Supporting staff to embrace Wellness & the practicality of

implementing a new paradigm

Louise Forster

Copyright ©2015 CommunityWest

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@lasaq14

@CommunityWestWA

@loubaforster

#agedcare

Definitions

• Wellness (underpinning)

• Enablement

• Reablement

• Consumer Directed Care

3

A reformed community care system

System underpinned by a wellness and enablement

approach...identify strengths and attributes...build

capacity...maximise independence, autonomy and

well-being.

Commonwealth Home Care Package Guidelines 2012/CHSP Discussion Paper 2014

4

Simmons’ triangle

Source: Heather Simmons. A presentation for the Better Practice Project. June, 2010

Values

Practice

Planning

0

Inherent systemic and cultural challenges

• ageism/discrimination ingrained in society - needs to be challenged to realise potential of CDC

• society devalues older people - low expectations of their restorative capacity

• passivity/learned helplessness - poor health and low motivation

• enablement requires motivation that individuals may not apply themselves

It’s my choice – Inclusion, Melbourne, 2013

Culture change - TSP

• Thinking

• Skills

• Practice

Picture Source: iStock

Copyright ©2015 CommunityWest

• Thinking

- Choice

- Control (expert)

• Skills

- Understanding

- Listening

• Practice

- Tools

- Reflection

Culture change - TSP

Picture Source: iStock

Copyright ©2015 CommunityWest

A reformed community care system

Consumer goals around health, independence, wellness forms basis of Home Care Agreement

Consumer direction empowers individuals to makechoices and take charge of decisions

Commonwealth Home Care Package Guidelines 2012/CHSP Discussion Paper 2014

10

A good life

1. Personal identity and self-esteem

2. Meaningful relationships

3. Personal control and autonomy

4. Home and personal surroundings

5. Meaningful daily and community life

6. Personalised support and care

Source: Imagining a positive future for older people: leadership, partnership and change. Ronda Held 2011

What older people want

I want to be valued

I want to make decisions

I want to contributeI want to be involved

I want to be as healthy as I can

“It is after all for me and about me.”Copyright ©2015 CommunityWest

Culture change - TSP

• Thinking

- Choice

- Control

• Skills

- Understanding

- Listening

• Practice

- Tools

- ReflectionPicture Source: iStock

Copyright ©2015 CommunityWest

Whole of person approach

An extra 1.2 million extra adult social support staff will be needed by 2025

Source: Skills for Care - using data taken from the National Minimum Data Set for Social Care, 2008

Upholding individuals’ rights

Everyone has the right to:

Copyright ©2015 CommunityWest

Culture change - TSP

• Thinking

- Choice

- Control (expert)

• Skills

- Understanding

- Listening

• Practice

- Tools

- Reflection Picture Source: iStock

Copyright ©2015 CommunityWest

Tools

• Appreciation

• Relationships

• Important to/ important for

• Histories

• Wishing

• Good days/bad days

• Working/not working

• 4 + 1 questions

• ‘My Story’ booklet

‘My Story’ booklet

Picture Source: iStock

Copyright ©2015 CommunityWest

19

Culture change - TSP

• Thinking

• Skills

• Practice

Picture Source: iStock

Copyright ©2015 CommunityWest

Organisational culture of choice & enablement

• embed ‘enabling and wellness practices’ at every point of CDC journey and across all areas of an individual’s needs

• strengths, goals and aspirations

• challenges to building capacity

• role of staff as educators

• motivational interviewing, my well being plans

• routines – built around consumer not service/staff.

Risk reduction through improved skills rather than risk aversion

Seek and provide choice - important to individual not solely the organisation

Support opportunities beyond formal service delivery

Shared partnership of responsibilities and expectations

Advice and problem solving not ‘management’

Enabling the consumer to be known & understood

What’s working/not working

Relationship circles

What’s important to/for

Clear goals/desires

Person centred/outcome focused tools

What has changed for you?

What do you want to achieve?

What would support your wellbeing?

How can we build your capacity?

Failure to gather information from the person can be the biggest barrier to delivering effective support.

Personal to national outcomes

Outcome level Focus Examples

Individual/personal Defined by the person as what is important to them in life

I want to be able to get back to the bowling club

Service Defined by a service as a key focus to work towards with people

We work with older people to improve their ability to get out and about

Organisational Defined by the provider as a key area to work towards. Will increasingly be required to be defined across organisations

Improve the social inclusion of the older people we work with

National Defined by government to focus activity across sectors and organisations

We live longer, healthier lives. Our people are able to maintain their independence as they get older and access appropriate support as they need it

23UK Joint Improvement Team. Personal Outcomes Approach

What would you choose?

• Elderly male, deteriorating.

• Not cooking meals - lunch at pub. Some mobility problems.

Client desired outcomes:• continue to go to pub as also a social outlet• improve mobility so can get to pub• reduce risk of falling.

Action:• staff walked to pub with him (strategies

identified)• walking stick and new shoes• strength training exercises and personal

alarm • aimed overall at reducing current risks and

preventing future problems developing.

24No Choice Enabling Choice

Questions to consider

• How will your organisational culture support this way of working?

• Does your organisation continue to care for, or listen and enable?

• Do your current policies and procedures support the concepts of wellness?

• How will you adapt your current processes and tools?

• How will you introduce staff and clients to the concept?

• How do you currently support and promote each individuals strengths?

• What resources are available to assist you?

Sharing Client Stories

www.communitywest.com.au | (08) 9309 8180 | admin@communitywest.com.au

Louise Forster - Manager Innovation & Business Development

Email: louise.forster@communitywest.com.au

Facilitator Participant Videos

Module 1 Facilitator Guide Participant Workbook • Customer Service

Module 2 Facilitator Guide Participant Workbook • Stereotypes• LGBTI

Module 3 Facilitator Guide Participant Workbook • Consumer • Wellness

Module 4 Facilitator Guide Participant Workbook • Budgets 1• Budgets 2• New Types of Support• Budgets 3• Goal Setting• Advisors on budgets

Module 5 Facilitator Guide Participant Workbook • Arthur’s Story

Additional Evaluation Form Further reading • Advisor

Learning Modules

Links

1. WA HACC Wellness Approach – Challenging Community Care with Wellness https://www.communitywest.com.au/resources/cwnews/1204-now-available-challenging-community-care-with-wellness-report

2. The WA HACC Program Communications Kit: Talking about Wellness https://www.communitywest.com.au/sector-development/wellness/communications-kit-talking-about-wellness

3. Progress for providers personalisation http://progressforproviders.org/checklists/delivering-personalised-support-for-people-living-at-home/

4. Person Centred Organisations http://www.helensandersonassociates.co.uk/media/16516/what%20are%20we%20learning%20about%20person%20centred%20organisations.pdf

5. SCIE UK Reablement at a glance/reablement: an introduction http://www.scie.org.uk/topic/careservices/preventionreablement/reablement

Links

6. New South Wales – Towards an enabling approach in Community Care http://www.adhc.nsw.gov.au/__data/assets/file/0010/233965/Better_Practice_Project_-_Discussion.pdf

7. Silver Chain West Australia http://www.silverchain.org.au/assets/GROUP/research/Lewin-2013-evidence-for-the-long-term-cost-effectivenss-of-home-care-reablement-programs.pdf

8. Active Service Model DOH Victoria http://www.health.vic.gov.au/hacc/projects/asm_resource.htm

9. The Young Ones Series http://www.bbc.co.uk/programmes/b00txwgq