Having a different conversation
The personalisation of social care services is more than just personal budgets.
That is, it’s more than just handing over money to a person so they can choose how they want to be supported.
We would argue that personalisation is about seeing people as individuals and equal partners in making decisions about care and support.
It’s about treating people (and families and carers) with respect.
It’s about not making assumptions about who people are and what they might want to do based on labels or lifestyles.
And, if done well, it can work with everyone, even older people – despite what the headlines might suggest.
Take Arthur’s story for example. At 86, he had been living in his own flat for 35 years and was supported by the local domiciliary care services. But small things were turning into big issues, which risked him being “put into a home” – something he was “terrified of”. Arthur wasn’t having his meals served “piping hot”, meaning he was throwing his food into the garden. This created problems with his neighbours and worse, a rat infestation. His poor eyesight meant he would hit out at staff that came to get him up in the morning because he thought they were burglars. And when he couldn’t find the £10 note he always kept in his pocket because staff had put it away for safekeeping, he would get distressed and struggle on his hands and knees for hours looking for it.
Gill, a person-centred planning coordinator, spent an hour talking with Arthur to find out about his past, what made a good or bad day for him, how he liked to be supported and what kind of routine he likes. She used this information with his supporters to find out what was working and not working about his care and what needed to be done differently.
Now Arthur’s meals are prepared and frozen by his daughter so that care staff can just heat them up until piping hot and spend their time talking with him while he eats. His supporters will always call out to him from the bedroom door to let him know they have arrived to help him get out of bed, and they will never take the £10 from his pocket. He is now eating well, has company during the day and no longer any problems with his neighbours or rats.
At the most basic level, personalisation is about thinking differently and having different conversations. Small but significant changes meant Arthur’s life improved and that he was able to stay at home longer. These different ways of thinking can be grouped under the heading of person-centred practices.
“When people not used to being listened to are heard by people not used to listening, real change is made.”
Then there’s Florrie, a woman without any family, who lived in residential care and was very isolated from staff and other residents. When the people who supported her were encouraged to use person-centred thinking tools to have different conversations, including finding out more of Florrie’s history, they found she was a passionate cook and a former housekeeper. Staff could then increasingly involve her in life at the care home. Florrie became more than just another person to feed and wash. Relationships blossomed so much that Florrie sewed patchwork blankets for the staff’s grandchildren.
There’s also the story of Sam, an older man living in residential care with no family. He had lost touch with friends, but through using person-centred practice, the staff supporting him found he was a keen lawn bowler. They matched a staff member at the home with a similar interest and helped him reconnect with his mates at his old bowling club. While he can no longer bowl, he now writes their club’s newsletter and is enjoying the reunion with his old friends.
Simple tools created improved outcomes for people. And this is where we hope we can help.
As the debate on personalisation of health and social care in England continues, me and Helen will aim to show through as many real life examples as possible, that by doing things a little differently, and with determination and patience, personalisation can work for all people at every stage of their life.
Person-centred practice helps people be heard. It finds solutions that changes people’s lives, while also changing the culture of organisations that provide care and support services.
This isn’t something we’re doing because the government says that there is a target to meet 100% personal budgets by 2013. Whether there is a target or not is irrelevant. It is because, from a human perspective, this is the right thing to do.
When faced with a barrage of negativity and challenges, we try to remember that delivering personalisation through person-centred practice supports the work of the disabled people’s movement – who have fought and continue to fight for the right to live full and independent lives.
Person-centred practice is a way of ensuring people, including older people, are treated with dignity and respect. The way we would like our parents and grandparents to be treated and the way we would expect ourselves to be treated when it’s our turn to be labeled “an older person”.
To deliver personalisation, you need to know what is important to a person, how to best support them, the way they communicate and make decisions, and what is working and not working about the way they are receiving care and support.
Person-centred practice enables you to have that conversation. As we hope to show you in our posts over the next few weeks and months.
