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This month Emmett McConomy and Arthur share how Person-centred
thinking has enabled Arthur to achieve a lifetime ambition.
Arthur has been supported by Derry Supported Housing since
January 2011. It has been a lifetime ambition to learn to drive. So
with support from the team, Arthur has started to learn to
The commitment from the team to support Arthur to reach this
landmark in his life was supported by the use of person-centred
approaches and we were able to support Arthur the way he wanted
(person-centred review, what's working/not
working, communication profile), this
clearly demonstrates that we can make a real positive difference to
the people we support.
He has been making steady progress and Arthur knows that he has
a lot of learning to do. Bryan Morgan,his driving instructor, has
worked for Action on Hearing Loss for a number of years in Harkness
Gardens as a Support Worker before starting his own Driving
Arthur said "I'm really happy to be learning to drive, its hard
"Well done, keep up the hard work Arthur!!!" - Emmett McConomy
In the Policy and Practice team, we provide support to services.
A lot of the support has recently been around how to deliver
personalised services and our next challenge is to support services
to be person centred within staff teams. We feel that the only way
to be able to support other teams to be person centred….is to do it
ourselves! This blog and some future blogs will talk about some of
the challenges we faced and how we overcame them.
We started off by
doing our one page
profiles so we know what matters to people and we can
get the best out of each other. We all thought this was really hard
until we realised it was a chance for other people to say some
lovely things about us. It was very useful and we all learned
useful information about each other, especially how best to
support each other being a widely dispersed team and all
We had a discussion about how the one page profiles would be
used. Some people didn't feel comfortable about certain information
being shared throughout the organisation, but we decided that we
would be doing work one page profiles and people could share
personal information only if they felt comfortable. As a team we
decided if we expect other people to do one page profiles, we
should demonstrate our commitment by sharing our own.
In our team meetings, we have a big blank sketch book and in
this we have drawn a rough version of the team
Next, we had a bit of a thought shower about our team purpose
and vision. We found it difficult as our purpose became very wide.
We tend to help out wherever we are needed which can sometimes
extend beyond our job descriptions. We decided to use the
doughnut tool to work out exactly what our core
responsibilities are, where we could use our creativity and
judgement, and what was definitely not our responsibility.
This generated more discussion as some of the things we do have
elements of "core responsibility", and elements of "not our
responsibility". In our role we often work in partnership with
other people and teams, so sometimes get involved with extra pieces
of work. We have decided to discuss our job descriptions at the
next team meeting to see whether they need to be updated as a
result of this exercise.
We find it best to keep dipping in and out of the creation of
our plan to keep it alive and keep learning. Watch this space for a
future instalment where we will discuss the use of
communication charts and the stress and
This month, Jill Roberts from the Policy and Practice team
shares how Action on Hearing Loss is responding to the challenges
of delivering personalised services.
In December 2011, the Personalisation Board, which guides our
work on person centred practice, requested all care and support
services to complete a self-assessment on Progress for
Providers. Teams completed this in February 2012 and
responses were collated by teams and areas to identify where
services were delivering person centred support well and where more
support was needed.
We found there were clusters of similar responses. We asked
Helen Sanderson Associates for support to analyse the findings.
As a result of this we organised 3 days bespoke training with
Helen Sanderson Associates where the learning objectives were
tailored to the area. Some of the objectives were:
People from other departments were invited to the days. For
example, Becki Elphick, HR Business Partner, was invited and
discussed how she was using the person centred recruitment process
to inform the revision of HR policies and procedures.
Although it was clear from the 3 days that most people are using
person centred practices, this is often done in an informal way and
not consistently recorded. Participants described many coaching
opportunities where the tools could be used not only to assist in a
naturally occurring situation, but also to show staff how the tools
could be used.
(Lisa Orme, Bernadette Sweetman & Jill Roberts creating a
There were some similar themes that emerged over the three
Taking the learning from these 3 days and reflecting on progress
to date, the Personalisation Board worked with Helen Sanderson in
January to scope out next year's priorities. These include a
one page strategy for person centred working, stream-lining
paperwork and developing person centred reviews.
In this month's blog, Tracey, Deputy Manager at one of our care
homes shares how the person centred thinking tools
have been used to support Jonathan on his first home visit.
"Christmas was approaching and some of the people we support go
home to their families for a few days. This was a difficult and
tense time for Jonathan as this was to be his first home visit. We
sat and chatted to Jonathan to find out what he wanted for his home
visit, and used the Doughnut tool to plan a
The result was a communication and
lifestyle manual to enable him to communicate with his
family more effectively. The manual included information about what
Jonathan could do independently.
Jonathan worked alongside staff choosing his own images, which
were mostly photographs of him completing different tasks. The
manual included prompt cards to remind him that he should bathe
each day and clean his teeth. It also included a program of
activities to help his family build a structured day to try and
prevent him from becoming bored or being ignored. We used the
Emotions communications chart to explain what to
do should Jonathan become upset or angry. We developed this
information with Jonathan by using Good day/ bad
day and How best to support me.
Previously, Jonathan had needed encouragement to take his
medication; now he does this independently. He has a chart he signs
himself to remind him if he has taken it or not, therefore not
relying on family members to remember.
Before Jonathan went home the Important to and Important
for tool was used…this gave us the information that it was
important for Jonathan to maintain his family relationship and
On his return we used the what's working/ not
working tool to help arrange another visit. Jonathan's
parents and family were delighted with the progress he had made,
and so are his staff team."
The New Year is a good time to reflect on what has been achieved
and can help with planning what to do next. At Action on Hearing
Loss one of the highlights of 2012 was developing the mini book of
Person-Centred Thinking tools for people who use BSL.
It was developed using Helen Sanderson Associates set of
Person-Centred Thinking tools as a starting point. The language and
grammar was then adapted to make the tools more accessible for
staff and people we support who use BSL as a first language.
BSL is a rich and creative language so this mini book acts as a
starting point for interpreting and communicating how the tools can
be used. A copy of the mini book can be found here.
The idea for adapting the tools started in our Midlands
services. The Head of Service, Lisa Orme, is an experienced and
keen devotee of person-centred working. She listened to staff and
people using services, and found that they struggled at times with
the English explanations of how to use the tools. Working with
staff and people we support who use BSL as their first language,
Lisa coproduced a draft version of 10 adapted tools.
The adapted tools were piloted with people who are d/Deaf BSL
users and also experience learning disabilities, mental health
issues, physical disabilities or other additional needs.
Our feedback led us to talk to HSA about what we had done and
what had worked. Helen was very supportive and offered to produce
the mini book.
Now all services and staff have copies of the mini book. It is
used as part of our induction of new staff and by our
person-centred champions across the organisation.
To aid accessibility we worked with Remark to produce
BSL clips to explain the tools.
We now have another way to engage with and support people in a
format that works for them. A number of our blogs in 2012
demonstrated how people had made positive changes using the
We hope to continue learning and developing our approaches in
2013. We look forward to sharing our ideas and experiences in
Lindsay Hodgson, Outcomes Implementations Manager shares how she
used person centred thinking tools to design and implement the new
Today is my three year anniversary working for Action on Hearing
Loss. When I accepted the job I accepted the task of developing an
online Outcomes Tool for Care and Support services. This meant that
I also took on the task of convincing 500 people that it was a good
idea to use it in their everyday jobs. Here's the story of how I
achieved both of those things…
Having worked in Care and Support myself I know these
are often under pressure and pushed for time
have to record a lot of information, some of it duplicated in lots
of different places
can struggle to access computers due to location, equipment and
My goal was therefore to create an online application that
√ Quick to use and
only collecting meaningful information
√ In line with what
Support Workers did already - not an addition or duplication
√ An intuitive, easy
to use 'click-of-a-button' IT system.
On August 29th we launched the tool in all 51
services and have since trained 64 Outcomes Tool Champions through
Their feedback is the best way to show that we have achieved our
How did we achieve this result? We ran person centred
workshops. We centred the training around each staff
member and their own life. We each shared our own goals, plans,
achievements and outcomes. I'd tried this once before at a
managers' conference and after using the Working / Not
working tool I realised that this was the key to success.
I captured this journey using the Achievement Using Person
Centred Thinking tool.
Now we have an Outcomes Tool to help us ensure that the people
that we support are getting the personalised care and support that
is important TO and important FOR
them. It helps Support Workers plan their activities and have
evidence based reviews and it demonstrates to friends, families and
commissioners that we are delivering a service valued by the people
Ian, who uses services, shares with us how the "presence to
contribution" tool has made changes to his life.
Before having support from Action on Hearing Loss I spent many
years trapped in my house and was very isolated, my confidence was
low which meant that I wasn't able to communicate with anybody. I
felt that I didn't fit in the deaf world or hearing world, i had
become very depressed and self harmed every day.
Although I was under the care of Social Workers, local Mental
Health Team and CPN's I had never built up any relationships with
them and it was always just focused on my health. The first
step I needed to take was getting well and rejoining society.
Action on Hearing Loss Staff used a tool 'Presence to
Contribution' with me to help me get started, basically, these were
steps and things I needed to do so that I could achieve my goal of
rejoining society. When we started the thought of rejoining
society was too overwhelming, but it was something I wanted and
needed to do, so visually breaking it down has made this easier to
manage but also reinforce the positive of each small step.
It started where staff would encourage me to leave the house for
10 minutes, then we go to town, then to a coffee shop. Everything
was broken down into manageable steps. Using the tool enabled me
visually to see how I was going to achieve this and has contributed
positively towards my mental wellbeing as I can already see the
steps I have already taken.
This tool became a two year plan, from a time in my life where I
wouldn't make eye contact with anybody and hide behind my Support
Worker. Over time my Support Worker, me and Hettie get known,
people stop and talk, at first it was like 'oh no get out of here'
but now I'm relaxed to communicate with people who ask about my
Hearing Dog, Hettie and with one person this has developed into
building friendship and meeting this person by myself.
The goal wasn't that as such but the small steps along the way
has enabled me to feel more confident about myself, less isolated,
have more trust in my ability to communicate with people. Words
whether written or spoken don't sink in, I can be told repetitively
'well done' or praised but meaningless. However, visual media
such as photographs do convey a message so I created my own life
path using my photographs and now i think wow I done that, I
achieved that and it makes me feel positive. If I feel down I stay
focused on negatives but if I look at my visual path it changes my
view point to a more positive state of mind.
Ian n Hettie
By David Victor Dilkes(in his own words)
David and I have support from Action on Hearing Loss. I live my own
home self from when I born 1945 same house!
On my support plan I have goal for make garden nice
again. Problem my garden what? I been do 'Working and Not Working'
with my support worker show what wrong my garden. Since I
been have stroke 2007 I find hard keep garden nice. It have big
lawn and all over grow and like jungle, I can't go in garden now
because it make me sad see all mess. This Photo page from my book see
garden before. Me and my support worker do 'My Journey' for just
garden, show me steps on way to fix garden finish. We as well make
book with photos, stickers and letters from council for sort out my
garden. This good. I learn how take my photos
can print myself in photo shop. I like make book creative with my
support worker. It remind me what garden look like when start and
how garden progress. Now Council agree clear my garden and I been
ask for pave in garden. Easier for me keep nice, not grass, I'm too
tired. I write letter and put copy in book means keep all
information together safe. When pave I will buy table and chairs
for sit outside, I also want get flash doorbell light
for outside so if have person come I know they here when me
outside. I want get rid of shed old mouldy danger now in wind it
shake. I'm buy new shed or maybe glass house for grow flowers and
tomatoes. I am enjoy my path to get new garden, we only slow start,
when steps along path finish me we put sticker footprint on 'My
Journey', but when finish will become lovely and relax. I like my
'Garden Path' book. It means I see remember future how garden
before from photo and show how change will.
This month Vanessa Keen, Senior Policy and Practice
Advisor, shares our journey towards 'Making it Real' through the
use of person centred thinking tools:
We are often informed, through involving people groups and
forums, of amazing and inspiring individual achievements by the
people using services, which have had a huge impact on the person
concerned and also on the people within their circle of
These groups/forums enable people to share their passion,
enthusiasm and success regarding the continual development of
personalised services; the meetings bond hearts and facilitate
future motivational incentives.
We were eager to take part in the Making it Real pilot project
as the framework and markers ("I statements") had been produced by
people who use services. We felt this would help confirm our
commitment to personalisation. We were very excited to be accepted
onto the pilot as the Making it Real programme was completely in
line with our vision and values.
We asked all services (within care and support) for volunteers
to be part of the pilot program and made the decision to
concentrate on four services. The 4 services provided us with a
good reach across the country and also a chance to provide examples
of different services going through the Making it Real Process
(i.e. day services, supported living, and care homes for older and
We created a template adapted from the 4 +1 questions tool for
services to use to record their action plan.We asked what worked
well, what didn't work and what they had learnt, and this was
shared with those taking part.
4 + 1 questions: Making it Real
Based on what we know, what are the next steps?
Work through action plans, keeping team and the people we
support fully involved.
Managers of the service commented that they found the template
easy to use as it provided reflective questions which were easily
understood by people in the service and the staff team. This
then helped them to concentrate on what the barriers may be and to
plan their next steps.
The services involved in the pilot regularly review their
progress using the 4+1 questions tool, and have recently
adapted a template to provide a six month review of their action
plan which is to be up-loaded on the Making it Real website
This project has created some real changes for people - new
accessible information has been created with the support of the
people using services, which provides them with more choice and
control over their lives. Some services are building stronger
relationships with other providers by sharing
information/resources, and all 4 services have downloaded the
making it real kite mark which confirms their commitment to
providing personalised services.
Rosemary moved to a residential home in Birmingham 6 years ago,
and worked with staff on her life and interaction skills. Rosemary
worked so hard on this that in 2008, she moved into a flat above
the residential home to continue her journey to independent life.
Rosemary did a college course in flower arranging and started a
course at BID Services.
Rosemary's mother sadly passed away in 2010. Rosemary inherited
some money which allowed her to re-think her circumstances and her
aims and goals. She decided her dream was to live in her own
We used person centred thinking tools with Rosemary throughout
the moving on process, to make sure that the support package was
exactly what Rosemary wanted from her service. We used the "right
move 4 you" tool in the early stages to establish where Rosemary
wanted to live and the sort of support package she would be looking
We then helped her create a support plan under outcome areas,
which people using Action on Hearing Loss services have identified
as being important to them. This refreshed things we needed to be
aware of that were important to and for Rosemary when building the
Rosemary achieved her dream in November and was delighted and
proud to be moving to her own house.
chooses to have some continued support from Action on Hearing Loss.
She has been able to have some familiarity in her new life, as she
has support from the staff from her previous service.
With very little help, Rosemary cooks, pays her bills, cleans,
manages her finances, maintains her personal hygiene and plans her
own daily activities. Rosemary has come on leaps and bounds since
moving and with her own will power and skills, will succeed in her
goals. She appears very happy and content with her new life and
still continues to strive to reach her goals in life!
person-centred review tools every 6 months, to review how Rosemary
is feeling with her support package, and what support she wants to
help her to achieve the new goals she has set herself!