This morning I spoke at a conference on the importance of knowing the person. My audience was predominately social care providers. My remit was to focus on real lives, drawing on my experiences of care in terms of the importance of knowledge and skills and with a strong message of person-centred-ness in all care.
Since so many of my blog readers are also social care professionals, I thought it would be worth sharing some of what I spoke about. But this blog isn’t just for social care professionals, it’s for families too. My understanding of what makes great person-centred care began in the years my dad was living with dementia, and despite all of the experiences I’ve had through my work since, the education I had from my dad remains unsurpassed.
Since my dad’s passing, the rise in prominence of person-centred care has grown. Virtually every care and support provider will tell you that their care is person-centred. The danger with person-centred care being in the mainstream, however, is that huge variations now exist in how different providers interpret this.
Everyone thinks they deliver great person-centred care, but do they?
As part of my presentation, I shared three slides taken from the training that I devised for social care staff, particularly care home staff, that is based on my personal experiences and designed to help staff understand more about the practicalities of what person-centred care means. Some of the examples I use are very obvious but don’t be fooled by the simplicity. The most person-centred organisations I know realise that EVERY little detail matters.
To explain the many facets of person-centred care, I like to begin with the obvious physical differences between individuals, picking up on their appearance and personal effects. But I also talk about interpretation beyond the physical characteristics. Think expression, personality and history as just three examples.
Expanding more into everyday life, it’s vital to understand the role of a personalised environment and appropriate communication. Beyond that, the key question is how each individual’s qualities, interests, preferences, abilities, needs and aspirations are supported. Maintaining skills, a sense of purpose and the enjoyment of achievement is vital for all of us, but for this to happen in care environments staff need to believe in it and make it happen. In dementia care especially we talk about entering the person’s world, but in reality this is vital to achieving person-centred care for any individual.
I know from my experiences of delivering my training that staff sometimes wonder how being person-centred is going to benefit them. Their bosses might argue that their staff aren’t at work to benefit themselves, they are there to provide care and support for the people accessing their service. But if we don’t look at how being person-centred enhances the knowledge and skills of staff to help them feel a sense of achievement and pride in their work then we are making a big mistake.
When staff struggle to support a person who is living with dementia because that person is experiencing symptoms associated with their dementia like confusion, anxiety, emotional outbursts or repetition, being person-centred in their whole approach can not only halt the escalation of these symptoms, it can change the feelings, perceptions and motivation of staff. They don’t leave work feeling baffled and as if they’ve failed the person, but instead are able to reflect on how their response helped the person, and how they might refine that response further in the future to enable an even more positive outcome.
Ultimately, though, it would be wrong to talk about person-centred social care and not address the culture and leadership of organisations. It’s no fluke that every CQC ‘Outstanding’ rated adult social care provider is well-led.
Sadly, I’ve seen too many care homes where Joseph White is supping his morning coffee (that should be tea), eating a digestive (that should be a custard cream) wearing the vest belonging to Margaret Ross (but Margaret’s a large lady and she’s got plenty so it’s fine – it isn’t), while Joan Ellis is listening to Frank Sinatra (even though he’s her least favourite member of the Rat Pack – she’s a secret Sammy Davis Jn fan. Oh and by the way, she’s mumbling about being cheated on and fighting with a man because she is remembering headlines of Sinatra’s stormy personal life). Meanwhile, Edward Lewis is pacing the corridor, wanting to fix engines but being told to sit down and have a nice glass of juice (only Edward hates ‘juice’ because he knows it isn’t real orange juice, just watered down squash).
The challenge for every social care provider isn’t just knowing, and by knowing I mean REALLY knowing, the people they are providing care and support for, but knowing their workforce too. Joseph, Margaret, Joan and Edward could just as easily be employees that a social care provider doesn’t treat in a person-centred way as they could be residents or clients.
Complacency is the enemy of person-centred care. Recruiting staff with the right values and ensuring they complete e-learning modules on person-centred care isn’t enough. Authentic and embedded person-centred care is cultural, organisational, and comes from the very top and pervades down through every employee no matter what their role or responsibility.
So, my challenge to every social care provider reading this blog is:
Embed observation and responsiveness into your leadership. If you think you already have, do it again, evaluate and keep evolving the leader you are, and the expectations you have of everyone in your team. Just as no two days with my dad during his years with dementia were ever the same, so the knowledge and skills needed to be a truly person-centred social care provider never stand still either.
Until next time…