Truly person-centred support work

Often we find ‘funding’ is the reason support workers will use to explain why they can’t support someone in the way they want. Whenever we hear that we are skeptical. With a positive mindset it is still possible to support people with learning disabilities to live great lives, and it needn’t cost a single penny.

The one small change support workers can do to make a huge difference

Moving to a cashless society

I was talking to a colleague from another organisation the other day who commented on a problem they’re facing in London: nowhere takes cash.

It wasn’t long ago when I’d feel shame at buying a packet of crisps on my card, or you’d see a ‘minimum £5 card spend’ sign on the till. Not now; everywhere wants you to tap your card. Spending money is so much easier unless you have to use cash.

She told me that support staff say they won’t ‘allow’ people to have a plastic card—why they insist on this is vague, though.

A plastic card doesn’t mean having a credit or debit card; it can be a virtual wallet where small daily amounts aid budgeting. Having £30 on your Monzo card is less risky than having £30 cash in your wallet.

Plus, your Monzo card will store all your transactions, so there’s no need to ask busy bar staff to write receipts. (Other virtual wallets are available!). Instead of all that faff it’s all there in the app for you.

Is there an excellent safeguarding reason for not ‘allowing’ people some agency over how and where they spend their money or is something else going on?

Support providers need to work around it or campaign for change if there is.

So in my mind, a virtual wallet is not only more convenient and more accessible, but it’s also safer and has a lot less hassle. If you lose your virtual wallet, you can block the card. If you lose a £20 note, that’s generally that!

There’s nothing person-centred about blanket rules for people with learning disabilities

My colleague Florence was recently at a conference and got talking to a couple of managers who were talking about a woman they supported, Jo [name changed],  who has some one-to-one support and loves staying up late at home. They then talked about how one of them was a ‘night owl’ themselves and then dropped into conversation: “Do you know what? Maybe Jo’s a ‘night owl’ too!”

Florence then asked them a few questions to explore this:

“Could you change Jo’s schedule so she can stay up later?”

“No, because of her medication.”

“So could that be shifted back to 11 pm from 9 pm if you spoke to her GP?”

“No, our staff can’t give drugs to people at different times.”

“Why not?”

“No, you’re right, we should change that!”

The manager hadn’t seen the issue from Jo’s perspective and asked themselves and their team, “So here’s the problem, and it’s stopping Jo from living the life she wants. So what are we going to do about it?”

But we also discovered that her staff team were already struggling because Jo didn’t want to go to bed when they wanted her to. Why should she?

She’s an adult living in her own home, and the rules developed by the staff to make their day run smoothly were having the opposite effect on Jo and them!

So, for example, imagine what might be achieved at their next team meeting if they planned how to better support Jo around her evenings, and how they could make them so much more fun. Instead of talking about the problem they will actually be finding a solution. But more than that Jo will be having a great time.

The secret to being person-centred

So, what are the two things that link these two stories together? The support providers who won’t ‘allow’ people with learning disabilities to have virtual wallets and those who insist everyone’s medication has to be taken at 9 pm regardless?

Neither are questioning the rigid systems we put in place that don’t take account of our changing world and that we’re all evolving in it, too. And that includes people with learning disabilities. Instead of challenging the status quo to find a better way of doing things they’re reinforcing ways of working that quite simply aren’t working.

A person-centred approach is all about getting alongside someone, finding out what makes someone with learning disabilities tick and then making those small changes that make a massive difference to someone.

So it’s all about seeing someone as a fellow human, putting yourself in their shoes and having the mindset I’ve seen in many brilliant support workers and managers where the focus is on finding solutions. And often, those solutions don’t just cost nothing; they can transform someone’s life.

What we find so frustrating is those managers who immediately get defensive and tell us they can’t afford to support people to stay out late. In practice, it might mean moving a few hours around each month. Is it about the money, or do they want to avoid the inconvenience of bringing more flexibility to their work?

They’ll find that it costs almost nothing, makes a massive difference to the people they support, and brings much more joy to their work.

The one small change needed to change everything for people with learning disabilities

That’s the one small change needed: an open mind and a desire to support someone to live the life they want: being flexible, creative and focused on them. Ultimately all support work should be about that.

But we need to all stop taking things so personally. We’re not saying staff are being deliberately self-centred in their inflexibility; that’s what poor cultures do to you, though.

Being person-centred is about being open to challenges and being part of making great things happen, instead of putting up barriers. It’s not possible to be person-centred and self-centred. It’s one or the other so the choice is ours to make.

Whenever something isn’t working for the people we support we need to investigate why and change it if we can.

Changing our mindsets

Here’s a great video from Open Future Learning that shows how a change in approach by a support worker makes all the difference and costs nothing.

And while we’re on the topic of medication and needing to take them at 9 pm.

How big are the bloody tablets you can’t put in your pocket?

What are your stories?

Have you got stories you’d like to share about the small changes that can make a big difference to someone?

Or maybe you want to tell us we’re being too simplistic about all this.

Wherever you stand we’d love to hear your thoughts. Please post them in the comments below.

Read about Learning Disability England’s ‘Good Lives’ project to find out more about what is important to people with learning disabilities.