Person centred induction to sure care dorset cis std 7 v2


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  • Care workers are used to following tasks on a care plan get into a habit don’t really look at care plans ISP's change this focus on what has been agreed in partnership, Still be tasks but NTOW will work with the person to achieve what is important to them. Will be able to add new goals and progress
  • Physical e.g Assist to get up I would like my NTOW to support me to get in and out of bed on my own at the moment I need help but I would like to do this more independently or on my own. Health needs E.G choices in eating healthier looking for new ways to support their health needs, understanding more Emotional needs As we all get down from time to time so do the Individuals we support, many care workers lend a listening ear NTOWS will have a responsibility to plan and set goals with Individuals to overcome negative emotions KEY: Individual Support Plans are key to building effective PERSON CENTRED PARTNERSHIPS with Individuals for NTOWS-responsible to be aware of the choices
  • Person centred induction to sure care dorset cis std 7 v2

    1. 1. Care to Train LtdPerson Centred SupportProduced by Bob WadeCare To Train Ltd
    2. 2. PersonalisationThe catch-all term used to encapsulate the governments new agenda for adult social care. Described by the Department of Health as being an approach in which: "every person who receives support, whether provided by statutory services or funded by themselves, will have choice and control over the shape of that support in all care settings." 2
    3. 3. Personalisationmeans starting with the individual as a person with strengths and preferences who may have a network of support and resources, which can in- clude family and friends.reinforces the idea that the individual is best placed to know what they need and how those needs can be best met.means that people can be responsible for themselves and can make ther own decisions about what they require.they should also have informaton and 3 support to enable them to do so.
    4. 4. Self-assessment, Self-directed care & Self CareSelf assessment:It will give individuals the opportunity to assess their own care and support needs and decide how their individual budgets are spent.Self-directed care:Individuals are the ones who know their own needs best and what services might best meet those needs.Self-care: 4Individuals caring for themselves
    5. 5. Person-centredLargely means the same as personalisationPlacing the person at the centre of the caring and supporting process 5
    6. 6. Person-centred ValuesValues relate to our personal principles, morals, and ideals—that is, what we consider to be important 6
    7. 7. Person-centred ValuesIndividuality – the unique individualIndependence – doing things for oneselfPrivacy – behind closed doors, confidentialityDignity – promoting persons self-respectRespect - valued as an individualChoice – Making own real choicesRights and responsibilities – human rights but also responsibility (for own well-being and well-being of othersCitizenship – as part of civil societyInclusion – being accepted as part of communityWorking in partnership – working with the 7 individual
    8. 8. Person-centred Concepts 8
    9. 9. Person-centred ConceptsCommunication relates to a two-way process that involves exchanging information; it includes ensuring understanding and communicating in ways that meet an individuals communication needsAn advocate is a person who intercedes on behalf of another person in a bid to ensure that their best interests are communicated and metInvolvement is the inclusion or engagement of the person including regarding their planned care or treatment. 9
    10. 10. Person-centred ConceptsParticipation takes involvement a step further, and relates to taking a more active role and sharing; including actively engaging the person in the development of their care or support planTrust relates to having confidence in another person—that is, to having faith that they are reliable and honestA partnership involves working together for a shared purpose and can relate to, for example, jointly developing a plan of care and agreeing how both parties will work 10
    11. 11. Person-centred ConceptsTo empower is to give or delegate power or authority to and entails letting the person take responsibility for their consequencesEmpathy involves the practitioner considering the situation of the person and imaginatively entering into how they feelChoice involves providing the person with alternatives from which to choose and goes one step further in respecting the decision that is made, as far as possible 11
    12. 12. Person-centred ConceptsHolism refers to the practice of considering the per- son as a whole, addressing their physical and psychological needs collectively, rather than seeing them as separate entitiesAssessment needs to be undertaken at a level commensurate with patient need and must address patient values, needs, and preferences, as a foundation for the achievement of care that is person-centred 12
    13. 13. Common Core Principles to Support Self-careEnsure individuals are able to make informed choices to manage their self care needsCommunicate effectively to enable individuals to as- sess their needs, and develop and gain confidence to self careSupport and enable individuals to access appropriate information to manage their self care needSupport and enable individuals to develop skills in self care 13
    14. 14. Common Core Principles to Support Self-careSupport and enable individuals to use technology to support self careAdvise individuals how to access support networks and participate in the planning, development and evaluation of servicesSupport and enable risk management and risk tak- ing to maximise independence and choice S ou rce : Th e C om m on C ore P rincip le s to S u p p ort S e lf C are -A G u id e to S u p p ort Im p le m e ntation 2008) 14
    15. 15. Values into PracticeExamples of following person-centred values in your day to day work – Page 76Go through each of the Person-centred Values (from Slide 6 & 7) and give examples of what you have or can do in your work that will put each value into practice (these values repeated on next slide) 15
    16. 16. Person-centred ValuesIndividuality – the unique individualIndependence – doing things for oneselfPrivacy – behind closed doors, confidentialityDignity – promoting persons self-respectRespect - valued as an individualChoice – Making own real choicesRights and responsibilities – human rights but also responsibility (for own well-being and well-being of othersCitizenship – as part of civil societyInclusion – being accepted as part of communityWorking in partnership – working with the 16 individual
    17. 17. Why it is important to work in this wayWhat research has shown that people wantValues of social care eg GSCC Codes of PracticeWhat research has shown are effective ways of promoting individuals well-beingBenefits of this approach to individuals emotional & psychological well-beingQuestion Page 77 17
    18. 18. Promoting DignityExamples of how you can promote dignity – Page 78 18
    19. 19. Promoting DignityFrom SCIE Dignity in Care guidance – 8 FactorsChoice & Control: Enabling people to make choices about the way they live and the care they receivePositive & effective communication: Speaking to people respectfully and listening to what they have to say; ensuring clear dialogue between workers and servicesEating & Nutritional Care: Providing a choice of nutritious, appetising meals, that meet the needs and choices of individuals, and support with eating where needed.Pain Management: Ensuring that people living with pain have the right help and medication to reduce suffering and improve their quality of life. 19
    20. 20. Promoting DignityPromoting postive hygiene & personal appearance: En- abling people to maintain their usual standards of personal hygiene.Practical Assistance: Enabling people to maintain their independence by providing ‘that little bit of help’.Promoting privacy & confidentiality: Respecting people’s personal space, privacy in personal care and confidentiality of personal information.Promoting social inclusion: Supporting people to keep in contact with family and friends, and to participate in social activities. 20
    21. 21. Working in a person-centred way – key featuresPerson at centre of everything we doIndividuals having control over the care & supportIndividuals making real choices about their care & supportPositive stable relationshipsEmpowering approach to practice – active supportWorking with strengthsWorking with the person not just doing for themFlexibilityRecording & planning with the person, not just about them 21Promoting self-care
    22. 22. Care & Support Plans – contribution to person-centred workingWhat is important to the individual The focus is on what individuals want, and not on what others think they should have!The changes they want to make, to live healthy, happy and positive lives The focus is on ‘can do’ and how to overcome the “can’t do’s”How they have chosen to receive their support This may be combinations of supports, so homecare, voluntary organisations, paid family or friendsHow they plan to stay in control of their support This focuses on how individuals can become more independent and gain more control over their 22 lives.
    23. 23. Care & Support Plans – contribution to person-centred workingPlanning builds up a picture of the individual you are supportingIt organises their choices and outlines what they need support withIt is a place for individuals to set personal goals – and keep a record of their progressIt focuses on the ‘positive’ – what individuals can and would like to do!Planning puts the individual in the driving seat by concentrating on them! 23
    24. 24. Care & Support Plans – contribution to person-centred workingSelf-assessment – individual assessing their own needsSelf-directed support: Individuals can write their own ‘Individual Support Plan’ in a number of ways: On their own With their family, friends or advocates With their home care provider agency With the local authority’s Care Management team With an independent broker With the support of health care professionalsEnables individuals to make their own 24 decisions about how they want to be supported
    25. 25. Trad itional h om e care p roce s ss homecare servicessits the individual and makes an assessment on their neewhich provider will support themen with a list of tasks that the care worker must follow ty to change what is onunless there is a review 25
    26. 26. Th e trad itional care p lanDay TimeMonday 8.30am-9.00amAssist to get up, washed, dressed and make breakfastMonday 12.00pm-12.30pmAssist to make lunch and prompt medicationMonday 16.00pm – 16.30pmAssist to make teaMonday 20.00pm-20.30pmAssist into bed, prompt medication 26 A re thes e flexible? Do they promote choice? Who has the control?
    27. 27. P lans d on’t live in fold e rsIndividual support plans are ‘living documents’that should be seen as important as ‘daily carenotes’Within your role as new type of worker you willadd to individuals’ support plansThis means working in partnership withindividuals to update their plans and set newGOALS 27
    28. 28. Ins id e an ind ivid u al s u p p ort p lan 28
    29. 29. N e w typ e of worke r re s p ons ib ilitie sf aware of the ‘whole’ Individual Support Planularly look at the individual’s support planu are aware of the ‘goals’ individuals are working individual’s support plan with your team leader and at team meetings anplan with the individual rstanding of why the choices individuals have made are so important to t uals about the positives – ‘what they can do’ – andn contribute to what they have difficulty to try and dress yourself this morning, see how an support you with any areas you find e can keep working on them together if you would like?’ndividual Support Plan with them – regularly! 29
    30. 30. Person-Centred ThinkingYou working in a way that involves thinking in a per- son-centred waySureCare developing tools to help you to start doing thisAppreciationLife HistoryOne Page ProfileGood Days – Bad DaysCommunication ChartsMore to follow – at team meetings 30
    31. 31. Knowing the Whole PersonWhy this is important - Question Page 80 31
    32. 32. Knowing the Whole PersonWhy Important?So that some needs dont get overlooked (eg social & emotional needs)Helps you to understand the person Whats important to them and why What their wants and goals are Their behaviour & actions How they make decisions What their coping strategies are Times when they are more able to make decisions Part of who they are, their identity 32
    33. 33. How do you find out about these thingsReading previous care notes, care plans, communication assessmentsDiscussion with colleaguesDiscussion with family & friendsDiscussion with other professionals who have worked with the individualDiscussion with the individualSpecialised assessment by other professionals (eg sensory loss, speech therapist, GP, CPN, DN)Observation of the individualFinding out in general about the individuals condition 33
    34. 34. Changing Needs & Support PlansChanging Needs: a persons life changes; condition, behaviour, physical state, emotional state cognitive state, environment, circumstances, social relationships and network, eligibility, goals Care & Support Plans: active document, it should reflect their life rather than rule their life; once a change has been identified the support plan needs to be changed to reflect this Person-centred approach: changes in real life dictate changes to support plan, which may result in changes in support or services; Discuss the Individual Support Plan with individual – regularly; Within your role you will add to individuals’ support plans; This means working in partnership with individuals to update their plans 34 and set new GOALS
    35. 35. Individuals planning their own futureAn example of supporting a person planning their own future well-being and fulfilment - Handouts:Worksheet 2.1, 2.3, 2.4 Question on Page 82 35
    36. 36. Active ParticipationParticipation operates at many levels; it can range from individual control over day-to-day decisions about what to wear, what to eat and how to spend one’s time, to collective decisions about service governance or commissioningParticipation is not simply about being present or taking part but should be based upon having some influence over decisions and actionIssues of power and controlPerson-centred means "every person who receives sup- port … will have choice and control over the 36shape of that support in all care settings."
    37. 37. Benefits of Active ParticipationWay of working that recognises an individual’s right to parti- cipate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than as a passive recipientIncreased confidence and self-esteemChance to acquire new skillsGreater satisfactionImproved quality of lifeMay also help create a stronger sense of 37 community
    38. 38. Barriers to Active ParticipationThe Individual: low self confidence; lack of motivation; lack of practice (learned helplessness); consequences of loss & dealing with and reacting to it; physical changes; isolation; limiting long term conditions; anxiety; have very set routines; physical states, cognitive states, emotional statesSocial environment: people making assumptions; missing opportunities to participate; negative attitudes and behaviour; poor communication, poor supportive relationships; organisational cultures & boundariesPhysical environment: poor access; poor transport opportunities; disabling built environmentEconomic environment: individual financial 38 resources; eligibility for benefits
    39. 39. Reducing Barriers & Encouraging Active ParticipationEffective communication adapted to the individualTake time to get to know the individualSupporting the individual with SMART planningEncourage the person to ‘be in charge’Celebrate all achievements – no matter how smallFocus on ‘abilities’ and strenghtsSet realistic expectationsBuild person-centred partnershipsFocus on positivesSeek advice – If in doubt, always seek advice from your su- pervisorApproach support work with a ‘detective’s eye’ – look out for opportunities for participation & self-careSignposting to information, services, groups 39Discuss & signpost to assistive technologies
    40. 40. Supporting Active Participation -valuing people, non-judge- mentalExamples Questions Page 87 40
    41. 41. Supporting to be involved in activitiesExamples Questions on Page 87 41
    42. 42. Supporting to maintain relationshipsExamples Questions on Page 87 42
    43. 43. Supporting individuals to make informed choices about their livesMental Capacity Act Code of Practice – how to help individuals make their own decisionsProviding relevant informationCommunicating in an appropriate wayMaking the person feel at easeSupporting the person, can anyone else help or support or express a view – who can they talk it through with 43
    44. 44. Empowering Decision-making and ResponsibilitiesProviding relevant informationTake time to explain anything that might help the person make adecision. It is important that they have access to all the information theyneed to make an informed decision.Try not to give more detail than the person needs – this might confuse them.In some cases, a simple, broad explanation will be enough. But it must notmiss out important information.What are the risks and benefits? Describe any foreseeable consequences ofmaking the decision, and of not making any decision at all.Explain the effects the decision might have on the person and those close tothem – including the people involved in their care.If they have a choice, give them the same information in a balanced way forall the options.For some types of decisions, it may be important to give access toadvice from elsewhere. This may be independent or specialistadvice (for example, from a medical practitioner or a financialor legal adviser). But it might simply be advice from trusted 44friends or relatives.
    45. 45. Empowering Decision-making and ResponsibilitiesCommunicating in an appropriate wayAsk people who know the person well about the best form of commu-nication (try speaking to family members, carers, daycentre staff or support workers). They may also know somebody theperson can communicate with easily, or the time when it is best tocommunicate with them.Use simple language. Where appropriate, use pictures, objects or illus-trations to demonstrate ideas.Speak at the right volume and speed, with appropriate words and sen-tence structure. It may be helpful to pause to checkunderstanding or show that a choice is available.Break down difficult information into smaller points that are easy tounderstand. Allow the person time to consider and understand eachpoint before continuing.It may be necessary to repeat information or go back 45over a point several times. (continues)
    46. 46. Empowering Decision-making and ResponsibilitiesCommunicating in an appropriate wayIs help available from people the person trusts (relatives, friends, GP, socialworker, religious or community leaders)? If so, make sure the person’s rightto confidentiality is respected.Be aware of cultural, ethnic or religious factors that shape a person’s way ofthinking, behaviour or communication.If necessary, consider using a professional language interpreter. Even if aperson communicated in English or Welsh in the past, they may have lostsome verbal skills (for example, because of dementia). They may now preferto communicate in their first language. It is often more appropriate to use aprofessional interpreter rather than to use family members.If using pictures to help communication, make sure they are relevant and theperson can understand them easily. For example, a red bus may represent aform of transport to one person but a day trip to another.Would an advocate (someone who can support and representthe person) improve communication in the current situation? 46
    47. 47. Empowering Decision-making and ResponsibilitiesCommunicating in an appropriate wayHelping people with specific communication or cognitive problems Wherepeople have specific communication or cognitive problems, the followingsteps can help:Find out how the person is used to communicating. Do they use pictureboards or Makaton (signs and symbols for people with communication orlearning difficulties)? Or do they have a way of communicating that is onlyknown to those close to them?If the person has hearing difficulties, use their preferred method of commu-nication (for example, visual aids, written messages or sign language).Where possible, use a qualified interpreter.Are mechanical devices such as voice synthesisers, keyboards or othercomputer equipment available to help?If the person does not use verbal communication skills, allow more time tolearn how to communicate effectively.For people who use non-verbal methods of communication, theirbehaviour (in particular, changes in behaviour) can provide 47indications of their feelings.
    48. 48. Empowering Decision-making and ResponsibilitiesCommunicating in an appropriate waySome people may prefer to use non-verbal means of communication andcan communicate most effectively in written form using computers or othercommunication technologies. This is particularly true for those with autisticspectrum disordersFor people with specific communication difficulties, consider other types ofprofessional help (for example, a speech and language therapist or an expertin clinical neuropsychology 48
    49. 49. Empowering Decision-making and ResponsibilitiesMaking the person feel at ease:Location - In terms of location, consider the following:Where possible, choose a location where the person feels most atease. For example, people are usually more comfortable in their ownhome than at a doctor’s surgery.Would the person find it easier to make their decision in a relevantlocation? For example, could you help them decide about medicaltreatment by taking them to hospital to see what is involved?Choose a quiet location where the discussion can’t be easilyinterrupted.Try to eliminate any background noise or distractions (for example, thetelevision or radio, or people talking).Choose a location where the person’s privacy and dignity can beproperly respected. 49
    50. 50. Empowering Decision-making and ResponsibilitiesMaking the person feel at ease:Timing - In terms of timing, consider the following:Try to choose the time of day when the person is most alert – somepeople are better in the mornings, others are more lively in the after-noon or early evening. It may be necessary to try several times beforea decision can be made.If the person’s capacity is likely to improve in the foreseeable future,wait until it has done so – if practical and appropriate. For example,this might be the case after treatment for depression or a psychoticepisode. Obviously, this may not be practical and appropriate if thedecision is urgent.Some medication could affect a person’s capacity (for example, med-ication which causes drowsiness or affects memory). Can the decisionbe delayed until side effects have subsided? 50
    51. 51. Empowering Decision-making and ResponsibilitiesMaking the person feel at ease:Timing continued -Take one decision at a time – be careful to avoid making the persontired or confused.Don’t rush – allow the person time to think things over or ask for clari-fication, where that is possible and appropriate.Avoid or challenge time limits that are unnecessary if the decision isnot urgent. Delaying the decision may enable further steps to be takento assist people to make the decision for themselves. 51
    52. 52. Empowering Decision-making and ResponsibilitiesSupporting the person:Many people find it helpful to talk things over with people they trust – orpeople who have been in a similar situation or faced similar dilemmas. Forexample, people with learning difficulties may benefit from the help of a des-ignated support worker or being part of a support network.If someone is very distressed (for example, following a death of someoneclose) or where there are long-standing problems thataffect someone’s ability to understand an issue, it may be possible to delay adecision so that the person can have psychological therapy, if needed.Some organisations have produced materials to help people who need sup-port to make decisions and for those who support them. Some of this materi-al is designed to help people withspecific conditions, such as Alzheimer’s disease orprofound learning disability.It may be important to provide access to technology. Forexample, some people who appear not to communicate wellverbally can do so very well using computers. 52
    53. 53. Assessing and Managing RiskPeople have the right to live their lives to the fullas long as that doesn’t stop others from doing thesameHelp people to have choice and control over their livesRecognise that making a choice can involve some riskRespect people’s rights and those of their family carersHelp people understand their responsibilities and the implic-ations of their choices, including any risksAcknowledge that there will always be some risk, and thattrying to remove it altogether can outweigh the quality of lifebenefits for the personContinue existing arrangements for safeguardingpeople 53
    54. 54. Using risk assessment to support informed choicesUsing format to help think about risks and ways to manage them or agree unacceptable risks, all can help to make informed choicesWith individual do 5 steps to risk assessment STEP 1: Look for the hazards STEP 2: Decide who might be harmed and how STEP 3: Evaluate the risks and decide whether the existing precautions are adequate or whether more should be done STEP 4: Record your findings STEP 5: Review your assessment and revise it if necessaryDiscuss and agree with individual actions to be taken (including by them) to minimise 54 risk
    55. 55. 55
    56. 56. Your personal views influencing individuals choicesCare workers are used to following a list of tasks on the care plan. This can create a “I’ll just…” effect. They don’t involve the person in planning and setting new goals to achieve self care.They worry that if individuals self care – there will be noth- ing for them to doFeeling of overriding duty of care – no risksYour views influenced by your culture, beliefs, experiences, emotions – not the individualsQuestion on Page 93 56
    57. 57. Supporting individuals to challenge decisions made by othersSupporting decision making (Mental Capacity Act Codes)Help with communicationHelp with informationExplaining complaints proceduresSignposting to help & adviceSignposting to advocatesQuestion on Page 94 57
    58. 58. Individuals developing self-care skillsWhy important? Question Page 90 58
    59. 59. Individuals maintaining their social & community networksWhy important? Question Page 90 59
    60. 60. Identity & self-esteem linked with spiritual & emotional well-beingSpiritual well-being – core belief system, will be part of who they are (identity) and how they feel about themselves (self-esteem)Emotional well-being – having positive feelings and thoughts about yourself and your situation con- tributes to positive longer-term self-esteem (how you feel about yourself), self-image (how you see yourself), and therefore your personal identity 60
    61. 61. Attitudes & approaches that promote spiritual & emotional well-beingQuestion on Page 96 61
    62. 62. Promoting identity & self-esteemQuestion on Page 97 62
    63. 63. Environments that promote spiritual & emotional well-beingEnvironments that promote privacy and dignityPersonal possessionsItems of spiritual significanceAccessible environmentsPleasant surroundingsEnvironments appropriate to times of day or activities (restful, stimulating, light, dim)Environments chosen and controlled by individualAccess to spiritual services 63
    64. 64. Summary“every person who receives support, whether provided by statutory services or funded by themselves, will have choice and control over the shape of that support in all care settings." 64
    65. 65. Signs of Dementia Early stagesforget about recent conversations or eventsrepeat themselvesbecome slower at grasping new ideas, or lose the thread of what is being saidsometimes become confusedshow poor judgement, or find it harder to make de- cisionslose interest in other people or activitiesdevelop a readiness to blame others for taking mis- laid itemsbecome unwilling to try out new things 65 or adapt to change.
    66. 66. Depression, delirium & memory impairmentMild Cognitive Impairment – mild loss of memory, age related – can be mistaken for symptom of dementiaDepression – symptoms include mood changes, be- ing withdrawn, losing interest in people & activities, forgetfulness, which are also symptoms of dementiaDelirium – acute confusional state – often caused by disease from outside the brain (eg infection), symptoms include memory impairment, behaviour changes, confusion – which are also 66 symptoms of dementia
    67. 67. Dementia & Early DiagnosisRuling out other illnessesReceiving early treatments which are beneficial over the longer termCan help individual and family plan for the future 67
    68. 68. Reporting suspected dementiaWho to?Encourage individual to consult GP themselves, self-care 68