Person-centred active support is the key to increasing engagement in meaningful activities and relationships which, is itself, is key to achieving a good quality of liflife. It is very difficult to grow in independence and experience social inclusion or choice and control if you never a range of experiences. In person-centred active support, staff:
— See every moment as potential—every activity, task or interaction at home, at work or in the community is an opportunity for the person being supported to be involved, even if not for long or if they can only do a small part of the activity.
— Use a ‘little and often’ approach, working at the pace of the individual and keeping tasks and support simple,
— Provide just the right amount of help and support for each individual in each activity, and
— Maximise choice and control for the person they support.
There are two fundamental components to making sure active support is implemented. Organisations need to ensure that staff both have the skills to use person-centred active support and are motivated to work in this way. In terms of ensuring staff have the skills to do person-centred active support, training is the key and research has shown that both classroom-based training and handson training are essential.
The Nurse and Midwifery Planning and Development unit (NMPD, Tullamore) recently provided funding support for 11 individuals from intellectual disability services in the Midlands region to train as trainers in Person-centred active support. The participants work in a range of services, including residential settings and day services. The first day of the training involved an introduction to Person-centred active support, using worksheets, videos and anecdotes to illustrate the essential components of the system. Day Two combined hands.on training with the opportunity for trainers to observe and think about the feedback they would give. A number of service user volunteers came to the venue and were supported by the trainers to engage in a range of activities, including making their lunch, baking, cleaning etc. Although they had never been to the venue and many of them hadn’t met the person supporting them before, they successfully participated and appeared to enjoy themselves. Day Three of the training focused on training and practice leadership and also allowed participants to discuss some of the issues they thought they might meet curing their training. Key issues included anticipated resistance from some staff, a tendency to care for people and do things for them (rather than enabling them to be as independent as possible), the perception that they wouldn’t have time to do active support because they of too much paperwork, lack of opportunity because of the size of their service setting, and a locked kitchen and lack of funding for adapting the environment to make it accessible. These are similar issues to those raised in training sessions with staff in almost every organisation across the world.
As noted above, training is only one element of implementing Person-centred active support within any organisation. It is also necessary to identify what motivates staff to work the way they do. There are a number of elements of motivation, all of which have to be considered:
— The personal attitudes of staff
— The values of management and how these are perceived by staff—do staff believe that managers think that the quality of life of the people supported and whether they enable people using Person-centred active support is the most important element of their work? Is this apparent in all aspects of the organisation?
— The consequences of doing or not doing active support for staff; do those who are good at enabling people receive recognition and are those disciplined who do not (even after additional training and support)?
If organisations do not pay attention to the motivational context and the informal culture of the services, it is unlikely that training will be as effective as it could be, or perhaps not effective at all. However, if both the motivational context and training are in place, then the positive impact on the quality of life of the people supported can be extensive.