Implementing Person-Centred Planning in Intellectual Disability Services

1. 1 Implementing Person-Centred Planning in Intellectual Disability Services Rory Douglas R.M.H.N./R.P.N Woodbridge Services Galway

2. 2 Person Centred Planning What is Person-Centred Planning? Process of implementation in a Service. What can Nurses contribute to Person-Centred Planning?

3. 3 1. What is Person-Centred Planning? The particular Person-Centred Planning illustrated is that of Personal Outcome Measures. Originated in the U.S.A and designed by the Council on Quality and Leadership who work with service providers to enhance and support their efforts towards quality improvement. Allows for the identification of each persons priorities leading to an increase in the quality of life through focusing on those priorities. Enables the Service to be built around the individual rather than the person having to fit into an existing Service. Complies with National and International requirements and current best practise. Fits neatly into National Disability Database requirements and accountability of funding bodies.

4. 4 25 Goals in Personal Outcomes in 7 main areas of life Identity: Autonomy Affiliation Attainment Safeguards Rights Health and Wellness

5. 5 Identity People choose where they work People have intimate relationships People are satisfied with services People are satisfied with their personal life situations People choose personal goals People choose where and with whom they live

6. 6 Autonomy People choose their daily routine People have time, space and opportunity for privacy People decide when to share personal information People use their environments

7. 7 Affiliation People live in integrated environments People participate in the life of the community People interact with other members of the community People perform valued social roles People have friends People are respected

8. 8 Attainment People choose services People realise personal goals

9. 9 Safeguards People are connected to natural support networks People are safe

10. 10 Rights People exercise rights People are treated fairly

11. 11 Health and Wellness People have the best possible health People are free from abuse and neglect People have continuity and security

12. 12 Person-Centred Planning A Key worker is organized for each Service User Through interviews with individuals and those closest to them, it is determined what personal outcomes exist for an individual and what areas there are gaps in. 5 priority goals are chosen along with how to achieve them. An individual plan is developed and co-coordinated by the Key worker. As outcomes are achieved more are chosen. A barrier sheet is filled out if it is not possible to achieve a particular goal. The sheet is entered in the Personal Outcomes Database and the information is used to inform the organisation’s future planning. This information will assist in advocating to put in place the supports required to develop a person-centred service that adequately meets the needs of individuals

13. 13 2. Process of Implementation in a Service Senior Management undergo a 4 day training in Personal Outcomes The Organisation needs to adopt a Person-Centred philosophy Personal Outcomes Facilitators need to be employed 4 day Personal Outcomes training for all Team Leaders and “leaders” in teams 2 day training for frontline staff Identification of a Key worker for each Service User who ensures that a named person receiving services receives a high quality, personalised service according to his/her needs and wishes. The Key worker is supported by the line manager in carrying out the role. Personal Outcome interview to be held around each Service User I.P.P meeting to be held and a personal plan to be written up to include the 5 priority areas and agreed review dates and named individuals to help achieve the goals A successful Person-Centred Plan requires, that all people associated with an individual Service User, play their part in helping to achieve the goals. Key workers need to be freed up and supported, in order to achieve, in a significant way, the goals outlined in the I.P.P.

14. 14 3. What can Nurses contribute to Person-Centred Planning The Commission on Nursing refers to the need for the R.M.H.N to be at the centre of service provision and respond to the changing needs of the population to ensure a quality and responsive service. The Report of the Special Working Group on the R.M.H.N noted that the R.M.H.N specifically adopts an holistic approach in the care and training of people with special needs. The National Health Strategy states that “Improving quality in the health system requires implementation of internationally recognised evidence based guidelines and protocols and on-going education and commitment by health care institutions and professionals” and emphasised the need for the development of a “people centred health system that identifies and responds to the needs of individuals”

15. 15 What can Nurses contribute to Person-Centred Planning A Nurse because of his/her training and experience is very well placed to play a pivotal role in leading and driving the process. The various skills required by a Key worker are skills that are used by the Nurse in their daily work. The educational element in being a Nurse enables the Nurse to mentor other staff in some of the skills required for the process. Skills such as consistency, talking with families, progress reports, calling meetings, checking with people, taking the initiative etc. In Intellectual Disability Services the Person-Centred Planning approach is a natural follow on from the Nursing Process and the various models of Nursing. The Nurse because of his/her training can slide effortlessly into the new process and can provide quality leadership and proactivity which is of immense benefit to the Service User and to other staff who may not have the core skills required. “Cream will rise to the top”