This update talks about PERSON CENTRED CARE and details the new system of care planning we will be implementing. At the end is a reflective exercise that asks you to think about a time when a person centred approach has yielded positive results for one of our service users. Try to complete this when you do the daily observations and then keep it in your file for your next supervision.
The care certificate
This relates to STANDARD 5 of the Care Certificate “Work In a Person Centred Way”, work booklets for which can be found in the office.
Using the Internet for Help
Here are some useful links to websites that have information about PERSON CENTRED CARE; either copy the addresses into the address bar at the top of your web browser or just click the link if you are reading this online.
Here is a useful booklet produce by The Health Foundation, a paper copy can be found in the office. http://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf
Here is video made by The Health Foundation explaining the document in more detail.
Here is a good introduction to person centred care aimed at Canadian health care professionals but is still very useful.
Of course you can always search “PERSON CENTRED CARE” for more information, (hint – start with Wikipedia!).
Is Our Care Person Centred?
Taking a person centred approach is not a new concept to us at 18 Hope Street, what is new is our system of care planning designed to make putting our service users at the centre of their own care easier than ever before. So before discussing the new system in detail, let’s look first at what person centred care is and how we can ensure we are putting our service users at the centre of their care plans.
The health Foundation is a charity that produces material to help care providers do their job more effectively and they have produce a booklet discussing PERSON CENTRED CARE in detail called “Person Centred Care Made Simple”. In it, it discusses what makes care person centred and it suggests that it depends on four criteria the care must meet –
1. Is the care personalised?
2. Is the care coordinated?
3. Is the care enabling?
4. Is the person treated with dignity, compassion and respect?
So do we get a “yes” for all of these?
Looking at number 4 first, treating our service users with dignity, compassion and respect has always been one of the core values at 18 Hope Street, something reflected in both service user feedback and inspection reports. It is a value we all share and we would expect anyone joining our team to also share, but what about the other questions?
Is our care personalised? We certainly hope so, and all of us make efforts to personalise the care we give our service users but without a formal one-to—one session where we get to speak to the service users about their care, can we really be sure? This is something we should be doing.
Is our care co-ordinated? Again, we all discus our service users’ needs and care and have a culture of sharing best practice with our co-workers but is it written down? Could a new member of staff pick up what they need to know just from reading the service users files? Are our files up-to-date and accurate? This is something else we need to do.
Is our care enabling? This one we should look at in more detail.
Is Our Care Enabling?
In recent years we have talked a lot about recovery and the recovery model and the barriers to recovery work we face. Previously, all our service users were long term residents who would require lifelong support from us and any work towards recovery would have to reflect this. We have come up with many creative ways of enabling our service users to take control of their lives whilst living at 18 Hope Street. However, we now have services users who are preparing to live independently, this will hopefully not be the end to the support we give them and they will still be part of our support community. It does mean that we will have to make that distinction between those service users who are here on a long term basis and those on a short term. But if our care is personalised and co-ordinated, we can really put our knowledge of recovery into practice in a truly person centred way.
So how will we do this?
A Holistic View
One aspect of the recovery model is that we should take a holistic view of our service users, looking at all areas of their life, not just the ones we think they have issues with. Think about how a problem in one area of your life can have an effect on another area, for example, if you have an old, uncomfortable mattress it can affect your sleep, making you tired and groggy in the morning, affecting your ability to do your job. All your co-workers will see is that your performance is declining. The same is the same for our service users, issues in one area of their lives may show up as problems in other areas and they may not realise it. For us to offer truly effective care we must look at all aspects of our service users’ lives systematically. This is an approach that our new system not only supports but reinforces.
Instead of tackling the service users’ care plans in one big chunk, a method that encouraged skipping over the seemingly “less important” sections, we will now take one section at a time and focus on that one area. We will follow the calendar included with this update, working through one section every two weeks until the whole plan is completed. This way we get a chance to focus on every section for every service user, helping us to spot issues we may have otherwise missed, ensure all of their needs are met and help bring structure to the support we give.
To help us focus on each particular section, weekly updates such as this one will provide a brief refresher of our knowledge as well as where to find useful resources relating to the area of focus. Each one will have a reflective exercise at the end to help you put theory into practice. These will use the Borton 1970 model of reflection (What? So What? Now What?) which we discussed in a previous staff meeting on REFLECTIVE PRACTICE, the handouts for which are available in the office. I recommend you try to complete these when you are completing the daily observations for the shift. These can then be stored in your individual files and be brought to supervisions to form the basis of a discussion.
Key Worker Sessions and Booklets
Every week from now on, every resident will have a keyworker session with a member of staff during which they will be supported to complete a booklet relating to the section of the care plan we are focusing on. These booklets detail where the service user is now, where they want to be and how we are going to support them to get there, as well as ways of managing risks. These booklets serve three purposes; firstly, to guide your discussion with the service users in a way that empowers them to take control of their own care. Secondly, the completed booklets will serve as a guide to other members of staff/professionals involved in the service user’s care on how to support the resident, what their needs are and how to support them to manage risks appropriately. Finally, the completed booklets will demonstrate to inspectors and commissioners that we are offering an appropriate level of care to service users so that we meet essential criteria for you to continue operating and offering care.
Once the booklets are completed, the sessions can cover any topic you or the service user feel need to be addressed, or maybe just used for an opportunity for an informal chat. Whatever the topic, these sessions should be used to build a bond of trust with the service user and empower them to live as independently as possible, whether they will be with us for a short time or longer. These sessions should be held somewhere quiet, private and comfortable, I recommend you use the basement lounge; you will not be over heard and have access to tea and coffee as well as the internet. Always make sure the other staff on shift with know you are conducting your session and where you will be.