This resource is firmly based in care practice and uses a person-centred practice development approach. It is relevant to all health and social care professionals across a multitude of settings. By paying attention to developing person-centred cultures in care settings (hospital and community based) and care homes, the conditions to ‘grow’ person-centredness for patients, service users and residents can be created. These conditions of course need a learning culture within the workplace and the organisation or care home to thrive. A learning culture helps care teams to be reflective about their work, to learn in and from work and to evaluate their effectiveness. This culture also supports teams, their leaders and managers in developing helping or facilitation skills across the team. Look at these examples from East Sussex Healthcare NHS Trust on the south coast of England.
Inspired by a practice development session at their hospital, Lizzie and Katherine asked their local practice development lead for support with finding out what patients really thought of their care and of their experiences. Lizzie and Katherine started with just an idea about what they would like to do although they didn't know how to collect their evidence. After a few informal discussion sessions they had a plan for what they would do (patient stories), why and how. They commented that the barriers they thought would deter them no longer seemed such a problem.
A therapist working in a rehabilitation unit, and developing her facilitation skills, learned how to do this by committing to clinical supervision and becoming a supervisor for other practitioners. Within a year she was leading action learning sets in the unit and could identify how she was using her facilitation skills in many other aspects of her role.
Also, see what team members say who have experienced developing their practice in a care home in the way we are offering you in this resource (adapted from McCormack et al., 2010).
Mary identified the lack of Catering involvement with the people who live in their homes other than through the provision of food. For example, many in the catering department could not identify people who live in the home by their face. This brought about the ‘Face to the Plate’ development where a photo of each person who lives in the home was placed on their menu sheet.
Mary describes the processes she used: I spoke to staff about this and I asked them to introduce the catering staff to people who live in the homes so that residents could tell the catering staff a little about themselves. I further developed this new relationship by talking with the catering manager. We explored other ways to involve the catering team with people who live in the home's care. Now they take part in social activities such as outings and sitting down with a cup of tea in the dining room at breakfast time to talk with people who live in the homes. They will also be involved in helping the selection of daily menu choices within the coming weeks, and some are now part of our person-centred working group. (Registered Nurse)
We have been overly obsessed by tasks in my team. I am developing a greater awareness of how this gets in the way of being person-centred. However, it is only when we all have a similar awareness that we become truly person-centred in the way we work. How I achieve this whilst working in a busy community team is my challenge! (Therapy assistant)
Team members started the day by reviewing how they would schedule the different activities that needed to be done with patients and identified who needed to be involved. The plan included those activities (such as showering) that could be undertaken in the afternoon as a more ‘relaxing activity’ as opposed to a ‘morning task’ … it was good to see team members check with each other what help they needed with their work.
Welcome to this Practice Development Workbook for Nursing, Health and Social Care Teams. Developed by a team with expertise in practice development, from the England Centre for Practice Development at the Canterbury Christchurch University and the University of Ulster, these resources can help you and your colleagues to improve the care you offer patients/clients and other service users (or residents) and families in your service(s). We believe these resources will be particularly useful to experienced and new or novice practice developers because of the way we have designed them to be used and the options and guidance we offer throughout. Whilst the focus of this resource is to enable the provision of enhanced or better care for patients and residents, its use could help you and others have a much wider impact in your service/care home or across your organisation. This could include you feeling more knowledgeable and confident, the development of more person-centred relationships with patients/residents and families, more power sharing and joint decision-making between service or care home managers and team members and developing a culture that enables everyone there to feel valued, respected and helped to achieve their full potential.
Although we refer to this as a ‘resource’ it can also form a workbook for individuals or small groups of practitioners to work through in their workplaces or as part of a programme or academic module. Many of the resources, learning activities and tools in this resource have been developed, tested, revised and collected, over several years, by the authors in collaboration with other practitioners with whom they have worked in a variety of settings, including hospital, community, residential and nursing care homes. In a few cases there are resources developed by other practice developers and practitioners in associated fields (such as education and research). As far as possible, original sources are acknowledged and references provided.
You will note that a few of the resources offered are specific to engaging patients and residents with dementia in practice development. They are here for two reasons. The first relates to evidence that the number of older people being cared for in health and social care settings is growing significantly. Whatever setting or profession you are in, you are increasingly likely to be working with patients/residents with dementia at some point. The second reason concerns the assumption that patients/residents with dementia or severe cognitive impairment cannot meaningfully engage in practice development (or research or evaluation for that matter) nor can they give consent. So they tend to be excluded. However, over the last few years, great strides have been made in developing approaches to include patients/residents with dementia and severe cognitive impairment in practice...