This is an example of using the 4 Plus 1 Questions Tool in my own goal to stop smoking:
- What have you tried? Cutting down on the number of cigarettes I smoke and replacing some cigarettes with an NRT inhalator
- What have you learned? I do not need to smoke as many cigarettes as I do and nothing bad happens when I don’t smoke for a prolonged period of time.
- What are you pleased about? That I am beginning to genuinely believe that I can actually stop smoking
- What are you concerned about? That I continue to smoke some cigarettes even though I know that they are not useful or good for me.
What next? Continue to try and reduce the number of cigarettes I smoke with the aim of going a whole day without a cigarette next month.
From this exercise I have learned that my process of cutting down the number of cigarettes I smoke is working and giving me more self-confident that I could stop smoking completely, however it has not worked in allowing me to stop smoking yet.
Regarding the client that is indecisive, I have found that it is better to have regular conversations with them about what they want and need and to only pursue the items which they regularly and consistently are happy about over a longer period of time (weeks/months). For the lethargic client, I was able to motivate them by having regular informal conversations with them until I had an idea about what was important to them and some of the things they might like to do. I then outlined how they could achieve this by using a person-centred approach and they were more interested in becoming involved.
In my own work, a challenge that is often faced when implementing a person-centred approach is that a particular client regularly changes their mind and an idea that they love one day, they might hate the next. Another challenge that I have faced is a lethargic client that had absolutely no interest in personalising the support he receives.
My own role in person-centred thinking, planning and reviews when supporting individuals is to communicate with and observe individuals to discover their needs and what is important to them. I may then offer suggestions as to how they might want to pursue their interests or ambitions and help them to devise a plan of action to achieve them.
As I am the Key Worker for a particular individual, I will take responsibility for ensuring that their needs and interests are met and have tri-annual reviews with them to discuss their achievements, what is working and not working and if there is anything they would like to change or anything new that they would like to pursue. I also make myself available for an hour each week for them to discuss anything that is on their mind.
Person-centred thinking can be used with teams to create a shared purpose. Because the team knows what is important to its members, roles and tasks can be allocated according to a person’s strengths and interests.
Person-centred thinking can be used with individuals to allow the to have choice and control over the support that they receive and have their dreams, desires, needs and personal preferences catered for.
Person-centred planning is an approach and set of tools to gather information about what an individual requires in terms of support. Personalisation is using this information along with a personal budget to put the in place the support that an individual needs, giving them choice and control over the outcome.
Current legislation, policy and guidance underpinning person-centred thinking and planning includes:
- The governmental policy ‘Putting People First’ aims to transform social care so that it is person-centred
- The Department of Health’s white paper ‘Valuing People’ (later updated to ‘Valuing People Now’) outlines the government strategy for ensuring a person-centred approach for people with learning disabilities
- The government white paper ‘Personalisation Through Person-Centred Planning’ seeks to share learning about how person-centred thinking and planning can help the delivery of ‘Putting People First’ and Valuing People Now’
- The Disability Discrimination Act makes it unlawful for anyone to be discriminated against because they have a disability
The person-centred review process usually comprises of the following steps:
- What people like/admire about the individual
- What is important to them now and in the future
- What support they require
- What is working and not working for the individual, their family and others
- Questions to answer
- Action plan
As described earlier, a one-page profile is a brief introduction to a person, capturing key information on a single sheet of paper including appreciations about the individual, what is important to them and what support they require. They often also have a photograph of the individual. An example template has been provided below: