1

Person-Centred Planning

Processes in Action:A Description and Analysis of

processes used to implement person centred planning in a residential centre

2

Research Questions

• What are the implementation processes of St. Vincent’s Approach to Care?

• What appear to be the strongest and weakest aspects of these processes?

• What, if any, are the barriers to successful implementation of the processes?

3

RESEARCH DESIGN

Review of the literature on PCP Q uestionnaire Instrum ent Holburn et al (2000)

Instrum ent required adaptation

Focus Group Interview N=10

Analysis of data- Form ulisation of 1st draft of IPPCPS

1st Draft of IPPCPS distributed - Pilot Study- N=21

Further Adaptation of Q uestionnaire Instrum ent

Final Draft of IPPCPS Instrum ent distributed -M ain Study- N=147

N=103 com pleted IPPCPS inputted into SPSS Statistical Package-Process Analysis of Data

4

IPPCPS Instrument• Section A:Organisational Framework.

• Section B: Personal Planning.

• Section C:Collaboration.

• Section D:Spirituality.

• Section E: Demographic data of respondents

5

Presentation of Significant Findings

Carestaff 18 P.E. Teacher 1

Speech Therapist 1 CNM2 8

Named Nurse Unit Based 53 Psychologist 2

Occupational Therapist 5 Social Worker 1

Named Nurse Day Service 9 CNM3 3

Psychiatrist 1 Manager 1

Total 103

No of respondents and relationship with service user

6

Section A: Organisational Framework

•The study found that a number of core systematic processes were employed across nearly the entire organisation, which could be conducive to person-centred planning.

7

A Lack of systematic processes were found:

• An advocate is the least proposed person to be at IPP meetings.

• Extra funding is seldom made available enabling the service user achieve his/her outcomes.

• Most nurses have had training in person-centred planning whereas only a few multidisciplinary team members and care staff attended training sessions.

• Responses varied in agreement relating to the presence of a skilled facilitator guiding the group in creating a common vision for the service user.

8

Section B:Personal Planning (Significant Findings)

• Staff place more emphasis on identifying priorities and setting goals than identifying preferences and perspectives of the service user.

• Priorities are set and goals are achieved to the relative neglect of taking the service users preferences and perspectives into account. – Interestingly

• Staff who had attended training sessions in spiritual awareness/ reflective learning tended to place more emphasis on identifying preferences and perspectives of the service user.

9

identifying outcomes(2)

0

5

10

15

20

25

30

35

alw

ays

usua

lly

50%

of t

ime

seld

om

neve

r

mis

sing

%of

res

pond

ents

N=1

03

Personal outcomes aredefined by the person

evidence is availabledetermining how theperson defined his/heroutcomes

10

Cross Tabulation:Identifying Outcomes

• Highest numbers of nurses report that evidence is available determining how the person has defined his/her outcomes

• In contrast:

• Highest numbers of the multidisciplinary team members report evidence is rarely available.

11

Processes supporting the achievement of personal outcomes

0

10

20

30

40

50

60

% o

f res

pond

ents

N=1

03

The service specif ically applies itspolicies and procedures to enablethis person to achieve his/heroutcomes

The person and/or those w ho knowhim/her best make decisions aboutboth major and minor uses ofresources

The person and/or those w ho knowhim /her best about major & minoruses of funding

A copy of the minutes of Individualprogramme meetings are sent tofamily

contributions of supportingmembers concentrate on w hat'simportant for the person from theperson's perspective

12

Collaborationinformation sharing across disciplines

020406080

100el

ectr

onic

mea

ns

pers

onal

file

care

plan

% o

f res

pond

ents

TRUE

uncertain

not true

missing

13

Variations in Responses:• More clinical nurse managers and named nurses

unit based have more beliefs regarding a service users preferences and perspectives of quality of life issues than multidisciplinary team members, named nurses day service and care staff

• More nurses and care staff report that evidence is available determining how the person has identified his/her outcomes than multidisciplinary team members and managers who report that evidence is rarely available determining how the person identified his/her outcomes.

• Disparities are present relating to whether or not personal outcomes are defined by the person irrespective of his/her level of disability.

14

Highest no’s “Don’t know” Highest no’s • N=28 (27.2%) “don't know” how many personal

friends the service user has.• N=58 (56%) “don't know” if the service user has

a meaningful regularly recurring relationship with another person with L.D. living outside the centre.

• N=46 (45%) “don't know” if the service user has a meaningful regularly recurring relationship with somebody from the community other than family.

• N=29 (28.2%) of staff “don't know” if the service user has access to pets.

• N=42 (40.8%) of staff report that the service user would “properly not” be allowed have an intimate relationship.

15

Recommendations

16

Education

17

Advocacy

18

Get Big Ears and Listen until we HEAR

19

20

Personal Vision -Competent Facilitation

21

Common vision

22

Family Involvement

23

It’s My Money!!!!

24

UNDERSTANDING HOW A PERSON WANTS TO LIVE

COMPARE WITH HOW THEY LIVE NOW

ADDRESS ISSUES OF HEALTH/SAFETY IN THE CONTEXT OF HOW THE

PERSON WANTS TO LIVE

A LIFE THAT MAKES SENSE TO THE

INDIVIDUAL (O’Brien, 2000)

25

Accountability

26

Spirituality -Friendships

27

Terminology- “Nurse”

28

Where Do We Go From Here????

29

30

31