Peter Kinsey, Chief Executive at provider of care and support, Iris Care Group, shares his thoughts on the importance of meaningful engagement for people with learning disabilities.
I have worked with people with learning disabilities for nearly 40 years. A passion throughout that time has been promoting engagement in meaningful activity. I’ve visited thousands of services for people with learning disabilities over the years, including as a consultant as well as a senior manager. My rather depressing conclusion is that engagement in meaningful activity is still pretty poor in many places.
We made a huge step forward in the 1980s and 1990s when we closed the long-stay hospitals and I remember the passion we had to really change people’s lives. Sadly, I’m not sure that much has changed since then. Supported living was supposed to be the big game changer. Some people still hold on to this view almost as though it’s a religious truth. Yes, there are some very good supported living services out there, but there is also a lot of poor quality with people being supported who are living fairly barren lives. The idea that giving someone a tenancy agreement will automatically transform a person’s life is frankly naive.
I think part of the problem is that commissioners who set service specifications almost never visit services and a lot of them have no experience of actually working in or running services. The problem is compounded by a regulatory system which seems to be more interested in infection control and whether staff training is compliant than on what sort of life people being supported are having. I spoke to a number of fellow CEOs a few weeks ago and we all agreed that neither commissioning nor regulation drive improvement in the lives of people we support; that comes down to leadership and culture in individual organisations.
At Iris Care Group, we are doing a lot of work to implement “active support”. Many of you will be familiar with the term which has been around for nearly 30 years. I first learned about “active support” from the inspirational Professor Jim Mansell who we sadly lost at a young age. It was quite fashionable back in the 1990s but I don’t hear people talking about it so much now. I still think it should be central to service provision.
The key concept behind “active support” is that people can and should be involved in everyday activity, irrespective of their level of disability. Rather than having activities that are meaningless and designed simply to pass the time (the one that really annoys me is going for drives !), “active support” encourages staff to see opportunities to involve people in functional activities of daily living, like cooking, shopping, cleaning, gardening and hanging out the washing.
There are 4 key principles behind “active support”:
- Every Moment Has Potential
- Little and Often (it’s OK for people with a short attention span to dip in and out of activities while the staff member continues)
- Graded Assistance (providing just enough support to enable the person to participate, which could include verbal or physical prompting)
- Maximising Choice and Control
We have adopted a cascading training model which was developed by the Tizard Centre at the University of Kent. The senior operational team were trained in “active support” and observed working with a person to make sure that they could demonstrate it in practice. They then train and observe front-line staff. This approach is working well and we are very fortunate in Iris Care Group to have senior operational managers who are also very good practice leaders. I don’t think we talk enough about the importance of practice leadership which I think is essential in the provision of high quality person-centred support.
I visit services every week and am always delighted when I either see “active support” happening or am shown photos of people we support engaging in meaningful activity.
@ iriscaregroup
iriscaregroup.co.uk
