Enabling Independence and Person Centred Approaches

– Translating Research into Practice

Celebrating Aged Care and Rehabilitation in South West Sydney and Beyond

Conference

16 December 2014

Director

Carrie Hayter Consulting

15/12/2014

Enhancing Independence and Person Centred Approaches © Carrie Hayter Consulting

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About Carrie Hayter Consulting

15/12/2014

• Personalisation – Translation Research and Evaluation– A Handbook for community care services , Empowering People,

Enhancing Independence, Enriching Lives with Alt Beatty Consulting for NSW Government

– Strategic Planning

– Education, Coaching and Mentoring– Person Centred Practice and Thinking (managers and support workers)

– Cultural Diversity and Cultural Competence

– Ageing and Sexuality (managers & front line workers)

– Consumer Directed Care (Managers and Support Workers)

– Living Life my Way (Service Users)

Enhancing Independence and Person Centred Approaches © Carrie Hayter

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Huon Pine Picture

Introduction

• Enhancing Independence & Personalisation

– Policy Context

– Research

• Challenges & Opportunities

– Older People and their allies

– Frontline Practitioners

– Managers & Senior Executives

– Health Policy

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Source: downloaded from http://lwdp.org.uk/more_info.asp?current_id=296

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Shifting Policy Landscape –Personalisation

Passive Clients

Active Participants

Block funding

Individualised funding

Rigid large inflexible,

bureaucratic services

Flexible responsive

services15/12/2014

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The rise of the ‘Consumer’

Consumer asPurchaser

Citizen

Social and political rightsEconomic

purchasing power

Relationship between client and

professional

Client Citizen –Consumer

Active or passive

subjects?

Mechanisms for enacting ‘choice’ and ‘voice’

Market mechanisms via competition (LeGrand, 2007)

Managing self interest

(LeGrand, 2007) and voice mechanisms

Enable ‘choice’ through ‘voice’

mechanisms (Simmons et al 2011)

Diversity of policy

mechanisms

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Picture of Sick and Geriatric ageing centre of the Audrey Hawkins Centre

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Personalisation Narratives

• Personalisation works, transforming people’s lives for the better.

• Personalisation saves money.

• Person- centred approaches reflect the way that people live their lives.

• Personalisation is applicable to everyone.

• People are the experts in their own lives (Needham, 2011: pg 7).

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The Lucky Ones

Source: downloaded from https://au.tv.yahoo.com/x-factor/#page1/?_s_ref=9JI102jjS&kw=x%20factor&creative=55215366484 1315/12/2014

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FEAR

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Visionary Leadership

Creating Shared Values and Beliefs

Outcomes for individuals

Community Focus

Empowered and Valued staff

Individual and Organisational

Learning

PartnershipsSource: Williams and Sanderson (2005)

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Translating Research into Practice

Hearing Older Peoples’ Voices

• Voice – Having more say in

services and getting access to support

– Individual or collective voice (Simmons et al, 2011)

– Voice can go beyond the confines of choice• Relationships

• Connections (Simmons et al, 2011)

• Voice mechanisms – Complaints

– Surveys

– Political activity through voting or lobbying

– Participation in representative bodies or groups (Simmons et al, 2011)

– Creating engagement frameworks and structures

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People Leading the Way Older People –Village to Village Network

BostonBeacon Hill Village • Grass roots movement created by

older for older people• Member basedhttp://www.beaconhillvillage.org

Village to Village Network http://www.vtvnetwork.org/

• Australia -Wavertonhttp://wavertonhub.com.au/

People with a disability –My Choice Matters

• Ideas and resources for people to have more voice, choice and control

• Run my projects

• Become a leader

http://www.mychoicematters.org.au/

• Community Disability Alliance Hunter – Planning Cafes

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Hearing and Responding to Carers’ Voice

• Formal care system would not exist without informal carers

• Access to personalised budgets – Conservatism of carers and the risks of personalisation

(Needham, 2011)– The traditional model gives them security and comfort

• Choice and comfort for service users may not necessarily bring choice and comfort for carers

• Voices of carers not being recognised and heard (Carers NSW, 2014)

• Challenging, educating and supporting carers• Research on carer perspectives of enablement

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Front-line Practitioners

• Reflective Practice – Seeing older people as active participants– Small steps can bring systemic change – Educating and supporting carers

• Planning – Whose plan is it?

• Innovation – Test the boundaries

• Research – Test out new ideas – Translate research into practice

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Management

• Get behind front-line staff

– Support and encourage discussion

• Navigate and challenge the hierarchy

– ‘productive tension’

• Research

– Attend conferences, network and share ideas

– Initiate and participate in research

• Lead by Example

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Opportunities and Challenges – Policy

• External policy changes in aged care and disability funding will impact on health policy and funding

• Block funded and individualised funded operating in parallel universes

– Can block funded services become more personalised?

– Does a personalised budget mean personalised support?

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Opportunities and Challenges-Commissioning Services

• Shaping services to meet service users interests and preferences

– What mechanisms are needed to enact this?

– Partnerships and/or Co-operative Models

– Service User led

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Opportunities and Challenges –Engaging People who use Services

• Co-Production or Co-design• Working with people for planning and designing or co-

producing services – http://www.ndti.org.uk/uploads/files/Personalisation

_-_dont_just_do_it_coproduce_it.pd

• Engaging people who speak a language other than english

• Challenges – Staff resistance – Engagement of people who use services– Power differences

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Conclusion

• Positive Ageing

– Changes in systems to support front-line practitioners

– Engage users of services

– Professionals as vessels

• Changing Organisational Culture

– Management gets behind the front-line practitioner

• Reflective Practice

– Testing ideas and translation into practice

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References

Carers NSW. (2014). The NDIS One Year In - Experiences of the Carers in the Hunter trial Site Sydney Carers NSW

Glendinning, C. (2008). Increasing Choice and Control for Older and Disabled People: A Critical Review of New Developments in England. Social Policy and Administration, 42(5), 451-469. doi: 10.1111/j.1467-9515.2008.00617.x

Le Grand, J. (2007). Choice and Competition In J. Le Grand (Ed.), Delivering Public Services through Choice and Competition - The Other Invisible Hand (pp. 38-62). New Jersey: Princeton University Press.

Needham, C. (2011). Personalising Public Services Understanding the Personalisation Narrative Bristol, UK Policy Press

Simmons, R. (2011). Leadership and Listening: The Reception of User Voice in Today's Public Services. Social Policy & Administration, 45(5), 539-568. doi: 10.1111/j.1467-9515.2011.00790.x

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References

Moran, N., Glendinning, C., Wilberforce, M., Stevens, M., Nettens, N., Jones, K., Manthorpe, J., Knapp, M., Fernandez, J., Challis, D., & Jacobs, S. (2013) Older people’s experience of cash-for-care schemes: evidence from the English Individual Budget pilot projects, Ageing and Society 33, pp 826-851

Needham, C. (2011). Personalising Public Services Understanding the Personalisation Narrative Bristol, UK Policy Press

Simmons, R. (2011). Leadership and Listening: The Reception of User Voice in Today's Public Services. Social Policy & Administration, 45(5), 539-568. doi: 10.1111/j.1467-9515.2011.00790.x

Simmons, R., Birchall, J., & Prout, A. (2011). User Involvement in Public Services: ‘Choice about Voice’. Public Policy and Administration, 27(1), 3-29. doi: 10.1177/0952076710384903

Williams, R., & Sanderson, H., (2005) What are we learning about person centred organisations?, downloaded from Home Care today www.homecaretoday.org.au

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More Information

Carrie Hayter

Email: Carriehayter@gmail.com

Twitter@carriehayter

Slideshare: Carrie Hayter

Linked in http://au.linkedin.com/pub/carrie-hayter/34/536/517/

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