Tag Archives: Person-centred care

Working with Strengths

Working-with-StrengthsAt a strategic level we are continually expanding the language, but essentially using new words and phrases to say the same thing… recovery, personalisation, self-directed support, person-centred planning, re-ablement/re-enablement. Nobody can seriously disagree with the premise that service users should be given a voice in order to say what they need and want, to reflect on how best to meet their wishes and aspirations, to exercise choice and feel supported in their decision-making. However, there is often a gap between what we are saying we are doing as services, and what service users are experiencing on the receiving end. The distance between strategic vision and practical reality rarely conforms to anyone’s idea of close proximity.

This is where the Strengths Approach or Working with Strengths come into their own… call it what you will, but we need some way of translating the big picture into something that is clearly understood and able to be delivered by workers with service users (and carers). We can talk about journeys all day long, but unless you can walk it unaided then we need a vehicle, a route map, a travel guide or companion… a means of travelling that journey. The Strengths Approach sets out a clear statement of values and principles to guide and support good practice; it provides fit-for-purpose tools and the necessary guidance on flexible use of such tools; and it sets out practice-based policy statements that help to tie-in the organisation – team – practitioner levels to an agreement on what we are doing to support people to experience the rhetoric of person-centred services in reality.

Check out my 2014 publication ‘Working with Strengths…’ for the full story, complete with ideas and tools to support the implementation of best practice.

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Dementia and Positive Risk-Taking

JRF screenshotSteve Morgan (Practice Based Evidence) and Toby Williamson (Mental Health Foundation) were commissioned by the Joseph Rowntree Foundation to produce a ‘Viewpoint’ think piece for their published series of thought-provoking topics. The focus was to apply the concept of ‘Positive Risk-Taking’ (developed from 1994 by Steve Morgan) to the relatively new UK government initiative of ‘Dementia-friendly Communities’.

Check out the following link for the full publication, which sets out an explanation of ‘Positive Risk-Taking’, ‘Dementia-Friendly Communities’, and the benefit of taking risks to support people to live with dementia better:

http://www.jrf.org.uk/publications/how-can-positive-risk-taking-help-build-dementia-friendly-communities

 

Podcast Episode 035: Care & Support Planning

TheStrengthsRevolution_albumart_2-2Why develop care or support plans in health and social care services? Isn’t it just another one of those bureaucratic requirements from the world of box-ticking, form-filling, audit-pleasing managerial culture? Well no it shouldn’t be; we need a thoughtful person-centred approach to the complex physical and psychological needs experienced by many people across all age groups and disabilities.

The strengths approach focuses specifically on the priorities expressed by the person through the vehicle of a strengths assessment, and these priority wishes will only become achievable goals if we put some kind of plan in place. The planning element is essentially about actions and responsibilities for actions. Within a strengths approach care or support planning is not limited to strengths-based wishes, we also need to plan for the difficulties and concerns that need to be managed. But the paperwork, paper-based or electronic, will have a role to play if we can keep it to the essential minimum amount.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/035-care-support-planning/id867043694?i=326563007&mt=2

https://soundcloud.com/stevemorgan57/035-care-support-planning

“Spontaneity is one of the joys of existence, especially if you prepare for it in advance.” [Alan Dean Foster].

Podcast Episode 023: Wanda Rusiecki Interview Part 2

TheStrengthsRevolution_albumart_2-2In this second part of the interview Wanda Rusiecki talks about the work she does as a case manager with specific service users, ‘getting on the healthy side’ and supporting people to exercise more control over their own lives. She recognises the real reasons behind the cynacism and mistrust that some people come with, and how the focus on the conversation and humble listening helps to create a different experience of services for many people.

The issue of ‘time’ is discussed; it is the service user’s time, so we need to ask how they want to make best use of it, rather than succumbing only to systems needs that serve more bureaucratic requirements. Helping people to search for satisfaction also brings greater satisfaction in the work for practitioners.

Wanda also reflects on working alongside the criminal justice system through court order treatment, the importance of integrating mental and physical health care to be truly holistic, and the role for peer services employing service users to tap into their experience and talents.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/023-wanda-rusiecki-interview/id867043694?i=318839498&mt=2

https://soundcloud.com/stevemorgan57/023-wanda-rusiecki-interview

Working with Strengths

TheStrengthsRevolution_albumart_1At a strategic level we are continually expanding the language, but essentially using new words and phrases to say the same thing… recovery, personalisation, self-directed support, person-centred planning, re-ablement/re-enablement. Nobody can seriously disagree with the premise that service users should be given a voice in order to say what they need and want, to reflect on how best to meet their wishes and aspirations, to exercise choice and feel supported in their decision-making. However, there is often a gap between what we are saying we are doing as services, and what service users are experiencing on the receiving end. The distance between strategic vision and practical reality rarely conforms to anyone’s idea of close proximity.

This is where the Strengths Approach or Working with Strengths come into their own… call it what you will, but we need some way of translating the big picture into something that is clearly understood and able to be delivered by workers with service users (and carers). We can talk about journeys all day long, but unless you can walk it unaided then we need a vehicle, a route map, a travel guide or companion… a means of travelling that journey. The Strengths Approach sets out a clear statement of values and principles to guide and support good practice; it provides fit-for-purpose tools and the necessary guidance on flexible use of such tools; and it sets out practice-based policy statements that help to tie-in the organisation – team – practitioner levels to an agreement on what we are doing to support people to experience the rhetoric of person-centred services in reality.

The Working with Strengths document represents an overview of how this challenge has been met through a collaborative initiative between Practice Based Evidence and Granta Housing Society between 2007 and 2012.

Does the whole picture fit together?

AoCC 2009

This question captures the meaning of ‘care coordination’. Are all the elements coming together in a coordinated sequence or pattern? It is a question that we apply to many aspects of our daily lives. We ask it, for example, about the colour schemes and fittings of interior design; the layout of an exhibition or gallery; the clothing we wear in particular situations. Simplicity and straight lines in a map or set of instructions often seem to help us to understand what we are doing, where we are going and how we can get there more easily. Complex pictures and plans might please people who enjoy the challenge of working out puzzles rather than having the solution given to them but, depending on how much time you have and what kind of person you are, high levels of complexity may serve only to frustrate you and turn you off.

The degree of creativity experienced in the smallest to the most complex of mental health tasks will largely be influenced by the attitudes, feelings and personal values that are in play at the time. For example, the simple task of arranging an appointment, and then attending it, might just be part of what a particular person does, and they might do it methodically, with little or no thought. But even a simple task like this can be subject to enormous influences, such as the availability of rooms, effective computer systems, clarity of communication, motivation to attend and transport on the day. Failure to meet the appointment, for whatever reason, has the potential to cause frustrations, fuelling deeper tensions and attributions of blame. But the successful completion of a simple task like this rarely generates the positive feelings that perhaps it deserves. Not all appointments and methods of support are creative, passionate and artful events; but the message is that we need to be more reflective about the smaller details if we are to derive more pleasure from our work routines. This message applies to all practitioners involved in care and support, as the care coordinator occupies a role of supervising the whole picture, not painting the whole picture alone!

Successfully coordinated care and support can be a great source of satisfaction and pleasure for providers and receivers alike. See the ‘Art of Coordinating Care’ manual for a detailed approach to capturing the creativity in the role.