Person-centred practices

At a time when we see more shocking reports about how poor some home care services are, and the impact of the cuts, it can be hard to keep believing that we can do more, and do better. Better communication with families may just seem like the icing on the cake. Yet the longest research into happiness published recently confirmed what we knew; that relationships are central to happiness. Here are some ideas of how we can do this, and how organisations are taking this forward.

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One of my favourite gifts is a book. Last year Nic told me about a powerful book that she was reading, and generously sent me a copy. I know to say that ‘the book changed by life’ is a tired cliché, but it had the impact of focusing my work in a way no other book has.
The book was Atul Gawande’s ‘Being Mortal’. By the end of the year I had bought and given away a further seven copies. This blog describes how it led to our partnership with Community Integrated Care to change care homes.

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Last Tuesday I was drinking coffee with Rod, in Jonkoping, talking about the presentation we were due to give the next day. My phone rang and I got the call that I knew was coming soon but still not expecting. The message was that my friend and colleague Max had died.
Max was prepared for the end of his life, more than prepared, he faced it head on. He had cancer for the last two years. We had had many conversations (electronic – our favourite kind) about life and death, about contributions and appreciations, and about what needed to be said and done for a good death. We said what we wanted to say to each other – and I asked for and got my ‘legacy instructions’.

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Two weeks ago I was surprised to get a call from a provider asking for help to recruit a new Person-Centred Planning Co-ordinator. This role is an echo from the past for me. I have friends who used to be ‘PCP Co-ordinators’, but I don’t think this role still exist in local authorities, and there are a handful of people with a similar role in some providers. The Person-Centred Planning Co-ordinator was a new role emerging in 2000 to help implement Valuing People. Essentially, their role was to train and support person-centred planning facilitators, to ensure that person-centred planning happened and it made a difference. Our aspirations were high for person-centred planning to lead to great lives for people and rock services. There was lots of effort and energy, and great co-ordinators, yet history tells us that success was mixed. I was part of that change, and if I had my time over again, there is a lot that I would do differently. This is how I would change the role.

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I was 50 last year. Turning 50 made me pause and consider how I am using my time, and what I want to change – a huge ‘working and not working’ about work and life. Being part of a small team is definitely on the ‘working’ list , and I don’t want it to get bigger, but this creates a tension too. How can a handful of people be part of contributing to big changes? However good our training is, if we carry offering training in the same way, I am not sure how we can influence change at scale. I keep asking myself how our team can support people to do great work and make a difference.

The context of training has changed as well. The financial situation means that training budgets keep shrinking, at the same time that colleagues are expected to implement The Care Act, the SEND reforms in education, and introduce care and support planning too. I know that taking staff away from the workplace for two days to learn new skills is harder to do, particularly when you also have to pay for the venue, pay travel and sometimes back pay as well. Even when staff can attend an excellent course, how can managers be sure that it results in changes to practice?

So eight months ago, as I passed 50, I started to look at these two questions:

How can people gain new skills and knowledge without leaving the workplace?
How can people get ongoing support to implement what they have learned?

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Talking about death is difficult. It’s an annual conversation for me and my mum. Mum already had a one-page profile, developed after a spell in hospital. In essence we were updating this and adding two other sections about what she wanted and did not want around the end of her life. This was easy to take from the ‘Living Well’ and is almost an executive summary.

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