1. from Social Role Valorisation and are commonly

1.     
Understand
how then active support model translates values into person-centred practical
action with individuals

 

1.1   Evaluate the extent to which the outcomes
for a range of individuals conform to contemporary person-centred values and
aims using the principles of the active support model

Contemporary person-centred
values and aims are derived from Social Role Valorisation and are commonly
expressed as the five service accomplishments of Respect, Competence, Participation,
Community Presence and Choice. This contrasts with the practices seen in the hotel
model, where the person caring undertakes all domestic tasks e.g. cooking,
cleaning etc. while the individual remains unoccupied and are rarely encouraged
to participate in looking after their own home. This is staff-led, not person-centred
and offers a poor quality of life to the individual.

The Active support model
comprises a person-centred model of how to interact positively with individuals
combined with daily planning systems that promote participation and enhance
quality of life.

When an individual moves to Thorndene
we use a ‘brief overview’ section. This details the following information;

• A brief life story which is
produced with everyone’s help e.g. social worker, family friends other care
staff and the client.

• Then we have a section on who
is important in the individual’s life and why e.g. family friends, staff and
even animals.

• There is a section about what
the client thinks others like about them and what they like about themselves
e.g sense of humour, chatty and friendly.

• Section on what they like to
do: at home, at work, at the day centre, just for fun, when on holiday, and on
a daily basis.

• Also lets us know what types of
music and films and tv shows they like.

• The different kinds of foods
and drinks they like and do not like.

• Any hobbies, do they collect
anything e.g. dolls, stamps

• What they do not like doing
e.g. going on escalators

• It lists their favourite thing
they like doing at home e.g. watching tv, when they are out in the community
e.g. going to the pub/cinema.

• It tells us things they do not
like doing e.g. cleaning their bedroom, cooking

• It tells us things that are
important to them like their pets/photographs

There will be a section on their
preferred daily routine, when they like to get up, what time they eat their
breakfast and when they like to go out. Who they like to go out with?

The next section lets us know
what makes them angry and sad how they communicate this to others.

There is a section on a typical
weekly activity planner and a typical weekly menu planner.

There is a section on what they
like to do in the evenings and what support they need to do this.

Another section highlights what
they like to do at weekends, who they like to be with.

Another section asks how they
look after themselves to stay happy and healthy and what help they need to do
this.

Then we ask what would they like
to change in their lives what do they want to start doing what do they want to
stop doing.

• Where would they like to go?

• What are their hopes dreams
goals for the future?

Then we put this altogether and
agree with the client and family that it is accurate. Finally, we decide
between us the support that is needed by whom and when it is needed. Once we
have a clear picture of the individual we put this altogether and update it
regularly so that we are confident we are delivering a service that is
requested. We will update the short-term goals and the long-term goals to
reflect any changes to the client’s independence.

It is through these comprehensive
person-centred plans that we can deliver the support and help that the client
needs to live the life they want. At Thorndene we like to evaluate every
individuals LTTP (long term treatment plans) on a monthly basis, taking into
account all appointments, any behavioural changes or anything of relevance that
may alter the support required. We then, when necessary, further evaluate the
change in needs and contact the relevant bodies to generate funding, care,
medication etc. reviews.

 

1.2   Analyse the practical changes which need to
be made within a work setting to improve individuals’ independence, informed
choice and quality of life.

When individuals have the
knowledge and skills to act independently, it is much easier for them to take
control of their lives, make their own choices and meet their daily needs.
However learning disability clients need varying degrees of help to achieve
this At Thorndene we embrace the person-centred approach to ensuring we deliver
an individual support plan which is custom designed for each individual taking
into account their choices aspirations and abilities.

To improve a person’s independence,
we may use a number of practical adaptations:

•        
Installing a bath seat to enable an individual to
get in and out of the bath themselves             

•        
Adapted cutlery and cups/glasses -helps the
individual to eat and drink unaided.

•        
Talking aids such as scales for the kitchen
watches for the time- to help visually impaired individuals

•        
Vibrating watches, clocks that help deaf people
know what time it is.

•        
Kettle tippers to help people with weak arms or
restricted movement

•        
Pill dispensers to help people in taking their
medication on time

•        
Clamps and holders to help people open tins jars
etc

•        
Communication aids so the individual can let
people know their choices and opinions.

 

An informed choice means that an individual has the
information and support to think the choice through understand what the
consequences might be before making the decision. However too much information
may cause problems, so it is best if the information is concise and delivered
at a level the individual can understand and respond to. This will vary from
one individual to another, It is important that we maintain an individual’s
choice and control over their lives, we can achieve this by:

•        
Treating people as individuals and making sure
they are in control of their own lives.

•        
Not assuming that, because an individual has a
learning disability, they do not understand and therefore cannot make decisions
for themselves.

•        
Encourage and support individuals to access the
wider community.

•        
Empower individuals to make sure they have
access to information about services they want or need.

•        
Ensure individuals are fully involved in any
decisions that affect them such as what to wear when to go to bed what to eat
and also with wider decisions like who they want to help them with their care/recruitment
of new staff.

•        
Make sure clients independence is not being
undermined and challenge decisions if it is.

•        
All information should be accessible, accurate,
available when needed and in a format the client can understand.

All individuals living at Thorndene are advised of the
options available to them with regards their care. Every week each individual gets
together with their keyworker for a meeting to enable them to raise any
concerns they may have, they then have monthly and three-monthly key-working
meetings. To ensure all concerns are dealt with without bias each individual
has a keyworker, a co-keyworker and also a key-working manager. The meetings
are alternated between the key and the co-keyworker, any concerns/issues are
raised with the allocated manager and as a check to ensure all concerns are
raised the key-working manager goes through the key-working folders every six
weeks.

At Thorndene we understand the importance of social contact especially
with family and friends, we encourage all family members to be as involved as
possible, providing transport for those parents who find it difficult to travel
to Thorndene or providing transport for the individual to enable home visits.

 

1.3  
Explain
how to lead the implementation of practical changes within the work setting to
improve individuals’ independence, informed choice and quality of life.

As care providers Thorndene has
embraced person-centred planning which encompasses the individual’s rights,
independence, choice, empowerment and inclusion. As a manager it is my
responsibility to ensure my staff team are fully trained on the principles of
person-centred planning. It is down to us to ensure we help and encourage each
individual to achieve the lifestyle they want and make a positive contribution
to their local community. It is important that the skills and numbers of staff
support are adequate to achieve this end. Mansell and Beadle-Brown(2004) state
that skill shortages can impede the implementation of these plans and
Packer(2000) points to a strain on resources in terms of lack of staff.
Magito-McLaughlin (2002) state that staffing levels need to be adequate to meet
the needs of one on one working that are often required by person centred
planning, as opposed to procedures within traditional services where staff were
required to supervise a group of service users. They also raise the issue of
stability within the workforce. They also note that direct care staff need to
feel that they are effective in their support role, otherwise they may become
frustrated which could result in them leaving the service. Such instability can
compromise the success of person centred planning, here at Thorndene we have a large
portion of staff who have worked here for longer than ten years.

As the manager who is responsible
for the rota I must first ensure I have sufficient staff to support the needs
of my clients, I make sure the staff are well trained and have the necessary
skills to empower and encourage my clients to achieve their goals. In order to
do this, I have a number of training matrix’s that show me who is trained in
each area or whose training needs refreshing. I involve everyone in the decision
making and producing a person-centred plan for each client. These helps give
staff a better understanding of what is required of them and makes them happier
in their job roles they are more able to effect positive change.

I always make sure we have the
equipment to carry out their tasks and responsibilities and that they have
enough specialist training to be confident in their job roles.

When producing a person-centred plan,
we ensure that the history of a client is included so staff can refer back to
information which is relevant, this can tell them a lot about a client’s wishes,
aspirations, character, behaviour and habits.

We also work closely with other
multi-agencies, family and friends to produce an achievable person-centred
plan. According to Towell and Sanderson (2004) multi-agency engagement needs to
be at three levels. First, at a personal level, the focus being on increasing
opportunities available to individuals. Second, at a service level, managers
need to increase the capacity of staff to be able to deliver the personalised
support. Finally, at a local public service level, where the focus is on
developing strategies for including clients in their local communities. The way
in which we manage services impacts on the ability of frontline staff to do
their job well and promote independent living.

 

2.     
Be able to
use practice leadership to promote positive interaction.

 

2.1  Explain the principles behind practice leadership.

Practice leadership refers to the
development and maintenance of high quality support, involving a constant focus
on promoting an optimum quality of life for individuals. Key elements include:
organising others to deliver support when and how individuals need and want it;
coaching others to deliver better support by observing them, providing
constructive feedback and modelling good practice; and reviewing the quality of
support provided in regular supervision and finding ways to improve it. The
style and quality of a company’s leadership will determine how well they
perform. Effective leadership will result in good quality care. This in turn
will ensure that staff morale and motivation is good. Recruitment and retention
of good quality staff is easily achievable. The service offered to clients will
be efficient, of good quality, effective and pro-active which in turn will
benefit staff as they will have opportunities to develop their professional
careers and expand their knowledge.

Practice leaderships key areas
include:

•       
Organising others to deliver support when and how
clients need and want it.

•       
Training staff to deliver better support by observing
their methods and ways of working

•       
Providing constructive feedback on good practice.

•       
Constantly reviewing the quality of support delivered.

•       
Regular supervisions with staff to receive and give
feedback so we can improve our service.

Practice leadership is when
managers and senior staff teach and guide support workers to deliver a person-centred
package to individuals with diverse needs. In order to deliver a good effective
service, we must ensure that staff have access to good quality ongoing
training. Good leadership will result in a motivated and committed staff team
which in turn will provide our clients with the best possible support. Good
managers will deliver regular feedback sessions via 1:1 chats, supervisions,
team meetings and appraisals. Staff are encouraged to engage with management
and voice their ideas and opinions which increases their knowledge confidence
and job satisfaction.

It is important that management
understand the need to implement the following:

•       
Recognise the value of routines for people we support  

•       
Make sure opportunities are offered to everyone on a
regular basis.

•       
Ensure staff have the skills to support the clients.

•       
Be aware and respond to individuals’ communication
needs.

•       
Encourage participation in a range of activities both
in the home and the community.

It is important that managers judge
their success of client engagement by looking at the response they get from the
clients after all it is their lives we are trying to improve. We need to
observe how the support staff carry out their duties and if there could be
improvements made. Managers need to look critically at their care
provision to ensure they are offering a real person-centred approach for each
individual.