July 2012 (1)
June 2012 (1)
May 2012 (1)
April 2012 (1)
March 2012 (1)
February 2012 (1)
January 2012 (1)
December 2011 (1)
November 2011 (1)
October 2011 (1)
September 2011 (1)
August 2011 (1)
June 2011 (1)
May 2011 (1)
April 2011 (1)
March 2011 (1)
Meeting a gentleman last week in
Macclesfield, made us consider just how we work with people who are
moving on in life.
Paul has for many years lived in a residential mental health
hospital and now has the opportunity to live in his own home, with
new house mates, in a different town.
How many of us could make that change without a great deal of
planning ahead, and thought into how best to make it as positive a
move as possible?
Many of the Person Centred Thinking tools are perfect for
supporting someone going through this type of change in their
lives. Paul has a very small but important circle of
support. The main person in his life is his dad, who was
fantastic at helping us create and complete Paul's history map,
which helps us reflect upon not only what is Important to Paul but
also remind us of his strengths and abilities. We were able to
re-discover some great talents and skills which he had lost
over the years and instantly Paul identified opportunities he would
like to try again, once settled in his own home , such as bike
riding , train spotting, making his own lunches.
Just listening to Paul's team and his dad remembering and
talking - it was a natural and trouble-free way to pick up some of
the valuable information required for Paul's One Page
But moving home can be a daunting time for any of us. It is a
time that we all take some opportunity to think and consider what
support we would need and what are the most important things we
need to keep with us. For me - as well as making sure my
family are ok, there are a few essentials I need to have with me -
my iPod and kindle, marmite and coffee, my slipper socks and my box
of treasures. These might be viewed as "junk" by some people, but
this box is full of important things and memories and I would be
lost without it. These are my essential things - no one else's.
They make me feel good.
By asking the simplest of questions like "What
would you put in your suitcase?" helped people share what is truly
non negotiable in Paul's life. Like his Elvis book, his music CD's,
his bike and his dad - although we were not sure he would fit in
the case! These are some of Paul's essentials - no one else's
and they make him feel good.
Using a person centred process during the transition means that
hopefully we should be able to make sure that critical information
is shared. One of the essential tasks was to share information in a
meaningful way so we know Paul has all the information to help him
make his decisions, so photographs of the new home, new house mates
and key people involved were gathered and shared in a booklet, so
he could talk through the move with his staff team time and time
Throughout the transition we will be using Learning Logs and a
Working/Not Working review to check that all is going ok and if we
need to change anything for Paul. We may find more essential things
that Paul needs in that Suitcase of Support, to ensure a successful
If all goes well, Paul will be moving into his new home, making
new friends and experiencing new opportunities in the not so
In the world of health and social care, we all know the pace and
rhythm of the work has always been at a fast, evolving tempo. But
in this current climate the momentum has definitely picked up a
gear, and we are all being kept on our tippy toes. But we must be
careful that in this work culture of "busyness" we take time to
time to think and reflect.
Following on from our May Blog on story-telling, we were really
taken aback on how much we learnt from the stories we heard - not
only were they interesting, but refreshing and some of them very
moving. Managers had an opportunity to learn from each other, find
creative solutions to problems they have may have been
experiencing, get positive support from their colleagues, and some
great top tips to inform best practice.
This really inspired us to rethink about how we spend our time
and how we could ensure that the team had opportunities to stop,
listen, reflect and learn more from each other.
Instead of thinking how do we make this happen, and squeezing
this on top of everything else, surely it is a matter of rethinking
and getting smarter in how we use some of the existing processes
and systems we have in place: such as team meetings.
Meetings are often the one and only opportunity that colleagues
get together, but meetings can sometimes come with negative
reputation: an impact on people's work time, problems talked
about but no clear solutions, fear of not being listened to, and a
potential increase in someone's work load. Therefore we have been
looking at how our meetings could be more positive and productive
and how we can use this time more effectively to meet the teams
needs and better outcomes for the people we support.
We have been applying the person centred thinking tools and
approaches to how we have meetings.
We use a meeting map to define our purpose and
peoples roles - a time keeper is a must for me!!! All our
meetings have an opening round of appreciation, and a fantastic
round of storytelling, this really encourages everyone to be
involved. We use lots of art materials, flip chart and tape -
encouraging lots of engagement and focused discussion.
We have used the What's working and What's not Working tool to
help us problem solve and enable us to drill down to the real
actions. We have also used the 4 plus 1. I recently used this
in a meeting with trainers to help us review a recent training
workshop we had implemented. We found it really helped us to
quickly identify the things we were pleased about, what we had
learnt, things we had tried, identify the real concerns and what we
needed to change to make the training course better. It was a real
refreshing approach that engaged everyone.
What we have found valuable is the closing round and asking the
questions - "What messages have you heard today?" and "What are you
taking away with you today?" We always record the closing
round and capture the actions people are taking away.
We obviously continue to discuss and work on tricky issues,
having meetings in this way does not deter the focus, it actually
helps us stay focused, encourages a whole teams participation and
view point, enables us to really get to the route of problems, and
understand clearly our roles and responsibility; and actions.
People have been inspired by how some of the tools can be used in
their meetings and teams are actually looking forward to using them
in their next meetings.
Story telling is part of our history, culture, childhood, and
here at care UK the sharing and writing of stories is part of our
everyday person centred practice.
Yesterday I joined a team of managers at their monthly meeting.
As part of the meeting, the Manager Phil, asked his team to
remember /celebrate some of the great success stories that have
happened in their time with Care UK by use of sharing "Head Line"
stories. This was not only fun and helped people remember why we do
what we do, but an opportunity to take a step back from the "hustle
and bustle" and remember what a difference we do make and can
continue to make, to people lives. It was a great opportunity to
share learning and celebrate success.
We heard many great stories, but one of the most powerful
stories of the day was told by Karen, one of the Enablement
Karen told us about a group of 4 close friends who
had spent a huge part of their adult life together in an
institution. As we know the institutions are now closed, but only 3
of the 4 people were able to live together, the other lady Olwen,
did not get that option. However over the years they remained in
touch, spending time together when they could. But Olwen's biggest
wish was to live with her dear friends.
Time was passing by now and all 4 friends were older and
required different housing; a bungalow with good access and wider
door space. Karen told how her team recognised the
possibility and opportunity of helping secure Olwen and her
friend's dream of sharing a real home together.
Karen spoke about how hard it was sometimes to ensure everyone
involved the friends, the 4 families, the staff team and the
housing association. But by connecting everyone together, things
started to change - Olwen and her friends could not believe that it
really was going to happen. That was in 2009, around 16 years after
they moved from the institution. Karen remembers how much it meant
to her and her team to help make people's dreams come true, and so
ensuring a "happy ever after" ending. Obviously there is much
more to this inspiring and motivating story but in a blog we only
tell so much. Our message this month is just how powerful
remembering and sharing great stories can be.
Olwen with her friends.
Applying one page profiles to support planning across the
business has been successful and welcomed by both customer,
families, professionals and staff.
One page profiles for children are a valuable tool to ensure
that people who support them can understand them as individuals, to
know the times where they can emotionally struggle but are not able
to express themselves and to support them on their learning and
even more vital when we are supporting teenagers. The need to
understand the things that can trigger them to have a bad day is
detriment to their confidence and their development, especially
through school and the pressures of exams. Leah who was kind enough
to demonstrate how one page profiles could look, is just one such
teenager. She is a very focused young lady and needs support at
certain times, with certain subjects, to keep her in the sets she
aims for. Leah can become privately stressed when participating in
school assessment times. Although she is in all the top sets, maths
doesn't come naturally and she has to work hard to stay where she
would like to be. Leah will not express in class or at home, when
she is struggling with her maths. The best support for Leah is to
set times every week where she can access the My Maths websites and
to research other sites that can help her learn in a way that she
can feel confident and work things out for herself, which she
prefers to do.
Understanding Leah's health needs has been detriment to good
support. She suffers from Asthma and can at times forget to take
her medication out with her. As this is a condition she needs to
learn to manage, to know she needs a gentle reminder ensures she
doesn't get caught short, especially at vulnerable times. It was
also key to inform people of her peanut allergy. This can be a life
threatening allergy reaction and it is really important that all
those in Leah's life, are aware to check all ingredients of all her
Leah really enjoys celebrating her personality in her one page
profile, especially finding pictures that says who she is as a
person. As her own mother, I can say I understood my daughter a
little better in terms of understanding how important her love of
clothes and makeup are to her and how I need to balance
teaching her to enjoy her interests and to not grow up too
Any team or group of people who work together can benefit from
person centred thinking practices and developing their team
As well as working with our practices leaders in developing
their area and micro team plans, we have been supporting our
service user action groups to use person centred thinking tools to
shape their meetings, to focus the purpose of their group and to
establish how they are able to communicate and celebrate the great
work that they do.
The Essex 'listen to me' action group are part of a
network of groups throughout England and Scotland, that advocate
for other people who use Care UK services. They work in partnership
with us to share their opinions and experience about receiving
services and what good support services should look like.
As a group of people making decisions that helps shape the
business, it was important to establish a clear purpose of the
group, to know what is important to them and to know what support
they need as group members, establishing the roles and
responsibilities of others who support their group.
They achieved their purpose and success statements using symbols
to make their poster accessible to them and to those they advocate
for, as well as effectively communicating to our staff and
professionals what their group is about and what they want to or
Using person centred thinking tools has become
fundamental for ensuring constructive meetings. By developing the
members and facilitators one page profiles we had an understanding
of how to get the best out of the group. They also agreed what the
roles and responsibilities of others should be so they understand
what specific support is required, to enable them to be active
The group regularly review what is working or not working about
what they do and how they work together. This has lead to some
great actions that have enabled them to evolve and became a more
self facilitated action group, providing valuable contributions
that lead to better outcomes for other people with
We would like to pass on a big thank you to the Essex Listen to
Me Group for sharing their purpose. Stay inspired.
For this month's blog, we would like to share Carol's story with
you, and how using person centred thinking tools helped to ensure
she had a successful transition.
Carol's supported living setting where she lived was pleasant,
but it was unsuitable for her physical needs. Carol is wheelchair
dependent and her bedroom barely had space to fit her wheelchair
inside and was very challenging when providing the support she
needs. Each day, it was essential to Carol to enjoy some time
alone, to relax in her own space, listening to relaxing music.
Having her bedroom directly onto the busy lounge, rarely provided
her with the peaceful environment she wanted.
Carol found a spacious supported living house that was purpose
built for wheelchair users and was located in a scenic location
that was more suited to her physical needs. In addition to Carol's
physical needs, with non-verbal communication and a profound
learning disability, being supported by new people in a new
environment would require careful planning. We worked together with
Carol and her team, who had supported her for some time, who know
her well prior to transition. Using person centred planning and
thinking tools enabled us to ask the right questions and capture
valuable information that would make Carol's transition a
capturing a detailed description of what a good
day and a bad day looks
like for Carol, we are able to ensure her routines are maintained,
we can learn what things are important to
Carol and how best to support. It also
helps us avoid the things that make her feel unhappy.
For carol, probably the most valuable information captured
through person centred planning, was how she communicates.
During the transition process, we asked her support team at the
time, to complete a How I communicate with
you chart, explaining what Carol does to indicate her
choices or express how she is feeling. They also completed a
How we communicate with you chart so
Carol's new support team would speak to her using familiar words
and objects of reference, ensuring consistency in how she is
Carol's transition went smoothly with as little disruption to
her usual day as possible. Using person centred thinking tools
through transition, enables people to live the life they want, that
doesn't change when there are changes in their support team or
environment and when communication is a challenge.
Well, we believe the people we support should be involved from
the start, after all - who are we recruiting for?
As we all know person centred thinking is at the forefront of
everything we do within the Learning Disability Services and
therefore recruitment plays an important part of this.
This month, I would like to introduce to you our guest
blogger "Gary Cunningham", one of our Enablement Leads. Gary has
taken the lead on some meaningful initiatives with his colleagues
on recruitment. Here he shares what they have learnt and some of
the great actions they have achieved.
After a number of discussions around how we
could make this procedure more personal to the individual services
we were aiming to recruit for, it was both a unanimous agreement
and a crucial factor that the people we support must be involved -
Firstly - it was felt that it was important to
understand the people we support and staff match with suitable
applicants. Since all our customers have one page profiles, this
seemed to be a "no brainer".
We found that by using the one page profile we could establish a
framework to enhance our recruitment process as follows:
Secondly - it is important to involve the
individual in the interview process, after all who knows their
needs better than themselves. This can be achieved by having
the individual present -however we have learnt not everyone always
likes to participate at the interview stage - or alternatively, we
can involve people at a second informal interview and/or present
their questions for them, taking into consideration the information
on their one page profile. "No one shoe fits all.
Thirdly - this information is extremely
valuable and therefore once collated it can be retained by both the
individual and the Recruitment Support Team.
We have introduced a new section to the person centred support
plan, called "How I like my support managed". A great place to
ensure this information stays with the person.
To ensure the information is kept fresh and alive for future use
it is updated in harmony with the Person Centred Review
This process has many benefits - the people we support are
always part of recruitment and selection of staff from the very
beginning and the foundations are resting on the individuals needs,
whilst ensuring consistency of support.
"Let's get it right from the start of the recruitment process
and alleviate future problems".
Think individual, think Person Centred Recruitment!!
Signing off for now and looking forward to sharing more
initiatives next time.
'Let's get it right from the very beginning' - this is what
started a conversation only a couple of months ago. Since starting
our journey with delivering person centred thinking to Care UK's
learning disability services, we have realised that to really
deliver person centred services, we need to train people from the
very beginning of their employment.
Our guest blogger is Teresa Preece, an Area Trainer, who shares
with you her thoughts on the induction programme and how she has
been introducing person centred thinking tools to ensure people get
the right start.
No getting away from it, person centred support is mandatory!
It's one of the common induction standards so how can we expect
staff to work in a person centred way if we are not sharing our
learning with them and supporting them to develop their skills from
the time of induction?
So much work had already been done on induction training and
ensuring that people completed all of their mandatory courses such
as first aid and fire awareness but when looking a little deeper -
there wasn't enough information shared about values or what it
means to be person centred. In the past we have expected people to
come into this role with the right values and attitudes but we have
to recognise that we are a diverse group of people who hold
different values dearly and our own values may not be that of the
people we support.
We want our induction training to be that special cake with
royal icing rather than just a plain sponge!
This took lots of conversations and discussion around the best
way to do this. As with every organisation in the current climate,
we had to consider cost effective ways of delivering the training
without putting additional days into the induction process. The
most logical way of doing this was to start weaving in the
fundamental person centred thinking tools into the mandatory
Day one of induction informs people about our journey to
becoming a person centred organisation and people start working on
their one page profiles. It's exciting to think that on the first
day staff start supporting people, they already have their work one
delivering safeguarding training we thought it would be great to
use the Doughnut tool. This really gets people thinking about their
own roles and responsibilities in safeguarding the people they
support from abuse. Although we are not teaching people how to use
the tools, they are then exposed to them and are thinking in a more
person centred way.
Now we have weaved person centred thinking in to all of our
induction courses for learning disability staff from the very
beginning. This is really exciting and I can't wait to see the
difference in the way people are supported. This should encourage
an enabling approach rather than people thinking of themselves as
carer's and not encouraging people to lead the life they want.
This month we have been looking at reviews. We want to ensure
that everyone we support has a person centred review and that all
reviews look at a person's whole life, rather than the
relationship between themselves and a particular service.
A team of Enablement Leads and Enablers spent two creative days
with Jonathan Ralphs (HSA) who shared his skills and expertise in
facilitating working and not working reviews for people.
Our guest blogger is Simon Torres, an Enablement Lead
who shares his learning from person centred
Having a person-centred review should be the norm for
people receiving a learning disability service but in reality most
reviews I have experienced tend to lean to a more
traditional approach, which is often professionally led
and based on sorting out problems relating to the person's
condition and based on service delivery outcomes.
Even though we have seen local authorities take steps to ensure
that a person-centred approach is an integral part of the review
process, it still tends to be very structured and driven by a set
of predetermined outcomes - and not the preferred holistic
I often felt like the reviews were done and dusted before the
actual review had taken place with the individual. The planning
process tended to be a paper task - of me asking staff to collate a
review report for me to present and discuss at their review
This has always mystified me - as the process did not always sit
right with the person from whose perspective I was driving things
It is like buying a winter coat four sizes too big for the
summer - it is not suitable for the season or the individual.
By using the
"Important To and For Review" together with a "Working and Not
Working Review", I have found a great way to facilitate a
successful review that ensures that the person is
truly at the centre and is a forum that enables meaningful
contribution and participation.
These approaches to reviews ensure we are able to identify:
1. What is important to the person now and in the future?
2. What good support looks like for them?
3. Find out things from different people's perspective.
4. Have a greater discussion that leads to action.
It is important that we pay greater attention to each other and
proactively listen to the people we support.
We have learnt that it is good to "mingle". Mingling time is a
valuable way to engage people at their reviews, therefore getting
great contribution and enabling everyone to have the opportunity to
partake and write down information…… what a contrast to sitting
around a table discussing a report!
The reviews have become a positive experience - making the
whole process lighter but still gets down to the real "nitty
gritty" issues in people's lives and finds out what really matters
We learnt different and exciting ways to engage people in their
The process is not limited to annual reviews, but can be used to
revisit our team plans and informally look at "what is and isn't
working" in a multitude of work and home situations.
Using reviews in this way just seems to make sense, to ensure
that everyone is working towards the same outcome and that the team
are clear on what matters to the individual, to make a
"The contract said you will need to promote an inclusive
lifestyle, independence and choice, but no suggestions on how to do
or what this looked like for Jennifer".
Jennifer (name changed) is described by those who know her well
to be a well organised and confident lady who enjoys spending time
painting her nails, putting her make up on and takes great pride in
her appearance. She lives with 2 other people in a supported living
Jennifer's support plan file was bursting with paper and a
wealth of information from a whole wealth of people over the years
and professionals, giving their recommendation on what this could
look like for Jennifer. At best, this information is great in
creating some ideas on how to boost Jennifer's wellbeing and give
the support team some ideas to try.
However every time a new recommendation came forward the staff
team had been trying and trying their best to implement the advice.
For Jennifer there seemed to be more unsuccessful events than
successful ones, to the point that it felt that opportunities were
becoming more and more limited, Jennifer seemed to be getting more
and more unsettled and she was starting to get a negative
reputation within her local community.
It was clear to the people in Jennifer's life that something had
to change and fast.
By doing a review of what's working and not
working from different people's perspectives, we learnt
that there had been too much emphasis on the paper work and not on
improving Jennifer's life and that we had not asked professionals
enough why and how questions, we also needed to have a greater
understanding on what is important to Jennifer and what works best
What we did learn is that Jennifer is a fantastic communicator,
even though she does not use words, we learnt that pictures work
really well for her. By using the communication
charts we were not just able to learn how Jennifer
communicates, but also how we should communicate with Jennifer. The
team started to work with Jennifer to gather a collection of
pictures to help develop her communication, from local places,
things she may like to do, food choices, housekeeping through to
personal care. Putting Jennifer in the driving seat on making
choices and decisions about her life.
We also learnt that being organised and planning a day ahead is
really important to her. We learnt that Jennifer is very skilled at
sorting things out and organising herself, but needed to know the
sequence of events; she could not always remember them all or would
get muddled, making her feel anxious and cross.
We introduced a tomorrow board to help Jennifer to make choices
about how she wants to spend her day, she then organises the
sequence of events by using pictures.
The team also spent time with Jennifer to develop her
one page profile; this has formed the basis of her
support plan, on what is important to Jennifer and how best to
support her. We know that she loves handbags and shoes, having her
hair done, real attention to detail to how her nails and make up is
applied. This has been the starting point for developing great
community connections. She is a regular now a regular visitor at
her local health centre and hairdressers.
When out and about, she has uses a talking key-ring, so she can
let people know where she wants to go and what the next steps
Jennifer's life is looking very different now, by knowing that
she is involved in making decisions in her life, she has developed
trust with the people around her, she is making her own choices,
going to places she likes to be, gained new independence and has
made new friends.
The team have also learnt that it is okay to ask professionals
questions to ensure that they get greater clarity on what is
expected. The person centred thinking tools have not only enabled
the team to sort out what inclusion, independence and choice looks
like for Jennifer, but they are much clearer about how Jennifer
communicates and what good support for Jennifer looks like, seeing
the difference that this has made has been truly inspiring.