1. commonly expressed as the five service

1.     Understandhow then active support model translates values into person-centred practicalaction with individuals 1.1   Evaluate the extent to which the outcomesfor a range of individuals conform to contemporary person-centred values andaims using the principles of the active support modelContemporary person-centredvalues and aims are derived from Social Role Valorisation and are commonlyexpressed as the five service accomplishments of Respect, Competence, Participation,Community Presence and Choice. This contrasts with the practices seen in the hotelmodel, where the person caring undertakes all domestic tasks e.

g. cooking,cleaning etc. while the individual remains unoccupied and are rarely encouragedto participate in looking after their own home. This is staff-led, not person-centredand offers a poor quality of life to the individual.The Active support modelcomprises a person-centred model of how to interact positively with individualscombined with daily planning systems that promote participation and enhancequality of life.When an individual moves to Thorndenewe use a ‘brief overview’ section. This details the following information;• A brief life story which isproduced with everyone’s help e.

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g. social worker, family friends other carestaff and the client.• Then we have a section on whois important in the individual’s life and why e.g. family friends, staff andeven animals.• There is a section about whatthe client thinks others like about them and what they like about themselvese.g sense of humour, chatty and friendly.

• Section on what they like todo: at home, at work, at the day centre, just for fun, when on holiday, and ona daily basis.• Also lets us know what types ofmusic and films and tv shows they like.• The different kinds of foodsand drinks they like and do not like.• Any hobbies, do they collectanything e.g.

dolls, stamps• What they do not like doinge.g. going on escalators• It lists their favourite thingthey like doing at home e.g. watching tv, when they are out in the communitye.

g. going to the pub/cinema.• It tells us things they do notlike doing e.g. cleaning their bedroom, cooking• It tells us things that areimportant to them like their pets/photographsThere will be a section on theirpreferred daily routine, when they like to get up, what time they eat theirbreakfast and when they like to go out. Who they like to go out with?The next section lets us knowwhat makes them angry and sad how they communicate this to others.There is a section on a typicalweekly activity planner and a typical weekly menu planner.There is a section on what theylike to do in the evenings and what support they need to do this.

Another section highlights whatthey like to do at weekends, who they like to be with.Another section asks how theylook after themselves to stay happy and healthy and what help they need to dothis.Then we ask what would they liketo change in their lives what do they want to start doing what do they want tostop doing.• Where would they like to go?• What are their hopes dreamsgoals for the future?Then we put this altogether andagree with the client and family that it is accurate. Finally, we decidebetween us the support that is needed by whom and when it is needed. Once wehave a clear picture of the individual we put this altogether and update itregularly so that we are confident we are delivering a service that isrequested. We will update the short-term goals and the long-term goals toreflect any changes to the client’s independence.It is through these comprehensiveperson-centred plans that we can deliver the support and help that the clientneeds to live the life they want.

At Thorndene we like to evaluate everyindividuals LTTP (long term treatment plans) on a monthly basis, taking intoaccount all appointments, any behavioural changes or anything of relevance thatmay alter the support required. We then, when necessary, further evaluate thechange in needs and contact the relevant bodies to generate funding, care,medication etc. reviews. 1.

2   Analyse the practical changes which need tobe made within a work setting to improve individuals’ independence, informedchoice and quality of life.When individuals have theknowledge and skills to act independently, it is much easier for them to takecontrol of their lives, make their own choices and meet their daily needs.However learning disability clients need varying degrees of help to achievethis At Thorndene we embrace the person-centred approach to ensuring we deliveran individual support plan which is custom designed for each individual takinginto 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 toget in and out of the bath themselves              •        Adapted cutlery and cups/glasses -helps theindividual to eat and drink unaided.•        Talking aids such as scales for the kitchenwatches for the time- to help visually impaired individuals•        Vibrating watches, clocks that help deaf peopleknow what time it is. •        Kettle tippers to help people with weak arms orrestricted movement •        Pill dispensers to help people in taking theirmedication on time •        Clamps and holders to help people open tins jarsetc •        Communication aids so the individual can letpeople know their choices and opinions.

 An informed choice means that an individual has theinformation and support to think the choice through understand what theconsequences might be before making the decision. However too much informationmay cause problems, so it is best if the information is concise and deliveredat a level the individual can understand and respond to. This will vary fromone individual to another, It is important that we maintain an individual’schoice and control over their lives, we can achieve this by:•        Treating people as individuals and making surethey are in control of their own lives. •        Not assuming that, because an individual has alearning disability, they do not understand and therefore cannot make decisionsfor themselves.•        Encourage and support individuals to access thewider community.

•        Empower individuals to make sure they haveaccess to information about services they want or need.•        Ensure individuals are fully involved in anydecisions that affect them such as what to wear when to go to bed what to eatand also with wider decisions like who they want to help them with their care/recruitmentof new staff.•        Make sure clients independence is not beingundermined 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 theoptions available to them with regards their care. Every week each individual getstogether with their keyworker for a meeting to enable them to raise anyconcerns they may have, they then have monthly and three-monthly key-workingmeetings. To ensure all concerns are dealt with without bias each individualhas a keyworker, a co-keyworker and also a key-working manager.

The meetingsare alternated between the key and the co-keyworker, any concerns/issues areraised with the allocated manager and as a check to ensure all concerns areraised the key-working manager goes through the key-working folders every sixweeks.At Thorndene we understand the importance of social contact especiallywith family and friends, we encourage all family members to be as involved aspossible, providing transport for those parents who find it difficult to travelto Thorndene or providing transport for the individual to enable home visits. 1.3  Explainhow to lead the implementation of practical changes within the work setting toimprove individuals’ independence, informed choice and quality of life. As care providers Thorndene hasembraced person-centred planning which encompasses the individual’s rights,independence, choice, empowerment and inclusion.

As a manager it is myresponsibility to ensure my staff team are fully trained on the principles ofperson-centred planning. It is down to us to ensure we help and encourage eachindividual to achieve the lifestyle they want and make a positive contributionto their local community. It is important that the skills and numbers of staffsupport are adequate to achieve this end.

Mansell and Beadle-Brown(2004) statethat skill shortages can impede the implementation of these plans andPacker(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 meetthe needs of one on one working that are often required by person centredplanning, as opposed to procedures within traditional services where staff wererequired to supervise a group of service users. They also raise the issue ofstability within the workforce.

They also note that direct care staff need tofeel that they are effective in their support role, otherwise they may becomefrustrated which could result in them leaving the service. Such instability cancompromise the success of person centred planning, here at Thorndene we have a largeportion of staff who have worked here for longer than ten years. As the manager who is responsiblefor the rota I must first ensure I have sufficient staff to support the needsof my clients, I make sure the staff are well trained and have the necessaryskills to empower and encourage my clients to achieve their goals.

In order todo this, I have a number of training matrix’s that show me who is trained ineach area or whose training needs refreshing. I involve everyone in the decisionmaking and producing a person-centred plan for each client. These helps givestaff a better understanding of what is required of them and makes them happierin their job roles they are more able to effect positive change.I always make sure we have theequipment to carry out their tasks and responsibilities and that they haveenough 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 toinformation which is relevant, this can tell them a lot about a client’s wishes,aspirations, character, behaviour and habits.

We also work closely with othermulti-agencies, family and friends to produce an achievable person-centredplan. According to Towell and Sanderson (2004) multi-agency engagement needs tobe at three levels. First, at a personal level, the focus being on increasingopportunities available to individuals. Second, at a service level, managersneed to increase the capacity of staff to be able to deliver the personalisedsupport.

Finally, at a local public service level, where the focus is ondeveloping strategies for including clients in their local communities. The wayin which we manage services impacts on the ability of frontline staff to dotheir job well and promote independent living. 2.     Be able touse practice leadership to promote positive interaction. 2.1  Explain the principles behind practice leadership. Practice leadership refers to thedevelopment and maintenance of high quality support, involving a constant focuson 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, providingconstructive feedback and modelling good practice; and reviewing the quality ofsupport provided in regular supervision and finding ways to improve it.

Thestyle and quality of a company’s leadership will determine how well theyperform. Effective leadership will result in good quality care. This in turnwill ensure that staff morale and motivation is good.

Recruitment and retentionof good quality staff is easily achievable. The service offered to clients willbe efficient, of good quality, effective and pro-active which in turn willbenefit staff as they will have opportunities to develop their professionalcareers and expand their knowledge.Practice leaderships key areasinclude: •       Organising others to deliver support when and howclients need and want it.

•       Training staff to deliver better support by observingtheir 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 givefeedback so we can improve our service.Practice leadership is whenmanagers and senior staff teach and guide support workers to deliver a person-centredpackage to individuals with diverse needs. In order to deliver a good effectiveservice, we must ensure that staff have access to good quality ongoingtraining. Good leadership will result in a motivated and committed staff teamwhich in turn will provide our clients with the best possible support. Goodmanagers will deliver regular feedback sessions via 1:1 chats, supervisions,team meetings and appraisals.

Staff are encouraged to engage with managementand voice their ideas and opinions which increases their knowledge confidenceand job satisfaction.It is important that managementunderstand the need to implement the following:•       Recognise the value of routines for people we support  •       Make sure opportunities are offered to everyone on aregular basis. •       Ensure staff have the skills to support the clients. •       Be aware and respond to individuals’ communicationneeds. •       Encourage participation in a range of activities bothin the home and the community. It is important that managers judgetheir success of client engagement by looking at the response they get from theclients after all it is their lives we are trying to improve. We need toobserve how the support staff carry out their duties and if there could beimprovements made. Managers need to look critically at their careprovision to ensure they are offering a real person-centred approach for eachindividual.



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