The cornerstone of being a person-centred organisation

An example of how one-page profiles have improved communication, daily interactions and strengthened relationships in this working environment. Tony Pearson describes one-page profiles as the cornerstone of being a person-centred organisation.

TonyWritten by Tony Pearson

Following a 20 year career in the public sector, in which I was a manager in both the NHS and in Local Government, I joined Real Life Options in November 2009. I am a member of the Institute of Healthcare Management (IHM) and of the Chartered Institute of Personnel and Development (CIPD).

As the Director of Human Resources and acting Director of Operations, making sure that colleagues feel valued and part of the wider organisation is an area of upmost importance. Recognising people as individuals, acknowledging their skills and strengths and supporting any areas for development are key to an engaged workforce. If our staff are happy, they will provide support to the best of their abilities. One-page profiles are a really good way to demonstrate person-centred values.

I gave my one-page profile a great deal of consideration before getting anything down on paper. At first it can feel slightly alien to be considering your strengths and the best ways in which others can support you. As a Director it has been a great opportunity to let others in on details that might seem insignificant but are actually quite important, for example my preference for face to face contact over emails or telephone conversations, and that it’s ok and actually appreciated when people remind me of deadlines. The section that addresses what people like and admire about me was gathered during an exercise in a Head Office meeting where we all worked together to develop our first one-page profiles.

My profile is displayed on the wall at all the regional offices, so that colleagues from all parts of the organisation can familiarise themselves with what I am about. I use mine to send out to people prior to a meeting, this is especially useful in situations where we may be meeting for the first time – It always gets a positive response.

Having a one-page profile has made a substantial difference in my every day interactions. It stands to reason that if you communicate what is important to you, who you are and what support you need that interaction becomes easier, and relationships are improved and strengthened. It is also good to have an opportunity to let people in to a little about your personal life. I mention my family on my one-page profile as they are very important to me.

On an organisation-wide scale as well as personally, one-page profiles have influenced the way in which people interact and communicate with each other.  It’s the cornerstone of being a person-centred organisation as you need to know these kind of details about others from the outset in order to be able to be supportive and treat people as individuals, respecting their needs and viewpoint.

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Is this care you would be happy with?

It started with a person-centred thinking course attended by Sue, the care home manager and now Sam, the people he lives with and the people who support them are on a life-changing journey. An example of how this man’s one-page profile has led to him reigniting old relationships and hobbies; making him feel like he has a purpose again. 

Sam's one-page profile

Sam’s one-page profile

Written by Gill Bailey

Sam is 78 and lives in a residential care home supporting older people on the Fylde Coast.

The manager, Sue, went on a person-centred thinking course and decided that things in the care home should and could change. She knew this required a huge shift in culture. This shift began with uniforms no-longer being worn, to create a more ‘family feel’ and a no ‘them and us’ culture. Toilets became communal – so there were no separate staff toilets, no staff mugs and sitting and eating with people who lived there became the way things were done.

Sue’s enthusiasm was contagious and the majority of the staff team are now competent in using the person-centred thinking tools. Each member of staff was taken off rota for two hours and asked to simply sit in the lounge in order to feel, hear and see the ‘lived experience’ of the people they supported. They were then asked “is this care you would be happy with?” The resounding answer was ‘no’ and so the desire for real change began in earnest.

They began to develop one-page profiles with everyone who lived in the home and staff developed their own which included their hobbies and interests . Sam who lives in the home developed his one-page profile with help from Sue.

The main thing that wasn’t working for Sam was that his friendships had all been lost after spending three months in hospital and then coming to live in the home four years earlier. Sam particularly missed his connection with the crown green bowling club he had belonged to for a number of years – he had lost all contact with his old mates.

Sam was supported to write to some of his old friends and as they responded, he gained the confidence to think about how he could reconnect with the bowling club, which wasn’t far away from the home. There was a spring in Sam’s step as he anticipated the possibilities.

The challenge now was finding the right staff member to support Sam to go and watch the bowling. Sue found that Greg, a new member of staff, looked the perfect match for Sam, as he too was a keen bowler. Sam agreed. Within a month, they went off to the bowling club together. Sam cannot bowl because of his hip injury but enjoyed catching up with his old friends, while Greg would play a few games. After a couple of months, it was as though Sam had never been away. Greg and Sam went once a fortnight.

Sam now writes the monthly newsletter for the bowling club. Prior to retiring, Sam was a keen writer and produced the church newsletter each week, so he feels that he is giving something back.

Sam’s life feels very different now and as he said recently, “I’ve got something to get up for, meeting the lads and I’m working on a newsletter”. This all began by listening well to Sam and developing his one-page profile with him. The information it captures is used by all those involved in Sam’s support to ensure that he is living life the way he chooses.

Read more about personalisation and dementia including blogs, resources and related media articles at www.personalisationanddementia.wordpress.com

At the heart of support

A powerful reminder of how what might seem like a small gesture can significantly improve a person’s happiness and wellbeing. Mary was brought to tears when her support team introduced her to the home pet, after stating how important animals were to her in her one-page profile.

Mary's one-page profile

Mary’s one-page profile

Written by Lancashire County Commercial Group Care Services

Mary is 75 years old and has dementia.  She was living in a care home and we were asked to see if Mary could move to Beaconview. When we assessed Mary she was laying on her bed with the bed rails up. Mary is registered blind and has had some paranoid experiences. The staff from the home where we saw her said that ‘she liked to spend time in her bedroom’. Mary was very quiet and appeared to be quite isolated.

During our assessment, we asked Mary what her hobbies were and what her preferences were for a variety of things. We also asked her if she really did like to spend all her time in her bedroom, her answer to this was that she liked to spend some time alone. Mary also told us that she loved animals.  From this conversation we were able to create a one-page profile for Mary before she came to Beaconview.

Once Mary’s one-page profile was completed the care staff were able to read it and had an understanding of what her needs and preferences were, whilst also having a clear understanding of what was important to her.  Mary’s experience in moving to her new home was enhanced by the fact that staff were able to have conversations that were more pleasant and personal to her as a result.  Because of this all the staff at Beaconview were able to begin to build a trusting and meaningful relationship with Mary from the very moment she moved in.

We had recently bought a bunny for Beaconview and because the care staff knew from her one-page profile that Mary liked animals they decided to take the bunny to Mary so that she could enjoy its comforts.

Mary’s face lit up when she was informed that the bunny was here to see her, we asked her to put her hands out so that she could feel it. Mary was so pleased that we had ‘thought about her’ and the things she liked that she began to cry. Mary then cuddled the bunny and kept talking to him. Mary never did spend all day in her bedroom after that as she had something to focus her attention on. She felt a great sense of wellbeing each day.

Mary kept thanking the staff for what they did and although it seemed a small gesture on their part it really made a difference to her life.  The care staff were also extremely pleased that they were able to bring her so much happiness.

Having a one-page profile makes a massive difference to a person’s wellbeing, as it helps to build and form good relationships and it makes staff realise from a snap shot what is most important to a person.

The one-page profile is easy to read and easy to understand. This skill is very useful to all other professionals also.

Before we had one-page profiles it was difficult for all the staff to understand what was important to that particular person. The profiles ensure that not only is the person supported in a way that makes sense to them but that what matters to them is also included in their support.  The important bit is to act upon the individual preferences outlined in a one-page profile; truly keeping the person at the heart of all support.

Using profiles professionally with colleagues and families

An example of how one-page profiles can assist people professionally. Chris talks about how his profile has improved communication and understanding with colleagues, managers and the families he works with.

Chris' one-page profile

Chris’ one-page profile

Written by Chris

I am a Facilitator with MacIntyre’s Family Footings programme.  I support families to learn new ways to make their voices heard and exercise greater choice and control over the care and support they receive. I use my one-page profile as a way of introducing myself to new people.

I originally created my one-page profile when I was applying for my job. I was asked to bring one along with me to interview. By writing it, I felt like I could give my interviewers an idea of who I really am – not just the qualities I have that I would normally talk about on an application form, but information about my other interests and a bit about challenges in my life too. I wrote the text for the profile myself and showed it to my wife and my parents afterwards, asking for their feedback. Since then I have made a lot of little changes to my profile to keep it relevant. For instance, I have amended the bit about my running as my weekly training mileage has increased. I added the bit about supporting individual families when brokerage started to become a bigger part of my role at work.

I use my one-page profile a lot at work. I often bring copies with me to workshops I lead for parents and professionals in order to introduce the tool to them in a way that will support them to use it reflectively before immediately applying it to children they support. I give copies of it to families that I work with on an individual basis to help them see a less formal side of me straight away. I have also written another, less personal version of my profile that I can use to introduce myself in circumstances where I need to showcase my professional skills and attributes, as I realise that my personal one-page profile isn’t appropriate for every situation.

Parents and carers with whom I share my one-page profile frequently tell me how refreshing it is to have a more holistic look at who someone coming to their house to support them actually is. It’s a good way for me to introduce the tool to them too because reading my profile often causes them to get excited about the potential benefits it could have for members of their own family. When I have had chance meetings with people who have attended my workshops in the past and have seen my one-page profile, I am often surprised when they ask about my running or songwriting. Because we have shared things with each other about what is important to us, we have a better starting place for forming relationships that are based on mutual respect and understanding.

My one-page profile has also allowed me to have better relationships with my colleagues and manager. Because we all created and shared our profiles when we started in post, we all started our work with an appreciation of each other’s strengths and information about how best to work together. For instance, my co-workers know from my one-page profile that I prefer to receive information electronically, and I know that some of them prefer to receive information on paper or in conversation. We have also taken time during team meetings to revisit the ‘Like and Admire’ sections of our profiles and add things to each other’s. This has helped build our working relationships with each other and has helped me to gain extra confidence in certain areas of my practice because of how my colleagues see me.

Revolutionising the way we teach

One-page profiles are used with every pupil in this school so that teachers can personalise the education and support that they give. Capturing the individual information about each child in this way has changed the way they teach and share information. This is Sion’s story.

Sion's one-page profile

Sion’s one-page profile

Written by Teacher, Carys Bird

Sion is 14 years old, born one of twins, he is on the autistic spectrum and has no verbal language but makes his needs known by making noises and reaching for items. Sion has severe learning disabilities, and attends a Special Needs School.

As a school we took the approach that each pupil would have a one-page profile and a person-centred review.  Sion’s profile was developed as part of that piece of work.  We wanted to take a person-centred approach to education to ensure that we supported each pupil as an individual and to make sure that others had positive and useful information about each child as they came into school as visitors or professionals.

Sion’s one-page profile was developed by classroom staff, as well as others who know him well.  It has been added to and changed over the years as Sion has grown and developed.  We use the person-centred review process annually and this gives us the opportunity to formally update Sion’s profile with his parents and other professionals who support him.

Sion’s one-page profile can be accessed quickly from a file in the classroom enabling people to identify Sion, and to be immediately aware of how best to support him, as well as giving them a positive description and information which helps them to engage with Sion.  As he enters ‘transition’ it will be used to inform the development of his Transition Plan.

Using one-page profiles throughout our school has made understanding the needs of pupils at each level much easier.  For Sion, it has taken the guesswork out of getting to know and understand him, especially for new staff coming into school, and professionals who are starting to work with him through transition, such as his careers adviser.

Other people knowing how to interact and engage with Sion has led to him feeling more comfortable with staff and has reduced his anxieties when around new people. This has resulted in him having more positive connections with others and he will now sit alongside his fellow pupils in class of his own accord.

As all staff understand the importance of consistency in supporting Sion, he is now able to have more social opportunities out and about as part of his school day.  Staff no longer have to delve into huge files to find the information, which is not clear and concise, in order to support Sion well . His one-page profile holds all the vital information and positively presents Sion, making it easier for people to support him in what he wants to do and build a relationship with him based on a deeper understanding.

To learn more about personalising education visit www.personalisingeducation.org

Chief Exec advocates one-page profiles

An example of why this Chief Executive advocates the use of one-page profiles throughout his entire staff team and the people they support. Brian Hutchinson has had personal successes with his profile too, believing that sharing it aids better understanding, first impressions and relationships. 

Brian Hutchinson's one-page profile

Brian Hutchinson’s one-page profile

Written By Brian Hutchinson, Chief Executive of Real Life Options

I’ve worked in community based learning disability services for 20 years; primarily with people who have a diagnosis of autism, or with people who have a formal or informal forensic history and I’ve been working for Real Life Options for 11 years now.

From my perspective as Chief Executive the purpose of introducing one-page profiles into the organisation was twofold. Firstly it was a way for the people we support to communicate what they are about and what is important to them. This works well between the person and support workers but also in the wider community. Secondly, and from an internal perspective, when used with staff it helps embed our person-centered ethos into the culture from the get go. It’s one of the first things that new members of staff do when they come to work for Real Life Options.

I was among the first to produce my one-page profile and it is displayed on the wall at each of our office buildings. I send it out prior to meetings with new people. We take part in a lot of cooperative work with similar organisations to share best practice, it really helps to break the ice in a situation where lots of new faces gather together to discuss issues that can be challenging.  I thought it was important to be very honest when producing my own one-page profile as personally I feel it’s worthless if it doesn’t reflect who you are as a person and how you work.

I believe that using one-page profiles throughout Real Life Options has helped people we support and members of staff to really understand the core of person-centered values. When you begin by examining yourself and your own traits, needs and values it’s then much easier to transfer this way of thinking into the work that you do. On a personal note it has helped me to avoid misunderstandings that might cause tension. For example, my profile tells people that my leg shakes during meetings when I’m interested, it has in the past been misconstrued as irritation or unease. It’s good to get these things out there and avoid any unnecessary misunderstandings.

Having a one-page profile has definitely made a difference to my initial encounters with new people. It’s a great way to begin a new relationship and reflects the honest, open and genuine way in which we operate at Real Life Options.

You know me so well!

Written by Victoria Metcalfe, Dementia Consultant, Anchor

Victoria Metcalfe

Victoria Metcalfe

I had a birthday this week. It was one with a zero in it… I sat nervously in my living room all day, responding to birthday well-wishers by text and email, dreading the possibility that one of my nearest and dearest might have had the bright idea of throwing me a surprise party. I hate surprises. I love surprising other people – but I’m awful at being taken by surprise. Thankfully, this message must have trickled through somehow and it seems I needn’t have worried; my friends know me well!

Knowing someone well is the focus of a big piece of work I’m involved in at the moment. I’m a Dementia Consultant working for Anchor and we have been looking at how one-page profiles can be used to ensure that the people that live and work in a care home can really know and understand each other well. One-page profiles do much more than this of course. They help people with common interests and outlooks be matched together, they communicate important information for people who might not be able to communicate it themselves, they empower people to direct their own support and live the life they choose, but ‘knowing someone well’ really is at the heart of the concept.

Over 25 years ago I had a chance encounter with a young man who had Alzheimer’s . He changed my outlook on life. I can clearly remember to this day my first meeting with him and how distressed he seemed about being unable to communicate with the people around him.  I remember those same people equally as clearly and how little they were attempting to engage and understand him. They saw him as a bunch of symptoms not a person and it was incredibly sad to realise.  My overriding feeling about this was one of injustice and it is the injustice of people being marginalised or defined by their illness that still motivates me today to be person-centred in everything I do; to have empathy, compassion and most importantly of all, to care about knowing people well and basing support on this in-depth knowledge of them.

I’ve never had a planned career path – it just wasn’t something that I set out for myself. But I’ve been working with people with dementia for more than 25 years now, with social services, with the Alzheimer’s Society and for the last 13 years with Anchor. I knew when I joined Anchor that I agreed with and believed in their organisational values but it is the people I work with and their relationships with the people we support and their families that has made this job so worthwhile for me.

Anchor is the largest not-for profit provider of support and housing for people over the age of 55 in England but that’s not what makes us special. We are special because we believe in seeing and treating people as individuals. We provide person-centred care and moreover we want to improve on this further, embedding person-centred thinking deep into the culture of our organisation by making tools like one-page profiles commonplace for colleagues and customers.  We believe in doing with a person not doing for them. In supporting family and friends to adapt to a person’s changing abilities and always focusing on what they can do not what they can’t do. In a world that can see older adults as broken people, our celebration of people’s individual talents and gifts and determination to support them to live the life they choice is something I’m really proud to be a part of.

My own one-page profile describes what people like and admire about me, what is important to me and how best to support me. Needless to say I have included in it that I don’t like surprises – something which my friends might know about me but might be useful for a work colleague to know too. I’ve already changed my approach to team members after reading their profiles and understanding them better. It’s strange, you can work with someone for years and think you know them so well only to learn important information that you just hadn’t uncovered before – this is the power of the one-page profile; the succinct way it communicates the essential information to enable relationships, collaborative working and support.

This week I’m attending the annual Dementia Congress. I’ve spoke most years but this time I’m going just to soak up the information, to learn about the new and innovative ways people are transforming care for people with dementia, to meet colleagues and share best practice. I’ll be shouting from the roof tops about one-page profiles and how this relatively untapped resource could revolutionise care for people with dementia. I believe that the one-page profiles that we are introducing in Anchor really will change people’s lives;  helping people with dementia live a life that makes sense to them in the way that they want and all based on a deep understanding of who someone is and what is important to them. Everyone should be able to say ‘you know me so well’ and soon they will!

Look around the rest of this site using the menu bar at the top of this page to learn more about one-page profiles, how to create your own and to read stories from people using them from birth to end of life.

Getting others to sit up and listen

A great example of how this woman’s one-page profile has made people sit up and listen when she says what she needs.  Doreen experiences dementia and often felt threatened and confused by her interactions with support staff. They now understand her well and know how to support her in a way that makes sense to her.

Written by Gill Bailey

Doreen PicIf you do not know that you have dementia, and once the disease advances you may not be aware, what would it feel like to be approached by someone offering support? Imagine you are sitting in an armchair and a person you don’t know or recognise comes up to you and tries to stand you up to walk you to the dinner table to eat. I can only imagine how it must feel to someone with Dementia but understanding this is the first step to approaching support differently.

Doreen doesn’t know that she has dementia.  She is 79 years old and lives in a residential service supporting 44 people who also live with dementia. She is described as someone who ‘restores your faith in human nature’’.  Doreen is a gentle lady who was always at the heart of her church community until her dementia progressed.

Over the last eighteen months we have been introducing one-page profiles to people living and working with dementia. The team worked with Doreen and her husband Clifford to develop a one-page profile. They learned to pay attention when Doreen told them she was becoming frustrated and wanted her own space. From the details written on her profile they understood that this meant that she needed to be supported to find a quiet corner or to go to her room. Understanding what ‘best support’ looks like from Doreen’s perspective has made a huge difference to her happiness and wellbeing .

Obviously there was information held in Doreen’s care plan but you get a very different understanding of who Doreen is from her one-page profile. The organisation has put a lot of effort into their care plans and they do contain some good person-centred information but crucial information about Doreen was  scattered across 60 pages of mainly clinical notes and assessments plus a page of  ‘likes and dislikes’.

From Doreen’s one page profile we learn that she enjoys talking to Winifred and Kathleen and that she gets upset if she is ignored; knowing this helps staff to encourage and support these relationships.  We learn that Doreen likes to get up in her own time, between 8am and 10am in the morning. She used to be rushed in the mornings but now that this information has been shared she is left to rise at her leisure.  As well as a personal change for Doreen, this is a shift in culture from a once largely task focused organisational culture to one that is based on relationships and deep understandings of individuals. This is one of the great advances that has come out of introducing one –page profiles where Doreen lives.

Doreen now has greater choice and control in her day-to-day life. The staff that support her know how to do it well and anyone new to Doreen can quickly learn the important information about her from one single sheet of paper. For Doreen it means she isn’t as confused or frightened about where she is and what is happening to her – instead she dictates her own routine and stays connected to her life before dementia by doing the things that she always has, like baking, reading the newspaper and seeing her grandchildren.

Doreen’s story features in a newly published book by Helen Sanderson and Gill Bailey called Personalisation and Dementia available to order from HSAPress.