Living Ambitions (Provider)

Living Ambtions were delighted to be asked recently by HSA to contribute a number of examples of the One-Page Profiles we have helped to facilitate with both our employees and the individuals we support, and provide a little background as to how these had made a difference in people's lives.

I brought this request to our Person-Centred Task Group (a forum where we all come together to "Work in partnership to empower others to promote a person centred culture") and our teams certainly rose to the occasion - the challenge was which examples to provide!

Now while im quite confident that the understanding and purpose of the use of One-Page Profiles is firmly embedded within our organisational culture, I was particularly struck with one example provided by Mo Hunstone.

Mo is the Operations Manager over in our Salford region. Mo not only demonstrated how One-Page Profiles link with our organisational primary purpose and core values (developed by all our stakeholders) but how versatile the actual tool can be (To quote Mo "It's like having a dress for every occasion!"). Mo also explained the power of One-Page Profiles when supporting people in a crisis, demonstrating that as an organisaiton we really do empathise with the situations our supporters may find themselves in and that we do very much value the contributions they make when supporting others.

Mo sums this up much better in her own words, so I guess it's over to her:

Hi,

My name is Mo Hunstone. I am 57 years old, mother of two and Nanna to one. I live in the Salford area of Manchester but was born in the Peak District of Derbyshire; moving away many years ago when I got married. I have worked in Health and Social Care for over thirty years and feel that it is where I definitely belong!

I have seen many cultural changes in social care over the years but none of them have excited me more than "Personalisation" it's great to finally see people fully in control and self directing their own lives!  I have worked for many years for Living Ambitions, based over in Salford and have seen the organisation transformed in the last three years due to our person-centred approaches, and am incredibly proud to be part of an organisation that genuinely puts person-centred practices at the heart of everything we do - not just for the people we support but just as importantly our entire workforce. Living Ambitions fully understands that in order for supporters to deliver person-centred support, they have to feel just as valued and engaged.

As the organisation developed across the whole of Lancashire, I became part of a wider management team and this is when I personally recognised the importance of my own team "One-Page Profile" as it really helped me to get to know the managers in other regions whom I did not have day to day contact with and thanks to our One-Page team profiles they could really get to know me.

Another example of the value of my One-Page team profile is when I became part of the whole organisations tier two out of hour's emergency on-call service (meaning I am required to offer guidance to members of our workforce in other regions to support them around charged and stressful situations). I recall trying to support and be empathetic to support staff (who were in the middle of a crisis) who I didn't really know. I found this very difficult as I don't like to be just a voice at the end of a phone!

To remedy this, I asked those staff in other regions to complete another person-centred thinking tool called "What's Working/Not Working" around on-call support. This identified from their side what needed to be in place for me to give them my best support and I did the same. This enabled me to not only update my own One-Page Profile but to share this with the rest of the workforce and citizens - this along with other managers profiles is now with the on-call numbers so there is a "Familiar Person" at the end of the phone - I am now known as Mo , not the on-call manager!

I in turn have an iPad where I am able to access support staff and citizens profiles so I can really know who I am offering advice to - particularly around incident debriefs and it's the little things such as making reference to their children or interests or telling them to go and grab that coffee with two sugars (as identified on their profiles) - that act as great ice breakers and diffusing techniques - really supporting people coming out of charged situations. This (I've been given feedback on) makes people feel like you actually know and value them as individuals and that they are not alone in difficult situations. This in turn leads to great workforce engagement and really promotes our person-centred culture which underpins everything we do as an organisation - helping us to stay true to our primary purpose and core values - The little things might not sound much but as Tesco says, "Every little helps"!

Languages are a pet hobby of mine. Please don't get me wrong, I don't have a vast range of foreign languages that I can rattle off fluently at any given opportunity, but I do enjoy learning languages. I love the rhythm of the words, especially Italian, the language is almost musical in its delivery and for me this adds to the fun. The additional attraction of languages for me is that it helps me to feel part of the country I am visiting, making the experience more enriching. Even the most basic understanding of the local lingo will not only endear you to the indigenous population but it also helps you to make your needs understood.

So what if you don't speak the language? Well I guess nothing happens. Your visit will hopefully still be a good one and you will still get fed and watered, this is assuming of course that the staff where you're staying understand English. But what if the people where you are going do not speak English? Well you would probably have a bit more of a tricky time, for a start there would need to be some hand signals and some pointing, maybe some impressions of animal noises to try and get your point across. But what if you needed to convey something more complex, describe symptoms of an illness for example. In this case a translator would be necessary in order to ensure that the right level of care and support was given.

One of the things that I find intriguing about working in social care is how we use our own language. This is not uncommon in professional circles. However, we social care bods do enjoy immersing ourselves in our own bespoke dialect. Now there is nothing wrong with this at all, in fact speaking our own language has some distinct advantages. For a start it means that rather than having to explain in long winded fashion how we go about identifying the interpersonal support dynamics for an individual, we simply say, "relationship circle". Instead of an "overarching description of the preferences, support needs and disinclinations" of a person we say "one-page profile". We use others too, like, "Provider Brokerage", "Circles of Support" and "Passports". If this wasn't enough, we go and start abbreviating things down to 3 letters, "H.A.P's", "E.L.P's", "R.A.S", "I.S.F", you get my drift. Once again all very useful if you are in the know and have a full understanding of the social care "dictionary".

But what if you don't? What if you are looking for some support for a loved one for the first time and you are sitting in your first planning meeting? You have had no previous experience of social care and all of a sudden you are confronted with people speaking professional gobbledegook? Well the answer is, that the world becomes a very confusing and in some cases frightening place, as you try and work out what's best for the person you care about, whilst trying to decipher this new language and make sense of what is being said.

At Living Ambitions we had such an experience very early on in our V.A.N (there I go again) period. I remember it well, let me share what happened.  Jodie, Helen and I were delivering a presentation to a tender panel, consisting of commissioners, care managers, family members and service users. I was particularly proud of the PowerPoint presentation I had put together. It was professional, covered all the points raised in the question and had a couple of innovative ideas thrown in for good measure. As I was delivering my spiel, using the best social care language, I noticed different responses from the panel. The commissioners and care managers were nodding, smiling and looking interested. The family members and service users were frowning, doodling, looking out of the window and in one case, texting on their phone. When I had finished presenting I asked those assembled if they had any questions, at which point a service user asked me if I could do the presentation again, in English. When I asked what bits she didn't understand she said that some of the things didn't make sense like what is a "PCP Toolkit" and why did she need one, what needed fixing. Now it was the turn of the professionals to frown and the family members to nod and smile.

Living Ambitions took this message very seriously and from that point forward we have always attempted to de-mystify some of the language around Social Care. We are in the process of producing two "user guides" to help people navigate around support planning and assessment and accessing supported living services. Where possible we attempt to use plain English when presenting information and always check back whether our message has been clear enough. Our hope is that by doing this, similar to learning the language of a different country, peoples support planning experience with us will be more enriching and fully inclusive. After all how can you have a person-centred organisation if the people you are supporting don't understand the language you are using? Ciao miei amici

I am very conscious that we have spoken over the last year or so, via these blogs, about what tools we have used to embed a Person-Centred Culture throughout Living Ambitions. We have also shared some of the lessons from our VAN (Visionary and Naïve) period to re-assure you that mistakes do happen and that it is ok to stumble on the journey, provided that you learn before carrying on. One thing that I haven't really discussed was how we got the ball rolling in the first place. I'm hoping you might have found some of the content useful to date, but a practical example of how we engaged our workforce and the people who we support at the beginning, might help to promote some ideas in your own work place.

As previously mentioned in earlier blogs, I was very fortunate when I arrived at Living Ambitions in that I inherited a management team who were, on the whole at least, very supportive of change. Out of this management group Jodie, Helen and Mo were the ones who had felt for a while that they wanted to do things differently and had some great ideas about what needed to be done. I saw my role at the time as pulling these ideas together adding my slant on things and when necessary directing the energy and enthusiasm in the right direction. We worked together over a number of months to lay the foundations for a person centred culture, however, we didn't want this to be something that we inflicted on the workforce and people who used our services. We hoped that we could get everyone involved in our journey and empower them to take control over where the organisation was going.

One of the fundamental issues was that no one in the organisation knew what its aim was or in fact what values it stood for. I checked out by asking staff and people supported when I met them, "do you know what Living Ambitions stands for, why does it exist?" Or "what are the things that underpin it's work, its values?" Universally across the board these questions drew blank stares and in some cases blind panic as people thought they were being tested by this new upstart of an M.D. Having done some research, it wasn't surprising that people didn't know what Living Ambitions was all about or indeed what it stood for.  At the time of my inception, the company had very different wording to it's mission statement, depending on which document you were reading and over 40 different values, confusing to say the least.

So here was an opportunity to get the vision right from the outset and also make sure that the principals by which we operate were clear for everyone. Rather than sit in a darkened room and write these things myself, I wanted these vital statements to be developed by the workforce and the people we support. So this is when I hit on the idea of having a number of sessions whereby we gathered people together to gain their views.

The sessions were themed as being in a departure lounge at an airport, complete with soundtrack (available on-line), suitcases, golf clubs, sun hats, suitably arranged chairs and signage. This seemed an appropriate place to start our person-centred journey, at an airport. Everyone was issued with Living Ambitions "Passports" in which they could make notes and on the back was a statement of intent from me to everyone, as well as a quote from the great Henry Ford. The outcome I hoped from the sessions was that I would get enough information to work with the management team to answer these questions.

1)     What does Living Ambitions do or put another way, what is its purpose?

2)     How does Living Ambitions work? What are the principals that guide it?

In order to answer these questions we asked people to take part in a number of table top exercises, including drawing a picture of how they feel Living Ambitions "looked" at that time, and then how they wanted it to look in the future. We also held "what's working/not working" sessions and an open forum, which to say the least was a tad daunting. The outcomes from the sessions were very positive and to ensure that we captured everyone's views we held an independently facilitated event for people who we supported who didn't want to attend mixed events.

Having pulled all the information together myself, Jodie, Helen and Mo, set about assembling what people had said into some order. To my surprise there was a lot of similarity in what we were being told and some key themes emerged. In answering, "What does Living Ambitions do?" people told us that they felt our Primary Purpose should be;

"To provide quality individualised services to people who require support to fulfill their potential and live as independently as possible in their communities"

Our Core Principals, or more precisely, the answer to how we fulfill our Primary Purpose, is:

1)     Everything we do is person-centred

2)     We have a valued and skilled workforce

3)     We work in positive partnerships with everyone

4)     We provide good value

These statements were discussed in feedback groups following the initial "airport" sessions and were universally endorsed, (as you expect having had their origins in consultation).  As a result the core principals have underpinned all the work that Living Ambitions has done from that day and hopefully this has been apparent throughout this blog series. It is also a testament to the power that engaging your workforce and using the "Working Together for Change Model" can have. I would like to take this opportunity to publically thank everyone that was involved in that process and especially Jodie, Helen and Mo, I am hugely proud of what we have achieved together and Living Ambitions is a legacy that has and will continue to make a real difference as a result.

I have attached a picture of the Passport, such a small document produced such a huge reaction, and check the date it was only just under 3 years ago!

"You're a wizard Harry!" exclaimed Hagrid; now most of you will have some knowledge of what I am on about but for those that don't, I am referring to a line in the first Harry Potter novel. In order to explain why I am quoting J.K Rowling in a social care blog I am going to share with you a story.

A few months ago Living Ambitions was invited to attend a shortlisting interview for an award for which we had been nominated. For the most part the questions were as you would expect, relating to the category that we had been nominated in and me explaining the work that we had undertaken to develop our person centred culture. Whilst I tend not to enjoy interviews per se' I am happy to share the details of our journey with people and the judges were very knowledgeable and showed a real interest.  I was therefore feeling very relaxed approaching the end of the interview when one of the judges asked me this question.

"If you had a magic wand, what one thing would you do to improve social care nationally?"

Now the words "You're a wizard Robin" were never uttered to me as a young boy, nor did I attend Hogwarts School of Witchcraft and Wizardry. Therefore suddenly being afforded magical powers, albeit imagined, caught me quite off guard. In fact I was actually stopped in my tracks for a while as I considered what my answer would be. Imagine having one wish to improve social care nationally, what would you do? Go on try and have a think whilst I continue to write.

I mean the most obvious one would be to try and develop more money in the system, meaning that staff could receive a higher level of training and be paid more than the much talked about "living wage". Additionally individuals in receipt of services could actually have budgets that not only met their basic needs but also allowed for a little extra to achieve those additional outcomes that some people feel are just social or leisure outcomes and thereby shouldn't be funded by local authorities. Or increasing work opportunities for individuals so that they could actually get into the employment market in a real sense.

But funding isn't just the only issue, how about putting an end to disability hate crime. In one swish of my wand, that would be it, hate crime the end! Or let's go one step further and end abuse of vulnerable individuals, thereby ensuring that each individual is free from harm and safe in their homes and their communities. While we are on the subject of communities how about improving an individuals access to their communities. I mean the list is quite literally endless and therein lies the problem or at least therein lay my problem. You see I wanted to be profound; I wanted my magic wish to make a real difference and something that would be sustainable. It was Voltaire (Not Spiderman's Uncle) that stated "with great power there must also come great responsibility" and even though I was in a fictitious situation that responsibility weighed heavily on me.

Then it occurred to me that I should look towards what I felt was good about Living Ambitions and try and replicate that across social care. If I had a magic wand I would wish that all social care staff (and many of them do) have the best attributes of my workforce. I would wish that they were committed, enthusiastic, empathetic, supportive, positive, patient, understanding and empowering. This list is not exhaustive but you get my gist, in social care there are two brilliant resources to develop and promote positive outcomes. These are the people we support and the staff who support them. So Mr Potter, Mr Wesaley and Miss Grainger, you can keep your "Expelliarmus" and "Wingardiumleviosa"  spells, give me a wand my friends and I'll show you exactly how much good it can do.

Consultancy is a funny thing isn't it?  A consultant is typically a third party, independent expert who is commissioned to provide advice, usually in a specialised area in order to improve a company's output or quality. The consultant doesn't really have any recourse if their advice turns out be ill thought out, except of course that they wouldn't get the precious word of mouth recommendation that many need for future work, yet they do receive inflated fees for their knowledge and expertise.

So then what was the thinking behind Living Ambitions move to develop a Citizen Consultant role within our organisation? Well to be honest it was one of those flashes of inspiration that occasionally strikes us all. Alas this was an idea conceived in our V.A.N (visionary and naïve) period, which needed some work to make it a reality.  I'll start by explaining our initial thinking; we felt that whilst we had systems in place to get feedback from individuals using our services (in Lancashire the client group is called Citizens), this was done in a fairly structured way and at that time only about once a year. This annual feedback was sought through questionnaires and reviews. As previously discussed in last month's HSA blog we partly addressed the issue of feedback frequency through making the Citizen Forum's more of a platform for sharing ideas about our service provision. But how could we capture the views of people who chose not to attend the forums and didn't want to take part in the annual surveys? I can't remember who it was that hit on the idea of asking if one of the people who use our services would like to act as a "consultant". But the plan was quite simple, this consultant could visit people in their own homes, or people could contact them directly to let them know how things were going. The consultant would then feed this information directly back into our senior management team meetings. One of the other thoughts was that individuals who accessed support might prefer to speak to another person who received support, and could provide the SMT with a real idea of how it felt to receive the services that we provide, it all sounded good in theory.

From the outset we had a few practical issues to overcome, not least how the consultant would access services, also how would their support for this role be paid for? Obviously as they were doing a role for us, it wasn't fair that their support hours be taken from their individual budget. In addition to this how would we pay for the consultants services? As we didn't want their benefits to be affected if the role didn't prove to be full time. Should they be self-employed to ensure that they are truly independent?  If they were self-employed, how could they be supported to manage their own tax affairs? Once we had ironed out the logistical and practical issues, we then had to try and ensure that people knew about the role and what it was for. The obvious way of doing this was through the citizen forums but seeing as the consultant was meant to also get the views of people who didn't attend these, this would only go some way to promote the role. To address this we did a mail shot and sent out flyers and leaflets to all citizens explaining the role of the consultant and how it could help improve the services people were receiving.

We felt that we had done pretty well getting information out to people about our "Citizen Consultant". But at the first senior management team meeting our consultant informed us that no-one had contacted him and when he visited services no one had anything to report back. Now there are two ways to look at this, firstly we might think "well that's because everything we do is perfect" and therefore no one has any comments to make, or secondly, (as we did), people are perhaps still not understanding the role and what it's for. Now don't get me wrong, it's not that I thought there would be loads of negative comments but I did expect that there would be some take up of the service, as the people who use Living Ambitions services are always happily engaged in our organisations development and have a lot to say on the subject.

Now some of you might have already spotted the fundamental error in the development of our consultant role. But for us this only became clear when the service wasn't being used. Our mistake was not checking with the people who used our services whether a, they thought the idea was good one and b, how they wanted it to work in practice. Whilst we had the best of intentions, we didn't consult about the consultant. Doh! As Homer Simpson might say. So we set about gathering views about the "Citizen Consultant". From our research we were being told that yes, it was a good idea, but people didn't necessarily want to have a dedicated consultant for quality monitoring. Citizens were telling us that the quality checks that were done via our locality managers were sufficient and if there were more significant issues people would use the complaints procedure. What people did feel would be beneficial was if the "citizen consultant" undertook some of the same quality checks as our locality managers, accompanying them on visits to provide a different perspective, additionally for them to feedback directly from the Citizen Forums into the Senior Management Meetings so that we got to hear "their voice".

It's all too easy to get blinded by enthusiasm; we were so keen to develop our "consultant" idea that we lost sight of the need to keep everyone involved.  I am pleased to report that the consultant's role, once it was bedded in, has proved to be a very positive channel for receiving information about our service delivery. If you are planning on implementing a similar role it is to be recommended, just try and make sure that the planning stage is as inclusive as it can be.

"Power to the people" As Wolfie Smith and the Tooting Popular Front (showing my age again) once declared is obviously the underlying principal behind person centred thinking and practice. How that power can be expressed, encouraged and facilitated throughout an organisation provides an opportunity to develop meaningful interactions between individuals who use or purchase services and the organisation that provides them.

I was leaving the office the other day and I happened to notice that in our meeting room there was a Citizens Forum taking place. Some of you may call these service user groups or clients meetings, but at Living Ambitions individuals wanted to call them Citizens Forums.  Being the nosey type of chap that I am, I tapped on the door and asked if I could sit in, kindly they all agreed and I placed myself at the back of the room in order to be unobtrusive.

Our Citizen Forum is one of the many ways that the people who we provide services for (our customers) let us know how we are doing in terms of the quality of the support that they receive. Feedback from our Citizen Forums is provided to our senior management meetings by our Citizen Consultant (more of him in a later blog) and helps to inform the business plan. The forum also provides an opportunity for individuals to discuss matters of relevance to them ranging from Hate Crime to access at local community facilities.

The Citizen Forum hasn't always been such a positive platform for individuals at Living Ambitions. When Jodie and I first arrived the forums were designed as a get together and social event. Now once again I find myself edging towards issues that people may well feel are contentious. But in our view we feel that, yes, it is important for people to get together socially on a variety of occasions but actually these should be the same as they are for anyone else e.g. meeting in a pub or club, not badged as forums with no real purpose held in an office somewhere. Putting people into a room to socialise with each other just because they all have a learning difficulty didn't really sit well with our person centred values and therefore we asked the Citizens what they wanted from their forums.

People told us that they wanted to have more say in how the company did things and change "rules and regulations" {sic} (policies and Procedures). They wanted to be able to tell us regularly how we were doing, previously it was just an annual survey or service reviews. The last point that they made was individuals wanted the forum to be led by them, not organised by staff. As a result we now have a very influential group of people who are in direct receipt of services sharing ideas on topical issues and providing feedback directly to the senior management team on what Living Ambitions does well and not so well. Due to diary and time pressures I don't get to go to as many forums as I'd like, but it was brilliant to see how far they have evolved since the early days.

If you haven't done so already I would encourage you to ask you service user groups what they want the purpose of their meetings to be. If like ours they want to have a greater input into how the organisation is run, then I would encourage you to facilitate this because providing a platform to support "power to the people" is a very positive experience for all concerned.

I had the good fortune to be in Boston, Massachusetts, earlier this year sharing with colleagues across the pond some of our learning relating to how we are developing a person centred culture at Living Ambitions. Now if any of you have ever been to that particular part of the states, I would urge that you do because it is beautiful, you will not have failed to notice the amount of doughnut stores. On every street there is at least one and they are usually of the "Dunkin" brand, selling the most incredible variety of sugar based snacks.

Most of you will be familiar with the use of the Doughnut Sort in Person Centred Planning, however if you are not, here is a very, very brief over view.

The doughnut sort is used to identify and establish roles and responsibilities for individuals within someone's support plan. The inner ring of the doughnut is where the core responsibilities of staff/supporters sit, the next ring looks at potential and creativity where staff should and can use their judgement to problem solve and look at innovative ways of working. The outer ring is the limit of the staffs role and looks to identify who else can support the individual with responsibilities that fall outside of the staffs responsibility.

When we began our Person Centred Journey, we developed a staffing structure that placed emphasis on not only ensuring that person centred approaches were being implemented positively, but also that the quality and effectiveness of these were being monitored.  In order to do this we introduced a new management role that had the responsibility for quality assurance. However the introduction of this new role wasn't as straightforward as we had first hoped.  Whilst we were aware that quality monitoring was essential if our journey was to be successful,  we already had managers in place who had responsibility for certain quality checks and balances. What we didn't want to do was have people duplicating work, but we also didn't want people to feel that quality wasn't in their remit. The more we sat down and tried to scope out the quality managers job description, the more it seemed that roles and responsibilities were getting blurred and overlapping with the other management functions.

It became clear that we needed some help to establish who did what in our new person centred staffing structure. It was after a bit of head scratching that we thought about developing the Doughnut Sort to aid us on our way. With just a small amount of applied lateral thinking to the wording of the outer rings we found that the "Doughnut Sort" worked really well. We started by having three blank doughnut sorts pinned to the wall and we added the Job Purpose/Title to the inner circle for each of the three management roles (including quality assurance) that we were looking at re-designing. In the next ring we established what responsibilities or tasks would be needed to fulfil or achieve the main job purpose. Lastly, in the outer ring we identified things that would not fit with role, either because they were outside of the manager's sphere of influence or that they had no relevance. By having the three doughnut sorts next to each other we were able to move responsibilities from one to the other on "post-it-notes" until we had three job descriptions suitable for each role.

Using the Doughnut in this way proved so successful that we have re-designed all our Job Descriptions using this tool. Whilst I will admit that the "Dunkin" variety of Doughnuts found in Boston are far tastier, this variety is far more useful and much better for the waistline.

As I was grabbing a quick coffee the other day, I felt a tap on my shoulder and was greeted by "Ted". I haven't seen him in ages as he's always off doing something exciting like visiting Memphis or watching his beloved Liverpool (not so exciting if you are a Manchester United fan like me!). He said to me "Jodie, we finally got our dog, a little Chihuahua named (wait for it) - Tyson!!!

"That's fabulous" I replied (as I know Ted and his co-tenants have been working together for a long time to decide on the kind of pet they wanted, how they were going to pay for it and look after it etc). I commented to Ted that a dog usually has only one master, so who has the dog adopted? - he said Sue -  it's always by her wheelchair and won't leave her side and the first things she says when she wakes up is "Bring that dog in",  it's her best friend.

I immediately thought, I wonder if Sue's "Traffic Light" morning routine has changed its priorities now.

Let me explain.....

The traffic light element of a person's morning routine is a planning tool we evolved from Essential Lifestyle Planning around "Routines and rituals" and the person centred thinking tool "Important to/for".  Now we all know the importance of supporting people to think about their own routines and rituals, and the brilliant outcomes people get when they are respected and promoted, but what happens when real life gets in the way...........

Real life such as staff sickness, new members of staff joining the team (who perhaps haven't yet built up the required relationship), support hours being used flexibly or utilising natural supports that may not always be consistent (the reality is that best laid plans can go wrong!)

At Living Ambtions, we are very mindful of this and part of our support planning includes robust contingency plans. One of the ways we do this is by working in partnership with the citizens and families we support - take Sue for example (the first person we worked with to develop the "Traffic Light" tool) whom we spent time with to plan and develop her morning routine. Sue (who has both a physical and learning disability) is very meticulous around her personal care and requires quite intensive support around mobilising in the morning due to her health needs. Though we had a great picture of her support needs, the things that stood out around her personal care (particularly around promoting her privacy and dignity) was recognising how well she was feeling when she woke up and the "Trust" element of the relationship she had with her support workers - This meant we had to think about what would happen while she was still developing those relationships with new members of her team and if she did not feel well on waking.

This is where the traffic light system came into play - we supported Sue to develop three versions of her morning routine:

Red = 1^st Importance (non-Negotiable)

Sue uses this routine when she is feeling unwell or she is not fully comfortable with her supporter. This routine though very much paired down, still contains those elements she considers as non-negotiable (for example her hair must be washed).

Amber = 2^nd Importance

Sue uses this routine when she is not feeling well. This version is only slightly paired down in order to meet her health needs and not only contains those minimum elements she considers non-negotiable, but other elements that she feels still sets her up for the day (hair must be washed and dried).

Green = 3^rd Importance

This is Sue's usual and preferred routine and takes place when she is supported by those she feels at ease with and feels well. This routine contains every element of what is important to/for her and offers support in the routine manner she prefers (example her hair washed - with a little head massage and hair dried and styled).

This approach was so successful with Sue that this is now a standard part of how we support people to plan (this tool also fits really well with the "Just enough support" model to ensure that peoples budgets are used in a flexible bespoke manner) and forms part of our own person centred thinking tool kit - as it can translate into any area of a person's routines and rituals.

................Now just to get back to my first thought - has Sues "traffic Light" morning routine changed its priorities now? Yes it certainly has, for Sue, seeing Tyson first thing is the morning is definitely a "Non negotiable"!

This month's blog comes from our Operations Director, Jodie Allen-Cawley.

Those of you following our blogs will (hopefully) remember Robin back in February talking around the inception of our Person Centred Task group. I am pleased to have the opportunity to share with you some of the highs and the lows of our work to date.

We adopted the "Progress for Providers for Managers Tool" to both assess our person centred culture and to benchmark our progress. Because we had previously worked through the original "Progress for Providers Tool", we were very confident that as an organisation we were operationally responsive to deliver personalised services - the feedback from this initial work, led to an air of confidence from the people who signed up for the task group that most of the work had already been done, therefore our groups purpose would be around "Polishing up" an already embedded culture - how wrong they were!

Myself and Robin, (already having worked through and having had some input in the content of the tools) were more than aware that the original "Progress for Providers Tool" was more of a "Top Down" assessment of your culture, whereas the "Progress for Providers for Managers Tool" was more of a "Bottom up" assessment - the challenge for our task group was making the two meet consistently across the board (not just pockets of excellence). It was at this point that the group got a huge reality check and the realisation dawned that there was still plenty to do!

Well the group have risen to the challenge, we are six months in and Living Ambitions is very fortunate to have a great bunch of people who (after after lots of blood, sweat and tears working on and agreeing the groups purpose) are committed to:

"Working in partnership to empower others to promote a person centred culture"

By:

-      Sharing information and good practice

-      Celebrating success

-      Challenging barriers

-      Influencing change

(Their words not mine!)

Whilst the "Progress for Providers for Managers Tool" has proved invaluable in providing us with structure and focus, it has actually been the "Blue Sky Thinking" exercises we adopt around each domain, that has really made a difference,  enabling us to think "What  if  we were sitting at a 5, what would it..";

-      Look Like?

-      Feel Like?

-      The outcomes we would be achieving?

This thinking has not only led to some real creative ideas and actions (that are really raising the bar of our person centred culture), but a renewed enthusiasm and momentum, particularly around the recognition by all stakeholders in the group that being person centred extends to everyone at Living Ambitions, whether you are supported by or work with us!

We know that all our services are at different stages in their evaluations (this is to be expected when Citizens are driving their own services) and while some newer support teams are still getting to grips with building on their own "One-Page Profiles", whilst other more established teams are laying down the roots of sustainable "Circles of Support" with paid facilitators provided by ourselves (that's another blog!) or forming separate task groups to influence organisational policy,  the group continues to function as a great supportive platform, providing a vehicle for real change, which I have to say is something that makes us incredibly proud!

So there was I, all prepared to write this months blog, subject matter all sorted and ready to go, when something out of the blue happened which I felt I had to comment on. I have to be really careful how I write this because actually there are a number of legal considerations, (sounds serious eh?). But I will try and explain myself without getting myself hauled in front of a liable court.

Jodie and I were at a conference the other week, the subject matter is not that important. Whilst there, we witnessed a keynote speech by a representative of a provider who has had some safeguarding issues. During their talk, they described the steps that they have taken to remedy the situation and improve the outcomes for the citizens who they support.

One of the things that struck me about this organisation was - How could anyone let the situation get as bad as it had? How could people working in the services where these things were happening, not recognise that what they were witnessing was abuse in all it's most horrid forms? Now the issues are complex and I am not going to be able to cover them all in this blog, but there are also some fundamental values which can be promoted in the workplace, to ensure that staff are equipped with the right attitude to support vulnerable people.

Person centred thinking by definition, is one of the basic building blocks of organisational culture which can promote a safe and positive environment for individuals requiring support. Just think about it for a moment, if you have a person centred culture, then you are training and skilling your staff to understand that they are supporting people.  I would suggest that anyone who abuses another human being fails to respect their victim's fundamental human rights or simply put, fails to recognise that they are a person of equal status. Person centred thinking training instils this value from the outset of staffs employment, and ensures that individual power dynamics, so often prevalent in the abusers psychy are not present. If you then apply this principal to the whole organisation and you put person centred thinking and quality outcomes as the foremost consideration in the business plan, then you are developing a culture that values and empowers people, not degrades and abuses them.

I have to report with some sadness that in my personal opinion, the impression I got from the speech I heard, was that this fundamental value was being lost in a desire to ensure that KPI's and other benchmarks were being adhered to. Hopefully I am wrong.