Ellen has a killer wink. You may have seen her already on our facebook page, with her beautifully plaited hair, bobble and dramatic wink. There are people in my work, who come to signify important learning and change. Arthur is one of those people for me, Anne-Marie another, and now Ellen.

We are learning with Ellen, who is 98, and lives with forty two other people at Bruce Lodge who also have dementia, about just how far we can go in personalising care homes.

We are trying to work at two levels. Firstly, that people living with dementia direct their own support on a day to day basis. We therefore need to know what matters to each person (what is important to them) and what good support looks like. We record this as a one-page profile.

Secondly that people have an upfront resource allocation that they can determine how it is used. Each person will have 2 hours of individual one-to-one staff time each month that they can spend however they want, doing something that is important to them, where they want (in home or community) and choose who they want to support them.

We have a partnership leadership team, with the commissioner and contracts leads for Stockport, and the CEO, deputy CEO, and home manager from Borough Care. Together we have developed statements of what success would look like for both of these partners, and most importantly, for the people who live at Bruce Lodge and the staff.

This is what we are hoping that people living at Bruce Lodge will experience or be able to say:

"I am involved in the day to day life of where I live, in a way that makes sense to me"

"I am listened to and heard, and supported to make choices and decisions"

"I am supported by people who know me, and act on what matters to me now, for my future and how I want to be supported"

"I have individual time each month and choose what I do and who supports me"

We have started learning about this with Ellen. Ellen lives at Bruce Lodge and is 98. She has two sons, Stan and Roy who visit her. It is important to Ellen that she sits near the window or patio door where she can look out. She counts the planes which fly over and will tell you exactly how many have flown by. She loves watching the squirrels playing about in the garden. Ellen watches who is coming and going around the home and must always be supported to sit where she can keep an eye on what's happening, both inside and outdoors! If you went to Bruce Lodge you are likely to hear her singing. She is a wonderful singer and often sings Christmas carols in the Summer to raise a few smiles! She takes pride in her appearance and loves to have her hair tied up or plaited, with a bobble. A big Manchester United fan, Ellen also enjoys watching horse-racing. Gill (From HSA who is supporting Borough Care) gathered this information with Ellen, and by talking to Stan, Roy and the staff who know Ellen. She also gathered detailed information about how to support Ellen well. Here is what you would need to know if you were responsible for supporting Ellen:

• Ellen must be kept warm at all times.
• Always support Ellen to sit where she can look out of the window.
• Ellen loves birds - chat with her about the birds in the garden and when it is warm help her into the garden to feed the birds. Ellen must always be wrapped up well even if it feels warm outside - she is prone to chest infections & bouts of pneumonia.
• Know that Ellen will have lots of little naps during the day - she says there's nothing wrong with that at 98!
• Know that Ellen will sometimes shout at you & say she wants to die. She will usually feel better after a cup of tea and a cream biscuit. Know that chatting to her about Stan and Roy or looking out at the birds & squirrels helps too.
• When Ellen is very vocal and upset, know that what works best for her is some time to herself.

Now our challenge is to make sure that all staff know this, and act on it. When it came to 'spending' her two hours a month, Ellen said:

''I would love to go out to a cafe for a brew and a cake, or the park watching people, the dogs and the children playing. Then reading the war memorial on the tree in the park for the animals lost or who were a part of the war effort''

Lisa, the manager, is now looking with Ellen at which staff member she wants to support her, and how to make this happen on the rota.

Ellen's story is an important one. I have asked Gill to share what we are learning about this journey, and how close we are getting to the vision of success. Gill will start blogging about this next month.

In December I blogged about the power of circles, and offered some suggestions about how we could extend the breadth of circles across the country.

Caroline Tomlinson is one of the pioneers of circles. You may have heard how her son Joe, has a circle of support, and was the first personal budget through the early In Control pilots. Caroline is my guest blogger, and she has led the development of 'Our Futures' in Wigan, who are working to extend the ways that people can have a circle of support.

"The circles concept can play a huge part in getting a good life for individuals who need support and their families, but what about those people who are not as well connected or who don't have any friends or family? This was a question I thought long and hard about in my quest to get ordinary people a good life. Taking the PLAN institute model in Canada, we adapted the process to work in England and developed the 'Our Futures' model initially in Wigan, which is now rolling out across the country.

The model is simple, for each circle of support we have a facilitator who is paid for by the family or the individual themselves. Why paid? Well it is simple, if you pay someone to do a job you expect a certain quality and if you don't like what you get, you can replace them. Each facilitator works with 1 circle. This is to ensure each facilitator can concentrate on developing a circle unique and meaningful to the individual and their family.

To recruit families and facilitators, we needed a local host organisation who was trusted by families. The obvious choice was Embrace Wigan and Leigh who had been working in the locality for many years. Their role was to find local people who wanted a circle of support, to train the facilitators, co-ordinate the process and provide ongoing mentoring and support.

Encouraging some early adopters took a lot of energy and encouragement, but once one or two families got going with circles, word got out. In fact we had recruited several families and didn't have enough facilitators, so effort needed to be put in to recruiting local people to be facilitators. This process was helped by working with local providers of services who had a good person centred reputation and some skilled staff who wanted to be facilitators. We developed a 'trade off', where staff could be released to be trained as facilitators for local people who didn't receive support from their organisation and in return, other local facilitators would facilitate a circle for people who they supported.

The facilitator training was given, which emphasised people living a good life through positive friendships and relationships. We based the training on a model of hospitality and concentrated on developing a circle, person centred tools, effective mediation skills and keeping a circle alive and productive. As each circle meeting was held, the facilitators were brought together to be supported and mentored, this provided excellent peer support and enabled the co-ordinator to keep track of what was working and what was not working.

The outcome has been that 30 circles are now up and running in Wigan and some of them have been going for several years. Individuals and families have described the process as initially scary, but have been able to address the issue of who will be there for my family member when something happens to me? They also describe how the present has changed, how they are exploring many ways to give their relative a good life that they would have never have done.

Here are some of the stories so far:-

Pauls Pondering Posse

Paul has a circle that has been set up in the last few months, so that his mum and dad and their non disabled daughter, could have peace of mind if anything should happen to mum and dad. They had wanted a circle for years but didn't think it would be possible to do. The big issue for them was who would you ask and would people be interested. The facilitator, Kevin, really made this work and reassured them throughout the process. What they never anticipated was that when they set up the circle, there would be so many on-going issues that they were struggling to deal with; the circle has really helped on a practical and emotional level and is making the whole family feel much more confident about the future.

Jenny's Jolly Jaunts

A circle has been set up for Jenny, a young lady with very complex needs. She's in her final year of college within a special school setting. Both mum and dad were very anxious about their daughter's future and hadn't got confidence in a social worker giving the family the best options for their daughter. Where she lives, transition social workers still only get involved with the individual six months before they leave college at 19. After just two circle meetings and lots of tasks completed by the circle members, this young lady has more options available now than she can fit into a week. Ironically, most of the activities are part of universal services, which is fantastic considering this young lady's complex disability. We held a circle meeting last night and mum and dad said they are quite overwhelmed by what the circle has achieved in such a short space of time, and they couldn't measure just how much pressure the circle has taken off the family.

How long do we wait for the Invite?

A single parent heard a presentation from Our Futures and took the information away with her. She then got in contact with us four months later. She wanted a circle for both her son and daughter because mum has started to have concerns regarding the future and if anything should happen to her. Both her son and daughter currently live at home and have no plans for moving out in the future. Both her son and daughter have a learning disability, but if anything should happen to mum they would be able to live together without support except for someone popping in now and again. What mum's main concern is, that if anything should happen to her son and daughter they wouldn't financially be able to continue living in their current home. She feels that if they need to move they would be left vulnerable and could be open to financial abuse. At first she was struggling to think of anyone who would want to sit on a circle. However, after spending a bit of time with the coordinator she came up with 5 names. We have held one circle meeting to date. One circle member said we have been waiting to be invited in because we didn't know how to approach you. Mum said that she didn't ask in case people thought she couldn't cope. Again, at the circle meeting, day to day issues came up and mum had tried to sort some of the issues out but was struggling. Although it was the first circle meeting, 3 members have taken on tasks to help the family move forward. These issues have all now been addressed.

What about people whose family are not interested?

Carly has just turned 22 years old and has had a life of shared care between the state and her family. Carly has a moderate learning disability and went to a special school, but her support needs were heightened by her chaotic family life. Carly spent much of her childhood between council respite units and living at home. When Carly turned 18 years old, her family were persecuted by a firebomb at their home and this separated the family. The only option was for Carly to live in a hostel with 36 other people who all were significantly older than her. Carly was extremely unhappy, she didn't know many people and her family no longer wanted contact with her. Having known Carly for several years, to get out of the crisis situation we felt the best thing would be set to up the circle, even though this would be our first, it was worth a try. The circle was made up of several people who had known Carly in school and different places she went to. In the first instance the circle managed to secure some direct payments and manage the payments so she could have at least have some quality time with personal assistants outside of the hostel. Eventually the circle managed to support her to move into her own home and have been critical in terms of ensuring she can access and contribute to her community. The circle is as strong as ever 4 years down the line and has supported Carly with the struggles of where she lives and who she lives with. The circle are helping Carly look for an alternative place to live in the future, but are supporting her to get it right. They assist her with making choices on how to spend her money, getting her staff team to understand her and have recently enabled her to meet back up with her Mum again. By no means is Carly's life sorted but the circle has her vision at the heart of everything they do.

What happens when I'm gone?

Brendan is in his 40's and found himself in residential care. His Mum had died years before and his Dad had just died suddenly. Brendan wanted a circle but the people paid to be in his life resisted like anything. To cut a long story short the circle has finally got going after negotiating long and hard with the paid staff, and is working on a plan for Brendan to live with someone out of the residential care unit that he gets on with really well. They are looking for property near where he used to live and hope to be in their own home for Christmas.

What happens when I'm long gone?

Bernard is 62 and his family have either died or live abroad. He has lived on his own for years and has been supported by a provider who recognised he didn't have many people in his life, just paid support. A circle started to evolve as the facilitator recognised some of Bernard's interests. Bernard was an avid World War fan and so the facilitator has got a local group of veterans involved, some folk from the local supermarket distribution centre and other local people. The circle are in the early stages of building a relationship with Bernard, but already he is chatting more, is certainly more sparky and a glint seems to have come into his eye.

So to conclude

The circles have in some instances moved mountains, given people a feeling of security or have simply cheered people up. It is early days, but what we are seeing is a very real concept that whatever shape or form the circle takes, it is providing something which has never existed before.

The people at the heart of the circles and their family and friends are feeling much safer and secure. They say they can't believe how such a simple concept seems to be so effective.  The effectiveness we believe is that it is owned, loved and cared for by families. We don't profess it is the right solution for everyone nor do we think it should become a standardised practice. Our Futures is a concept and idea for people to think about and certainly is not the only way people can develop a circle of support, however it provides the infrastructure for offering people peace of mind should they wish to take it."

We are continuing the discussion about circles with Max Neill through a paper about circles that will be out early summer, and perhaps a North West event to! In the meantime, if you want more information about the work that Caroline is doing contact:-

Caroline Tomlinson

07947 608 915

Caroline_tomlinson@hotmail.com

In a few weeks time I am working with the Co-production group from Think Local Act Personal, to support them to develop their one-page profiles. The group want to have one-page profiles as a way to get to know each other better and in particular, how to support each person to be as effective as possible in their important role. It is encouraging to see so many organisations making a similar commitment for all staff as well as everyone they support to have a one-page profile.

Aisling, CEO of Certitude, explains why, in an email to all the staff:

"We believe that the more we understand about our colleagues the better we are in our jobs. This is why we are committed to supporting everyone in Certitude to develop their own one page profile and share these with their team colleagues. I know many of you already have one page profiles or are working on them as part of our commitment as a person centred organisation, which is great. Tools, such as these, do not in themselves create a person centred organisation but alongside our unwavering commitment to a culture of openness and communication, go a long way in creating the conditions where being truly person-centred is business as usual at Certitude."

If you read my blogs you will know that I am always concerned that one-page profiles do not simply become 'better paper', but make a difference. I was invited to attend a meeting with an organisation that are working to implement Individual Service Funds. The chair of the meeting asked everyone to bring their one-page profile to the meeting. She started the meeting, by asking everyone to introduce themselves using their one-page profile and share something that is important to them, and also one thing from the section that would be helpful for others to know, so that everyone knew how to support each other in the project.

If you visit the offices of Real Life Options, you will see a printed folder on the table at reception that introduces all of the head office staff through their one-page profiles. Upstairs, where the offices are, the Director's one-page profiles are framed on the walls. If you go to Dimensions website, all the Directors introduce themselves through their one-page profiles.

One of the most powerful ways that one-page profiles are used is in matching staff to the people who use the service or in recruiting new staff. This requires the information in a one-page profile to extend beyond what matters to people about their work, and includes hobbies, and interests too.  As matching this way is usually only done with direct support staff, most managers have not included information about their home life on their one-page profiles.

I started to think about the message that this could give - that we wanted direct support staff to share more about their lives, but if you were a manager, you did not need to?  When I talked to a senior manager about this, she was surprised that I saw this as an issue. "Why would it make a difference for my team to know that I love horse-riding?" she asked. I think it could make a big difference. I know that Michelle is a keen (and award-winning!) darts and dominoes player for a team, playing on Monday nights.  This means that I can ask her how it is going (actually - it is more good natured teasing!) and try to avoid any work commitments that would impact on her Monday nights. I can celebrate her wins with her and if I saw something  (silly, cheap!) related to dominoes or darts, consider getting it for her, or have a birthday card themed around darts. I asked Michelle whether this made a difference to her and this is what she said….

"Most staff would rate feeling valued at work as one of the things that is important to them, and in this I am no different. Knowing that I work in a team that wants to get to know me as a whole person, not just a worker gives me a sense of belonging and worth, that pay and other incentives don't give. I'm very passionate and enthusiastic (if not talented) about my involvement in a darts and dominoes league, however my team at HSA knowing this, not only informs them about how I like to spend time on a Monday evening, but also informs them of my competitive nature (I hate losing a game of dominoes!) and also about being a real team player. I also know that I am supported when I plan my diary in a way that avoids work which would result in me missing out on playing, which helps me to manage my work life balance a little better!"

At HSA our public one-page profiles were based on work. We have now updated them to reflect more of our lives - at home and at work. I think that one-page profiles that help people know what is important to you at work, and how to support you to do your best work are great. I think that one-page profiles that help us learn about each other as whole people are even better, and make it possible for us to have deeper relationships with our colleagues.

What do you think?

A new experience for me yesterday was being part of a Guardian Live discussion.  It felt slightly frantic (like having several people in a room having conversations at the same time but not knowing which one to try and follow) but also useful. Individual Service Funds came up several times as ways to deliver personalisation in services. In the last two weeks there have been two papers published on Individual Service Funds, both focusing on how people can have more control and choices in their life, when supported by provider services.

These papers reflect two of the most significant decisions that people need to be in control of. These are "How do I want to live (and be supported)?" and "Who do I want to provide that support?"

"How do I want to live" captures what is important to the person, and in good services will be recorded in a person-centred description or support plan. "How I want to be supported" is the mandate for staff; central to the job description of their role and what they need to deliver. We need to have this information for everyone we support so that people can direct their own lives. This, and choosing who supports you, is key to truly delivering choice and control in practice.

Many organisations consider the answer to 'choosing who supports you', as simply to have several service-users trained and supported, to sit on recruitment panels in the organisation. This sends an important message to people coming for an interview. It also enables the panel to see first-hand how interviewees respond to and respect people who use the service. It does not however, address the question of how we enable people we support to choose their staff. This has to start with the description of how the person wants to live, and then use the 'matching staff' person centred thinking tool to begin the job description. Here is how Jennie and her Mum, Suzie, chose the right staff team for Jennie. Jennie uses her personal budget to buy support from a local provider, through an Individual Service Fund. They used the person-centred thinking tools 'matching'; the 'doughnut'; and a 'decision-making agreement' as part of this 'person-centred recruitment process'.

Jennie, her Mum Suzie and her circle of support, worked with a provider, Independent Options, to recruit Jennie's staff team. Jennie does not use speech to communicate and has learning disabilities and autism. The family and the Circle worked with the provider to keep Jennie at the centre of the process. They started with Jennie's person-centred plan and then developed the 'matching staff' information as the person specification and from this developed the job description.

The job description is split into responsibilities to Jennie, the Circle and the organisation. Within each of these we used the headings from the doughnut to specify core responsibilities and where people can use their creativity and judgment. The family and the manager, Joanne, then developed a decision-making agreement so that everyone was clear how decisions were going to be made and that Jennie and the circle, would make the final decision on who to appoint. This included deciding that Suzie would short-list with Joanne, and Jennie and circle members would meet the short listed candidates (doing art together - an important part of Jennies life) before the formal interviews.

The advert introduced Jennie, used some of what people appreciate about her from her person-centred plan, and information from the 'matching' tool.

The interview questions were based around Jennie's person-centred plan and asked in the order of responsibilities - to Jennie, to the Circle and then the organisation. Suzie and another member of the Circle were part of the interview panel. Jennie had done her 'interviews' by seeing how people responded to her during the art session. Suzie made the final decisions with Joanne, about which staff to appoint.

Jennie is very happy with her staff team and Suzie is delighted with how the team is working to support Jennie. Working hard to both get a good match and ensure that Jennie, her family and the Circle were central to the process, made all the difference.

At the end of the three-month probationary period, Suzie shared her views with Joanne, the manager, for the 'end of probationary' review. She gave Joanne her perspective on the relationship that different team members had with Jennie - the most important issue as far as the Circle was concerned. Then Suzie used the job description, and worked through what was working and not working about each item. Joanne did the same and in the review, asked each individual what they thought was working and not working. Therefore, like a 360 degree appraisal, the review was based on information about each person's relationship with Jennie, and what was working and not working against the job description from the perspectives of Suzie, Joanne and the team member themselves.

One of the questions asked at the Guardian Live debate, was how can we measure personalisation, in ways other than just the number of people with a personal budget. An answer could be, finding out the number of people who have chosen the staff who support them and whose job descriptions are personalised to the support that an individual wants.

When I worked in services in Manchester, I worked with a team using person-centred planning, with the two people that they support. The team did some excellent work in providing very person-centred support, with two people who did not use words to speak. As well as giving them direct feedback and praise, I wanted their efforts and success to be rewarded and acknowledged. I thought that the best way to do this was to get the CEO to write to them to express her appreciation.

The next time I spent time with the team, I was surprised that they had not seemed very interested in the letter. I was disappointed. We started to have a conversation about appreciation, and I asked them 'What does appreciation look like to you?" They told me that what they really would have liked would have been to share what they had tried and learned with their peers. We arranged for two of the team to talk at the next staff development forum to do this. I learned an important lesson about not assuming that what would have felt like appreciation to me, (being recognised by the CEO) is what being appreciated feels like to other people.

The adage 'treat people in the way you would like to be treated' does not work in a person-centred organisation. You need to find out how people want to be treated and not assume that it is the same as you. Now, when I work with teams, I ask upfront what being appreciated means to them, rather than make assumptions.

I have been thinking and writing about person-centred organisations over the last few months with Stephen Stirk, and the chapter that I found most difficult to work on, was about person-centred leadership. It is one of those things that 'you know it when you see it'. In the end we think it boils down to four things. Person-centred leaders:

• Authentically live the organisations values
• Enthuse others with the vision and possibilities
• Pay attention to relationships, building trust and working together
• Use person-centred practices in all areas of their work

In the book, I wrote: "You would be able to see most of this just being in a meeting with a person-centred leader."

I witnessed that yesterday. I was in an all-day meeting with a progressive provider organisation who are developing as a person-centred organisation. The CEO, Agnes, chaired the meeting.

The first thing that stood out was how she chaired the meeting. She used person-centred practices and started with an opening round. She asked each person to share something that they were proud of in relation to person-centred practices. Agnes shared an inspiring story about someone who uses their service and that she had spent time with over the last week. She gently used it to emphasise the importance of relationships over 'good paperwork.'

The next item on the agenda was a review of the previous actions. I noted that two of the actions included Agnes giving positive feedback to specific staff members and sending thank you letters. The following agenda item looked at Peter's report from the third quarter metrics from the strategic plan. This discussion wandered into whether some numbers should be included or not, and Agnes brought the group back to the purpose of collecting the information, what it told us and how we were using it. She listened to Joanne's frustration that figures did not always reflect the hard work in recruiting volunteers but also clearly explained why we needed to measure outcomes in people's lives not processes.

Throughout the meeting she was generous in giving credit and appreciating people naturally and genuinely throughout the meeting: Tim for his hard work on iPlanit to try and make it reflect the headings in person-centred reviews; Joanne for her excellent example of a person-centred team plan.

She came and sat next to me in the lunch break and I talked to her about appreciation. She told me how she had been thinking about this in her life and how she had spent time writing appreciations in her Christmas cards to her friends this year.

On the agenda for after lunch was a session for me to talk about the learning from developing Individual Service Funds. I spoke for 15 minutes about the impact that this had on people supported and the staff culture. When I had finished, Agnes enthusiastically talked about the difference this could make in the organisation. Then she turned to the most junior person in the room (who would be the person who would be required to make these changes) and asked for her views, before asking everyone to contribute their views. She was honest about where she felt that the organisation was not achieving this as the moment.

As part of the last agenda item she offered the group a challenge. The agenda item was whether to integrate the strategy for implementing person-centred practices into the organisation, into the other strategic objectives rather than having it separately. She made sure that she heard everyone's views in a round, and then carefully challenged us with why, with this investment, we had not made more progress? The sharp intake of breath was audible. It was a well-pitched challenge - not critical but questioning, and led to the two senior managers in the room genuinely talking about the impact that this challenge had on them, and how they wanted to go back to their managers and work with them to have person-centred practices much higher on the agenda.

Agnes closed the meeting with a round, asking everyone to say something about what they had appreciated about their work together in the meeting. All the reflections were upbeat, enthusiastic, with obvious determination to keep improving. I got a sense that people felt that their work was appreciated, and that they were inspired and encouraged to do even more to make a difference in peoples lives.

Throughout the meeting Agnes had demonstrated both appreciation and accountability. She had kept people focused on what really matters to the organisation and people left their time with her, feeling positive and determined to keep moving ahead.

This is what person-centred leaders do - they stay focused on what really matters - keeping the people supported by the organisation at the heart of everything they do and create a culture of trust, empowerment and accountability. A leader can be at any level of the organisation - a social worker in that meeting could also demonstrate these same qualities as a participant in any meeting.

On the plane, on the way home, I reflected on spending the day with Agnes at the meeting. I felt inspired and challenged - I have a team meeting on Friday. Will my team be able to see this person-centred leadership so clearly in me?

How are we getting on with the new way to do support planning?

Support planning - the process where a person thinks through how they would like to spend the money available to them for their support so it can change their life - should be as simple as booking a holiday.

For example, you generally know how much money you have got to spend and whether you want sun, excitement and adventure or culture, relaxation and lazing by the pool. You get the information to book your holiday in lots of different ways - online using Trip Advisor, articles in specialist magazines, asking friends or talking to a travel agent. You also know there are different ways to use your money - give it to someone else to book an all-inclusive deal on your behalf or book the car hire, accommodation and flights separately.

You get the idea. Support planning for people who use services needs to feel that simple too, especially given the government expectations that it must happen at scale so everyone can use a personal budget.

We've been working with Trafford Council and a few other authorities to see just how simple we can make the support planning process. We have been doing this using the Empower and Enable approach which I blogged about back in June. This week we worked with Lancashire County Council to explore what this could mean for them. This is how Irene, a parent carer, describes what 'Empower and Enable' means to her.

At the moment, we know from our work, that even in the most innovative local authorities in England, only one-to-two per cent of people are actually developing their own support plan. The rest are caught up in the complicated paper work and review panels processes. Even though some people get linked up with a peer supporter or care manager to help them develop a support plan, there's often a very long waiting list and people get caught up in a backlog in the system.

This year, we have been saying that support planning is so simple that a person can do it themselves and this is the basis for new national advice on support planning published by Think Local Act Personal, the sector-wide partnership to transform adult social care to transform adult social care.

Joanne Willmott, the personalisation programme manager for Trafford Council, was a guest speaker at our national Support Planning Day in October. She talked through their approach to support planning, and the impact that "Empower and Enable" has had on her council's journey towards personal budgets for all.

For Joanne and her team, they realised they had to change the culture, systems and process that they had originally set up during the first phase of personalisation implementation. They had previously been using a mixed model of brokerage and support planning and used their social care reform grant to fund in house brokers directly employed by council, as well as brokerage services in the community and voluntary sectors.

This worked well initially - it managed people's concerns about a new way of working and supported market stimulation and development. It also improved relationships with providers and in house teams through having to work together on a range of pilots and projects that pushed through barriers and resistance to new ways of working.

But Trafford then realised there was a real need to shift to a model of support planning to one where personal budgets could be mainstreamed and delivered at scale. They recognised that support planning had the potential to become a new bureaucratic burden for customers, especially as use of professional broker had become a compulsory stage in the customer journey.

That's when they started working with us and Breakthrough UK to try the Empower and Enable approach.

The main element behind this approach is a presumption of capacity. This is pretty straightforward and what personalisation is all about: people are experts in their own lives. They may need the tools to translate that into a way that local authority systems demand, but never lose sight of the idea that an individual has knowledge and expertise.

Trafford hopes that this do-it-yourself approach will result in support planning (and therefore personal budgets) becoming a mainstream option rather than something for just the lucky few. They can show hard-headed commissioners that this way of working helps creates capacity in councils systems', freeing up professionals to help the people who really need it. All this without having to spend any more money.

Trafford still accepts they need a wide range of resources to make support planning happen, like peer support, open surgeries and specialist brokerage, and they're keen to stress they don't just give people money to get on with it. But they are changing their operating model and processes to support new customer journey. This is an ongoing process for them and they recognise they don't have all the answers - yet! But when they do, we'll make sure we let you know about it!

You can read more about the Empower and Enable approach to support planning click here.

I think personalisation has to start with a one page profile. A one page profile is a page of information about you and usually has three sections: an appreciation section about your qualities, what is important to you and support and help you may need from others. A one page profile reflects the balance of whats important to and for someone.

Historically, our health and social care services have emphasised what is important for people focusing on what it takes to keep them healthy and safe. Personalisation brings us back into balance. People are the expert in their own lives and we must know and pay attention to what matters to people and deliver support in the context of how people want to live their life. I have been thinking about what this could look like in schools, work and healthcare.

For me, a one-page profile is the foundation stone of personalised services. You cannot deliver personalisation without knowing what is important to the person and how they want to be supported. It can start at birth and can continue to the end of your life. Flo is the youngest person I know that has a one page profile. Her one page profile was created when she was just three months old. The family used it to share with grandparents when they were babysitting and with the team around Flo, who were providing her and her family with additional support. The one-page profile was important in helping Flo settle into nursery, providing information about who she is, and the support she needs.

What would it be like if one page profiles were used throughout schools, workplaces and health and social care? We are starting to see some of this happening in the UK. Can you imagine having a one page profile for your child at school? If it had information showing what people valued about your child;  recognising their gifts and talents; and was updated every year. What if the curriculum reflected what really matters to your child and every teacher knew exactly the best ways to provide individual support? At one mainstram primary school this is starting to happen, and not only does every child have a one page profile, but the teachers and teaching assistants do as well.

What about work? What if  people in your team had the opportunity to share what they appreciate about you? What if they knew what really matters to you as an individual and how to support you to work at your best? What difference could that make to your work experience? Some national organisations are doing this and are seeing a reduction in absences as a result.

What could this mean as we move towards personalising health care? What would it be like if you went into hospital and the first sheet of your notes was a one page profile? How would your experience in hospital be different if nurses knew you as a person and could talk to you about what matters to you? What if you were asked at admission what would make your hospital stay work well for you, and what would the best care and support look like from your perspective? I don't mean being treated with respect and care - we expect this to happen for everyone, but the very particular things that are just about you. For example the best ways to share information with you and the best ways to involve you in decisions.

You might be thinking, "I don't want everyone to know everything about me", but of course you'd only share the personal information that you wanted to.  For example, I am really happy for you to know that I have three teenage daughters and I'm a black belt in karate; I have a flock of seven hens that lay eggs periodically; I am a morning person and rarely stay up past 10:30pm and I get so excited about work that I have problems sleeping; I love single malts, especially those from Islay, but I am equally obsessed about black teas as well.  But there is information that I would not want you to know in detail, for example, my family's experience of cancer, unless that was directly related to the point you were giving.

What if there was an app for this and you could develop your own one page profile and share it with whoever you want to?

So does knowing more about me and other people change things? I think it does.  Conversation starts in a different place but is even more powerful when this is reciprocated. Imagine the first time you met a new social worker and they introduced themselves by sharing their one page profile with you?

For me, that is what personalisation is all about. It is a change in power. It is a different way to listen to people. It is a different way to work together and to pay attention to how people want to live their lives, not just keeping people safe with professionals in charge. So if your job has anything to do with personalisation and you don't start with a one page profile, where will you start?

On Saturday night, my 13- year-old daughter Laura asked me if she could do another one-page profile. Laura is proud to have had the very first one-page profile ever! This was when she was seven and was struggling at school because her teacher did not know her well, or how best to support her. From age 7 - 11 we updated her one-page profile every year, up to her transition to secondary school. We spent Saturday evening writing a new one and this evening she is finishing a self-portrait to go with it. This has got me thinking again about the headings in a one page profile and in particular, how they convey appreciation.

There are three components of a one-page profile. They are usually referred to as 'like and admire'; what is important to you; and best to support you. In person-centred thinking, we talk about this being what is 'important to you' and what is 'important for you', and the balance between the two. Chocolate is important to Laura. As her parent, I have to try and balance how important chocolate is to Laura, with how it is important for her to have healthy teeth and limit her fat and sugar intake. Therefore she has chocolate on her list of what is important to her and the support section reflects the balance we have negotiated of no more than two treats a day.

Over the last week, I have developed a new understanding of just how important the appreciation section of a one-page profile is. The first people to benefit from person-centred thinking and planning were people with learning disabilities.   I understood the 'like and admire' section as a way to balance and redress the negative stereotypes people had endured.

As one-page profiles are now used widely, for example with people who have long term health conditions, with older people and people who use mental health services, the term 'like and admire' started to jar and people expressed concerns about this being patronising. We even talked in the team about whether having any sort of 'like and admire' was necessary.

My view now is absolutely, yes we do.

Last week I was immersed in Appreciative Inquiry during a summit with the HSA and HSA Press teams. We were planning what we want to achieve together over the next two years. We started with individual interviews and storytelling and shared what other people appreciated about us. This did not feel patronising but rather life affirming and a great place to think about change by building on what was good.

This has convinced me that we absolutely need to keep a focus on appreciation in every plan, in every review and in every one-page profile. Everyone needs to keep hearing and thinking about what is valuable, admired and appreciated about them. Nancy Kline, author of 'Time to Think', talks about how important it is for people to feel appreciation, in order to think well for themselves and how much we need this in our culture.

"Everyday the world pulls us down, shakes us up, slices into us, laughs at our attempts and belittles our triumphs. We need to hear afresh every day a few good things that are honestly good about us."  Nancy Kline

You can use whatever language makes sense to people in describing these appreciations. My daughter Laura personally likes the heading what people 'like and admire' about her. Now, when I talk and write about one-page profiles, I am describing this as the 'appreciation' section, and it has a new sense of significance for me.

For many of us, New Year is a time for some reflection on the past year and resolutions for the year to come. This is true for HSA, as in the first week in January, we have two days together to learn from and celebrate the last year and plan for the future. I ask everyone to think about three or four things that they want to share that they are proud of. I would like to share with you something that I have been proud to be involved in and that is Jennie's Circle of Support. In December, I blogged about starting Jon's Circle, here Suzie, Jennie's Mum talks about the story of Jennie's circle, and the difference it has made.

"Jennie is 20 and has a warm personality; she is fun with a cheeky sense of humour, a real zest for life and is great company.

Even though it is sometimes hard for Jennie to articulate her thoughts and feelings, I admire her determination to communicate with us about whether she likes an activity, place or a person.

After Jennie was diagnosed with autism, we received four nights of overnight respite care a month and that began our journey with services.

In 2004 I learned about the world of person-centred thinking and planning. I was a bit cynical about the idea of person-centred planning at first and felt it was just another fad to come over from America and I was concerned that local authorities and provider organisations would not 'get on board' with the concept. But as soon as I realised its potential I jumped into it 100%. I went on a course for families and developed a person centred description of what is important to Jennie and how best to support her, with the help of everybody in her life who knew her best. Everyone involved in Jennie's life has a copy of her person centred description. When she was at school, a master copy stayed in Jennie's home/school communication book in her school bag so that comments and suggestions could be added by anyone, at any time who knew Jennie really well. I didn't want it to be this pristine plan that was stuck in a draw and as everyone got into the habit of using it, it became a 'living' document about Jennie with scribbles and crossings out - 'Jennie doesn't do this anymore she prefers this' - so we were constantly learning and everyone was using it and keeping it up to date.

I started worrying about Jennie's future and the transitions she would go through from finishing school, post-16 education and leaving children's services and moving into adult life. We were one of the first families to be offered a person centred review (Year 9 Review). There are a few important things I remember that came out of it. In particular it was the start of us looking at planning for Jennie's future. When we were developing her person centred description, I realised that I was making all the decisions for Jennie and that the emphasis needed to shift to Jennie being involved in making some of those decisions herself, whether I liked them or not!

We had also drawn a relationship circle for Jennie and it hit me that Jennie's circle included family but no friends. Although friendships had not been that important to her I thought we had a responsibility to look at this. So I raised this as an issue at the Year 9 review and asked everyone whether there were any relationships that Jennie seemed to be enjoying and this began work with Jennie to develop friendships. Her friendship with Rowenna came from the work that we did on this. They are still friends today.

A year later, Jennie has her Year 10 review. Both reviews made a huge difference to the way Jennie was included and talked about in a positive way. One of the main things to come out of the Year 10 review was the idea to set up a Circle of Support to help us achieve the future we wanted for Jennie and this has been pivotal. One of the long-term issues for me is that I'm not always going to be here to support Jennie. I wanted to make sure that there were enough people in her life, with the same interests and concerns for her future as me and who knew her well enough, who could make the right choices about what she wants when she is older. This was the reason behind setting up the Circle of Support.

Being a member of someone's Circle of Support is a voluntary role, so we asked everyone at Jennie's review whether they would like to participate. Dave, Matt and I joined the circle as did Julie. Debbie, a friend and colleague, also volunteered. She is a close and valued friend and has two sons with autism so brought a different perspective, as a friend looking out for me and a professional perspective too. Another friend, Carol, who used to be one of Jennie's support workers, also volunteered and attends meetings when she can. Jennie's dad Derek joined the circle at a later stage. It is a brilliant combination of family and friends who know Jennie well and have her best interests at heart. But also the circle has a good personal and professional quality, particularly with Helen and Julie having person-centred and service backgrounds. Once the Circle of Support was established it started to take that weight off my shoulders.

In the first six months of the Circle, Helen suggested we do a Path for Jennie and we used this to start looking at Jennie's future. It was a very visual process, with two facilitators, who drew up a huge poster showing a path and all the things Jennie would need to journey along it. We started off by looking at our hopes and dreams, then what was positive and possible, and then looked at the steps we would need to take in two years, one year, and six months, to reach that point. So, in effect, you start off by looking into the future and then work backwards to set the goals and deadlines to achieve that future and this is all written up on the Path. Using the Path taught me that it is important to think really creatively because it encourages you to aim higher.

The Path was really useful because it kept us focused on what was important to Jennie and the possibilities that were out there. But I personally found the Path quite a challenging person-centred planning process to use because I had to change my attitude from thinking 'this is ridiculous, it's never going to happen' to, 'if you don't strive for the ultimate then you are never going to take little steps to reach your hopes and dreams'. This is when we started to think about personal budgets. To cut a long story short we got a resource allocation for Jennie and used information from her person centred description and Path to put together a support plan. Everything we had learned about Jennie, from person centred thinking and planning, pointed to the fact that it was crucially important for Jennie to live on her own, supported by people who understand her. We based our decisions on our collective understanding of Jennie.

We also did a community map(person centred thinking tool) and the circle members were tasked with looking at local activities, groups or places that Jennie could visit or be part of, that were linked to things that we knew from her person centred description and her Path were important to her, for example could she visit an art gallery or take art classes, were there any groups where she could develop friendships? It was about making sure that she had a full, rich, active life and was spending time with people that were important to her; the sort of thing that we would all strive to have in our lives.

This was all recorded in her support plan. As well as recording what is important to Jennie, the support plan outlines how her personal budget will be used; sets out her 'perfect week'; and includes a communication chart and decision-making profile. The support plan is a really important document because everything we wanted for Jennie in the plan was costed, so it had to be signed off by us and the local authority.

Life for Jennie, who is now living in her own flat, is fantastic. In fact, I would say that Jennie is really deliriously happy most of the time and it is a delight and a relief for me to see that. Jennie had a few difficult months settling in and so did I letting go. She has a really happy, active life and is supported by great people. She is enjoying the independence away from us. If you had said to me 10 years ago this would have happened I would never have believed it. I was worried that by then she might be in an institutional setting or in supported living with people she didn't like or, worse still, didn't choose to live with, but now all the worry has gone which has been amazing for me."