Person centred practice are ways of commissioning, providing and organising services rooted in listening to what people want, to help them live in their communities as they choose. These approaches work to use resource flexibly designed around what is important to an individual from their own perspective and work to remove any cultural and organisational barriers. People are not simply placed in pre-existing services and expected to adjust, rather the service strives to adjust to the person. Person – centred practice is treatment and care and considers the needs of the individual.
Individuals have a role in planning the supports they receive and the staff that are hired. Regularly look at peoples lives to see what is working and not working. Employees know their roles and responsibilities in supporting people. Staff are matched with people based on skill and common interests. Person-centred practice is treating patients as they want to be treated.
Person-centred care has been defined as treating people as individuals and ensuring they are fully involved in the planning process. By being involving, discussing and consulting with the individual regards their care plans, it can be deemed that verbal consent has been given to the care provider. By enabling the individual to make choices and contribute in the decision making process the individual has consented to the care to be administered. Choice involves providing the person with alternatives from which to choose and respecting the decision that is made, as far as possible. Consent means giving permission, an informed decision, permit, approve or agree. A persons capacity to consent is considered to be affected by three main processes: comprehension (ability to understand and retain information) decision making (ability to weigh up information and reach a decision) and communication (ability to communicate the decision made).
Legally a competent adult can either give or refuse consent to care, even if that refusal may result in harm to harm to them. You must respect their refusal just as much as they would their consent. It is important that the person is fully informed with regards the consequences of their refusal EG: medication has been refused. If an individual refuses to give consent a record should be made. If an individual lacks the Mental Capacity to give consent to care. The Mental Capacity Act 2005 allows people over the age of 16 to appoint a proxy decision maker. The MCA has been in force since 2007 and applies to England and Wales. The primary purpose of the MCA is to promote and safeguard decision making within a legal framework. It does this in two ways: By empowering people to make decisions for themselves wherever possible and by protecting people who lack capacity by providing a flexible framework that places individuals at the heart of the decision making process. By allowing people to look ahead for a time in the future when they might lack the capacity for any number of reasons.
Wellbeing and quality of life for most people is enhanced through meaningful involvement and activity. It is crucial that individuals are involved in decisions that affect them. There are many ways in which such involvement can be facilitated and encouraged. Services should recognise the importance of social contact and companionship and on-going links with social networks. Your organisation should support continued community involvement, easy access to transport and the opportunity to participate in social and leisure activities. Maintaining social contact is also important to social identity and fulfilment. Active support is a proven model of support that encourages people with learning disabilities to plan the best use of their time, with the correct level of support to engage or participate in all activities that make day -to-day living. It empowers and motivates, changing the focus of support from caring for to supporting and working with.
Active support underpins all areas of health and social care as it is so person-centred values into action. Services are changing their approach to support from the “hotel” model to the active support model. Active participation is an approach that enables individuals to be included in their care and have a greater say in how they live their life in ways that matter to them. The benefits of active participation can be divided into primary benefits and secondary benefits.
An opportunity for individuals in health and social care settings to have a say in matters of direct concern to their lives. Increased opportunities for social contact and interpersonal relationships. Encouraging involvement and self-awareness. Individuals become more involved in the community and more aware of opportunities and what they can hope for themselves. Increased opportunities for learning and development of important skills, knowledge, education and employment. Enhanced wellbeing with increases in self-confidence, self-esteem and self-belief. The benefits of active participation included the above primary benefits where the individual gains from its application in real world of health and social care practice but there are also some secondary benefits.
The secondary benefits: can be described as benefits that occur as a result of active participation but are not a direct aim of active participation. These included: Decreasing the likelihood of abuse. As the individual engages positively by actively participating is area of their life, such as in personal care, the scope for abuse by others is reduced. Decreasing vulnerability. As individuals gain in their self-confidence and self-esteem they are less prone to exploitation and harm from others.
Active participation is an approach that empowers individuals in the activities and relationships of everyday life leading to them living as independently as possible. The importance to the individual as an active partner in their own care or support is that it brings physical, psychological, relational and over all wellbeing benefits. Service user participation has resulted in an impact upon the service users, themselves, the organisation and also what the organisation does. For individual service users, the benefits of participation may include increased confidence and self-esteem, the chance to acquire new skills and improved material resources if, for example it helps them to acquire paid employment.
Participation leads to greater satisfaction and improved quality of life for instance, older people mental health service users and people with disabilities who have had greater control in decisions about the support they receive, report greater satisfaction and better health than those who have not.
Today caregivers are adopting outcomes based practice methods to achieve desired patient care goals. Outcomes based practice ( sometimes called outcomes management ) involves a combination of teamwork, continuous quality improvement and process and outcome measurement. Outcome based care is about putting the person at the centre of the care service and not prescribing a standard service to everyone. It is about delivering meaningful outcomes to every individual and helping people to lead more fulfilling lives. Outcome based care requires careful planning which involves working with the people who use our services to help them identify and achieve the things they want to do. Delivered well, outcome based care increases interest and motivation and creates the enthusiasm needed to support people to lead a more fulfilling life.
The service users desires, aspirations, abilities and talents are explored and utilised to help ensure they lead a more fulfilling life. It empowers care workers to work more closely with service users to understand how best to enable their independence. The service can respond more easily to changing needs and preferences. It contributes to maintaining a service users independence.
It enables service users to exercise more choice and have more flexibility in the day-to-day delivery of their service. It encourages partnership working between all stakeholders involved in the delivery and management of an individuals care. It uses resources such as funding and time to gather effect. It provides a basis for evaluating the effectiveness of services. A fundamental part of outcome based care is looking for opportunities to support people in activity throughout the day. This means thinking about the activities that need to be completed- key tasks such as personal care, travel or meal preparation. The practice of outcome based care ensures that service users are involved in their daily living choices, no matter what their physical or mental ability. Of course not everyone using our support services can undertake all tasks independently, people need different levels of support. The role of the care worker is to provide enough support to enable the service users successful participation. A key principle of outcome based care is helping service users to engage little and often so that they build up experiences of success and increase their motivation.
Outcome based practice was introduced as a new way of working. Instead of, a needs based approach to care and the support offered, it became outcomes/results based accountability. A ‘needs’ based delivery of care was difficult to measure in terms of success or failure where as an ‘outcome’ based delivery was more focused on achievement. Outcomes in a social care context are concerned with quality of life rather than simply levels of ability, health, employment or housing status. At a community level this can be about people feeling safer, people being healthier, communities being stronger. At an individual level outcomes can be framed in terms of the steps a person needs to take in order to improve aspects of their lives relating to their own safety and security. For instance: Outome based practice is a disciplined way of thinking and moving from ‘talk to action’ quickly- from strategy to implementation. It is about re-focusing on the difference you are making to peoples lives, meeting their goals- knowing where you/re heading helps you change what your doing. Outcome based practice:
Offers a framework for strategic planning and enables all stakeholders, commissioners, service providers and communities alike, to improve the lives of children, young people, families and adults. Helps identify the activities that will make the most difference to individuals and communities. Can be used to improve the improve the performance of programmes, agencies and service systems through compelling links between service activity and outcomes for users. Can dramatically improve partnership working by creating a common language, shared ownership and maximising the contribution of all stakeholders.
Outcome based practice focuses on the individuals goals and steers the carer away from a needs based care delivery. It also has measurable aims and objectives where needs based care has not. The work becomes driven and specific because there is a goal in mind. When outcomes were first introduced into care some care professionals had difficulties seeing the differences between an ‘outcome’ and a ‘need’. Some professionals felt their role had been reduced because the individual became the ‘expert’ in their own care and the centre of the planning. This meant the care professional needed to come to terms with this new way of delivering services.