Being Person-Centred – A Guide for Supervision and Appraisals in Adult Health and Social Care. [TEXT ONLY VERSION April 2019] Disability Sheffield co-produced this guide on behalf of The Individual Employers and Personal Assistants Development Group [IEDG]. 1.0 Summary This How to Guide has been co-produced with colleagues involved in health and social care in Sheffield. It explores what being person- centred means as well as what can make supervision effective. The guide contains five work charts to support Managers to develop person- centred thinking and approaches with Employees through supervision. The work charts focus on: 1. Setting the right tone for supervision; 2. Developing an understanding of person-centred skills and approaches; 3. Exploring, reflecting on and developing person-centred practice 4. Supervision guidance for individual Employers; 5. A planning tool that draws on the six major themes of person-centred approaches from the TLAP ‘I statements’.[See Appendix 1] The guide is aimed at Managers who provide supervision to Employees working in a range of health and social care settings, such as the local authority, the NHS, community settings as well as individual Employees. 2.0 Contents Foreword 3.0 Background 4.0 Supervision - Setting the right tone 5.0 Work chart 1 - Setting the right tone for supervision 6.0 Work chart 2 - Supervision for individual Employers 7.0 Being Person-Centred – focusing on people 8.0 Work chart 3 - Being person-centred, skills, approaches and considerations 9.0 Work chart 4 - Explore, reflect and develop 10.0 Appraisals – looking back, thinking forwards. 11.0 Work chart 5 - Being Person-centred a one page planning tool 12.0 Resources 13.0 Appendix 1 14.0 About us 15.0 Acknowledgements 16.0 Contact 17.0 Examples of lived experience 18.0 3.0 Foreword People who need care and support need staff who understand them and treat them as equal citizens working with them and for them. For this reason, Employers in the health and social care world, supported by initiatives from Skills for Care, are increasingly looking to recruit staff on the basis of their values, behaviours and attitudes. For this to work, it is equally important that Employers themselves share those values, behaviours and attitudes in supporting and supervising their staff. Taking a ‘person-centred’ approach to people who need care and support is well established and ensures that the views of the ‘cared for’ person are centre stage and that person has input and choice in what happens to them. As this guide demonstrates, that approach can also be taken in the relationship between Employers and their staff. Adopting the approach of listening to staff and what they have to say, acting on their suggestions, taking account of their personal circumstances, and responding to their aspirations will result not only in happier staff but also better motivated staff who can work more effectively with those needing care and support. Employers of whatever size will benefit from this guide. You will find many useful tips which I am sure will enhance the Employer/Employee relationship and lead to better outcomes for all of us working and/or benefiting from health and social care support. Sue Bott CBE Deputy Chief Executive Disability Rights UK 4.0 Background Citizenship, equality, participation, living a valued life with independence, choice and control is often out of reach for disabled people due to society’s attitudes, the built environment and the infrastructures around them. This was reflected through the Social Model of Disability, this model offered a framework addressing the exclusion of disabled people. Person-centred approaches work hand in hand with the Social Model of Disability and reinforces equality, civil and human rights. Disabled people who use services want their services to reflect their lifestyle, to be person-centred and tailored, embedding choice and control, where people can make decisions and live the life they choose, and to be fully included citizens. Likewise, most people who work across health and social care would probably say “I want to ensure people get a good quality service”, one that is “person-centred” and “tailored to meet people’s needs”, enabling people to live the life they choose to live. The guide has been funded by Skills for Care and co-produced by Disability Sheffield on behalf of The Individual Employers and Personal Assistants Development Group, along with a range of colleagues involved in health and social care in Sheffield. Person-centred supervision and appraisals emerged as a route to increasing the knowledge and understanding of these approaches through the work of the Individual Employers and Personal Assistants Group. The guide will hopefully go some way in achieving this and ultimately improve and create a more skilled workforce able to deliver person-centred approaches. We asked some people involved in health and social care in Sheffield: * What does being person-centred mean to you? * What is good supervision? * What is a good appraisal? Responses to these questions are presented in the following sections. This begins with ‘Supervision; Setting the right tone’. Some work charts follow each section and provide tips and prompt questions to support line Managers to develop person-centred thinking and approaches. Social Model of Disability The social model of disability stemmed from the Fundamental Principles of Disability document, first published in the mid-1970s [UPIAS 1976], which argued that disabled people were not disabled by their impairments but by the disabling barriers faced in society. Whilst society and government has taken steps to address those disabling barriers by introducing anti-discrimination legislation in the form of The Equality Act 2010, disabled people still face many hurdles in living ordinary lives. Access to a range of facilities and opportunities still prevent disabled people from being fully valued citizens, who are able to participate in their communities. https://www.disabilitysheffield.org.uk/admin/resources/social-model-of-disabilityfinal-3.pdf Person-Centred Approaches An approach where the person using care and support is at the centre of the way care is planned and delivered. It is based around their individual needs, preferences and priorities. It treats people as an equal partner and puts into practice the principle of ‘no decision about me without me’. The Association of Directors of Adult Social Care Quality Matters https://www.adass.org.uk/quality-matters 5.0 Supervision - Setting the right tone Quote from a participant involved in the project - “Supervision is very important to keep you focussed on being person- centred and not go away, you know, and start thinking about ‘oh we got to do this, get this done and everything’. I think having conversations do help keep a focus”. Developing an ethos in supervision where people are put first, where we can think about daily work tasks and be reflective are crucial. As is space and time where challenges and critical thinking are valued. Person- centred approaches, designed around the individual, personalisation, putting the person in the centre, are all simply just statements it’s your practice and that of your staff that matters. The practice where people are listened to and understood, where what’s important to people is heard, and where what happens in practice, improves the person’s quality of life and will support the person to achieve the life they choose, and the life they want to live. Supervision is about giving support and guidance to an Employee so that they can do their job well. Whilst it typically involves a Manager meeting regularly with an Employee, supervision can also happen daily, on the ‘job floor’, in group meetings, through peer networks and through non- Managerial arrangements. See below for some definitions of the different forms of supervision. Ultimately supervision is about getting the job done, but it’s most effective when it empowers Employees. Enabling them to draw on their personal resources and initiative to get on and do it for themselves in successful and rewarding ways. The key purpose of Managerial supervision, as well as being about exploring practice and directing performance, is to provide accountability for both Employee and Manager alike. For the Manager this is about creating a dedicated space that is open and focussed on the goals and realities of the role. For the Employee it is about using this space to reflect upon workload, tasks and practice so that they can do their job well. For both its about thinking back and looking ahead together so that work can be focussed, productive and fulfilling. In health and social care, supervision is an important part of the job to be able to develop and deliver person-centred approaches. For it to be effective, it needs to be about both the management and empowerment of Employees to be both professional and personally reflective in all aspects of the way they approach the people they work for and with. People involved in health and social care in Sheffield who attended the workshops carried out to develop this guide, identified five key issues they considered important for developing person-centred approaches in supervision as follows. Regular – Making sure that there is enough time for consistent and regular supervision, but getting the right balance between what the individual Employee needs and how much the role requires. Always ensuring that the busy workloads do not prevent supervision from happening, and if a meeting can’t happen promptly rearrange it. Open – Building positive and trusting relationships so that Employees feel comfortable to share both professional and personal experiences. Giving direct and honest feedback, including praise. Encouraging Employees to develop reflective practice and critically evaluate everyday activities and broader aspects associated with their roles. Focussed – Being present, ‘on the job floor with people’ in the context and reality of their role so as to enable them to draw on supervision and support as and when they feel they need it, even if they work alone. Ensuring that supervision is relevant to the role and the wider purpose of what is trying to be achieved, so that Employees are clear about their roles, what tasks they should take on and when and what to do if things change. Flexible – Supervision needs to work for the learning and support preferences of the individual Employee. It should have a person-centred focus and be able to adapt to professional workload and personal circumstances. Being creative in the context of the role and who is being supervised is important, accepting that there no right way or wrong way can be helpful. Promoting learning through peer and group supervision can also be useful. Reflective – Supervision needs to be able to reflect on what’s worked well and what’s not worked so well, exploring different tasks or areas of work, thinking through what and how an Employee can change or add to improve their practice. Different forms of supervision. Quote from a participant involved in the project - “By having that [supervision] space, it makes us, more, I do not know if capable is the right word but by looking after ourselves we’re in turn able to look after, and work for [Employer] to a higher standard”. Supervision happens in lots of different ways and different places. Sometimes called catch-ups, or one-to-ones, here are some descriptions of different types of supervision. Managerial supervision – is focussed on an individual’s overall workload, functioning within the team, and maintaining clarity about role, responsibilities and accountability. Professional supervision - focuses on the professional identity and the professional development needs of an individual practitioner with the aim of identifying solutions to problems, improving practice and increasing an understanding of professional and clinical issues. Non-Managerial supervision – carried out by a person independent to the workplace or role, who aims to facilitate an Employee to reflect on workplace issues, problem solve, self-manage roles and responsibilities and to develop professionally. Peer & Group supervision – where a group of Employees or colleagues with similar responsibilities or professional interests come together to share experiences and reflect on practice. This may be guided by some discussion questions and ground rules. 6.0 Work chart 1 - Setting the right tone for supervision Quote from a participant involved in the project - “I think a really important question in supervision is about what we don’t know. So I think it’s always about being willing to learn”. This work chart is about looking at what needs to happen before the supervision discussion happens. It is about paying attention to some of the important aspects needed to facilitate a positive experience of supervision for all involved. Use the follow questions to plan how you want supervision to work. Use the blank spaces to set out and agree how supervision will work for you and your colleagues. Question - How should our supervision sessions be regular? How often should we meet? How long for? What should happen if we have to cancel? Question - How should our supervision sessions be open? How can we be honest? What might be difficult to talk of? What’s the best way to give feedback? Question - How should our supervision sessions be focussed? How do we make sure the job is being done? And that we have all the things to do it? Question - How should our supervision sessions be flexible? How do we best adapt to unexpected situations? What will we do if things change suddenly? 7.0 Work chart 2 - Supervision for Individual Employers Employing Personal Assistants [PAs] either through a direct payment or self funding is now fairly routine. Whilst there is a lot of information available, developing PAs through supervision and appraisals has not always been given the attention it deserves. We now know that supervision is a really helpful tool to help staff to deliver the best outcomes they can. A direct payment is an option if you receive a personal health budget [health care] or a personal budget [social care. This work chart provides an easy checklist ensuring that supervision can take place and promotes the development and welfare of your staff. Supervision check- list for individual Employers * Ensure you discuss supervision and appraisals at the recruitment stage. * Is supervision included in the job description, Employee contract and policy and procedures handbook? * Have you arranged supervision in the probationary period when your Personal Assistant is new to the job? * Are the costs of supervision covered by your social or health care budget? Personal Assistants should be paid for their time engaged in supervision and appraisal. * Make sure your sessions are regular, open, focussed and flexible. * Provide an agenda with regular discussions but with the opportunity to discuss other points, keep a record of them, using a format like that of below and refer back to them in future sessions. * Check your employment liability insurance policy to see if you have cover for employment issues. Example supervision note keeping format Things to talk about. i.e. What’s working well for you and for me? What’s not working well? What do we need to change? Is anything difficult? What can we do about it? Any learning/development/training needs? Annual leave? Anything else? Notes on what we said. i.e. Make summary notes of the discussion and key points made by all those involved. What we will do. i.e. Agree what actions will be taken, by who and when they will be done by. 8.0 Being Person-Centred – focusing on people Quote from a participant involved in the project – “It is all about working with that person, having conversations with them, using their language”. Nationally, health and social care are embedding person-centred approaches – looking at people’s well-being, people’s ability to live the life they want to live, a life which people value, looking at and working with people’s strengths and what they can bring to the table. Thinking through what is on offer in local communities, what groups exist, what activities are available including leisure, sporting, physical exercise and learning opportunities. Those who attended the workshops in Sheffield identified seven key issues they considered important for achieving person-centred approaches in their practice. These are: Shared understanding - Developing a core, shared and local understanding of person-centred approaches. Being able to state what person-centred practices are and what they are not develops a mutual understanding and helps challenge and change practice. Involvement – It is always possible to involve people in decisions about themselves. Taking time to understand how someone communicates, their preferences and background can help work out how to truly involve them. Choice and control - Promoting choice and control, enabling risk and supporting independence for people at all times. Ensuring that the individual has information that is accurate, accessible and relevant to them. Facilitating them to create and manage opportunities for themselves. Acceptance – Being non-judgemental and promoting equality and inclusion. Seeing things from the individual’s perspective and doing so without applying personal values or beliefs. Accepting people for who they are and where they are. Understanding how their perspective and circumstance may impact on you and drawing learning from the experiences and feelings that arise from it. Listening – Being present when you are with someone, focusing attention on them and resisting distractions. Hearing what they say, clarifying and supporting them to act if necessary. Reflection – Having time to share and explore the emotional and ethical implications of your interactions with the people you work for and with. Critically thinking about the impact of your practice, evaluating how and what you do, and drawing learning from it. Trust – Being reliable and consistent with people. Building trust and being clear and honest about what is and isn’t possible. Ensuring information is accurate and responding to people professionally but in human ways. Quote from a participant involved in the project – “It’s about working towards ideas they’ve got: not the ideas you’ve got; having no judgements about them for they know what they want to work towards”. It is therefore very important for those people working in health and social care across Sheffield, and for those people using services in Sheffield, that all of the above skills and approaches are used to develop person-centred approaches through good supervision and appraisal systems. 9.0 Work chart 3 - Being person-centred: skills, approaches and considerations Quote from a participant involved in the project – “It’s about having a genuine interest in the person that you are supporting, as opposed to it being a role that’s just person-centred. It’s about really being invested in that person’s life in the time you are with them and how you support them”. This work chart is about some of the skills and approaches that make up being person-centred and includes some critical questions to consider about how to work to achieve this. Use this work chart to consider person-centred skills and approaches. Skill = Inclusive Approach = Making sure people are involved in all aspects of their support. Working out what supports someone to take part, and putting it in place. Removing barriers, building enabling spaces and challenging others to be inclusive. Considerations = Are you communicating information and advice accessibly? Is something else needed to create an inclusive environment? Is what you are doing, and the way you are doing it welcoming? Do people feel comfortable enough to engage? Skill = Enabling Approach = Supporting people to be independent, make choices, assert preferences and to create and manage opportunities for themselves. Helping people to challenge and overcome social barriers. Considerations = How can you help people to live the life they want? How do you enable people to stay safe and well? Does the structure in which you work consistently enable independence? Are you giving people choice and control? Skill = Accepting Approach = Championing equality and accepting people as they are. Assessing how they may impact and affect you. Learning from the feelings that arise from this. Considerations = How do you embrace diversity in your work? Is unconscious bias relevant? What’s the difference between say disability ‘pride’ and ‘pity’? Skill = Reflective Approach = Exploring the emotional and ethical implications of your interactions with people. Evaluating how and what you do, and learning from it. Considerations = Do you take time to reflect on your practice? Do you know when your work is not person-centred? How can you check out your work is person-centred? Skill = Attentive Approach = Being reliable and consistent with people. Building trust and being clear and honest about what is possible. Considerations = Are you able to be open and honest with people? Do you reply promptly? How do you build trusting relationships with the people you work with? 10.0 Work chart 4 - Explore, reflect and develop This work-chart focuses on three areas. First, to EXPLORE and build a shared understanding of what ‘being person-centred’ means to you and your role. Second, to REFLECT, personally on ‘being [or not being] person-centred’. Third, to DEVELOP and set learning goals to enhance ‘person-centred’ skills. These are based on what people involved in health and social care in Sheffield who attended the workshops carried out to develop this guide said to us. Use this work-chart to look at how you might work towards each of the aims. Use these to plan your learning goals. Area = Explore what ‘being person-centred’ means to you and your role. Aim = To build a shared understanding of what ‘being person-centred’ means. Discussion prompts = What does ‘being person-centred’ mean to you? What does our workplace say about it? How does the local authority and NHS define it? How is it different from just being nice? Is it like being ‘inclusive’? Or promoting ‘equality’? What helps us to be ‘person-centred’? What stops us? Area = Reflect on what ‘being [or not being] person-centred’ means to you. Discussion prompts = When have you been ‘person-centred’? When have you not? How did it make you feel? How do your values and experiences impact upon you ‘being person-centred’? What challenges you to be ‘person-centred’? What enables you? What evidence do you have? Area = Develop; set some learning and development goals to enhance ‘person- centred’ skills. Discussion prompts = Can we describe what ‘being person- centred’ means? Do we know how to put it into practice and apply it to all aspects of our roles? How can we speak up when we see something that is not ‘person-centred’ in an appropriate and effective way? Set out your learning goals using the format, goal i.e. what you want to achieve, activity i.e. what you will do and, by the date you will have done it by. 11.0 Appraisals – looking back, thinking forwards. Quote from a participant involved in the project – “Challenge isn’t criticism” While supervision is seen as being regular, an appraisal typically happens annually. [Some systems have a mid-year review – supervision could feed into this process]. The appraisal process is more formal and links to the broader job role and responsibilities, performance and development. It provides an opportunity to reflect critically on both performance, circumstance and set development goals associated with the role. In some instances, appraisals could influence pay progression. Different forms of appraisals Annual Appraisals - Appraisals happen in different ways, in different places and at different times. They can be informal or formal conversations that are recorded and shared, or by completing specific appraisal forms. The appraisal process should be positive and transparent. It should review the past year and plan for the next. It should refer to the job description, performance, and focus on personal learning and development goals. Professional Development and Performance Review [PDR] - Many statutory organisations term their annual appraisal process as a ‘Professional Development and Performance Review [PDR]’. This is a focussed discussion between the Employee and Manager to review performance, development and support. The PDR offers a chance to review workload, reflect and learn from experiences and plan ahead. The review should be informed by the discussions that happen throughout the year in supervision and explicitly referenced at the mid- year review. Mid-year review – The mid-year review is an important part of the appraisal process. It should be a chance to review issues and progress so far against any goals set in the appraisal. It should be an opportunity to reflect on practice and progress so far, and adjust approaches where necessary. People involved in health and social care in Sheffield who attended the workshops to inform this guide commented on the appraisal or PDR process as something that builds on the discussions that happen during the supervision sessions. Similar to how supervision works, the need to ensure open and trusting relationships between Employee and Manager is key to achieving a reflective and effective PDR or appraisal. Some state there can be tensions for staff to complete a standardised corporate PDR form, because of the way some of the questions can appear distant from an individual’s role. However, Managers that enable Employees to own their appraisal and approach it as a development opportunity in creative ways state this achieves good levels of engagement and outcomes. Overall the appraisal or PDR process can offer a chance to take a step back, thinking about what has happened, collectively over a longer period. This can create opportunities to look back and learn from thinking about personal feelings and reactions to previous events and experiences. From this we can look forward, focusing on change, development and the future. ACAS – [Advisory, Conciliation and Arbitration Service] provide some useful guidance on conducting effective staff appraisals. Agree the objectives of the job and the knowledge, skills and personal attributes needed to achieve them. Hold regular appraisal reviews. Employees can perform better, and feel happier, if they have a recognised system for talking to their line Manager, getting feedback, and getting help to improve and develop. Work on one-to-one skills. Understand what makes your Employees tick and how they contribute to your business success. Conversations about good and bad performance can be emotionally fraught, so you may need training in how to effectively conduct difficult conversations. Focus on the development of your staff. If you buy a new piece of equipment, it comes with a manual explaining how to get the best out of it. It's not so simple with people. To work best, your Employees need an ongoing process of tweaking, adjusting and reviewing the way they work to continually improve. See http://www.acas.org.uk for more. Quote from a participant involved in the project – ‘You can’t ask PAs to be certain people and behave in certain ways and do lots of things you insist that they do, and then not give them the space to be able to make that OK with themselves.’ 12.0 Work chart 5- Being Person-centred: a one page planning tool for everybody This work chart is a one-page person-centred plan. Use this on yourself or another, with their permission of course, to explore and develop your person-centred planning skills. This planning tool draws on the six major themes of person-centred approaches from the TLAP ‘I statements’. [see Appendix 1] Remember, it is all about focusing on the individual, so feel free to adapt, change or start from scratch your approach to being person-centred. Question - Who am I? Question - What do I like? Question - What don’t I like? Question - How do I want to live my life and stay safe and well?[independence and wellbeing] Question - What information do I need and how? How do I communicate best with others? [information and advice] Question - Who is important to me? How do I stay connected to them? [active and supportive communities] Question – What support do I need? How do I like my support to be?[flexible and integrated care and support] Question – How do I manage change? How do I stay in control of my life? [when things need to change] Question – How do I like to be treated by the people that support me? [workforce] GOALS – What do I want to do? ACTIONS - What do I need to achieve these? What do I need to do NOW [by 1 month]. What do I need to do SOON [by 3 months]. And what can wait til LATER [by 1 year]. See https://www.thinklocalactpersonal.org.uk/makingitreal/ for more about the Making it Real ‘I statements’. 13.0 Resources - Being Person-centred Your guide to the care act: What you need to know about social care in England – by Disability Rights UK. Includes information about the care act, person-centred care and support planning, personal budgets and direct payments and other matters. https://www.disabilityrightsuk.org/care-act-guide Personalisation: Introduction e-learning course – by SCIE [Social Care Institute for Excellence]. This e-learning course explores personalisation and what you can do to make personalisation happen. https://www.scie.org.uk/e-learning/personalisation Person-Centred Care 2020 – by National Voices, 2014. National Voices members describe how person-centred care should look by 2020 and how to achieve it. https://www.nationalvoices.org.uk/publications/our-publications/person-centred-care-2020 Making it Real, how to do personalised care and support – by Think Local Act Personal [TLAP], 2018. Making it Real is a framework on how to deliver good personalised care and support across the health, care and housing sectors. https://www.thinklocalactpersonal.org.uk/Latest/Making-it-Real-how-to-do-personalised-care-and-support/ Person-centred care made simple, what everyone should know about person-centred care - by The Health Foundation, 2014. Overview of person-centred care, offering a clear explanation of the principles, why it is important, how it has developed, and some examples to help those considering putting person-centred care into practice. https://www.health.org.uk/publications/person-centred-care-made-simple Information for individual employers - by Skills for Care, toolkit covering the process of recruiting, managing and training PA[s] in six handy booklets. https://www.skillsforcare.org.uk/Employing-your-own-care-and-support/Information-for-individual-employers/Information-for-individual-employers.aspx Home Care Report: January 2019 Healthwatch Sheffield - A summary of findings in a model which shows what person-centred home care looks like to people locally in Sheffield. https://www.healthwatchsheffield.co.uk/wp-content/uploads/2019/02/Healthwatch-Home-Care-Report-DIGITAL.pdf Resources - Supervision British Association of Social Work [BASW] England research on supervision in social work – document designed to develop a BASW policy on supervision, based on research into the history of supervision, information about current practice and the views and experiences of members. https://www.basw.co.uk/system/files/resources/basw_13955-1_0.pdf Effective supervision in social care - by Skills for Care to support adult social care organisations plan and implement effective supervision. https://www.skillsforcare.org.uk/Documents/Learning-and-development/Effective-supervision/Effective-supervison-in-adult-social-care-Summary.pdf Supervising and Appraising Well. A Guide to Effective Supervision and Appraisal for those working in Social Care – by The Care Council for Wales [Care Council], the social care workforce regulator in Wales and is responsible for promoting and securing high standards across the social care, childcare and early years workforce. https://socialcare.wales/cms_assets/file-uploads/Supervising-and-appraising-well-social-care.pdf Effective supervision in a variety of settings – by Social Care Institute for Excellence, includes a series of recommendations for achieving effective supervision. https://www.scie.org.uk/publications/guides/guide50/ Achieving effective supervision – by Martin Kettle, Glasgow Caledonian University for The Institute for Research and Innovation in Social Services [Iriss] https://www.iriss.org.uk/resources/insights/achieving-effective-supervision People Performance Management – by Skills for Care. Toolkit for motivating, supporting and encouraging staff with sections on performance, reviewing, managing different types of performance and conversations about performance. https://www.skillsforcare.org.uk/Leadership-management/managing-people/performance-management-toolkit/People-Performance-Management.aspx 14.0 Appendix 1 The Think Local Act Personal Making it Real ‘I statements’. Making it Real is a framework for how to do personalised care and support. It’s for people working in health, adult social care, housing, and for people who access services. Making it Real is built around six themes to reflect the most important elements of personalised care and support. Each theme has a number of ‘I statements’ that describe what good looks like from an individual perspective. These are followed by ‘We statements’ that express what organisations should be doing to make sure people’s actual experience of care and support lives up to the ‘I statements.’ Wellbeing and Independence – Living the life I want, keeping safe and well Information and Advice – Having the information I need, when I need it. Active and supportive communities – Keeping family, friends and connections. Flexible and integrated care and support – My support, my own way When things need to change – Staying in control Workforce – The people who support me See https://www.thinklocalactpersonal.org.uk/makingitreal/ for more. 15.0 About us Disability Sheffield is committed to the ‘social approach’ to disability, rather than the ‘medical approach’. People with impairments are disabled by the barriers they face in every-day life such as inaccessible communication formats or buildings or negative attitudes. Disability Sheffield aims to work in partnership with disabled people and the wider community, to promote inclusive living, campaign for equality and co-produce innovative solutions to the barriers disabled people face. The Individual Employers and Personal Assistants Development Group is a group of Individual Employers, PAs, carers, Sheffield City Council and Sheffield Clinical Commissioning Group. The group exists to ensure that social care developments in the city engage with and benefit from lived. This group meet on a regular basis in order to discuss a range of issues that relate to the good practice and responsibilities of Employers, the legislative framework for employment and the rights of Employees. Sandy Marshall has worked across health and social care for 35 years, mostly in Adult Social Care, empowering individuals with knowledge and information, personal health budgets, personal budgets and access to work. As a disabled parent, Sandy believes direct payments have been a real benefit to enable her to work, parent and get a work life balance. Stephen Lee Hodgkins is neurodiverse and has significant experience of working with disabled people’s organisations across the UK. Stephen currently works as a facilitator and evaluator using creative techniques. 16.0 Acknowledgements To co-produce this “How to Guide” a combination of Steering Group meetings, development meetings in the form of workshops, individual interviews and research took place. Involving people in a range of differing health and social care roles this enabled the authors to draw on a range of knowledge, conversations and experience across the sectors. The authors would like to thank all of the above, particularly all the people that attended the workshops, and Daniel, Meranda, Blake, Anne and Sophie who were part of the film. 17.0 Contact Disability Sheffield The Centre for Independent Living The Circle 33 Rockingham Lane Sheffield S1 4FW Tel: 0114 253 6750 Fax: 0114 253 6752 Email: info@disabilitysheffield.org.uk Text Only Number: 07541 937 169 www.disabilitysheffield.org.uk 18.0 Examples of lived experience Access to Work Employer - I use my PA to support me in my activities at work for 28 hours per week, covering between 3 and 4 days throughout the working week. In addition to work activities, my PA covers elements of my personal care tasks whilst at work. It’s really important to me, and for me, that my PA knows he is working towards the outcomes I want and need to achieve, not the outcomes set for him. However, to ensure my outcomes are met, I also need to put my PA in the centre and have a person-centred approach for them. This approach helps people to learn and understand so much more about the social model of disability and what being a disabled person means in the world at large. Personal Budget Employer: - I use a personal budget from Adult Social Care to employ my Personal Assistants, I am an Individual Employer. If you are talking about providing services, the services must have that person’s needs and requirements as central. Dealing with different services can be difficult, it is important to me that I can open my front door, open my windows and have control over my environment. That’s being person-centred. Sometimes people don’t get what a person-centred approach means – instead setting out what they think I should do and saying what their Manager would agree to. Please treat my life like an ordinary life. I want to do a range of different things, and get support to do those things. I want to see my family and be able to go out more than one evening in a month. I haven’t had a holiday for a long time. It would be good if people would listen to what I say, and then repeat the version of what I say. And then I would absolutely know they understand what I am telling them. Personal Health Budget Employer: - I use Personal Assistants 24 hours a day, seven days a week. This enables me to live independently and have choice and control. Having a direct payment has given me that. It is essential to listen, and to hear, and to understand what is important to me and for me. People should listen to me about my everyday life and what I require to live it. This supports person-centred approaches for me. It’s often the simple things like ensuring I can wash my hair, put on my make up and be the glamorous me I want to be. My appearance is extremely important to me, I like to be glamorous. PA’s know it’s a bonus if they are handy with straighteners and a make-up brush.