‘The way we do things’
The Senior Management Team were completing Progress for Providers and as part of this process realised that culture was an issue in enabling us to provide truly person centred support. The Edward Lloyd Trust had and has fantastic staff that were very caring and known for going that extra mile. We regarded the support we provided as being person centred but it did not appear to be very enabling and was very much based on a caring or ‘hotel model’ of support.
We wanted something which would support us to change and embed a different culture of support… we explored a number of options and felt that the values of Active Support were a good fit with the values of the Edward Lloyd Trust.
In embarking on a journey to change culture we were clear we did not just want training for staff, we wanted something which would support us to change and embed a different culture of support which was enabling and facilitating growth and learning for staff and the people we support. We wanted this type of support to be embedded so that it was quite simply ‘The way we do things’. We explored a number of options and felt that the values of Active Support were a good fit with the values of the Edward Lloyd Trust which we had just refreshed during the business planning process. We had undertaken a management restructure and therefore we were in a state of readiness to embrace building on our person centred approaches and developing new ways of working.
We were very fortunate that at this point the opportunity to be involved in the pilot was offered and we were delighted to be accepted. We identified a service which had seen a number of changes in terms of staff changes including a change in management. We felt this was an opportunity to support the development of a new team and create the culture and ways of working which we hoped could be emulated across the whole organisation.
A challenging time
It was a challenging time as the 3 gentlemen supported in the service do not respond well to change and there had been significant change over a period of about a year. This meant that there were a lot of behaviours that could be described as challenging occurring. There were also communication barriers as two gentleman used Makaton as a form of communication and two gentlemen had non verbal communication. The mixture of poor communication and adapting to change resulted in some high intensity behaviours.
One of the gentlemen, Joe, would go for the last resort to get his needs understood dragging people, pushing punching and grabbing. It was evident that a lot had to change. Joe needed to be heard and understood and the staff needed to listen and understand. As part of introducing new ways of working and implementing change the staff had to work closely with SALT and BAIT teams to ensure that we were putting the right systems and strategies in place. This took quite a long time and the work with SALT (Speech and Language Therapy)is still ongoing.
The introduction of Active Support and systems and paperwork to support it quickly brought about benefits and the staff and the manager quickly became very positive about it.
All staff received Active Support training and there was initial resistance and the manager has admitted that she was very cynical but she was prepared to give it a go. The introduction of Active Support and systems and paperwork to support it quickly brought about benefits and the staff and the manager quickly became very positive about it.
Joe’s behaviours decreased as communication skills improved and Joe and his support staff began to understand each other and communicate effectively. Joe’s confidence has also improved and has begun to involve himself more around the house and actively taking part in tasks with very little prompts. He has been enabled to participate in a wider range of activities within his community.
Overall active support has really benefited Joe in all aspects of his life. This summer he was supported to attend the Tour de France in Yorkshire and this would not have been possible a year ago and it really has enhanced the quality of his life. All of the gentlemen in the house are more engaged in their own lives and are actively involved in aspects of day to day activities in their home and are more active on the community. One of the gentlemen has started a small job in our Head Office and his communication and engagement with staff has improved dramatically.
Due to the success of implementing Active Support we made the decision to implement it throughout organisation… including office staff and volunteers… we felt this would support embedding it into the organisation and changing the culture.
Due to the success of implementing Active Support we made the decision to implement throughout organisation before the pilot was complete. We agreed that all staff in the organisation would have the training including office staff and volunteers to ensure that everyone understands the principle and approach. We felt this would support embedding it into the organisation and changing the culture. We also realised that first line managers were critical to implementing the approach and that the managers training was therefore crucial.
Through the training process the majority of staff were open to the way of working introduced to them but there was some opposition e.g. it won’t work with the person I support, it won’t work with people with complex disabilities or children’s services. However as managers began to implement Active Support in services and staff began to see the benefits for them and for the people we support there has been less resistance and the majority of staff are very positive about it and like to share stories of how the people they support have become more engaged with their lives and we have some fantastic examples
- A house with 2 young women with very complex disabilities are now more engaged in their personal care in relatively simple ways such as carrying the towel on their knee in the wheel chair.
- Many examples of people being more involved with domestic tasks in the house
- One young woman we support has lost over a stone in weight by being supported to attend a slimming class and cooking and preparing her own meals
- A woman we support with challenging behaviour is being supported to be more involved in doing her shopping and is swiping her goods through the self-scanner with support
- A gentleman we support who is profoundly disabled is now able to feed himself small things such as sweets
- Staff were developed an opportunity plan for the women we support with the aim of enabling her to do her own washing. Much to their surprise they discovered she could do it and always had been able to but because we had been providing a ‘hotel’ model of support she had always let staff do this activity.
We have also had some very positive comments and compliments from professionals including:
‘I would just want to say that I have noticed a huge improvement in Amy’s communication skills and engagement in the music. I have worked with Amy for about 5 years now and difference recently is incredible and really wonderful to see. I can only attribute this to her support staff. Her sentence formation and vocabulary has improved so much that she now engages in short conversations and can answer a simple question. It is a joy to see and experience this as her tutor. She appears to be so happy and confident now.’ (Adult Learning Alliance Tutor)
One of the staff teams had a period of Interactive Coaching as part of an Active Support project by the Newcastle BAIT Team (Behavioural Analysis and Intervention Team) to further develop the support they provided to Simon. This coincided with us implementing Active Support. In their report they commented that:
‘It was a pleasure for us to work with the team. Before training staff were on-task 52% of the time and Simon was engaged 30% of the time. During the second activity observed, staff were on- task 83% of the time and Simon was engaged 45% of the time. This means Simon’s participation rose by a third, and staff on-task behaviour by over half.’
In a recent business planning meeting with managers it was evident that the introduction of Active Support has massive positive impact on the organisation and regarded as an achievement and something that is working well. Some of the achievements as a result of Active Support include:
- Supported individuals to fulfil their vision for a good life through Active Support
- Active Support – service users independence increasing. Improves general wellbeing and happiness e.g. Simon feeding himself
- Care and support plans are being implemented properly with Active Support
- Service users are accessing community activity more
- Recognising achievements of service users abilities – Active Support
- Active Support – staff continuity, greater understanding of work role by staff
- Improved wellbeing and confidence of the people we support
Where are we now?
We have developed a training package for new staff and refreshers for existing staff and this will form a major part of induction into services and general mandatory training. This has involved making videos of some of the people we support being supported in activities using Active Support.
Paperwork and monitoring process is being finalised having gone through trials in services.
Monitoring will be done using Positive Outcomes translated into statistics.
Active Support has been added to all agendas e.g. Supervisions, Service Meetings, Managers Meetings, Service Governance, Directors meetings.
The logo is on our paperwork and is advertised on any brochures, etc.
Children and Young Peoples and Outreach services –we are arranging extra sessions for them as they are mainly lone workers and therefore do not have the benefit of team working.
Chris Shrubb
Chief Executive
Edward Lloyd Trust