1. Care to Train Ltd
Person Centred Support
Produced by Bob Wade
Care To Train Ltd

2. Personalisation
The catch-all term used to encapsulate the
government's 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. Personalisation
means 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. Self-assessment,
Self-directed care & Self Care
Self 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: 4
Individuals caring for themselves

5. Person-centred
Largely means the same as 'personalisation'
Placing the person at the centre of the caring and
supporting process
5

6. Person-centred Values
Values relate to our personal principles,
morals, and ideals—that is, what we
consider to be important
6

7. Person-centred Values
Individuality – the unique individual
Independence – doing things for oneself
Privacy – 'behind closed doors', confidentiality
Dignity – promoting person's self-respect
Respect - valued as an individual
Choice – Making own real choices
Rights and responsibilities – human rights but also
responsibility (for own well-being and
well-being of others
Citizenship – as part of civil society
Inclusion – being accepted as part of community
Working in partnership – working with the 7
individual

8. Person-centred Concepts
8

9. Person-centred Concepts
Communication relates to a two-way process that
involves exchanging information; it includes
ensuring understanding and communicating in
ways that meet an individual's communication
needs
An advocate is a person who intercedes on
behalf of another person in a bid to ensure that
their best interests are communicated and met
Involvement is the inclusion or engagement of the
person including regarding their planned
care or treatment. 9

10. Person-centred Concepts
Participation 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 plan
Trust relates to having confidence in another
person—that is, to having faith that they are
reliable and honest
A 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. Person-centred Concepts
To empower is to give or delegate power or
authority to and entails letting the person take
responsibility for their consequences
Empathy involves the practitioner considering the
situation of the person and imaginatively entering
into how they feel
Choice 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. Person-centred Concepts
Holism 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 entities
Assessment 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. Common Core Principles to
Support Self-care
Ensure individuals are able to make informed
choices to manage their self care needs
Communicate effectively to enable individuals to as-
sess their needs, and develop and gain
confidence to self care
Support and enable individuals to access
appropriate information to manage their self care
need
Support and enable individuals to develop skills in
self care
13

14. Common Core Principles to
Support Self-care
Support and enable individuals to use technology to
support self care
Advise individuals how to access support
networks and participate in the planning,
development and evaluation of services
Support 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. Values into Practice
Examples of following person-centred values in your
day to day work – Page 76
Go 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. Person-centred Values
Individuality – the unique individual
Independence – doing things for oneself
Privacy – 'behind closed doors', confidentiality
Dignity – promoting person's self-respect
Respect - valued as an individual
Choice – Making own real choices
Rights and responsibilities – human rights but also
responsibility (for own well-being and
well-being of others
Citizenship – as part of civil society
Inclusion – being accepted as part of community
Working in partnership – working with the 16
individual

17. Why it is important
to work in this way
What research has shown that people want
Values of social care eg GSCC Codes of Practice
What research has shown are effective ways of
promoting individuals' well-being
Benefits of this approach to individuals' emotional &
psychological well-being
Question Page 77 17

18. Promoting Dignity
Examples of how you can promote dignity –
Page 78
18

19. Promoting Dignity
From SCIE 'Dignity in Care' guidance – 8 Factors
Choice & Control: Enabling people to make choices about the
way they live and the care they receive
Positive & effective communication: Speaking to people
respectfully and listening to what they have to say; ensuring
clear dialogue between workers and services
Eating & 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. Promoting Dignity
Promoting 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. Working in a person-centred way
– key features
Person at centre of everything we do
Individuals having control over the care & support
Individuals making real choices about their care &
support
Positive stable relationships
Empowering approach to practice – active support
Working with strengths
Working with the person not just doing for them
Flexibility
Recording & planning with the person, not just about
them 21
Promoting self-care

22. Care & Support Plans – contribution
to person-centred working
What 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 friends
How 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. Care & Support Plans – contribution
to person-centred working
Planning builds up a picture of the individual you are
supporting
It organises their choices and outlines what they
need support with
It is a place for individuals to set personal goals –
and keep a record of their progress
It 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. Care & Support Plans – contribution
to person-centred working
Self-assessment – individual assessing their own
needs
Self-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 professionals
Enables individuals to make their own 24
decisions about how they want to be supported

25. Trad itional h om e care p roce s s
s homecare services
sits the individual and makes an assessment on their nee
which provider will support them
en with a list of tasks that the care worker must follow
ty to change what is on
unless there is a review
25

26. Th e trad itional care p lan
Day Time
Monday 8.30am-9.00am
Assist to get up, washed, dressed and make breakfast
Monday 12.00pm-12.30pm
Assist to make lunch and prompt medication
Monday 16.00pm – 16.30pm
Assist to make tea
Monday 20.00pm-20.30pm
Assist into bed, prompt medication
26
A re thes e flexible? Do they promote choice?
Who has the control?

27. P lans d on’t live in fold e rs
Individual support plans are ‘living documents’
that should be seen as important as ‘daily care
notes’
Within your role as new type of worker you will
add to individuals’ support plans
This means working in partnership with
individuals to update their plans and set new
GOALS
27

28. Ins id e an ind ivid u al s u p p ort p lan
28

29. N e w typ e of worke r re s p ons ib ilitie s
f aware of the ‘whole’ Individual Support Plan
ularly look at the individual’s support plan
u are aware of the ‘goals’ individuals are working
individual’s support plan with your team leader and at team meetings an
plan with the individual
rstanding of why the choices individuals have made are so important to t
uals about the positives – ‘what they can do’ – and
n contribute to what they have difficulty doing.
ke 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. Person-Centred Thinking
You working in a way that involves thinking in a per-
son-centred way
SureCare developing tools to help you to start
doing this
Appreciation
Life History
One Page Profile
Good Days – Bad Days
Communication Charts
More to follow – at team meetings 30

31. Knowing the Whole Person
Why this is important - Question Page 80
31

32. Knowing the Whole Person
Why Important?
So that some needs don't get overlooked
(eg social & emotional needs)
Helps you to understand the person
What's 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. How do you find out
about these things
Reading previous care notes, care plans, communication
assessments
Discussion with colleagues
Discussion with family & friends
Discussion with other professionals who have worked with the
individual
Discussion with the individual
Specialised assessment by other professionals (eg sensory
loss, speech therapist, GP, CPN, DN)
Observation of the individual
Finding out in general about the individual's condition
33

34. Changing Needs & Support Plans
Changing 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. Individuals planning
their own future
An 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. Active Participation
Participation 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 commissioning
Participation is not simply about being present or
taking part but should be based upon having
some influence over decisions and action
Issues of power and control
Person-centred means "every person who receives sup-
port … will have choice and control over the 36
shape of that support in all care settings."

37. Benefits of Active Participation
Way 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 recipient
Increased confidence and self-esteem
Chance to acquire new skills
Greater satisfaction
Improved quality of life
May also help create a stronger sense of 37
community

38. Barriers to Active Participation
The 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
states
Social environment: people making assumptions;
missing opportunities to participate; negative attitudes
and behaviour; poor communication, poor supportive
relationships; organisational cultures & boundaries
Physical environment: poor access; poor transport
opportunities; disabling built environment
Economic environment: individual financial 38
resources; eligibility for benefits

39. Reducing Barriers & Encouraging
Active Participation
Effective communication adapted to the individual
Take time to get to know the individual
Supporting the individual with SMART planning
Encourage the person to ‘be in charge’
Celebrate all achievements – no matter how small
Focus on ‘abilities’ and strenghts
Set realistic expectations
Build person-centred partnerships
Focus on positives
Seek advice – If in doubt, always seek advice from your su-
pervisor
Approach support work with a ‘detective’s eye’ – look out for
opportunities for participation & self-care
Signposting to information, services, groups
39
Discuss & signpost to assistive technologies

40. Supporting Active Participation
-valuing people, non-judge-
mental
Examples Questions Page 87
40

41. Supporting to be involved
in activities
Examples Questions on Page 87
41

42. Supporting to
maintain relationships
Examples Questions on Page 87
42

43. Supporting individuals to make
informed choices about their lives
Mental Capacity Act Code of Practice – how to help
individuals make their own decisions
Providing relevant information
Communicating in an appropriate way
Making the person feel at ease
Supporting the person, can anyone else help or support or
express a view – who can they talk it through with
43

44. Empowering Decision-making
and Responsibilities
Providing relevant information
Take time to explain anything that might help the person make a
decision. It is important that they have access to all the information they
need 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 not
miss out important information.
What are the risks and benefits? Describe any foreseeable consequences of
making the decision, and of not making any decision at all.
Explain the effects the decision might have on the person and those close to
them – including the people involved in their care.
If they have a choice, give them the same information in a balanced way for
all the options.
For some types of decisions, it may be important to give access to
advice from elsewhere. This may be independent or specialist
advice (for example, from a medical practitioner or a financial
or legal adviser). But it might simply be advice from trusted 44
friends or relatives.

45. Empowering Decision-making
and Responsibilities
Communicating in an appropriate way
Ask people who know the person well about the best form of commu-
nication (try speaking to family members, carers, day
centre staff or support workers). They may also know somebody the
person can communicate with easily, or the time when it is best to
communicate 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 check
understanding or show that a choice is available.
Break down difficult information into smaller points that are easy to
understand. Allow the person time to consider and understand each
point before continuing.
It may be necessary to repeat information or go back 45
over a point several times. (continues)

46. Empowering Decision-making
and Responsibilities
Communicating in an appropriate way
Is help available from people the person trusts (relatives, friends, GP, social
worker, religious or community leaders)? If so, make sure the person’s right
to confidentiality is respected.
Be aware of cultural, ethnic or religious factors that shape a person’s way of
thinking, behaviour or communication.
If necessary, consider using a professional language interpreter. Even if a
person communicated in English or Welsh in the past, they may have lost
some verbal skills (for example, because of dementia). They may now prefer
to communicate in their first language. It is often more appropriate to use a
professional interpreter rather than to use family members.
If using pictures to help communication, make sure they are relevant and the
person can understand them easily. For example, a red bus may represent a
form of transport to one person but a day trip to another.
Would an advocate (someone who can support and represent
the person) improve communication in the current situation? 46

47. Empowering Decision-making
and Responsibilities
Communicating in an appropriate way
Helping people with specific communication or cognitive problems Where
people have specific communication or cognitive problems, the following
steps can help:
Find out how the person is used to communicating. Do they use picture
boards or Makaton (signs and symbols for people with communication or
learning difficulties)? Or do they have a way of communicating that is only
known 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 other
computer equipment available to help?
If the person does not use verbal communication skills, allow more time to
learn how to communicate effectively.
For people who use non-verbal methods of communication, their
behaviour (in particular, changes in behaviour) can provide 47
indications of their feelings.

48. Empowering Decision-making
and Responsibilities
Communicating in an appropriate way
Some people may prefer to use non-verbal means of communication and
can communicate most effectively in written form using computers or other
communication technologies. This is particularly true for those with autistic
spectrum disorders
For people with specific communication difficulties, consider other types of
professional help (for example, a speech and language therapist or an expert
in clinical neuropsychology
48

49. Empowering Decision-making
and Responsibilities
Making the person feel at ease:
Location - In terms of location, consider the following:
Where possible, choose a location where the person feels most at
ease. For example, people are usually more comfortable in their own
home than at a doctor’s surgery.
Would the person find it easier to make their decision in a relevant
location? For example, could you help them decide about medical
treatment by taking them to hospital to see what is involved?
Choose a quiet location where the discussion can’t be easily
interrupted.
Try to eliminate any background noise or distractions (for example, the
television or radio, or people talking).
Choose a location where the person’s privacy and dignity can be
properly respected.
49

50. Empowering Decision-making
and Responsibilities
Making 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 – some
people are better in the mornings, others are more lively in the after-
noon or early evening. It may be necessary to try several times before
a 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 psychotic
episode. Obviously, this may not be practical and appropriate if the
decision is urgent.
Some medication could affect a person’s capacity (for example, med-
ication which causes drowsiness or affects memory). Can the decision
be delayed until side effects have subsided?
50

51. Empowering Decision-making
and Responsibilities
Making the person feel at ease:
Timing continued -
Take one decision at a time – be careful to avoid making the person
tired 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 is
not urgent. Delaying the decision may enable further steps to be taken
to assist people to make the decision for themselves.
51

52. Empowering Decision-making
and Responsibilities
Supporting the person:
Many people find it helpful to talk things over with people they trust – or
people who have been in a similar situation or faced similar dilemmas. For
example, 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 someone
close) or where there are long-standing problems that
affect someone’s ability to understand an issue, it may be possible to delay a
decision 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 with
specific conditions, such as Alzheimer’s disease or
profound learning disability.
It may be important to provide access to technology. For
example, some people who appear not to communicate well
verbally can do so very well using computers. 52

53. Assessing and Managing Risk
People have the right to live their lives to the full
as long as that doesn’t stop others from doing the
same
Help people to have choice and control over their lives
Recognise that making a choice can involve some risk
Respect people’s rights and those of their family carers
Help people understand their responsibilities and the implic-
ations of their choices, including any risks
Acknowledge that there will always be some risk, and that
trying to remove it altogether can outweigh the quality of life
benefits for the person
Continue existing arrangements for safeguarding
people 53

54. Using risk assessment to support
informed choices
Using format to help think about risks and ways to
manage them or agree unacceptable risks, all can
help to make informed choices
With 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
necessary
Discuss and agree with individual actions
to be taken (including by them) to minimise 54
risk

55. 55

56. Your personal views influencing
individuals' choices
Care 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 do
Feeling of overriding duty of care – no risks
Your views influenced by your culture, beliefs,
experiences, emotions – not the individual's
Question on Page 93
56

57. Supporting individuals to
challenge decisions made by others
Supporting decision making (Mental Capacity Act
Codes)
Help with communication
Help with information
Explaining complaints procedures
Signposting to help & advice
Signposting to advocates
Question on Page 94
57

58. Individuals developing self-care
skills
Why important? Question Page 90
58

59. Individuals maintaining their
social & community networks
Why important? Question Page 90
59

60. Identity & self-esteem linked with
spiritual & emotional well-being
Spiritual 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. Attitudes & approaches that promote
spiritual & emotional well-being
Question on Page 96
61

62. Promoting identity & self-esteem
Question on Page 97
62

63. Environments that promote
spiritual & emotional well-being
Environments that promote privacy and dignity
Personal possessions
Items of spiritual significance
Accessible environments
Pleasant surroundings
Environments appropriate to times of day or
activities (restful, stimulating, light, dim)
Environments chosen and controlled by individual
Access to spiritual services
63

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. Signs of Dementia Early stages
forget about recent conversations or events
repeat themselves
become slower at grasping new ideas, or lose the
thread of what is being said
sometimes become confused
show poor judgement, or find it harder to make de-
cisions
lose interest in other people or activities
develop a readiness to blame others for taking mis-
laid items
become unwilling to try out new things 65
or adapt to change.

66. Depression, delirium & memory
impairment
Mild Cognitive Impairment – mild loss of memory,
age related – can be mistaken for symptom of
dementia
Depression – symptoms include mood changes, be-
ing withdrawn, losing interest in people &
activities, forgetfulness, which are also symptoms
of dementia
Delirium – 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. Dementia & Early Diagnosis
Ruling out other illnesses
Receiving early treatments which are beneficial over
the longer term
Can help individual and family plan for the future
67

68. Reporting suspected dementia
Who to?
Encourage individual to consult GP themselves,
self-care
68