a medical model, a person is seen as the passive receiver of services and their impairment as a problem; this often leads to segregation and places to live and work that are away from the community. A social model sees a person as being disabled by society. In this model, a person is proactive in the fight for equality and inclusion. The concept of person-centred planning is not new. One of the first people to develop the model was John O'Brien. His 'five accomplishments' (respect, choice, participation, relationships and ordinary places) were the foundation for person-centred planning in the USA. In 2001 the UK government published the White Paper Valuing people: a new strategy for learning disability for the 21st century. It had four key principles: rights, choice, independence and inclusion. This led to the adoption of person-centred planning by all local authorities. Person-centred planning tools Plans are owned by the person. There are many ways to plan with a person, what is important is that the plan must be meaningful to them and understood by them. Some planning methods (or 'styles') include: MAPS (Making Action Plans) - developed by Judith Snow, Jack Pearpoint and Marsha Forest. These are very visual graphic plans that look at a person's history and their aspirations for the future. PATHS (Planning Alternative Tomorrows with Hope) - developed by Jack Pearpoint, Marsha Forest and John O'Brien. This looks at a person's 'North Star' (dream for the future) and puts it into action, reviewing the plan in one to two years' time. Personal Futures Planning - developed by Beth Mount and John O'Brien. A graphic plan which maps a person's life now and changes for the future. A good style for community mapping. Essential Lifestyle Planning - developed by Michael Smull and Susan Burke-Harrison. This is very detailed and was developed for people with high and complex support needs. It includes a section on communication. It will usually have a health action plan as well. Page 20

21 All these styles of planning require a trained person, called a person-centred planning facilitator, to support the process. These are skilled individuals who involve everyone in the person's life in their 'relationship circle'. They also encourage and support the individual to take control of their own plan. They are very creative in their methods and have extensive knowledge of advocacy, working with families, finance, housing issues and how to develop better support for people. Families also facilitate person-centred plans, often using tools such as 'Families Leading Planning'. They make a commitment to the person to put plans into action. For people using services, it is not the planning that matters quite as much as the presence of personcentred thinking. This means that support staff hold person-centred values, and a belief that a person must have control in areas such as who supports them, what they do with their day, being listened to, and making decisions about their lives. An important first step in person centred approaches is to understand each person s unique way of getting their message across. This can vary from person to person, and can depend on the person s level of spoken language, their eye contact, and their body language. It is important in getting Person Centred Planning started that each individual is recognised as having their own particular way of communicating. Without an understanding of this we will struggle to achieve a person centred approach, and to hear about people s hopes and needs, and to achieving a better life for each person. The person at the centre Good communication depends on How well you can hear How well you can see How comfortable you are feeling How alert and attentive you are How well you can understand what is happening How well you can express yourself to someone else How interested and motivated you are to communicate Page 21

22 What you need to do: The Learning Company Ltd Make sure the person can hear, see and is comfortable Check when the last hearing or vision test happened; get an up to date assessment Make sure hearing aids or glasses are used if necessary, and that they work properly! Make sure you talk clearly and allow the person to read your lips if necessary Use sign /gesture and pictures to back up your speech Make sure you present information clearly for people to see Make sure people are positioned for good communication seating is key Make sure the environment is quiet and there are not too many distractions Check out general health and comfort pain, physical difficulties, effects of medication. Gain a person's attention before starting to talk Show that you respect a person's way of communicating by using it to them Make sure communication books/aids are available to the person when they need them not stuck in a cupboard! Be a good observer, and respond to all communicative signals Make sure the person can see your hands and face if you are signing and talking. Give enough time for the person to listen to you and respond Check that you have understood - by talking to others, helping the person to tell you when you have got it wrong. Don t pretend you can understand if you really can t! DID YOU KNOW? The average person falls asleep in seven minutes. Page 22

23 ACTIVITY TWO Circle the words or phrases you would associate with good communication Listen Goose Comfort Respond Understood Chicken Duck Attention Respect Criteria for Reviewing Person Centred Plans The plan will provide the reader with an understandable and comprehensive view of what is important to the person, how the person wants to live, and what supports the person needs in order for this to happen. Plans should be written in language that is understood by the person, family and those who are implementing the plan. Plans that use pictures, signs and/or graphics should also include a description of what these mean so that it is accessible to everyone. The plan should be pleasing and easy to read. It should not be in so much detail that the reader gets lost. It should be in enough detail to ensure that the plan will be read, understood, and implemented in the way the person wants things to happen based on what is important to the person. Reading the plan should make you feel that you know the person, and that you could use the plan to support the person in the way that they want to be supported. Includes who the people are in the person s life and the importance they have. What is their relationship with the person? What are the persons support networks? How was the person involved in their plan? Who else was involved and contributed? What was their involvement? How did they contribute? Page 23

24 Who facilitated the plan with the person? What is important to the person this would also include things that the person does not want in their life or things they dislike. What is important for the person from other people s perspective, carried out in a way that respects the person and is based on how to support the person in being a valued member of their community Describes the positive qualities, characteristics, talents, gifts, competencies and personality of the person. As described by the person and also by those who know and care about the person. Describes the qualities and characteristics of others that person likes or does not like to ensure that supports reflect the way the person wants to be supported. Describes the person s lifestyle at present, as a way to understand how they might be able to live in the future. Describes the person s hopes, wishes, dreams which are then reflected in action planning short and long term outcomes. Describes how the person communicates. Discusses in a respectful way the supports the person needs to be healthy and safe. This may be in a separate section. Sensitivity in this area should be reviewed carefully to ensure that any personal information is maintained with dignity and only shared with those the person wants to share this information with. For example, people who need personal care supports may have a separate part of their plan, which describes how the person wants their personal care provided. The person may want this information kept separate from the plan, and only provided to those that need to have the information. Things that people need to do to ensure that what the person wants is maintained if it is not happening consistently. Page 24

25 Issues to be resolved/questions to be answered should be included to ensure that the plan is developing as we learn new things, resolve issues and answer questions. Action Plan which focuses on: Changing the things that do not make sense in the persons life Getting the person closer to what they want/need now and in the future Supporting the person in changing/improving their lifestyle in the community they choose. Action Plan will include: What everyone is working on Why it is important How it will be done Who will help When it will be done by Action Plan identifies when follow-up will happen to ensure ongoing learning, celebration of accomplishments, ensuring that the plan is being implemented and how and when more planning will occur. These are basic criteria to determine if plans are meeting person centred planning criteria. Planning is not just about process without outcome. People who are involved in developing, implementing and reviewing plans should be aware that the plan should not be a paper exercise but a way of supporting people in getting better lives. The key to ensuring this happens is to use review criteria to identify how the plan is being implemented and that action is being taken. Ensuring that plans are being implemented should be a role and responsibility of a good facilitator and those reviewing plans. Supporting care plan activities When a care plan is in place, as well as carrying out your own duties under the plan you will need to support and supervise colleagues to carry out their specified activities. Page 25

26 Monitoring is essential to ensure that any plan of care is continuing to meet the needs it was designed to meet. A plan of care will have originally been assessed, planned and put in place to meet a particular set of circumstances. The original service user plan should include plans for monitoring and review, because plans put in place with even the most thorough assessment and careful planning will not necessarily be appropriate in six months or a years time, and continue to provide services of the quality or at the level originally expected. Monitoring may seem a complex process but its principles are very simple. Monitoring of care services needs to pick up and address changes in the circumstances of those receiving the services, their carers and service providers. For example someone recently discharged from hospital following treatment for mental health problems may receive quite extensive support under the care programme approach. However feedback on their progress may show that their mental health has improved to the point that day care is no longer needed on the previous level and that a lower level of care input can be planned for. Checking resources Checking on resources can also be important if changes in the availability of those resources means that a care package will have to be altered in some way. A reduction in the finding available or an increase in demand for a particular service may mean that adjustments in the level of service provision will have to be made. Regular monitoring makes it easier to be aware of where resources are being used and where changes can be made. Ways of monitoring. Whatever approach is taken to monitoring, it will be decided at the outset how a particular plan of care will be monitored and the methods will be agreed with the individual and their carers. Your feedback will be an essential part of the process. This may involve the following key people; The individual concerned Their carers and/or family Other health care professionals The service provider Page 26

27 The most important person in the monitoring process is they individual receiving the service, so they must be clear about how to record and feedback information on the way the care package is working. This can be achieved by completing a checklist on a regular basis, by maintaining regular contact with the care manager or coordinator or by recording and reporting any changes in the needs or in the care provision. Carers and families are also likely to participate in monitoring care provision but it is important they are not obliged to do this but do it willingly. Other health care professionals will also maintain contact between reviews and can offer a useful insight into how the package is being delivered. Your role in overseeing the plan of care means that you are in an ideal position to identify changes in an individual s circumstances that may mean a service is no longer appropriate. The changes do not have to be major but can have a significant impact on a person s life. Throughout any monitoring and evaluation process you are looking for and responding to change. It is important that you are clear about the difference between types of change requiring immediate action and those which are much simpler and easier to implement. For example there may be a change to financial income, a deterioration or improvement in mental health, a change on the level of family support or a change in housing conditions. What is task analysis? Task analysis refers to breaking down tasks into small, manageable steps as in recipes or DIY guides. The size of each step or number of steps for a specific task should vary according to the individual s ability or need for support. One method of helping to learn new skills is to break the skill to be taught into small steps. This method is called Task Analysis. A skill is broken down into small steps which add up to the whole skill. Each component of the skill may seem meaningless, but in its entirety the task analysis builds up to a full and useful skill. To ensure this process is successful it is important to make each step of the task small enough to be learnt easily by the individual. A task analysis is often completed by considering the task of both the helper and the disabled person as in the following example. Page 27

28 Taking trousers off: The Learning Company Ltd Carer Person learning 1. Prompts person to unfasten Unfastens buttons and zip buttons and zip. 2. Guides hands to waistband. Removes trousers from waist 3. Guides hands down over hips. Lowers trousers to hips. 4. Verbally prompts to sit down. Sits down. 5. Guides hand down over knees. 6. Prompts to grasp trouser Bottoms. 7. Assists in pulling trousers over feet. Pushes trousers over knees. Holds bottoms of trousers. Pulls trousers off over feet. The carer on each successive learning opportunity attempts to reduce the amount of assistance to the person. After one or two occasions the carer may not need to assist with step 7. After three or four attempts the carer will be able to let the person do both stages 7 and 6 independently. Gradually the carer assists less until the skill is able to be carried out by the person independently. When carrying out a task analysis it is important to ensure that the breakdown of the tasks reflects the ability of the individual to teach that component in isolation to the other components of the task. DID YOU KNOW? ABBA got their name by taking the first letter from each of their first names (Agnetha, Bjorn, Benny, Anni-frid.) Page 28

29 ACTIVITY THREE Circle the words or phrases you would associate with task analysis Learning Attempts Tiger Lion Assists Reduce Prompts Puma Method UNIT LD OP : SIGN-OFF Assessor s Name: Assessor s Signature: Date: Learner s Name: Learner s Signature: Date: Mentor s Name: Mentor s Signature: Date: Page 29

30 UNIT LD OP : ASSESSMENT ASSESSMENT ONE The Learning Company Ltd Compare the characteristics associated with active support and the hotel model in relation to an individual s support ASSESSMENT TWO Explain the practical changes that could be made within a service setting to: Promote an individual s independence Page 30

31 Support informed choices Improve quality of life Page 31

32 ASSESSMENT THREE The Learning Company Ltd Explain the levels of help an individual would need to participate in a range of new activities ASSESSMENT FOUR Explain how to use task analysis to break a range of new activities into manageable steps for an individual Page 32

33 ASSESSMENT FIVE The Learning Company Ltd Evaluate different ways of positively reinforcing an individual s participation in a range of new activities ASSESSMENT SIX Explain how to use positive interaction with an individual to promote successful participation in a range of new activities Page 33

34 ASSESSMENT SEVEN The Learning Company Ltd Explain how to develop daily plans with the individual and others to ensure a valued range of activities for an individual are available throughout the day, avoiding lengthy periods of disengagement ASSESSMENT EIGHT Explain how to support the implementation of daily plans that promote an individual s participation in a range of activities Page 34

35 ASSESSMENT NINE The Learning Company Ltd Explain how to review and revise an individual s daily plan with the individual and others to increase the opportunities for participation ASSESSMENT TEN Explain how to develop a person-centred record to monitor an individual s participation in activities Page 35

36 ASSESSMENT ELEVEN The Learning Company Ltd Explain how to review an individual s participation in activities to assess changes over time. Page 36