Person Centred Approaches 2011North Lancashire

Summary and response from the PCA teamAudit questionnaires were sent to 30 organisations in North Lancashire, 28 of them filled them in. This was a very good response.

Most of the organisations were supported living providers, others were day services, residential care, out reach and short breaks services.

The organisations varied in size from one that supports 156 people to one that supports 3 people.The 28 organisations audited employ 1206 staff between them to support 772 people.

There is a named PCA coach or champion in 22 out of the 28 organisations.

79% of people have some form of PCP

75% staff have been on PCA awareness training

668 staff are currently actively using at least one PCA tool.

177 people have a communication passport.

73% of people have a health action plan, 165 of those are using the health record booklet. 448 people have had a health check in the last year. 218 people have a hospital passport.

It is clear from the audit that some fantastic work is being done across the area in regard to embedding person centred approaches into organisational culture.Some examples of what has been tried by

organisations are –

•Setting up a PCA steering group within the organisation .•Multi media being used for peoples plans.•PCA champions or coaches in each service.•Introduction of skills matching to ensure best support.

The organisations said they had learnt a lot from trying person centred approaches over the last year. Some examples are -

•That the process of using tools does not always come naturally and that support sessions are needed for staff to feel confident in using the tools after initial training has been provided.

•That a more co-coordinated strategy, and better trained, and more focused workforce can make a real difference.

•Development of leadership team to drive and champion person centred thinking as a way to work across the organisation works well

•Supporting people to become Quality Checkers within the organisation.

•Involving people in training, recruitment and monitoring has helped shift the emphasis towards the person.

This is some of what the organisations said they were pleased about -

•All staff in our organisation attend PCA training whatever their role.

•The expectations of people we support in regard to what they can do and achieve are much higher.

•The balance between the person and the employee has changed with the power shifting to the people.

•Increased input from people we support in the way the organisation works.

•People have more control over their lives.

There were common themes in what organisations were concerned about -

Individual planning and ELP can be time consuming and subsequently costly.

Whilst ELP's are still used in certain situations, the recommended model is to start with a one page profile and add to this using the pca tools until a 'living description' is formed. Person centred reviews are then held to give direction and planning. This approach is much less time consuming yet in generates relevant, good quality person centred information.

Will the allocated resources be available to meet the wishes and aspirations of people rather than just basic need.

We need to support people to develop an increased range of informal support networks. We need to become community connectors and bridge builders. We need to start thinking in a creative way about how people can lead great and fulfilled lives with just enough support from services. We provide training in community connecting across the area and it is free for providers to attend, we recommend sending all support staff and their line managers.

These are some of the things that organisations saw as blocks to implementing person centred approaches -

•Some organisations have policies and procedures that have not kept pace with thinking on personalisation.

•Staff and management shortages.

•Staff culture.

•Time

We are currently delivering training aimed at the policy makers within organisations to ensure that their policies and practices are keeping up to date and enabling personalisation to happen.

Research has shown that person centred approaches need to become habit for the entire organisation and the DoH publication 'Person Centred Planning - advice for Providers' recommends that organisations use the Person Centred Teams model, this has been shown to change organisational culture.

Using person-centred thinking and approaches not only helps the people you support to have more choice and control in their lives, but enables staff to provide the best support they can in ways that reflect what is important to the person.

Working in this way is not about doing more, but doing things differently.

In difficult economic times, our experience is that implementing person-centred thinking and approaches makes it more likely that people will want to buy your services, and that good staff will stay with you.

Some of the things organisations have done in the last year to build person Centred Approaches into their culture are -

•Members of the Executive Board attended PCP facilitator training so that the whole organisation understands and lives these principles.•All heads of operations have One Page Profiles.•Team meetings following Positive and Productive format.•Team planning done with the use of Person centred planning tools.•Person Centred supervision and appraisal.

These positive changes reflect the 'whole organisational change' referred to above and these are excellent examples of good practice.

Practical examples of how people's lives have changed -

•Lots of people went on holidays to places of their dreams.•Became a Blackpool FC season ticket holder.•Now going to Newcastle FC matches with informal support.•Consistent support through the use of communication passport.•Using learning logs to help staff team improve the support they provide around specific activities.•Own Avon business and holds Avon parties.•One Page Profiles used as basis for support plans.

•Multimedia planning and review meetings with lead linked to persons television.•Using donut tools when staff felt that they were unsure of their role regarding certain decisions.•Volunteer work and independent travel•Several one page profiles for one person for various activities so she gets the right support in each situation•Use of Telecare instead of staff sleeping overnight.•Reduction in challenging behaviours after use of learning logs.•Improved and more positive support from nursing team when hospital passport was used.•Started own football team so he could be a referee.

Surprises -

We were surprised how few organisations seem to be implementing what they learnt on the PC Teams training, 83 managers have attended the training yet only 21 teams have a team plan, only 112 staff have a one page profile and 8 managers use person centred supervision. It is felt that people need support and mentoring after the training to keep up the momentum and that more people need to be trained.

Another surprise was how few organisations are using the staff matching tool, we felt that the use of this tool should have increased due to self directed support being rolled out and people now choosing who supports them.

We feel it is crucial to do staff matching and skills/interest audits amongst staff teams in order to provide the right support.

With the advent of self directed support we are expecting to see that people are involved, in whatever way best suits them, with recruitment, developing job descriptions and person specifications etc.

We were pleased that 177 people have a communication passport and we had excellent examples of how these were being used to improve the persons support and there lives.

Person Centred reviews were another area where we expected that they were more widely used than they are, 64 people have a person centred review out of 772. The DoH publication 'Person Centred Planning - Advice for providers' clearly advocated the use of PC reviews. The document states 'Person Centred reviews can lead to changes for individuals and to services and help meet statutory requirements. Information from these reviews can provide important data that can contribute to strategic commissioning. They are preferred by people who use services to traditional reviews'.

Organisations requested the following from the PCA team-

•Email reminder about additions to website.•Workshop type sessions focusing on the use of specific tools.•Person Centred Teams training.•Maintain contact, mentor and support organisations.•Access to all PCA training.•PCA coordinator to attend our locality meetings.•An external agent to talk to about some of the difficulties they may be experiencing.•Quality check our Person Centred Plans.

Moving forward in response to audit–

•Julie will send out an email notification when new information is added to the website. •A support group for PCA champions/coaches will be set up to be a forum where people can keep up to date, practise using tools and bring anything they're struggling with, dates for these will be circulated shortly. •Bespoke in-house teams training can be provided and works very well, we have had excellent feedback from this kind of approach, please contact Julie if you are interested in this. •If you would like one of the team to attend your locality (or similar) meetings then please ask. •Quality checks for your PCP's will be done on audit visits or can be requested anytime.• Finding ways to make PCA work sustainable.

The full audit report is available from Julie and willbe available on the PCA website –

www.northlancsleads.net