ACTIVE SUPPORT Challenges to making it work in an organisation'

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ACTIVE SUPPORT Challenges to making it work in
an organisation.

• Presentation to Active Support Conference
• 25th April 2008

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Community Lives ConsortiumWho are we?

• Previously known as West Glamorgan Housing
  Consortium
• Provide support services for adults who have a
  Learning Disability since 1988
• Non-profit making organisation with charitable
  status

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Community Lives Consortium

• Partnership with the City County of Swansea
  Neath Port Talbot local authorities
• Domiciliary Support
• Residential Care Homes
• Respite Service
• 210 Service users
• 576 staff

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Where did we begin with Active Support?

• Proposal from WCLD in March 1999
• to introduce active support
• Our existing system emphasised skills and not
  activity was not integrated into everyday life
• Active Support model tried and tested

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Challenge Staff perception that active support
was paper work

• Response
• Revised recording systems to integrate active
  support planning recording formats
• March 2000 delivered training on new recording
  formats

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Challenge Delivering training to a large staff
group

• Response
• August 2000 Training for Trainers for
• - Support managers (area managers)
• - 10 nominated team leaders
• Sept Feb 2001 training programme for all teams
  to attend 2½ days training course
• Additional relief workers to provide cover for
  staff to attend.

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Challenge Staff resistance to new ways of working

• Response
• The people with the greatest influence became
  the trainers
• Persistent, clear, firm message balanced with
  understanding
• Included Active Support in Induction Course

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Challenge Lack of staff confidence to use
techniques with some service users

• Response
• Training for managers to deliver interactive
  training to staff
• Introduced Interactive Training for all support
  staff on an annual basis
• Involved the Clinical support team

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Challenge Staff perception that they do active
support at specific times

• Response
• Integrated within Consortiums recording systems
• Internalised into Consortiums policies and
  practice guidance
• Reviewed all Support plans

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Challenge Limited staff knowledge and skills in
communicating effectively with service users

• Response
• April 2001 Inclusive Communication Initiative
  proposal from Bro Morgannwg
• Oct 2001 Training IC Co-ordinators
• Delivered IC foundation training to all support
  staff and managers

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Challenge How do we know it is working?

• Response
• Service managers expected to discuss information
  from participation summaries opportunity plans
  on monthly basis.
• Quarterly participation summaries collated into
  organisations performance reports.

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Challenge How do we maintain practice?

• Response
• 2003/4 Management re-structuring
• Active support responsibilities written into job
• descriptions
• Service Managers- Manage implementation of Active
• Support for specific
  service users
• Team Co-ordinators - Trainers in Active Support
• Complete annual interactive audits
• Refresher training for all staff teams and
  review plans for each service user

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Challenge Staff not making the links between
Active support and Inclusive Communication

• Response
• Team Co-ordinators - Trainers in both Active
  Support and Inclusive Communication
• Included Inclusive Communication into Interactive
  Training / Audits

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ChallengeThe balance between Active Support
and Low Arousal when working with service users
who challenge.Staff having to relate to too
many different support plans for people with
complex/challenging behaviours.

• Response
• Reviewing behaviour management plans
• Piloted integrating behaviour management
  guidance into activity support plans along with
  guidance on effective communication.

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Challenge How do we maintain practice?

• Personal Support Audits
• Developed in 2006 and piloted during 2007/08
• Aim is to assess and support improving
  performance of services with respect to Active
  Support and Inclusive Communication
• Ideally conducted within one working week
• Process led by the Team Co-ordinator
• Target to complete audit annually in each service

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Personal Support Audits

• Gathering stakeholders views regarding active
  support and inclusive communication
• Interviews with Service managers, key workers,
  support workers and service users.
• Review of service user records
• Interaction audits for each staff member
• Service culture observation
• Compile a draft report and shared with Service
  managers and area manager

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Personal Support Audits

• Report
• Managers discuss and agree final report
• Includes recommendations for further action
• Agree how it is to be shared with stakeholders.
• One of the components of QA system
• Possibly to be shared with Contract Monitoring

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Personal Support Audits

• Feedback
• Time consuming
• Needs planning
• Initial suspicion from staff managers

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Personal Support Audits

• Feedback
• Raises the profile of Active Support IC in
  services
• Promotes greater understanding and confidence in
  staff and managers
• Has had a motivating effect in team
• Has helped to identify knowledge and skills
  deficits.
• Improved levels of participation evident in
  quarterly reports

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Targeted support

• 2006-08 undertaking a pilot
• Assistive Technology
• Telecare
• Model of service delivery
• Support Co-ordinators work consistently
  with
• service users experienced coaching in
• interactive work
• Support Workers - provide additional support
  only when required

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Targeted Support

• Evaluated by WCLD
• Indicators include improved levels of service
  user independence and participation. i.e.
  increased evidence of implementation of active
  support

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Current challenges

• Maintaining building on good practice
• Consistency in standards across the whole
  organisation
• Using recording to influence practice
• Linking Active Support with Person Centred
  approaches
• Linking interactive audits with supervision and
  appraisal for staff.

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Future challenges

• In Control agenda
• How do we deliver Active Support
• in self-directed services?

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If we had our time again.?

• Monitor and measure outcomes and not process
• Enable people to tell their stories
• Use evidence of changed lives and not principles
  of management of change to influence the culture

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Community Lives Consortium

• www.communitylives.co.uk