Julie (Canada)

I hope that 2012 started off well and will be inspiring for everyone!

What seems to inspire me the most is when I hear stories of how Person Centred Thinking and Planning is being used in new ways, for new purposes and is making a positive difference in people's lives. It is especially exciting to see people's creativity and how these new ideas can be useful in my own life and my family's life.

Right before the holidays, Barb Swartz from Ontario told me about her new partnership with her local employment service. Based on her visioning work with a grade 8 class last June (click here to see the session outline),this year they will be doing Opportunities and Visioning sessions with all grade 8 classes in their area.  This work will take place from January to June of this year, which means that all students entering Parry Sound High School in September 2012 will do so with a One Page Profile and visioning board...How exciting!

Jordan developed a One Page Profile for High School using her vision board and information that she captured during the exercises (click here to see the pdf version).

Starting high school can be intimidating for any student.  Having an opportunity to think about hopes and fears and plan on how to cope with difficult situations can help them stay on their desired path to success. I am inspired by Barb's session and upcoming project with the employment service. We will work together to capture the experience and look at pulling it together so that others will be able to do this in their own area. I hope you are all as inspired as I am!

Hi everyone!

It's been a while since I've blogged and I'm happy to join you again to close off 2011 and bring in the New Year. I'd like to start by thanking Katherine and Jill for sharing their wonderful insights and personal stories with everyone these last few months. I hope that you've enjoyed reading their blogs as much as I have.

This time of year, much of our energy is spent on celebrating and indulging in festivities that are specific to each of our own personal cultures. For years now, I have encouraged support providers to ask people what is important to them in terms of celebrating the Holiday Season (or not), and to help them find a way to do this with their families, friends, neighbours and also take advantage of community celebrations.

When people rely mostly on paid support for day to day care, to connect with friends and family and to access their community, they also depend on these same service providers to help them celebrate or observe cultural Holiday practices. Providing this type of support is not always easy for the service provider and can take a lot of figuring out.

Since my childhood, I have been fascinated by discussions of how Holidays should be celebrated. Of course my way is the only right way (not really), but it is the only right way for me. I do care that what matters most to me in terms of celebrating is part of my celebration every year.

For me, being a French Canadian who was also raised Catholic, this particular Holiday Season means that we celebrate by going to church December 24^th for Christmas Eve mass. When I was young, midnight mass was actually at midnight (now we have the option of going to 'midnight' mass as early as 5pm - not the same but quite nice for my not so young body). In my young days, after church we gathered for a réveillon de noël. A réveillon is a party that lasts all night and involves eating loads of hot food including the traditional tourtière (meat pie), and singing des chansons à répondre (a unique type of sing-a-long). This is also when we opened our Christmas gifts.

Christmas still involves most of these French Canadian family traditions but sometimes they look a little different, which is okay with me because I'm part of making the decisions about how we modify our activities. Things that are most important to me, like baking, will never change because to me it wouldn't be Christmas without making batches of our favourite family recipes.

As you can probably imagine, supporting me during this Holiday Season would probably take lots of planning and creativity if I had to rely on paid supports to make it all happen. I do have to say that I don't think it would be much of a Christmas celebration without all my family traditions. Luckily, I have family members who also enjoy some of the same traditions and we take turns making bits and pieces of it happen. Together, we are bigger than the sum of our parts. It is much easier and a lot more fun, to come together to make it happen.

The best Christmas stories I've heard, are those where support providers have been able to learn what matters most to people and their loved ones, in terms of celebrating and observing cultural and family traditions and have worked together with them to make it happen. Not only did the person and their family appreciate the personalized support, but support workers were proud of the difference they made.

Thanks to all of you who take this extra care in providing person centred supports! It's not always easy but it sure is fun to see the difference it makes in someone's life.

I look forward to sharing my January blog where I share the inspiring work that Barb Swartz-Biscaro has done with a grade 8 class to help them prepare for secondary school.

Happy New Year everyone!

This months blog from HSA Canada comes from Jill Faber.

As promised from my blog in October, I want to share what I have tried and learned in helping organizations strategically plan for group homes and accommodation services.

Though my heart rests with the belief that every single person has the right to their own home, as they define and with the people they want… the reality is that accommodation services are still plentiful. Why not make them better now..?

By using person centred strategic planning methods, organizations can not only improve their present services, but can plan for the future based on what the people who use their services are telling them. They can plan for a more person centred future. Sometimes that distance from what is to what needs to be seems overwhelming. I believe this kind of planning is the "bridge" organizations need.

By having a strategic plan, the re-distribution of resources can be done over time and all with a clear and stated vision in mind, with real information directing and prioritizing the journey.

The strategic process that I've been using is by no means revolutionary. It merely uses what we already know about person centered thinking and blends it with common elements found in every strategic planning method.

Some of what I have used in this process was taken directly from…

From Individual to Strategic Change: Driving Change With Person Centred Information

Helen Sanderson and Max Neill

With Gill Bailey, Helen Smith, Lorraine Erwin, Alison Short and Charlotte Sweeney

--Thanks for the guidance and inspiration!

There are 7 steps in the strategic planning process:

1.Preparation

At the beginning of a strategic planning process it is essential that the strategic decision makers come together to clarify exactly what information they want and how they will use this to inform strategic decision-making.

1. What information do we want to gather from people?

2. Who are the people?

3. How will we gather the information?

a. What tools will be used?

b. Who will gather the information?

c. How will we manage the logistics of the process?

4. Who needs to be at the Strategic Planning Day(s)?

a. Who needs to be looking at this information to be able to use it to inform strategic decisions?

b. Who else would find this helpful?

2.Gathering Information

3.Transfer the information into a useable format.

Some organizations may wish to use their own survey or information gathering tool.

This, in combination with person centred tools becomes a highly effective way of gathering the needed information.

The One Page Profile for home became the "useable format" in order to think and plan how people wanted to live now and in their future.

4.Analyze

Depending on the mere amount of information and size of the accommodation services, the actual strategic planning sessions could range from 2-4 days.

Here is a meeting map of my last session in Hamilton, Ontario, Canada.

5.Action Plans

6.Sharing Information

7.Evaluate

You can't have strategic planning without the development of action plans.

Usually action plans are developed in tandem for three groups:

1- The person and their support network- Strategic planning can bring up more questions than answers sometimes. Therefore the first steps are to go back and ask further questions from the people and their supports. Checking in to see if we've got it right, share what was learned and involve people in the next steps.

2- Teams- Good planning will bring issues of support to light that require change. Teams leave with a plan of how they can make the lives better for the people they are supporting right now.

3-The Strategic Plan- This is the culmination of all the group work and blue sky thinking that happens over the two days. I encourage people to think about the immediate and the long term. In addition, building the evaluation of progress right into the strategic plan will ensure it happens.

If you want more information on my strategic planning adventures and what I have learned, please contact me directly, jillf@hsacanada.ca

This months blog from HSA Canada comes from Jill Faber.

"The ache for home lives in all of us, the safe place where we can go as we are and not be questioned" Maya Angelou

I have spent the good part of my life in the homes of others. No, I'm not a squatter or a couch surfer. I have merely spent the good part of my adult life working in group homes created for people with disabilities.

Group homes in theory should be the way of the past but a large section of people with disabilities continue to live this way. Many organisations primary funding is for residential accommodations that include group homes.

Through the years, I've met so many people living in group homes that were desperately unhappy about their "living situation" or "accommodation". I use these terms because thaese have been coined to steer us from the reality of what people actually want - that being a home, not an "accommodation".

At one point, many years ago, in my role as manager of several group homes, I realised that we could do better for people with their homes if we started to really listen to what they were trying to tell us.

What I knew that was that there had never been any strategic planning done in my agency to make positive changes for people concerning where they live. Planning was only done in terms of vacancies or crisis or when the government bestowed some money.

New group homes would be chosen because the senior managers thought they were pretty more than functional and they would show them off like they personally owned them. Locations of the homes, at least in my city, was determined by the city because of the archaic and discriminatory by-laws concerning where group homes could be located.

But the worst injustic was how people were "grouped" together. The reasons I have heard over the years of "why" people should live together are plentiful, but shy of any real input from the people themselves.

And then there were all the people that were suped into believing they should move from one group home to another, because "we" wanted the "spot" for another person. Only to criticise the person who moved months later for being unhappy in the their home.

People like to describe this time when a person moves into a new group home as the "honeymoon" phase. I personally dislike this term, as I think it gives permission to ignore what people are trying to tell us when they are unhappy. I have recoined the term to "hope" phase. When people "hope" their new home will be better and show this by wanting to fit in, wanting to feel safe, wanting to feel at home. When these are not fulfilled or validated, hope falls away and people start telling us they are unhappy.

Many of my co-workers were skeptical when I proposed person centred strategic planning for the group liiving program. It would gives us an indication of how and where people actually want to live, by which we could make plans accordingly. "Would it really be person centred?" "You are going to get people's hopes and dreams up"

Others claimed, "Nothing can be done, this is the way it has always been". I was told that the people living in the group homes were basically prisoners of their own circumstance.

I believed the only circumstance that people were imprisoned by was that which we had created. I knew we could do better.

So I started my journey in developing a process that involves listening and learning from people about their home life and using this to inform strategic changes in group living programs as a whole.

Next month, our blog will describe this strategic planning process and Helping People Plan for Home.

Stay tuned..........

This month's blog comes from Katherine Fleming of HSA Canada.........

"I don't know what I would do if I was given more time to live. I don't think I would be able to handle it. I don't know what I would do". I think of these words often, words spoken by my sister in law, Virginia, at our usual Sunday suppertime gathering of the family. We had just been reflecting on impossible to imagine decisions people need to make in their lives. This was in the fall of 2009, in April 2010 Ginnie was diagnosed with colon cancer and died January 31, 2011, one day before her 54^th birthday. She never wanted to know how much time she had. She was going to live each day like there was going to be another and no one was going to tell her when she was going to "expire". The doctors never expected her to live past November. She lived 2-3 months longer than she was supposed to.

Virginia believed in the power of person centered thinking and remaining in control as much as possible even when faced with something over which you have no control. She loved the idea of the one page profiles and gave permission to share her profile that we posted outside the door of her palliative care hospital room (Please click the pictures for the full profile). She was very interested in helping to make change so she and her family contributed towards a working, not working review to be shared with her medical professionals.  It was very therapeutic for both Gin and her family to work through this exercise. It created a vehicle which shared positive and productive perspectives towards change.

Soon after Virginia's death, I joined our local hospice palliative care society. They were planning around creating ten new hospice rooms in a local facility. Part of their mission reads "to be a voice for the community, an ear to public need". I asked them when was the last time they asked the community what they needed and it had been almost 8 years. Offering to set up a survey of the community, I showed them Virginia's profile, a sample of what family felt was working and not working and the process of Working Together towards Change to use as the survey format. They were intrigued both with the process and Virginia's information. There were some fears that if we ask people what they would suggest as recommendations for change that they will ask for extravagant unrealistic things when in fact simple things are what people are asking for... having an A & W chocolate milkshake, internet to connect with their children, a window that was low enough to see out. We launched our online survey and are just now tallying the results. At first glance the recommendations we are seeing is very similar to that of Virginia's. I will be posting a link to the final report of our survey for a reference for others. The Working Together Towards Change process is an excellent, simple way to gather information  from individuals using supports and can be used to help services maintain the integrity behind statements that they are truly consumer driven.

This months blog is written by Jill Faber, a colleague of Julie's at HSA Canada.

I often think people visualize a dream or wish as an extra something that gets added to your life like a fashion accessory. Not really something you need, but it looks nice if you've got it, just don't show it off, and don't have too much.

Sometimes during a planning or training session I can feel like I'm trying to literately sell "it"  (the person's dream or wish) to the crowd.  One summer in 1989, working on commission at a jewelry and shoe store was enough selling for me.  I am no salesman.

But dreams really aren't fashion accessories are they? Why am I feeling this way? Of course I've met people that have been less than enthusiastic regarding the dreams of the people they support. They can dismiss the simplest of wishes, sometimes literally because of its simplicity! Why is it that when I start talking about dreams and wishes in planning and training I see the look of terror in some people's eyes? It seems that sometimes one person's dream is another's nightmare?

Often staff that support people with disabilities struggle with what they have defined as the "unachievable dream". We know we should dig deeper and understand why this dream is important to the person. But for most of us, some dreams are the most far-reaching possibilities in our lives. Reaching is good.

During training, I share my own dream of being an actress. I explain that I've had formal theatre schooling, I tried to pursue it, a little, but really it's a grandiose dream. I talk about how my dream relates to what I do for a living (I do love to tell stories), and how I keep myself updated in my interests in the theatre and movies, and if someone offered me job on television I would drop everything to do it. 

The funny thing is, that that there are always participants who want to talk to me afterward about my dream. After awhile, I started to see a trend in what people were saying to me: 

• I can help you- People want to tell me where I can go to learn or participate more about my dream in my community (this often bubbles up in Community Connecting Courses). 
• I'm like you- People want to share their dream of singing or dancing or acting. 
• I believe in you- People tell me I should keep pursuing my dream of acting. 
• I'll keep you in mind- People just want to tell me they liked my story. 

Maybe this should be the short list to start with when thinking about helping people with their dreams? 

• Can I help you and how?
• Who are the natural connectors?
• I respect your dream.
• I won't forget it. 

I have had the privilege of witnessing and being a small part of people's wishes and dreams coming true. I have witnessed and felt the ripple effect of excitement on the hot pursuit of a dream and the long lasting results long after the climax of the event has past. 

One of my favorite stories is about a young woman whom wanted to meet Richard Simmons, fitness guru. She had faithfully worked out to his videos every single day for years! During a planning session she expressed her desire to meet him. That would be a great dream! Of course as soon as she said it, I saw some eyes roll and the expressions of " oh isn't that nice" in the room, but onto to the action plan it went. She was going to meet Richard. 

The next day her support staff was in my office with that look of terror again. How could I put this on the action plan?  This is impossible! After some reassurance that she need not rob a bank to make this happen, I left her with the thought. " If you keep your eyes and ears open, and don't forget this is what she wants, something will happen" Did I know what would happen? No. But I knew something would happen if the support staff believed it would. And it did. 

Months later I am sitting in my office when I get the call. "Jill, she spoke to Richard Simmons! " The support staff was yelling it out on the other end of the line, and I had to ask her to repeat herself several times before I realized what I heard. Yes, the dream had become closer to reality. 

You see the staff had kept her ears wide open and that dream in mind.  So when she was listening to a radio show one lazy rainy Sunday morning, and heard that Richard Simmons was up next, and he was taking callers, she went into action. One telephone call later, from Richard's biggest fan, and tada = one incredible experience for the young woman. Days later an autographed picture from Richard arrived in the mail  She was suddenly blessed with that "you talked to a celebrity" buzz, and the conversations, laughs, and "oh my god, really that happened?' moments went on for weeks. 

I could go on and on about how that one moment reverberated through the group home where this woman lived. Suddenly the look of terror began to fade away from staffs eyes and staff wanted, yes wanted to help people pursue dreams, without fear, without concerns that they would let people down. Dreams and wishes became ongoing conversations, rather than a statement once a year at a planning session. 

Dreams and wishes had graduated from accessories to essentials.

In Canada we have been exploring how we can use person centred practices within strategic planning. I have been working with Helen on this and we wanted to share with you what we are trying, and hope to hear from you about what you are doing in this area.

Traditionally, strategic planning includes an analysis of where the organisation is now; the context that it is operating in; a way to hear from people who use the service; and using this to create 3 - 5 year objectives.

This is what we are trying in Canada:

a) Listening to people differently through Working Together for Change

Working Together for Change is a way to use person centred information (from person centred reviews) to identify the top areas that people think are working well, the most important areas where people think things are not working, and an understanding of what people want for the future. Therefore the process is based on the person centred thinking tool 'Working and Not working' but then aggregates individual information to be able to identify themes. The process does more than identify themes, people (including families and people who use the service) work together to identify and then analyse the root causes of what is not working, and develop success statements. These statements then give us a focus for quality assurance - are we working towards these success statements? How can we know how well we are doing?

Using Working Together for Change eliminates the need for costly service user satisfaction surveys that take up the person's time as well as staff time in getting and analysing the data. Instead, people's views are taken from their reviews (where we ask people to simply prioritise their top two working/not working and important in the future). Another benefit is that people who use services and families rarely get to see what happens as a result of the data. In Working Together for Change they have the opportunity to aggregate, analyse and act on the data together, something that in the UK is called 'Co-production'.

b) Self assessing ourselves against best practice using 'Progress for Providers'

Progress for Providers is a self assessment for providers in delivering person centred services. It is high level, and looks at how the structures, systems and processes in the organisation work in an effective and person centred way. Senior managers are asked to score their service on a scale of 1 - 5, with 5 being best practice. One of the benefits of using Progress for Providers is the discussion it generates about where people think they are, and how they know this (and then how they check this). Another benefit is that it conveys a clear sense of what 'good' looks like at an organisational level, and therefore an opportunity to measure against that standard.

c) Reflecting on what we have tried and learned using the Four Plus 1 person centred thinking tool

So far the information we have gathered is the working/not working and important in the future from the perspective of people using our service, put alongside how we are doing in the way we organise ourselves to deliver our service (Progress for Providers) and now we want to think about what we have tried and learned through our existing efforts to change our service.

One way to approach this is to use 4 plus 1 on the existing objectives that the organisation has been working towards from its last strategic planning (or other initiatives to develop the service, like Transforming Teams or Good2Great). This gives staff and managers a chance to reflect on their progress and look at what has been learned and what needs to happen next.

d) Putting this information alongside a PEST  or SWOT analysis

PEST is an acronym to examine the following areas of influence on the organization:

• Political/Legal factors
• Economic factors
• Social factors
• Technological factors

The PEST analysis is used to evaluate the factors affecting the organization's work, progress and future direction and to examine the organization's main threats and opportunities, providing a context with which more detailed planning could take place.

A SWOT analysis is also a helpful check for the staff and managers. Here is how the information from Working Together For Change (WTFC), Progress for Providers and the 4 plus 1 contribute to this:

Strengths  - what is 'working' from WTFC, the scores of 4 and 5 from Progress for Providers and the list under 'what we are pleased about' from 4 plus1 add to this

Weaknesses - what is 'not working' from WTFC, the scores of 1 and 2 from Progress for Providers, and 'concerns' from the 4 plus 1 add to this

Opportunities - the information from WTFC on 'important in the future' contribute here

Threats - not changing what is not working from WTFC and scores of 1 or 2 would also contribute to threats

Here is how we can putt this information together to begin to generate 3 - 5 year objectives:

Putting it together with a K.I.S.S

The Keep, Increase/Expand, Stop, Start format is used to celebrate successes, identify top priorities and develop objectives and an action plan. This is a way to take the learning and priorities from WTFC, PEST, Progress for Providers and 4 plus 1 and to see what this tells use we should:

• Keep (Items that are going well and should be maintained)
• Increase/Expand (Items that need further attention, expansion and development)
• Stop (Items that are currently being done and need to be stopped because they are not effective or of value)
• Start (Items that are not currently being done and should be action planned and started)

There are a large range of processes used within strategic planning. This is what we are trying in Canada, and I am keen to learn how other organisations are integrating their person centred practices within strategic planning processes. Please comment and let me know.

Before I talk about the new opportunities coming up in June, I would like to share what I have appreciated most about May. At our international team meeting in May, Helen introduced us to what she is learning around wellness. Together, Helen, Amanda, Deb and I used person centred thinking tools to work through each area of wellness as described by The New Economics Foundation. Please go to Helen's blog for more information on this. I am sure some of you will find this information very useful. I know that it is already starting to make a difference in my life.

 On a different note, I am excited to let you know that in a few weeks I will be working with an organization to evaluate their services and look at strategic direction by working with the Progress for Providers (checking your progress in using person centred approaches) in combination with the Working Together for Change process. This will be our first opportunity in Canada to work with both tools simultaneously. I look forward to sharing our learning with you.

The other exciting news is that I have been invited to present at the Ontario Hospital Association conference in Toronto June 14^th.  The group is interested in hearing about HSA's work around Think About Your Life. Thanks Amanda George for your wonderful leadership with this website. I look forward to introducing this work to the medical community in Ontario. 

I would like to wish everyone a wonderful summer!  I look forward to giving you updates on these events when I join you again in future blogs!

Joey is my 15 year old son.  He is interested in finding a summer job and realizes that many other students are currently trying to do the same.  Last weekend, Joey and I put our heads together to see how we could create a resume that is a bit different than everyone else's resume.  I showed Joey a few examples of One Page Profiles and Joey thought that the Like and Admire and Important To sections of the One Page Profile might be good additions to his resume.

Joey is now bringing his resume to different employers in our community and keeping his fingers crossed.  One of the employers told him that they thought it was a great idea to put his picture on the resume since this would remind her of their first introduction. 

I appreciate Joey's willingness to share his resume with a local employment service that supports people with disabilities.  They were interested in seeing how this might be helpful in supporting people to find employment.    

Please let me know what you think of Joey's resume and how you think most employers would respond to this type of approach.  I would also love to hear about your own experiences.  You can email me directly at juliem@hsacanada.ca or leave a comment here. 

When asked to describe a good day from a bad day and what is important to her, Judy surprised Krista, the Care Coordinator for Assisted Living, by telling her that she loves sunshine and snowflakes.  She also shared that she was not able to enjoy this anymore because she did not feel safe going outside alone - not even on her porch!  Quick action led to Judy getting a Help call system and her feeling safe to go out on her porch.   She has also said that this has brought more joy to her life. 

Over the last 4 months, The Mills Community Support Corporation has developed an Assisted Living service for older adults who are considered to be 'at risk' in their own homes.    These support services focus on helping older adults to have a good life and a safe life, to continue to live at home and to participate in the life of the community.  From the beginning, The Mills wanted this new service to be person centred.  Jill Faber from the HSA Canada team supported Wendy (Manager) and Krista (Care Coordinator) on their very first day of work.  Wendy recently shared that:

"Using the tools Jill provided helped us establish our vision and our work plan. It helped us discover our creativity and pulled out our passion for a person centred vision of service. It was a great first step because it has become our guiding principle."

From this vision and work plan, Wendy and Krista approached the hiring, matching and orientation of staff in a person centred manner.  Wendy shared that they have also applied what they learned from their own experience with Person Centred Teams to this new workforce and feel that it has helped in supporting staff by facilitating positive open communication and a collaborative approach to problem solving.

I am also very excited to share with you the Support Plan that was fuelled and developed by the initial visioning exercise, Person Centred Thinking training and Krista's own research and experiences as an Occupational Therapist.  Krista says that the Support Plan has been well received by those supported and that they see it as an ongoing/evolving process.  This Support Plan is used when first meeting the person and must then be updated and shared as they learn more about the person.  It needs to be a living document.

This particular team is helping us think about How to Help People Stay at Home.  We look forward to continue learning from this team and sharing this learning with you.  I would love to hear your thoughts and ideas on this.  Please email me at juliem@hsacanada.ca with questions or suggestions.