ISF module 2 - Person Centred Planning & PATH

1. Module 2 – Person Centred Planning
and PATH

2. Welcome and
Introductions
Gary Kent & Jacqui Hendra
Self Directed Futures and Fellows
of the Centre for Welfare Reform

3. Module 2: Person-Centred planning & PATH
Learning Outcomes
Understand what Person-
Centred support planning is,
the different people and
organisations involved and
how your role can support it
Demonstrate the ability to write
good outcomes for individuals and
to communicate them to everyone
that's involved in their care and
support
Be able to co-ordinate and
facilitate good person-centred
support planning

4. What would we love to see
People whose lives we touch feeling safe, healthy and fulfilled
Safe
• There is a difference between being unsafe or in danger and the person moving out of their (or our) comfort
zone when trying new things.
Healthy
• People feeling as physically and mentally fit as they can be so that they can learn new skills, make and maintain
new friendships and lead a full life
Fulfilled
• The person taking responsibility for their own life including identifying their own goals and aspirations
• Supporting the person to identify barriers that are stopping them from achieving and how those barriers will be
removed
• The person learning new skills, building natural networks, gaining confidence and pride in what they have
achieved
• The person doing as much as they can for themselves, running their own home, maintaining relationships,
earning money and having a sense of belonging in their community.

5. What is your
experience of
person centred
planning tools?

6. The Provider
journey
• Moving away from a residential model
• Moving away from time and task
• Moving to a weekly budget rather than
an hourly rate
• Understanding the value of outcomes
and eligible outcomes
• Working in a genuinely person-centred
way (including PATH and ISFs)
• Joint working with other Providers and
positive relationships with the LA

7. The journey
from a Social
Care
perspective
My first involvement with an ISF was working
alongside NewKey in 2019. This was part of the pilot
project that was being run at the time in which I
became involved with through the assessment and
review process for a small group of people.
I always believed I worked in a person centred way,
however, I have since developed my way of thinking
using PATH. Broadening my knowledge of
alternatives, asset, strength and community based
support options focusing outcomes on individuals
wants, needs, interests and preferences captured in
the PATH, ensuring everyone is working towards
these outcomes. This has been a positive outcome
for all involved and most importantly giving the
person being supported choice, control and a more
creative future.

8. Why are PATHs a good tool to use with ISFs from
Provider perspective
• A good visual tool that allows everyone to input and be involved, it’s inclusive
• Using the PATH enables people to understand and be in control of the process
• It sets clear direction and outcomes for people (both short and long term) it is particularly useful
when setting long term ambitions
• It allows the ability to have timely reviews of how things are going.
• It supports you as a Provider being able to proactively put forward ideas as to how they can help a
person move forward with their PATH
• It is useful for identifying who can support an individual and the strengths that they have and can
contribute to helping the person achieving their goals.
• It works well when there are a committed group of people who want to support the individual to
achieve their outcomes.
• Develop a shared understanding of Care Act eligibility
• Improved relationships – better communication and trust with the local authority and with families
• Increased job satisfaction for support staff as they see people grow in their skills and independence

9. Why are PATHs a good tool to use with ISFs
from social care perspective
• It is a Person Centred approach in line with the Care Act and the
expectation that the assessment format works well for the person
and their family too
• A positive experience that develops better relationships – the support
provider not scared to share information and ideas, clients see you as
part of the solution, you learn more about the people you support
and they feel heard
• Does not require additional resource - 70% of information needed for
Care Act assessment can be taken from the PATH and the rest can be
captured from the assessor asking additional questions

10. From a family perspective
For some time James has had the fortunate use of an ISF Service. The ISF has improved
James’ life offering him more choice and flexibility in the way his support is provided and the
range of activities available.
The greater involvement by James in how his support is provided has made him proud of
having an active role rather that accepting what has been on offer previously. This ISF has
released us of all fears as to how things could be managed when we are no longer around,
whilst giving our son all the independence that he wishes and deserves. The standard phrase
that he now uses is “it’s my choice” those are the words we have always waited to hear. As
parents we do not feel constrained by the need to bring James home at set times of the year
giving us more flexibility. A lot of this started with doing James’s PATH.

11. From a person’s
perspective

12. Person
centred
planning – a
statutory
duty
• Health and Social Care Act 2012 requires Clinical
Commissioning Groups to promote the involvement
of each patient
• Care Act 2014 requires local authorities to involve
adults in their assessment, care and support
planning and review
• Integrated care licence condition applies to
licensed providers of NHS-funded services, including
person-centred delivery and engagement
• CQC: Health and Social Care Act 2008 (Regulated
Activities) Regulations 2014: Regulation 9 describes
the action to make sure that each person receives
appropriate person-centred care and treatment.

13. Care Act Guidance
• 10.5 Ultimately, the guiding principle in the
development of the plan is that this process
should be person-centred and person-led, in
order to meet the needs and achieve the
outcomes of the person in ways that work
best for them as an individual or as part of a
family. Both the process and the outcomes
should be built holistically around people’s
wishes and feelings, their needs, values and
aspirations, irrespective of the extent to which
they choose or are able to actively direct the
process.

14. PATH – the technical
stuff
PATH = Planning Alternative
Tomorrows with Hope
• An inclusive graphic planning tool to
create a shared vision of a positive
future for individuals and families
• A step-by-step process that works
backwards from the dream to identify
SMART outcomes
• Involves the person and those who
know them best

15. PATH – the technical
stuff continued
• Using a PATH template the group
are guided by the facilitator
through the process and record
the plan in words and pictures
• Then follow the 7 - step process

16. Now
• First step, before the
session, is for people to
come prepared having
thought about what
their life looks like now.
What do they do? who
do they see?

17. Who’s here
• A key to this planning process is identifying
who will be responsible to do what to help
achieve a person's goals. This is a way in
which the person him or herself, family
members, other community members, and
agencies can make specific commitments to
take action. Opportunities to review the
pathfinders' goals and update actions are
then provided. This is completed at the Key
at the bottom of the page with each person
colour coded to signify agreed
responsibilities.

18. HOPES & DREAMS
• The first step is to look at the
person’s dreams – can be as
wacky they want e.g., to be a
brain surgeon.
• No limits or constraints are
placed on the dreams or the
ideal future that they
illuminate, so that a person can
indicate what matters most to
him or her.

19. POSITIVE AND
POSSIBLE
• This is where it has to be
achievable
• The group imagine possible and
positive achievements/goals
that could be made within 1
year
• Brain surgeon example:
volunteering in a hospital
• Also start to identify how these
fit with eligibility criteria

20. Strengths
• The group identifies ways
to build strength to
accomplish the goals (for
example, what skills need
to be developed or what
relationships maintained)
e.g., is Mum particularly
good at filling in forms

21. Next Steps 0 - 3 months
•Then identify shorter term
steps (0-3 months)

22. Next Steps 3 - 6 months
• Then they identify long
term steps (3-6 months)
needed to achieve the
goals.

23. Enrol
• The group then identify people
that they can enrol to help the
person get to their goals and
what they need to do to stay
‘strong’ and motivated.

24. Incorporating The Keys to
Citizenship in the PATH
•When supporting an individual to create their
PATH, you should consider the 7 “Keys to
Citizenship” to ensure that these areas are covered
within the plan in the most relevant and person-
centred way to the individual.
•The “Keys to Citizenship” is a movement created by
Dr Simon Duffy from the Centre of Welfare Reform
in 2014.
•The seven keys cover areas needed for people to
gain true citizenship and be a valued members of
society, in a way that is usually taken for granted.
•https://youtu.be/avnKfGJm81k
24

26. The Keys to Citizenship
•Freedom – the control and ability to speak up, be heard and
legally visible in society. Taking charge of my own life.
•Life – to play an active part in my community including
contribution through love, gifts and talents. Getting stuck in
and making a difference. Learning from others and them
learning from me.
•Love - rights to a range of loving relationships and with it the
responsibilities for others are upheld. Friendship, love and
family.
•Purpose – having goals, hopes and dreams, a structure for life
and a plan to achieve this. Having my own direction.
•Money – to have money for what I need and control over how
that money is spent. Having enough to live a good life.
•Home – a place that belongs to me, where I have control over
everything that happens there. A place that can be the base for
my life.
•Help – good quality help that enhances my gifts, talents and
skills and ensures my social standing, freedoms, rights and
responsibilities in society.
26

27. Group Exercise
Mini PATH plan: 1
person describes their
hopes and dreams for
the next year and the
group supports them
to develop a PATH

28. My life in 1 Years Time
Exercise - Feedback
1.What did it feel
like to do (or
attempt!) this
activity?
2. What special
skills and insights
did you need to
carry out the
PATH?
3. What would you
do differently the
next time?

29. Person-Centred Planning
and PATH – discussion
• How does this approach
currently fit with what you
already do?
• Can you foresee any challenges
and barriers? How can these
be over come?

30. What will we cover next: module 3
•Care Act 2014 eligible outcomes
• When creating the PATH, aims and outcomes that fall within the Eligibility Criteria will be
highlighted and separated from goals which are not classified as an Eligible Need, and therefore
not funded by the local authority. This ensures that there is clear guidance and understanding
over how the person can be supported through funded support to meet their aims and
outcomes, and how other goals can be achieved through different means, such as paying for
additional support privately, or via voluntary or natural support solutions.
•Creative support planning
• The PATH will be used as part of the assessment and information gathering process to contribute
to the creation of a Person Centred Support Plan which reflects the Eligible needs and additional
aims and outcomes of the individual. The whole process will be based around the Keys to
Citizenship model.