Understanding what is important to someone so you can support them well

An example of how this gentleman has developed new relationships with the people he lives with by sharing detailed information about himself on his one-page profile. As well as directing his own support and having a greater sense of choice and control in his life, Thomas has found things in common with the people he lives with that they can now talk about together.

Thomas' one-page profile

Thomas’ one-page profile

Peter  is 89 years old. He likes to be called by his middle name; Thomas. He did live in Rushall which is just outside Walsall but came to live here in 2011.  Thomas likes to be organised.  He likes his routine and in his own words is ‘very regimented’ in his ways – his main support needs are around mobility as he has to walk with two sticks.

We wanted to create a one-page profile with Thomas to help us understand him better as a person and not just someone who lives here. We wanted to find out about his individual wants and needs and not just what he does because it is the routine of the staff or the home.

Thomas has become less independent since moving here and because he was now more reliant on support staff it became crucial that we knew just how to support him in the right way. Thomas’s one-page profile would help us to achieve this.

Care Assistant Margaret and Thomas met in his bedroom. Margaret explained to Thomas what a one-page profile was and what it would do for him.

Thomas showed a great deal of interest in being involved and looked forward to having his photograph taken to use in display. Margaret initially spent about an hour with Thomas asking him questions about his background.

Thomas’s one-page profile is kept in his plan of care. It’s available for all staff to read. Thomas also keeps a copy for himself so he can read it and show it to his carers and visitors when they meet him. It has enabled staff to provide the appropriate level of support without altering Thomas’s regimented daily routine. Margaret regularly discusses the one-page profile with Thomas to see if it needs updating with new information

Since the completion of his profile, Thomas feels that he has more control in his life. He feels his needs are being met at a more personal level by staff. Prior to using his profile Thomas said that he was feeling that life was institutionalised but now he feels that his views about his level of care are acknowledged and listened to.

Thomas has always had good relationships with both staff and the other people he lives with but the one-page profile has highlighted new areas of his life that he has in common with people. He was in the Forces for years and he now sits at the table with another gentleman who also served, swapping stories and memories. These are new relationships developed because they know more about each other through their one-page profiles.

We no-longer fear change

A practical example of how teams and organisations can use one-page profiles to build cohesiveness, person-centred attitudes and a positive attitude towards change when going through periods of transformation.

Written by Tracey Chappell Merry Hill House

Tracey Chappell from Merry Hill House one-page profile

Tracey Chappell from Merry Hill House one-page profile

I work at Merry Hill House; a Local Authority care home for older people that is currently going through a period of transformation.  The Local Authority is introducing a rolling respite service and has put a hold on accepting new people to move in permanently.

This is a change for the people living at Merry Hill House, their families and the staff. It was decided that there needed to be support tools in place to assist people with this change. One-page profiles were introduced. The aim was to support staff through this transformation by empowering them as a team and developing their individual skills and confidence to help people living there to adapt too. The profiles would also help staff better understand the people they support and help managers with the recruitment of new staff that fit well with the overall team and our ethos.

We started with staff meetings and support from consultants Helen Sanderson Associates. We looked through our existing practices to identify what was working and what was not working.  We then developed a strategy to achieve change on a single sheet of paper – this is called a one-page strategy and it really helped us to focus on our goals and how we could achieve them.

The next phase was to identify one-page profile champions who could lead each staff team to develop their own profiles.  Once the staff had completed their profiles managers used the information they provided to fit them into positive and productive teams based by matching characteristics, personalities and interests.

Once all team members knew how to create one-page profiles and how to use them for best results, we were in a position to help the people that live at Merry Hill House create their own. This then enabled support staff to be matched to individuals based on commonalities.

We have since evolved further and actually create one-page profiles with people staying with us on a short or temporary basis so that we can provide them with the best possible care whilst they are with us. It also means we have excellent information to pass on to their future care provider or at-home assistance once they are discharged.

Since using one-page profiles staff have an appreciation and clearer understanding of how the people they support want to be supported and why our traditional roles and the culture of caring for needs had to change and develop. Together we have learnt that people don’t always want to be cared for but instead want to be involved and listened to when planning their support. There is now a strong feeling shared amongst staff of wanting to drive change forward because we are seeing the benefits for ourselves.

This is a big difference from the fear of change (and holding on to the security of how things were) that used to exist within the teams. Staff are sharing experiences and learning how to have different types of conversations with the people we support by focussing on what is important to that individual rather than focusing on tasks which need to be performed.

We have learned through conversation with the people that live at Merry Hill House, to consider how our attitudes and personalities are perceived by the people we support and what kind of impact this can have on their stay with us.

Staff have all taken the opportunity to reflect on their personal qualities and not just the skills they have and the work they do which has really helped us work more collaboratively and appreciate what each and every person brings to the team.

Overall our teams are working together better and the people we support have more choice and control in their lives. It feels like we have come really far and we are excited and enthusiastic about what lies ahead.


Living with dementia – Shirley loves to feel the rain on her face

A powerful example of how a one-page profile can empower people living with dementia to direct their own support. Shirley is now supported in a way that makes sense to her thanks to the deeper understanding people have about what is important to and for her.

Shirley's one-page profile

Shirley’s one-page profile

Written by Narindra Devi and Gill Bailey

Shirley is 78 years old and a retired accountant living in Wolverhampton.  For the last five years Shirley has lived in a residential service supporting people living with dementia. Described as a strong character who is always kind and considerate, Shirley is very active and can rarely be found sitting down but prefers to be on the go, walking around and chatting to others.

As someone who has worked with numbers her whole life it isn’t surprising that Shirley still talks about and quotes numbers to people regularly. This is something that the staff who know Shirley well understand and are able to respond to. In the same way, the support staff who know Shirley well realise how important it is to enable her to freely move around and how she doesn’t like to sit still. Recently it became apparent that some staff didn’t know these important details about Shirley. She was being asked to sit down more which was causing her to be distressed and she was also getting upset when her support team didn’t converse with her about numbers and statistics; something that she loved to do.

Meeting together, the staff team realised that only a few of them knew what worked for Shirley and that they needed to find a way of sharing this information more widely so that everyone could support Shirley well. To do this they used a one-page profile. Together the team talked about all the things that were important to Shirley and what best support looked like. They shared what they like and admire about Shirley and these appreciations were all captured on her one-page profile.

The profile communicates vital information about how to support Shirley well. All staff must be aware never to try and make Shirley sit down as this would lead to her becoming very distressed and could lead to her harming herself or others. They also learnt that when giving Shirley medication they should wait for her to pass and never chase after her as this would create great distress and anxiety for Shirley. Another rich insight that is shared on Shirley’s profile is her dislike of people touching or talking about her feet. Making staff aware of this means they can avoid upsetting Shirley unintentionally.

Shirley now has more control over how she lives because the people who support her understand what is important to her. She now goes for walks outdoors as much as possible. Previously staff would have shied away from supporting her outside if it was raining but they now understand how important this time is for her and acknowledge that going out for a short time in a little rain won’t cause Shirley any harm and actually she appears to love to feel the rain on her face if her huge smile is anything to go by!!

Even new staff can get to know Shirley well and quickly by looking at her one-page profile.

Shirley is much more relaxed and content since developing her one-page profile. It is my belief that if we are to truly personalise support for people living with dementia, we have to support a way of living which makes sense to the person as well as ensuring they stay healthy, safe and well. This has been achieved for Shirley.

For more details on Gill Bailey and Helen Sanderson’s book; Personalisation and Dementia please visit Jessica Kingsley Publishers.