facilitators guide - cota australia · 2018-11-29 · home care today facilitators guide page 4 of...

CONSTRUCTIVE CONVERSATIONS

WITH CONSUMERS

Facilitators Guide

Home Care Today Facilitators Guide of 99

LEARNING MODULES OVERVIEW These learning resources are provided for advisers/case managers working within community care environments. The aim of these modules is to enable advisors to embrace the thinking, skills and practice (TSP) for transitioning to and working in a Consumer Directed Care (CDC) model. It will provide participants with the knowledge and skills to work, and have conversations with consumers and their carers to achieve positive outcomes. The resources are designed to be delivered by an experienced trainer. The learning modules have been prepared for Home Care Today by Community West Inc., a respected not-for profit organisation with over 20 years' experience working alongside service providers in the home and community care sector.

Who can I contact for further information or assistance?

Please feel free to contact us for assistance or conversations regarding the implementation of CDC.

Email us at: [email protected]

Phone: COTA Australia 03 9909 7910

DISCLAIMER

This website provides some general practical advice for home care providers and is not intended as legal or financial advice. This website should not be the only source of information for providers of home care. Home Care Today encourages anyone who has questions about providing home care to get the relevant professional advice to discuss their organisation’s particular situation.

Home Care Today makes this information available on an as is basis. Home Care Today makes no representations or warranties of any kind with respect to the contents of the information. To the maximum extent permitted by law, Home Care Today disclaims any such representations or warranties as to the completeness, accuracy, merchantability or fitness for purpose of the information.

This work is licensed under a Creative Commons Attribution-Non-commercial-Share Alike 4.0 International License.

http://creativecommons.org/licenses/by-nc-sa/4.0/


Contents Training Overview ................................................................................................................. 4

Icebreakers ........................................................................................................................... 6

MODULE 1 Consumer Directed Care – Setting the Scene ....................................................... 7

MODULE 2 How to work within a Consumer Directed Care Model ...................................... 18

MODULE 3 Supporting Consumers to Live a Good Life ........................................................ 31

MODULE 4 Consumers Continuing Control of their Lives ..................................................... 48

MODULE 5 Our Approach Counts ........................................................................................ 70


Training Overview

This training is provided for advisers working within community care environments. The aim of these training modules is to enable advisors to embrace the thinking, skills and practice (TSP) for transitioning to and working in a consumer directed care (CDC) model. It will provide participants with the knowledge and skills to work, and have conversations with consumers and their carers to achieve positive outcomes.

For the purpose of this training the preferred terminology is ‘adviser’ however other names that may be used in the sector could be ‘case manager’ or ‘coordinator.’

There are numerous skills that advisers need to facilitate positive consumer outcomes. Each adviser will develop their own personal style. Some of these are learned informally through life whilst others are learned theoretically and developed through formal training.

There is an assumption that advisers completing this training will be familiar with and understand essential adviser skills.

Some of these include:

interviewing

communication

critical thinking

negotiation and collaboration

advocacy and mediation

awareness of diversity.

This training aims to provide advisers with the skills and tools to work in a CDC model to support people to remain living at home for as long as possible. It also equips them with the knowledge to enable consumers to have choice and flexibility in the way that care and support is provided at home. Quotes, ideas and tools will be embedded throughout the modules as will the underpinning values and principles of CDC.

The content of these training modules is centred on giving advisers the tools to create partnerships and build relationships with consumers. The training includes practical strategies to have empowering conversations with consumers from their first point of contact through to monitoring, review and potential exit.

This training is broken into five training modules that can be used as a full training session or standalone units.

The five modules are:

Module 1: Consumer Directed Care - Setting the Scene

Module 2: How to Work within a Consumer Directed Care Model

Module 3: Supporting Consumers to Live a Good Life

Picture source: iStock


Module 4: Consumers Continuing Control of their lives

Module 5: Our Approach Counts.

The training will explore theoretical concepts of CDC and its key principles within community care environments. Practical activities and videos throughout each module reinforce the CDC Philosophy and principles underpinned by a wellness framework. A recommended reading list is provided within each module of training and other areas of training that are available and that may be useful.

About this Facilitator Guide

This Facilitator Guide (FG) is intended to be used as the ‘roadmap’ for facilitators that are training ‘Constructive Conversations with Consumers’. There are five individual guides one for each of the training modules outlined above within this document. Included in this guide are practical activities, reflection questions, video links and tools to deepen the participant’s understanding of how to have effective conversations with consumers within a CDC model. While this guide provides the materials to facilitate the tasks effectively, facilitators require a strong understanding of community care and training in order to conduct these training sessions.

The FG is to be used in conjunction with the following documents:

PPP – PowerPoint presentation

PW – Participant workbook

A further reading list, resources and available training

At the end of the FG the answers are provided to the questions asked in the PW for ease of delivery. Before commencing the facilitator should be familiar with the documents outlined above.

This guide includes many interactive learning opportunities for participant discussion, conversation and involvement. Time frames within this guide are approximate so the facilitator will need to be flexible and intuitively know when to determine when groups need more or less time for topics. The decision to add more time should be based on the benefits of continuing the discussion.

Once you have completed the module(s) a sample workshop evaluation form is provided that participants to fill out.



Icebreakers

Sociometric line ups

Socio metric line ups are an effective tool for breaking the ice, getting participants moving and promoting a community environment. This activity promotes communication and collaboration as they work together to organise themselves.

Below are two suggested line ups that may be used at the beginning of the modules:

Line up alphabetically by first name with one end of the line being ‘A’ and the other

end of the line being ‘Z’. Then starting at Z (to provide the participants with names

beginning at the latter end of the alphabet with an opportunity to go first), ask each

person to introduce themselves to the group by stating their name, the organisation

they work for and one thing they enjoy about their work.

Line up according to length of time working in aged care packages with one end of

the line representing a ‘1’, (new to packaged care) and the other end of the line

representing a ‘10’ (10 years plus working in packaged care).

This provides the facilitator and the participants with a visual representation of levels of experience in the room.


MODULE 1 Consumer Directed Care – Setting the Scene

CONSTRUCTIVE CONVERSATIONS

WITH CONSUMERS

MODULE 1

Consumer Directed Care – Setting the Scene

Facilitators Guide


SLIDE TIME TOPIC/ACTIVITY FACILITATOR NOTES AND PURPOSE RESOURCES

-15.00 mins Set up

Facilitator to set up room and equipment.

PPP – PowerPoint

WB – Whiteboard

FC – Flip Chart

BP – Butcher Paper

PW – Participant Workbook

HO – Handout

VO - Video

Laptop Projector

REGISTRATION

Session 1 Welcome and introduction

Introduction

Slide 1

2.00 mins

(2 mins) Total

Aboriginal acknowledgement statement

“I would like to acknowledge that this meeting is being held on Aboriginal land/ the traditional lands of the [insert local Indigenous group's name] and acknowledge the ancestors and traditional owners of this country. I would also like to acknowledge their continuing custodianship and ongoing cultural, spiritual and religious practices.”

Facilitator to read the Aboriginal acknowledgement statement before starting the training session.

If appropriate, Aboriginal attendees could be asked privately if they would like to read acknowledgement statement.

If known include the name of the local Indigenous group on whose land the training is taking place.

PPP



Slide 2

2.00 mins

(4 mins) Total

Welcome and Introductions Welcome to Module 2 How to work within a Consumer directed care model developed by CommunityWest.

10.00 mins

(14 mins) Total

Housekeeping and ice breaker

Explain where the toilets, emergency muster and morning tea areas are and introduce the following information:

Request to turn off or silence mobile phones.

Request one person to speak at a time.

Emphasise the need for an open mind and

willingness to consider different ways of doing

things.

Advise that out of scope questions will be ‘car

parked’ on the WB and if time permits will be

addressed at the close of the workshop. Otherwise

the facilitator will speak to the participant/s after the

workshop to address these question/s if possible.

Participation – key to participant’s learning.

Introductions and sociometric line up

Socio metric line ups are an effective tool for breaking the ice, getting participants moving and promoting a

WB

FG p.5



community environment. This activity promotes communication and collaboration as they work together to organise themselves.

Below are two suggested line ups.

Line up alphabetically by first name with one end of

the line being ‘A ‘and the other end of the line

being ‘Z’. Then starting at Z (to provide the

participants with names beginning at the latter end

of the alphabet with an opportunity to go first), ask

each person to introduce themselves to the group

by stating their name, the organisation they work

for and one thing they enjoy about their work.

Line up according to length of time working in aged

care packages with one end of the line representing

a 1, (new to packaged care) and the other end of

the line representing a 10 (10 years plus working in

packaged care).

This provides the facilitator and the participants with visual

representation of levels of experience in the room.

Slide 3 2.00 mins

(16 mins) Total

Training overview Check for participant expectations. VERY BRIEFLY present the

Explain that this module is the second of a five part suite of training in ‘Constructive Conversations with Consumers’, outline the other modules on the slide.

If participant expectations are different to learning outcomes/objectives advise which areas will not be

PPP



module outlines to ensure participants are aware that this module is one of five modules.

covered and car park those.

Address at end of workshop if time permits and/or advise where further information can be obtained.

1.00 min

(17 mins) Total

Workshop methodology

Present the workshop methodology: The material is developed within a practical and reflective framework and is designed to be delivered as a facilitated workshop. It is activity based with workshop participants’ learning being drawn from their reflections and responses to the activities and peer discussion. Brainstorming, sharing experiences and visual tools are utilised to enhance personal reflection, peer and facilitator engagement.

1.00 min

(18 mins) Total

Participant workbook Show the participant workbook.

This Participant workbook is designed to provide a resource for participants to utilise during and post workshop. Each session will be outlined along with associated reference material.

PW

Session 2 Setting the Scene

Slide 4 3.00 mins

(21 mins)

What is consumer directed care? Lead a discussion on definition of

Consumer directed care (CDC) is both a Philosophy and an orientation to service delivery where consumers (including care

PPP



Total CDC then present the definitions. Keep this session brief.

recipients and their carers) can choose and control the services they get to the extent that they are capable and wish to do so.

The main objective of CDC is to offer consumers more choice and control than they would have from traditional programs.

Slide 5

3.00 mins

(23 mins)

Total

Timeline for consumer directed care Present the timeline for CDC.

PPP

Slide 6

5.00 mins

(28 mins) Total

Guiding principles of consumer directed care

Present and discuss the guiding principles for consumer directed care. To enable consumers to experience:

greater choice and control

rights, dignity and control upheld respectful and balanced relationships

transparency

participation and partnership

wellness and enablement.

One of the most important things for providers to get right is to view the consumer as a partner. The following quotes sum up some of the most important aspects of CDC:

“It is not all about the fact that we will give you more choices. It is about how we can work together

PPP



to design the best package of support for you.”

“A wellness/enablement approach starts with understanding what a ‘great day’ or a ‘great life’ might look like for the consumer. From there, aim to understand what strengths and attributes a person has to realise their potential, and specifically, what challenges they have in achieving their goals on a day-to-day basis.”

“There is an inherent contradiction on the surface between the Philosophy of choice and control and enablement, which means providers must also take on the role of educator.” For example, to give an older person the basic choice between having their cleaning done, and undertaking an exercise program to be able to do it themselves may be problematic as the consumer may choose the least taxing option. Focusing on a Wellness Approach and healthy living options that can maximise wellbeing will have a flow on effect to basic tasks of daily living.” (Sources quotes: Hilary O’Connell: Wellness Philosophy Expert CommunityWest)

Slide 7 5.00 mins

(32 mins) Total

Why Implement CDC? Briefly present these reasons for implementing CDC.

Consumer directed care was implemented due to:

Changing consumer expectations.

People wanting more choice and control.

Current system being viewed as complex.

PPP



Research which shows that people are healthier and happier when they have more control over their lives.

Services needing to be competitive.

Government direction to provide CDC.

(Research sources cited in the Workshop Resource)

Slide 8

5.00 mins

(37 mins) Total

CDC - A significant cultural shift

The introduction of CDC may require a significant cultural shift for organisations and staff as they change from a Philosophy of doing for people to doing with them.

PPP

15.00

(52.00) Total

3.1 Activity

Ask participants to split into groups and work through the activity in the participant workbook comparing traditional service models to person centred and consumer directed models.

This section explores a definition of CDC in depth and in context. Comparative analysis between CDC and traditional care. In groups participants complete an interactive comparison which progresses their definition of CDC. The participant workbook answers for this module can be found at the back of this FG.

PW pp.13-14

Slide 9

10.00 mins

(1 hour 2 mins) Total

Person centred approaches & planning. 3.5 Activity Ask participants to talk to the

Person centred - Attitudes, values that honour a person’s

unique individuality and perspective and are concerned

with their full inclusion.

Person centred approaches - A range of ways in which we

can make our own practice more respectful of a person’s

PW p.16

WB



person next to them.

discuss last activity

discuss what it means to be person centred

discuss the definition of person centred.

Whiteboard answers from group. Discuss. Arrive at definitions with group consensus.

choices and wishes.

Person centred planning - A process of individual discovery

and action that assists a person to live the life they want to

live and find their place in their community.

Person centred thinking, working and planning. A

presentation for the Better Practice Project (Heather

Simmons June 2010).

Allow participants to come up with the definition. They can come up with different words as long as the essence is the same. (They may come up with some of the bolded words above or similar).

Self-direction is about the choice and control over assistance and support needed to live daily life. It is about people’s lives and improving people’s quality of life and sense of control. It is not about service based solutions.

The work is about rebuilding or renewing control for people who have lost control due to ill health, exclusion, discrimination or life events.



Slide 10

10.00 mins


Customer service video Ask the participants after the video: What worked or what didn’t work? How does this relate to the case manager and CDC? Outline the importance of relationships, collaborations and negotiation with an adviser and consumer.

This humorous account of customer service depicts the relationship between a client and an adviser and aims to represent how not to do customer service. This video aims to highlight the importance of customer service and how this can affect the nature of the CDC relationship. The key learning here is the importance of relationships, collaboration and negotiation any customer service interaction in many walks of life. CDC is no different. http://homecaretoday.org.au/provider/knowledge-centre/learning-modules Customer service activity (optional) Ask the participants to think of a time when they experienced bad customer service? What was it specifically that made it so bad?

VO

Slide 11

8.00 mins


What older people say they want Ask participants what they want for a good life? WB answers to the question. Compare group answers to what UK studies have shown older people want. Discuss similarities.

Older people and people with disabilities are requesting more flexible support targeted to their needs and want and provided in a manner that upholds personal choice and control. CDC can deliver what people say they want if the right structures, attitudes and values are in place. Discuss each of the points outlined on the slide:

WB

http://homecaretoday.org.au/provider/knowledge-centre/learning-modules




Older people say they want:

choice and control over their lives/services

to strive to be oneself not withstanding any limitations

to be known and understood

individualised, targeted, flexible and enabling support

enhancement of health and wellbeing

connection and contributing to the community.

Quotes provided by older people include:

“I want to be known and understood”.

“It's not just what you do...It's how you make me feel”.

“Know what I can do and support me to do it”.

“Remember all the little things add up”.

“Remember… I’m more than the sum of my parts”.

(Optional)

Slide 12

5.00 mins

( 1hour 25 mins) Total

Summary and workshop evaluation If only completing this module today present a summary and ask for evaluation forms to be completed.

This session summarises the workshop content and

encourages reflection on supporting people within a

consumer directed framework underpinned by a Wellness

Philosophy.

Evaluation forms (HO)

MODULE 2 How to work within a Consumer Directed Care Model

CONSTRUCTIVE CONVERSATIONS WITH

CONSUMERS

MODULE 2

How to work within a Consumer Directed Care

Model

Facilitators Guide



-15.00 mins Set up


PPP – PowerPoint

WB – Whiteboard

FC – Flip Chart



HO – Handout

VO - Video

Laptop Projector

REGISTRATION


Introduction

Slide 1

2.00 mins

(2 mins) Total


“I would like to acknowledge that this meeting is being held on Aboriginal land/ the traditional lands of the [insert local Indigenous group's name] and acknowledge the ancestors and traditional owners of this country. I would also like to acknowledge their continuing custodianship and ongoing




PPP



cultural, spiritual and religious practices.”

Slide 2

2.00 mins

(4 mins) Total

Welcome and Introductions Welcome to Module 2 How to work within a Consumer directed care model developed by CommunityWest.

10.00 mins

(14 mins) Total





Emphasise the need for an open mind and willingness

to consider different ways of doing things.

Advise that out of scope questions will be ‘car parked’

on the WB and if time permits will be addressed at

the close of the workshop. Otherwise the facilitator

will speak to the participant/s after the workshop to

address these question/s if possible.



Socio metric line ups are an effective tool for breaking the ice, getting participants moving and promoting a community environment. This activity promotes

WB

FG p.5



communication and collaboration as they work together to organise themselves.



the line being ‘A ‘and the other end of the line being

‘Z’. Then starting at Z (to provide the participants

with names beginning at the latter end of the

alphabet with an opportunity to go first), ask each

person to introduce themselves to the group by

stating their name, the organisation they work for

and one thing they enjoy about their work.





packaged care).



Slide 3

2.00 mins

(16 mins) Total

Training overview Check for participant expectations. VERY BRIEFLY present the module outlines to ensure


If participant expectations are different to learning outcomes/objectives advise which areas will not be

PPP



participants are aware that this module is one of five modules.

covered and car park those.


1.00 min

(17 mins) Total


Present the workshop methodology:

The material is developed within a practical and reflective framework and is designed to be delivered as a facilitated workshop. It is activity based with workshop participants’ learning being drawn from their reflections and responses to the activities and peer discussion.

Brainstorming, sharing experiences and visual tools are utilised to enhance personal reflection, peer and facilitator engagement.

1.00 min

(18 mins) Total



PW

Slide 4 23 mins 2.2 Activity - know yourself Rationale

This section engages participants in self reflection to

PPP



(41 mins) Total

Topics

values activity

challenges

the journey

Picture

This photo depicts ‘a look’ in the mirror so some self reflection can occur.

explore their own values, and the values which underpin person centred practice. It explores some of the challenges participants may face and the types of values people might manifest in their work under this Philosophy.

Values activity

Hand out values cards to each table. Ask each participant to choose two values which are important to them. Discuss choices with partner. (Why did they choose those values? What does this value look like in action? How will I know when I see it?).

Ask “what are values?” WB answers.

Possibilities could include:

something we hold dear

a strong belief

a principle

some measurement of worth

different for each person.

Values cards HO

WB

PW p.8

Slide 5 7 mins

(48 mins)

Simmons Triangle

Personal values are crucial to the way people work. Everything that is said and done is underpinned by a person’s ethics and values which is translated into speech and action. Person-centred thinking is about values –



Total Present slide and discuss as per notes.

namely what each worker believes and thinks about the person they are working with. Changing negative beliefs and perceptions into positives can radically change consumer outcomes. Person centred planning is about, ‘getting a life not getting a service’ (Simmons 2010).

Simmons triangle shows that the majority of a person’s attention needs to target identifying their own ethics and values and determining how these impact on their professional practice rather than simply developing a service delivery or support plan which is not grounded in an empathic understanding of the person being supported.

Slide 6

10 mins

(58 mins) Total

Discussion

2.3 Activity Brick walls

Question: Is it easy to work in this way? What are some of the possible challenges?

For advisers?

For consumers?

Whiteboard answers.

Some possible challenges for advisers:

To be at ease in the presence of difference.

To feel hopeless about how things are going (and then move forward).

To feel like we are banging our head against a brick wall (and sometimes we are).

To see things from another’s point of view.

To challenge ourselves.

To confront the brick walls in our heads and hearts

Complacency.

Lack of imagination.

Low expectations.

Complexity.

Competition.

Anxiety – do I have the skills/attitudes/values?

PPP

PW p.9

WB



Consumers change direction or emphasis in their life – how do we cope with this?

Structure of services and programs including the lack of flexibility.

Availability and time constraints.

Issues with costs and older person’s capacity to pay

Business processes and systems, including technology do not necessarily support a person-centred way of working.

Some possible challenges for consumers:

Ageism and negative attitudes towards older people.

Slide 7

10 mins

(1hour 8 mins) Total

2.4 Activity - The journey

Activity in PW:

Fill in the blanks PW p.11

Present slide.

Discuss what qualities will you display in CDC? How will you work and what will be different?

(It’s an on-going journey of self-discovery.)

WB answers.

Possible answers include:

listening

establishing rapport – share self to make connection

respect

dignity

equality

PPP

PW p.11



openness

non judgemental

inquisitive

enquiring

thoughtful

willing to learn

willing to change

when we don’t make decisions on behalf of client

feel empowered ourselves

becomes part of how we work

focus on outcomes not time and services

problem solvers

advocates

facilitators

partnering

critical thinkers.

Slide 8

5 mins

(1 hour 18 mins)

Total

We are working to create:

meaning

hope

power

Discuss turning ‘labels’ into ‘badges’. The labels we sometimes put on people hide the real person underneath and put us off in our efforts to establish

Optional activity – Taking off the lens – how other people see us.

This is an optional activity if time permits and the facilitator feels it is warranted. Ask participants:

1. How people at work might describe you, in a few dot points: e.g. 50 year old Scottish/Australian woman

2. Now write about who you really are - focus on strengths, qualities, how you make people feel, relationships.

PPP



relationships. Instead look at putting the best about the person upfront.

e.g. John’s partner, a big sister, a daughter, an aunt, a godmother, a best friend, a great employee, I’m clever, I’m funny, I’m a singer.

Slide 9

5 mins

(1 hour 23mins)

Video – Stereotypes Show the video on stereotypes.

Utilise this video to as a lead in to discuss discrimination below. http://homecaretoday.org.au/provider/knowledge-centre/learning-modules

VO

Slide 10

10 mins

(1 hour 33 mins)

Total

Discrimination, ‘isms’ and value judgements

Activity

Present the overview and then ask participants to form into pairs.

Discuss a situation where they felt personally discriminated against or they were aware of discrimination

Present a discrimination overview

Discrimination is the act of prejudice against a person because they have a certain set of characteristics. Discrimination characteristics can include disability, age, gender reassignment, religion, race, sex and sexual orientation. Discrimination can take various forms:

Direct Discrimination – the individual is treated less fairly due to the characteristics described above. For instance, when a person is denied employment because he or she is gay - that is direct discrimination.

Associative Discrimination – when someone is discriminated against because of their association with

PPP





against another.

Discuss how discrimination such as ageism can impact on CDC.

Request feedback from participants.

some individuals who have any of the characteristics listed earlier. For example, young people hanging out in groups in a shopping centre may be moved on as they are considered to be a ‘gang.’

Discrimination by Perception –a generalisation of the discriminated characteristic. For instance, just because a person with a mental illness has been violent and abusive does not mean that all people with mental health issues are violent and abusive.

Indirect Discrimination – This is when, for example, an employer forces a specific set of requirements on its employees. It may count as indirect discrimination if a company requires all employees to work overtime. This threatens the livelihood for those who cannot comply with the requirement.

Harassment – An example of this is an employee being harassed in the workplace because a characteristic.

(Barrier Breakers March: 2011)

Slide 11 5 mins

(1 hour 38 mins)

Impact of discrimination, ‘isms’ and value judgements

Transition in the impacts of discrimination to consolidate the learnings

Problems can arise when value judgements indiscriminately affect others and when beliefs and personal values are allowed to influence attitudes and behaviour.

It is important therefore for staff to identify societal



Total from the last activity. discriminations which may impact on older people.

Human beings make value judgements all of the time as a result of myriad variables; however care needs to be taken to ensure value judgements are made on others. If a person believes, for example, that someone who needs support to manage their personal care will also require support in all aspects of daily living, they may inadvertently ‘care take them’ to the point of creating a dependency.

Autonomy, independence and self determination has been defined as, “The ability to make free and rational decisions, to identify one’s own desires and assess what constitutes one’s own best interest” (Kendall & Rogers, 2007).

Examples of ethical dilemmas include but are not limited to:

perceived client safety versus client self determination

client choice not to access respite care services versus carer stress.

societal values vs. wellness focused support

client choice to self-neglect.

Slide 12 5 mins

(1 hour 40

Video – LGBTI Show the video on LGBTI with subject matter expert June Lowe chair of GRAI. Refer participant to the reading list for additional training available nationally in this area.

http://www.homecaretoday.org.au/provider/knowledge-

VO

http://www.homecaretoday.org.au/provider/knowledge-centre/learning-modules



mins) Total centre/learning-modules

Slide 13

(optional)

2 mins

(1 hour 40mins) Total

Summary and workshop evaluation

If only completing this module today present a summary and ask for evaluation forms to be completed.

This session summarises the module content and


consumer directed framework.

Evaluation forms

HO


MODULE 3 Supporting Consumers to Live a Good Life


CONSUMERS

MODULE 3

Supporting Consumers to Live a Good Life

Facilitators Guide



-15.00 mins

Set up


PPP – PowerPoint

WB – Whiteboard

FC – Flip Chart



HO – Handout

VO - Video

Laptop Projector

REGISTRATION


Introduction

Slide 1

2.00 mins

(2 mins) Total


“I would like to acknowledge that this meeting is being held on Aboriginal land/ the traditional lands of the [insert local Indigenous group's name] and acknowledge the ancestors and traditional owners of this country. I would also like to acknowledge their continuing custodianship and ongoing cultural, spiritual and




PPP



religious practices.”

Slide 2

2.00 mins

(4 mins) Total

Welcome and Introductions Welcome to Module 3 Supporting Consumers to Live a Good Life developed by CommunityWest.

10.00 mins

(14 mins) Total







things.




the facilitator will speak to the participant/s after

the workshop to address these question/s if

possible.


WB

FG p.5






Line up alphabetically by first name with one end

of the line being ‘A ‘and the other end of the line


participants with names beginning at the latter

end of the alphabet with an opportunity to go

first), ask each person to introduce themselves to

the group by stating their name, the organisation

they work for and one thing they enjoy about

their work.

Line up according to length of time working in

aged care packages with one end of the line

representing a 1, (new to packaged care) and the

other end of the line representing a 10 (10 years

plus working in packaged care).

This provides the facilitator and the participants with

visual representation of levels of experience in the



room.

Slide 3

2.00 mins

(16 mins) Total

Training overview Check for participant expectations. VERY BRIEFLY present the module outlines to ensure participants are aware that this module is one of five modules.


If participant expectations are different to learning outcomes/objectives advise which areas will not be covered and car park those.


PPP

1.00 min

(17 mins) Total


Present the workshop methodology: The material is developed within a practical and reflective framework and is designed to be delivered as a facilitated workshop. It is activity based with workshop participants’ learning being drawn from their reflections and responses to the activities and peer discussion. Brainstorming, sharing experiences and visual tools are utilised to enhance personal reflection, peer and facilitator engagement.

1.00 min

(18 mins) Total


This Participant workbook is designed to provide a resource for participants to utilise during and post workshop. Each session will be outlined along with

PW



associated reference material.

Slide 4

7 mins

(25 mins) Total

Consumer video

Activity 2.1

A good life

Debrief after the video. http://www.homecaretoday.org.au/provider/knowledge-centre/learning-modules

Have discussion around topics in the video such as:

What is important to consumers? (e.g. choice, freedom independence).

Anne allowing her neighbour has a key of the house.

Support worker walking the dog.

The benefits of CDC for the consumer.

PPP

PW p.7

VO

Slide 5

10 mins

(35 mins) Total

2.1 Subject matter expert

Allow participants to take notes in the PW

Debrief with participants on the following:

Language of wellness

Good questioning


PW p.8

Slide 6 15 mins

(50 mins)

The Wellness Philosophy

Present an overview of the Wellness Philosophy

The Wellness Philosophy is about thinking and working in a way that maintains or builds a person’s potential to live as independently as possible. It focuses on a person’s skills and

PPP







Total

abilities and what support they may need to maintain and enhance their capacity, build social connections and improve their quality of life.

Wellness focuses on partnerships and collaboration and seeks to enable individuals to make informed choices and take control of decision making. Wellness based language focuses on what a person can do to retain, regain and enhance existing skills and develop new skills.

Wellness and enablement are guiding principles of CDC. To maximise a CDC approach, it is essential that wellness/enabling approaches are adopted as they:

o Focus on, and enhance, individuals’ capabilities, and supports them to achieve personal goals.

o Identify that there is considerable benefit to the individual as well as service providers/funders for people to regain skills rather than be ‘cared for.’

This ensures that:

The person’s strengths, goals and aspirations are considered both during assessment and throughout delivery of supports.

The person is engaged in the planning of their



package of support.

The funding allocated to the package can be maximised for the individual with the focus of enablement and supports are not over supplied, or provided for longer than required, thereby reducing the funding available.”

Slide 7

10 mins

(1 hour) Total

Language of Wellness

Listening

Good questioning

Discuss language, relate back to the video where subject matter expert discusses strategies to support a person.

Discuss p.10 of the PW differences between dependency associated language and wellness associated language.

Facilitator to read the ‘LISTEN’ poem, participants to listen. Tell them not to look at it in the PW, Suggest the participants get comfortable and can close their eyes if they want to. It is important that they ‘listen’ and hear the poem.

Listen

When I ask you to listen to me and you start giving advice you have not done what I asked.

When I ask you to listen to me and you begin to tell me why I shouldn’t feel that way, you are trampling on my feelings. When I ask you to listen to me and you feel you have to do something to solve my problems, you have failed me, strange as that may seem.

PPP

PW p.10



Listen! All I ask is that you listen.

Not talk or do – just hear me.

And I can DO for myself; I’m not helpless. Maybe discouraged and faltering, but not helpless. When you do something for me that I can and need to do for myself, you contribute to my fear and weakness. But when you accept as a simple fact that I do feel what I feel, no matter how irrational, then I quit trying to convince you and can get about the business of understanding what’s behind this irrational feeling.

And when that’s clear, the answers are obvious and I don ʹt need advice.

So, please listen and just hear me, and if you want to talk,wait a minute for your turn; and I’ll listen to you.

Anonymous

Reflect on poem – Share with your partner. What is the key message for you from the poem? How does this relate to your work?

(Optional Activity) – What are the key elements of listening identified in the poem?

Put in the key elements into the EAR framework on whiteboard. See PW pp11-12



Reflect in pairs What are the ‘Road blocks ‘to listening effectively to the consumers you work with?

Discuss the importance of questioning

Close ended questions seek specific facts. They’re often answered with a yes or no, or with a simple statement of fact. Closed ended questions are used to direct the conversation.

Open-ended questions give you a window into the other person’s thinking and builds empathy. They demonstrate interest in the other person’s ideas, encourage continued conversation and help you get more information.

Probing questions are open ended questions that seek clarification about information.

Avoid leading questions they are of little value as they put answers into the mouth of the person.

Slide 8

10 mins


Ask participants to complete a personal ‘important to’ and ‘important for’ record, ‘good day’ and ‘bad day’ and share it with a partner. Ask if anyone wants to feed back.

On other side of the HO discuss working/not working

My Story Booklet

‘My Story’ is a simple user friendly booklet based on the work of Helen Sanderson and Associates (UK) in the area of person centred thinking with older people. The booklet has been designed and published by CommunityWest for use by individual consumers, carers, family and friends and staff providing individualised support.

My story booklet HO



Slide 9

10 mins


and how it is used to facilitate working with consumer.

The booklet is structured into sections enabling the recording of relevant aspects of a person’s life, their history, relationships, likes, dislikes, needs, wants and desires. The booklet also enables the consumer to record the things they like about themselves, personality traits, values and beliefs they hold dear. In addition this section records what other people find admirable and appreciate about the consumer.

Relationships

The ‘Relationships’ section enables the individual to identify the people in their lives that are really important to them and record them close to the centre of the circle with acquaintances and others recorded towards the outside of the circle. This material provides valuable information as to the range and strength of a person’s relationships in order to meet their goals and enhance and expand social connections.

Important to me section records what is important to the individual; what they hold dear and is meaningful to them. This may include information about favourite sports, activities, pets, food preferences, spiritual or religious faith, culture, hobbies, interests and achievements. This section compliments the wellness whole of person approach in determining what gives an individual’s life meaning and purpose.

Important for me section records the things that the



person needs to feel healthy, safe and well. This section also records how the support being provided can enhance things that are important for the consumer and how best that support can be provided.

Communication – This section records how the consumer feels in different situations and how they communicate this either verbally or otherwise. It also shows how and where the consumer prefers to communicate and where they cannot (or will not) communicate. In addition this section documents when the consumer finds communication easy and when they find it difficult.

Good days – This section records what the consumer identifies as ‘good days’ how they feel, what they are doing and who is involved. It also records what the consumer thinks would help them to have more good days. Space is included in the booklet to attach photos, drawings and any examples of what might constitute a good day for the individual.’

Bad days This section describes what a bad day looks like from the eyes of the consumer and identifies what others could do to prevent some of the bad days or to make them happen less often. Once again, photos, drawings and words are used to help those supporting the consumer to understand what sort of day they are having.



10 mins

(1 hour 20 mins)

What’s working? The information is a simple way to analyse whether what is important to the consumer is present in the consumer’s life and whether they are being supported in a way that makes sense to and enhances their quality of their life.

When ‘what is working’ and ‘what is not working ‘are examined from different perspectives disagreement may result and it becomes clear where there is agreement and where there is difference. This helps in identifying the areas that need to be adjusted or changed.

What’s not working?

What’s not working enables people to discuss their different perspectives on how well something is going. It enables people to see something from another’s perspective, to stand in different shoes and to consider the topic from a different viewpoint. This prevents those supporting a consumer from inadvertently changing aspects of the person’s life that is working for them.

What needs to happen to build on ‘what’s working’ and change ‘what’s not working’?

‘What’s working’ and ‘what’s not working’ are the core principles of negotiation. Getting everyone’s perspective on paper enables them to feel listened to and heard. Identifying solutions from the differences enables all of those involved to start on ‘common ground’ to achieve



Slide 10

Total the best person centred outcome.

Slide 11

10 mins


Relationship Circles

Optional activity. Provide HO relationship circles and ask participants to complete their personal record. Discuss any relationships they would like to move closer or distance.

When working with consumers to identify their goals and what is important to them, they will usually include who is important to them.

A 'Relationship Circle' is a particularly useful tool for exploring:

who a person knows

how they know them

who knows whom

how these networks can help the person find opportunities and support to live the life they want and to achieve their goals.

This process not only identifies who is important in the person’s life, but can suggest how they can stay in contact with them and whether there is any support the person may need in keeping and developing those

PPP

HO

http://www.helensandersonassociates.co.uk/media/72090/relationships.pdf



relationships. It can also show if there are other people with whom the person could share ideas, support or resources.

If people find that their relationship circle is not as full as they would like, then it can become a focus for action by asking: “What would it take to increase the number and depth of your relationships?”

Slide 12

15 mins


Person Centred Planning

Work through the diagram on slide.

‘Person Centred Planning’ is a process for continual listening and learning focusing on what is important to someone now and in the future, and acting upon this in partnership with their family and friends. It is the foundation of self-directed support’ (Helen Sanderson & Associates 2013).

Once all of the information has been gathered and analysed strategies can be developed to provide person centred support. This process is known as Person Centred Planning. Strategies to be considered in the first instance are those that are safe and important for the consumers and those that are safe and important to the person. This will result in that person being both happy and safe within the Person Centred Planning grid.

Strategies that the consumer is not so happy with ‘but are required to ensure the consumer remains safe’ need to be considered in light of what would make the consumer less unhappy.

PPP

PW



Strategies that are unsafe and the consumer is unhappy about need not even be considered.

Wishes, dreams and goals - Documents the consumer’s wishes, dreams and goals, things they did in the past and miss and things they would like to try or do in the future. It then leads into a goal setting tool which specifies the goal, determines if it is realistic and defines why the consumer wants to achieve the documented goal and what support they would need to make it happen. The tool then progresses to document the steps involved in supporting the consumer to achieve their goal. Consequently the success of achieving the goal can be monitored, adjusted and measured.

Making decisions and staying in control documents the consumer’s decision making processes against the questions:

Who do you make choices and decisions with?

What support would you like to make choices or decisions?

Do you want support with making an advanced health directive?

It records information relating to how the consumer stays in control and who helps them get their views



across.

Budgets and administration records how much information the consumer wants to be provided with regarding their budget and how their budget is to be managed. This is important information to gather, as consumer directed care requires consumers to have as much control of the issues that affect their lives including their personal finances.

Slide 13

2 mins






consumer directed framework underpinned by a

Wellness Philosophy.

Evaluation forms

MODULE 4 Consumers Continuing Control of their Lives


CONSUMERS

MODULE 4

Consumers Continuing Control of their Lives

Facilitators Guide



-15.00 mins Set up


PPP – PowerPoint

WB – Whiteboard

FC – Flip Chart



HO – Handout

VO - Video

Laptop Projector

REGISTRATION


Introduction

Slide 1

2.00 mins

(2 mins) Total


“I would like to acknowledge that this meeting is being held on Aboriginal land/ the traditional lands of the [insert local Indigenous group's name] and acknowledge the ancestors and traditional owners of this country. I would also like to acknowledge their continuing custodianship




PPP



and ongoing cultural, spiritual and religious practices.”

Slide 2

2.00 mins

(4 mins) Total

Welcome and Introductions Welcome to Module 4 – Consumers continuing control of their lives developed by CommunityWest.

10.00 mins

(14 mins) Total







things.




the facilitator will speak to the participant/s after the

workshop to address these question/s if possible.


WB

FG p5







the line being ‘A ‘and the other end of the line


participants with names beginning at the latter end

of the alphabet with an opportunity to go first), ask

each person to introduce themselves to the group

by stating their name, the organisation they work

for and one thing they enjoy about their work.





packaged care).



Slide 3 2.00 mins Training overview Explain that this module is the second of a five part suite of PPP



(16 mins) Total

Check for participant expectations. VERY BRIEFLY present the module outlines to ensure participants are aware that this module is one of five modules.

training in ‘Constructive Conversations with Consumers’, outline the other modules on the slide.

If participant expectations are different to learning outcomes/objectives advise which areas will not be covered and car park those.


1.00 min

(17 mins) Total



The material is developed within a practical and reflective framework and is designed to be delivered as a facilitated workshop. It is activity based with workshop participants’ learning being drawn from their reflections and responses to the activities and peer discussion.




1.00 min

(18 mins) Total



PW

Slide 4

10 mins

(28 mins) Total

The consumer is the expert

Scales of control

Give participants an introduction on this section.

This section is key to consumer directed care. It encourages participants to reflect upon the notion that the consumer is the expert on their own life. This does not mean that the consumer is all knowing about everything but rather, knows what works and doesn’t work for them, what makes them happy and safe and what gives their life meaning and purpose.

Participants will gain an understanding of what it means for the balance of power to shift to the consumer in terms of control.

The scale of control activity looks at the triggers that cause a change in service delivery.

Participants will gain awareness that the scale of control can be set anywhere depending upon the fluctuating needs of the consumer. In completing this session the participants will have a visual representation of the scale of choice a consumer has/chooses to have.

PPP

7 mins

(35 mins)

Ask the participants to comment on their response to the statement ‘the

You may hear the following:

complete agreement

WB



Total

7 mins

(42 mins) Total

consumer is the expert.’ Acknowledge the many and varied responses such a phrase may evoke.

2.1 – The consumer is the expert on their own life activity

Ask the participants to reflect upon a time in their life when their knowledge about themselves (their needs, their desires, their inner knowing) was not acknowledged. Or a time when someone took over or made decisions on their behalf without due consultation. Ask them to share what this felt like.

Capture this on the WB

Each person is their own expert when it comes to them.

challenges in accepting this with a consumer who has dementia or some other cognitive illness (in that case it may be the consumers and their families who are the experts)

feeling like their professional identity is being challenged, because they are not the expert

uncomfortable with shift in balance of power

more used to thinking of consumers as people to be ‘looked after’

A counsellor may know the theory behind emotional distress. But only you can describe what that distress is, how it feels, how it impacts on your life and possible solutions which may work for you.

While you and your organisation know a great deal about providing services to consumers, the consumer is the best person to describe their needs, what works for them and what doesn’t work for them. Therefore with your expertise about service delivery and their expertise about themselves a true collaboration with respect for one another can develop.

There will be varying levels of collaboration that can occur. For example:

When consumers are new to a service.

When they are very familiar with a service.

PW p.7



When they require more/less assistance.

When they transition from one package level to another.

When they choose to have you manage/manage their own budget.

Flexibility, individuality and respect are required to foster and maintain a truly collaborative relationship as consumers move between levels.

15 mins

(57 mins)

2.2 Activity - Scales of Control.

Participants can use grey lead pencil for the next activity as they may want to make amendments to their drawing as they progress.

Ask the participants to turn to the diagram in their PW.

At one end of the diagram it shows ‘the adviser has full control’ and at the other end it shows ‘the consumer has full control’. The participants (working in pairs or a group) are to use a grey lead pencil to draw in three alternate possibilities of control between the service provider and consumer.

As well as drawing in three possibilities ask them to write in the benefits the consumer may gain by having more control (e.g. autonomy, self-determination and self-efficacy) or the consequences to the consumer if the adviser has more control.

The diagram below shows one possible outcome.

PW p.9

Grey lead pencils with erasers

PW Activity - Scales Control

Adviser has full control

Consumer has full control

Benefits to Consumer

self determination, autonomy, high self esteem, retaining physical capabilities

Consequences to consumer

Helplessness, feeling useless, losing physical capabilities, depression

Adviser and consumer share control

Adviser75 % control Consumer 25 %

Adviser 25 % control Consumer 75 %



Discuss turning points in service delivery.

Turning points in service delivery can occur at any time during the service episode between a consumer and the service provider.

Possible triggers for turning points include:

Admission to or discharge from hospital.

Request by family or consumer for review of support needs.

Exit from package.

Change in key support staff.

Changes resulting from improved care processes.

Change in individual circumstances for example:

o Increasing levels of difficulty across life domains/need for higher level of support

o Change in carer status (sickness, death)

These triggers can result in:

short term change

reduction in need

increase in need

PW p.9



2.4 activities - scenarios – Scales of control (optional)

After this discussion, provide the participants with some time to amend their diagrams.

It is not necessarily negative that the service provider has full control as long as this is what the consumer chooses. (The design and information on the scale is not important. It is the concept that the consumer is the expert and makes their own choice as to the level of support they choose the level of support they require.)

This activity is only if time permits or facilitator feels it is necessary to consolidate the learning.

To summarise this scaling exercise read the following two scenarios. Ask the participants where the following two scenarios would be on the scale of control.

Pw pp.10-11

PW scenarios – Mr Casey and Mrs Inca

Slide 5

10 mins

(1 hour 7 mins)

Total

Supporting people to set and achieve goals

Present slide.

A key component of consumer directed care is assisting people to set and achieve goals. A goal orientated approach requires the identification of each person’s skills, abilities, needs and wants. Goal setting is also an essential tool of the Wellness Philosophy which:

identifies what the consumer wants to do

encourages the consumer to increase their ability

builds the consumer’s capacity and self-



Slide 6

5 mins

(1 hour 12 mins)

Total

management

increases the consumer’s confidence

respect peoples’ self-sufficiency and autonomy.

Effective goal setting builds on current skills and interests, and what each person wishes to achieve in both the short and long term. To actively engage people in goal setting a partnership approach can be used (where the person’s needs and concerns are acknowledged and their wishes and desires identified and formulated in a clear, graded and documented plan).

Setting goals is fundamental to CDC as it establishes early on in the support planning process what the consumer wants to achieve. People do not all think in terms of ‘setting goals’, so staff may have to support people to put their wishes and desires into words and make them more concrete, workable and achievable.

The following strategies are useful to help people identify goals:

support them to draw a picture of their dreams

empower them to ‘futurise’

ask them to finish statements such as

o my dream is to…



o I would like to try…

o it would be great if I could…

o I would like to be able to...

identify strengths and abilities

provide suggestions and opportunities

encourage consumers to try something new

use fun and humour

set up a goal or dream diary

use non-verbal communication tools, if necessary

Once a goal has been identified make sure that it is documented in a format that is meaningful to the consumer.

Slide 7

20 mins


Goal setting video

Ask participants to look at

the client profile for Joyce

MacDonald to give them

some background to watch

the video.

Play the goal setting video, allow the participants to

take notes in the PW.

When playing the video for the first time allow the

participants to grasp an understanding of Joy’s

situation.

Once the video has been played ask the

PW p.12

VO



participants to look at the questions on goal setting

in the PW.

Replay the video clip of goal setting asking the

participants to answer the questions as they watch

the video for the second time.

http://www.homecaretoday.org.au/provider/knowledg

e-centre/learning-modules

20 mins


Activity 4.1 Goal setting

questions

Allow participants time to

complete questions once the

video has finished.

Work with the group to

discuss possible answers to

the questions on goal setting

in the PW.

Goal setting video – PW – questions 1- 6

The participant workbook (suggested answers) for this module can be found at the back of this FG.

Key points from this video:

One of the roles of the adviser is to have

information available to enable a consumer to

make informed choices, and to work with a

consumer to facilitate those choices.

Utilising supports from friends and family could

save money.

Storytelling takes time but helps to build

relationships and rapport and is a great way to

identify interests.

PW pp.20-22





The more the consumer has control of what they

would like to do, the less case management is

needed. In this way the adviser is truly facilitating

the consumer’s journey and the consumer has

maximum choice and control. Remember that all

consumers are all different and will require greater

or lesser degrees of control (link with scales of

control activity).

20 mins

(2 hours 12 mins)

Total

Activity 3.2 Conversation

role play

There are three different

conversations the group will

have an opportunity to role

play:

1. New types of support

2. An introduction to

budgets

3. A monitoring

conversation for

budgets

Debrief with the group after

In groups of three each person will have an opportunity to

be a consumer, adviser and an observer.

See PW page 14 for instructions for the

participants.

See page 15 for instructions of the conversations.

Read each of these pages to know step by step

what the participants need to complete for the

role play activity.

Each person within the role play will have

approximately 5 mins each to carry out the

conversation. Facilitator to time each conversation.

Ask participants to provide feedback using the

traffic light feedback tool:

Explain the tool to the participants and give the

PW p.14 about the role-play

PW p.15 instructions for the conversations

PW p.16 Observer checklist

PW p.17 Self reflection

PW p.18 traffic light feedback

Timer/watch



the activity.

How did the group

feel it went?

What worked/what

didn’t work?

Was the

conversation

empowering self-

direction?

Next part of the session will

show each of these

conversations on video with

Joyce and Sue.

The facilitator can use the

videos and show examples

of some of the strategies

that advisers can use.

participant’s time to write on the traffic light

feedback model handout in their workbook before

sharing the feedback with each other.

Green/start – what could they start doing?

Amber/continue – what did they do well and should keep

doing?

Red/stop – what should they stop doing?

Reflection questions for participants on page 17

This component allows time for self-reflection for the participants to see how they felt the conversation went.

When the next videos are shown it will give the advisers examples to compare to the conversations they have had in the role play.

Slide 8 10 mins

2 hours 22 mins)

Total

Activity 4.2 - Budget video 1

& 2

Play each budget video,

once played ask participants

to answer the question

Budget video 1 – PW - question 7

Budget video 2 – PW - question 8


PW p.22

VO



applicable to that segment.

Allow participants time to fill

in questions once the video

has finished.



the questions on budgets 1

& 2 in the PW.



How might you explain budgets to consumers

What does it mean to them, write down some

notes for yourself.

Using an iPad to show information may not be the

best idea as Joyce may be used to hardcopy

information. Use clear language – if there is a

different way of saying ‘contingency fund’ then say

that.

The budget may also include a small “contingency” to make provision for emergencies, unplanned events or increased care needs in the future. However, it should be clear to the consumer that it is not a requirement for them to have a contingency fund. If a contingency is set aside, it should be no more than 10 per cent of the total annual budget for the package. The contingency amount must be clearly identified in the individualised budget and in the monthly statement of income and expenditure provided to the consumer. Contingency funds must be used before accessing additional home support programme services.





The home care provider must provide the consumer with a monthly statement clearly showing the income and expenditure of the package, in a format that enables the consumer to understand where funds have been expended, as well as the balance of available funds (or unexpended funds). Unexpended funds are the difference between the consumer’s income and expenditure within their monthly statement. This amount, including contingency funds, must carry over from month to month, and from year to year, for as long as the consumer continues to receive care under the package. There is no cap on unexpended funds for the consumer.

The format of the statement must be clear and easy to understand, should clearly state any unexpended or contingency funds, and should be consistent with the individualised budget. The means by which the statement is provided to the consumer, e.g. hardcopy, email or web-based, can be negotiated between the home care provider and the consumer. (Source: Home Care Package Programme Guidelines July 2014).

Slide 9 10 mins

(2 hours 27 mins)

Activity 4.3 - New types of

support video

Play new types of support

video, once played ask

participants to answer the

New types of support video – PW – questions 9 & 10

The participant workbook suggested answers for this module can be found at the back of this FG.


PW p.23

VO





questions applicable to that

segment.

Allow participants time to

complete questions once the

video has finished.



the questions on new types

of support in the PW.


Well thought out questions help to find out about

how Joyce is getting on with Jane and the support

she needs with the computer.

The adviser discusses all Joyce’s options for her to

consider.

Examples of helpful questions:

o Where would you like to go from here?

o Do you feel you would need support to do

the class?

Both are respectful of Joyce and very much facilitating

Joyce’s choices while giving her all the control.

Slide 10

5 mins

(2 hours 32 mins)

Total

Activity 4.4 - Budgets video

3

Play Budgets video 3

Once played ask

participants to answer the

questions for that segment.

Allow participants time to fill

in questions once the video

Budgets video 3 – PW - question 9



Key point from this video:

Each consumer is unique and therefore each conversation will be different. There is no one way

PW p.23

VO





has finished.



the questions on Budgets

video 3.

to have a conversation, but multiple ways.

This point should be reinforced with the participants again

after watching all the videos.

In a CDC environment, the consumer should not be limited by a “standard” menu of services or service providers. Providers and consumers should be thinking about innovative ways to meet the consumer’s goals and care needs. This may involve the use of sub-contracted or brokered services if the home care provider is unable to provide the service/s itself or where the consumer would prefer the service be delivered by a particular worker. Sometimes this may involve additional costs of setting up sub-contracting or brokerage arrangements and these costs should be made clear to the consumer. Whatever is agreed must be affordable within the total budget available for the package. (Source: Home Care Package Programme Guidelines July 2014)

Optional adviser video:

If the facilitator thinks that the group would benefit

from an additional resource advice from advisers in

relation to working with budgets in CDC.

Show the following video:

http://www.homecaretoday.org.au/provider/knowledge-

VO



SLIDE TIME TOPIC/ACTIVITY FACILITATOR NOTES AND PURPOSE RESOURCES centre/learning-modules

25 mins

(2 hours 57 mins)

Activity 4.5 Group work

Other considerations for

advisers

Split the group into four groups. Give each group a

piece of butcher paper and a marker.

Ask participants to work in groups to answer

questions 12-15.

Once completed present back to the larger group.

Key points:

There are many other areas for consideration that

we must think about when having conversations

with consumers.

The most important thing we must do is be

educated about the consumers that we work with.

Point out that there is a recommended reading list

provided with this training and information on

where there is training on where to find out more

around working with different people and groups in

a CDC model.

PW pp.24-25

BP

Marker




5 mins

(3 Hour 3 mins)

Debrief discussion Ask participants as a result of watching the videos –

“Is there anything you will change in your approach

when working with consumers?”

Slide 11

(Optional)

2 mins

(3 hours 5 mins) Total



This session summarises the workshop content.

Evaluation forms (HO)


This page has been left blank intentionally

MODULE 5 Our Approach Counts


CONSUMERS

MODULE 5

Our Approach Counts

Facilitators Guide



-15.00 mins Set up


PPP – PowerPoint

WB – Whiteboard

FC – Flip Chart



HO – Handout

Laptop Projector

REGISTRATION


Introduction

Slide 1

2.00Mins

(2 mins) Total


“I would like to acknowledge that this meeting is being held on Aboriginal land/ the traditional lands of the [insert local Indigenous group's name] and acknowledge the ancestors and traditional owners of this country. I would also like to acknowledge their continuing custodianship and ongoing cultural, spiritual and religious practices.”




PPP



Slide 2

2.00mins

(4 mins) Total

Welcome and Introductions Welcome to Module 5 – Our Approach Counts module developed by CommunityWest.

10.00 mins

(14 mins) Total



request to turn off or silence mobile phones

request one person to speak at a time

emphasise the need for an open mind and


things

advise that out of scope questions will be ‘car



the facilitator will speak to the participant/s after

the workshop to address these question/s if

possible.



Socio metric line ups are an effective tool for breaking the

WB

FG p.5



ice, getting participants moving and promoting a community environment. This activity promotes communication and collaboration as they work together to organise themselves.


Line up alphabetically by first name with one end

of the line being ‘A ‘and the other end of the line


participants with names beginning at the latter

end of the alphabet with an opportunity to go

first), ask each person to introduce themselves to

the group by stating their name, the organisation

they work for and one thing they enjoy about their

work.

Line up according to length of time working in

aged care packages with one end of the line

representing a 1, (new to packaged care) and the

other end of the line representing a 10 (10 years

plus working in packaged care).

This provides the facilitator and the participants with

visual representation of levels of experience in the room.

Slide 3 2.00 mins

(16 mins) Total

Training Overview Check for participant

Explain that this module is the second of a five part suite of training in ‘Constructive conversations with consumers’,

PPP



expectations. VERY BRIEFLY present the module outlines to ensure participants are aware that this module is one of five modules.

outline the other modules on the slide.

If participant expectations are different to learning outcomes/objectives advise which areas will not be covered and ‘car park’ those.


1.0 min

(17 mins) Total



The material is developed within a practical and reflective framework and is designed to be delivered as a facilitated workshop. It is activity based with workshop participants’ learning being drawn from their reflections and responses to the activities and peers.


1.0 min

(18 mins) Total


This Participant workbook is designed to provide a resource for participants to utilise during and post workshop. Each session will be outlined along with

PW



associated reference material.

Slide 4

10 mins

(28 mins) Total

2.1 Identified opportunities

Activity

Ask participants to identify opportunities of CDC for them. WB responses and then compare to slide.

Some of the opportunities inherent in the introduction of CDC include:

Consumers will have a greater say in the support provided.

More consumer choice and control.

Opportunity for individuals to take informed and calculated risks.

Potential for improved communication with carers and families.

Enhanced staff creativity and innovation.

Increased staff training and support.

Opportunity for flexible work practices.

Better targeted use of aged care funding.

Identified organisational and individual value bases.

Improved organisational management systems.

Organisations can become service providers of choice.

Opportunities for increased community partnerships.

WB responses

PPP

Slide 5 10 mins

(38 mins) Total

2.2 Challenges for CDC

Activity

Ask participants to identify

Some of the challenges inherent in the introduction of CDC include:

Supporting consumers versus creating dependencies.

PPP

WB responses



Slide 6

challenges of CDC for them. WB responses and then compare to slide.

Adviser Video

Duty of care versus dignity of risk.

Insufficient time to get to know each client.

Group dynamics, behaviour, prejudice etc.

Facilitating a conversation about consumer budget priorities.

Managing individualised budgets.

Availability of appropriate options and opportunities.

Practical considerations such as cost, transport, etc.

Empowering people to become independent.

Conflicting obligations and expectations.

Working within a culture of change and reform.

Staff recruitment and retention.

Giving up when challenges are encountered.


Discuss the video. Ask participants:

‘What where thoughts from listening to advisers that have already implemented CDC?’

‘Is it reassuring or unnerving?’

‘Are there any examples that surprised them?’

VO

Slide 7 12 mins

(50 mins) Total

2.3 Arthur’s story

Play YouTube clip.

VO

PW p.8





Debrief after the video has been played. Use this video to reference when speaking about duty of care versus dignity of risk.

Arthur – person centred thinking with older people.

Arthur’s story is taken from ‘Person Centred Thinking with Older People: Practicalities and Possibilities’ by Helen Bowers, Gill Bailey, Helen Sanderson, Lorna Easterbrook and Alison Macadam.

http://www.helensandersonassociates.co.uk/reading-room/who-/older-people.aspx

Slide 8

10 mins

(1 hour mins)

Total

3.1 Supporting decision making

Service provision and dignity of risk

“Risk is no longer an excuse to limit people’s freedom” (Department of Health 2010)

Define duty of care and dignity of risk then move into a discussion around risk management.

‘Duty of Care’ can be defined as:

“A responsibility to act in a manner that does not cause harm or loss to that person.” (Australian Medical Association 2012)

‘Dignity of risk’ is defined as:

“The individual’s right to make an informed choice, to experience life and take advantage of opportunities for learning, developing competencies and independence and in so doing, take a calculated risk.” (Department of Family and Community Services NSW 2013)

Risk management does not mean trying to eliminate risk, rather it means managing risks in order to maximise people’s choice and control over their support.

People are empowered to make decisions some of which

PW p.11

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service providers may disagree with. Risk management, or risk enablement as it is sometimes called, enables consumers to exercise real independence and personal autonomy.

The traditional model of service provision is firmly grounded in a deficit or dependency model where consumers are seen as needy, disabled and potentially at risk if organisations and staff do not ‘take care of them’.

By comparison a person centred, consumer directed approach enables people to assert choice and control in their lives and to take risk in matters affecting their lives.

Slide 8

15 mins


Life and risk activity

Introduce and discuss the notion that life and risk are inseparable.

Discuss quote.

“A reasonable person takes reasonable precautions to

avoid a reasonably foreseeable risk”

(Philips 2013)

Ask the participants for their thoughts and reactions to the statement ‘Life and risk are inseparable’ and picture on the slide.

WB responses.

Discuss the notion that a traditional approach to risk may impose a barrier to social inclusion and to an interesting and productive life.

WB



The problems of traditional risk assessment are becoming increasingly recognised by people who use human services, their families and carers, and now by many service providers, who are looking for alternative approaches to risk: ‘thorough, professional, personalised risk management’ (Bates and Silberman 2007, p6) It recognises that life and risk are inseparable and that look at risk from the point of view of the person, their family and friends and the wider community, rather than solely from the point of view of the service provider.

(A Positive Approach to Risk Requires Person Centred Thinking – Neill, Allen, Woodhead, Reid, Irwin and Sanderson 2008)

Slide 10

10 mins

(1 hour 25 mins)

Total

3.2 Balancing risk and duty of care

Shifting the balance away from risk aversion towards supported positive risk taking.

Risk is no longer an excuse to limit people’s freedom’ (Department of Health 2010)

Personalised care is for everyone, but some people will need more support than others to make choices about how they live their lives. Everyone has the right to personalised care and to be provided with choice and control. Risk is an accepted part of life which challenges perceived limitations and enables people to live their lives as fully as possible.

With the implementation of effective consumer direction and personalisation comes the need to enable people to make decisions as safely as possible. This includes people who may lack capacity or be quite vulnerable. It needs to be remembered that ‘Risk is no longer an excuse to limit people’s freedom’ (Department of Health 2010), and that

PPP

PW p.12



everything possible needs to be done to enable people to take positive risks in their lives to achieve personal goals and maximise their potential.

Slide 11

15 mins

(1 hour 40 mins)

Total

Risk mitigation

Discuss each point and lead discussion.

The following strategies are important when determining likely risk and ways to moderate these risks:

Determine the consumer’s ‘risk appetite’.

Determine the organisation’s ‘risk tolerance’.

Ensure appropriate risk policies and procedures are in place and followed.

Ensure risk mitigation strategies are the least restrictive options.

Involve significant others if the consumer gives consent.

Document all communication regarding potential risk.

Provide training and regular staff refreshers regarding risk management.

Provide training for all staff regarding duty of care and dignity of risk.

Reasonable precaution In order to mitigate risk the following needs to be considered:

The availability of precautions to be considered.

PPP



If the risk of harm can be reduced or removed by taking relatively simple precautions then it would not be reasonable to continue without taking those precautions.

If no feasible precautions are available then all parties need to assess whether it is reasonable to continue.

Where there are many effective precautions, the least restrictive precaution that would avoid or reduce the risk needs to be considered in the first instance.

The cost of the precaution has to be balanced against the likelihood of risk and the effectiveness of the precaution.

Purpose of the risk activity:

If there is little benefit for a consumer from an activity but it involved real risks it may not be reasonable to continue.

If the benefit is great and risks relatively small then it may be reasonable to proceed.

Professional judgement is vitally important, as is clear and honest discussion with all involved.



Slide 12

20 mins

(2 hours) Total

Section 4 - Person centred review and outcomes

Activity

Person centred review and outcome

In summary this section looks at review and outcomes in a person centred approach. It goes further than just monitoring consumers against agreed outcomes and asks participants to be proactive regarding supporting consumers to work towards these outcomes.

Discussion – person centred review and outcomes

Blind slide

Lead a discussion on the role of support staff in monitoring the progress of consumers towards their identified outcomes.

Ask participants

“Do you have a role to play in monitoring consumers against their identified outcomes?”

“What is that role?”

“What part do you play in the overall monitoring and review of consumers?”

WB answers.

Look for:

• ongoing monitoring of consumers by way of

PPP

PW p.14



observation

• ongoing reporting

• discussing with consumers ‘what’s working’ ‘what’s not working’ for them in the way they are being supported

• more responsibility on part of workers to initiate discussions on above pro-active rather than re-active

• celebrating achieved goals or progress towards identified goals

• supporting consumers to reach goals - discussion around progress

• continuous improvement process – is this working? If not why not?

• for coordinators it’s about ensuring staff are skilled and empowered to use their skills to support clients in this way.

(Show slide to confirm what has been discussed)

(15 – 20 mins)

Total

Optional activity

(Only the baton holder will speak until the baton is passed on).

Ask participants to complete

Commitment to change

Ask participants to fill out the table in the PW.

“As a result of my learning today I will change the following three things in my practice…”

Baton

PW p.15



the following sentence:

The most important thing I have learned from completing the five modules is……….?

and then pass the baton to the next participant until everyone has provided input.

Slide 13

2 mins

(2 hours 22 mins)

Total


Present a summary and ask for evaluation forms to be completed.



consumer directed framework underpinned by a Wellness

Philosophy.

Evaluation forms

Participant Workbook

Answer Pages

Module 1

Home Care Today PW CDC Conversations Module 1 - CDC Setting the Scene - with answers Page 13 of 19

Section 3 Service Centred Versus Person Centred and Consumer Directed

3.1 Activity

Using the service centred statements as a guide, complete the person centred and consumer directed statements. The statements should demonstrate the differences between types of delivery.

Service centred Person centred Consumer directed

Planning for Planning with Planning with your assistance as requested and/or required.

Talking about you Talking with you Listen to you and act on your views.

Advise you and facilitate what you want/need.

Doing things to you Doing things with you Assist you to improve your health and independence so you can do things for yourself. Supports you when and as required.

Following a program Having a life Consumer plans and decides which services, when, who provides and how delivered based on advice from the service provider. The consumer makes the ultimate choice within the allocated budget and any relevant regulatory or legal constraints.

Live where you ‘fit’ Live where you choose Live where you choose.

Home Care Today PW CDC Conversations Module 1 - CDC Setting the Scene - with answers Page 14 of 19

Start with what’s wrong Start with what matters Start with what matters to you.

Consumer defines goals and what’s important to them.

Health and safety determine what you do

We find a way to do what you want safely Finds a way to provide what you need and do what you want to do safely (balancing duty of care and dignity of risk and ensuring compliance with standards/legal requirements).

Words like ‘let’, ‘allow’, ‘place’ We suggest, you decide Consumer directs what they want and chooses level of involvement in management of the package.

Lifeless plans updated annually Plans constantly updated Consumer directs what they want and chooses level of involvement in management of the package.

You learn the next step We help you learn what you want in order to get what you want Consumer defines goals and what’s important to them.

Note Space - include ideas, insights, queries and comments

Module 2

Home Care Today PW CDC Conversations Module 2 - How to Work within a CDC Model - with answers Page 9 of 16

2.3 Brick walls – what are the challenges?

For advisers For consumers

To feel hopeless about how things are going (and then move forward)

To feel like we are banging our head against a brick wall

Ageism

To see things from another’s point of view

To challenge ourselves

Negative attitudes towards older people

Competition

Anxiety – how do we do this; do I have the skills/attitudes/values

Fear of the unknown

Consumers change direction or emphasis in their life – how do we cope with this?

Availability and time constraints

Uncertainty about what is acceptable


Home Care Today PW CDC Conversations Module 2 - How to Work within a CDC Model - with answers Page 11 of 16

2.5 Activity

How do values manifest in your work – What qualities should we display when working with consumers? Fill in examples of these qualities in the blank spaces below.

2.6 Discrimination, ‘isms’ and value judgments

Examples of types of discrimination ‘isms’ and value judgments

racism marital status discrimination

ageism single parent discrimination

sexism youth discrimination

disability discrimination employment discrimination

religious discrimination pregnancy discrimination

(CommunityWest 2013)

listening establishing

rapport

respect

partnerships equality dignity

thoughtfulness advocators facilitators

Module 4

Home Care Today PW CDC Conversations Module 4 - Consumers Continuing Control of their Lives Page 19 of 28

Section 4 Video Questions

4.1 Activity – Goal setting Picture source: CommunityWest

1. Joyce identified that she would like to get out to the shops, have a coffee and see people. Are there other ideas you could think of to help Joyce do that? Does the trip need to involve shopping? What about other social opportunities?

Maybe Joyce could still get out to the shops to have a look around, have a coffee, meet

someone but do her food shopping online and have it delivered to her. This option could mean

less time shopping and more time socialising.

2. Sue the adviser asked “if you did get out what would you like to do?” Is this a good question? Did it elicit much information from Joyce? How else could you phrase it?

Might be useful to make some suggestions to Joyce as she may be limited by what she

knows is available. One of the roles of the adviser is to have information available to

enable consumers to make informed choices, and to work with consumers to facilitate

those choices.


3. Should we involve Sarah or other members of the family in this conversation? Who else might be involved? If we do involve others what needs to happen first?

It could be good to have Joyce identify who she has in her relationship circle first, i.e.

people who are close to her and ‘in her world’. This could assist Joyce to identify those

who may be able to offer support. If the family are involved in the discussions they could

come up with creative ways to support Joyce. It would be best practice to ask Joyce she

might like to be involved and if she wants them involved in the discussion. Utilising

supports from friends and family could save some money.

4. You will notice that the adviser uses the photo album and interested questions to encourage Joyce to ‘tell stories.’ Storytelling takes time but helps to build relationships and rapport and is a great way to identify interests which Joyce may have and what is important to her. Can you think of other ways to identify interests or encourage consumers to share stories with you?

Pick up on objects (medals/trophies, photos, craftwork needlework, knitting, drawing,

wood work, cooking, pottery, animals in the home, plants or books) to start conversations

or encourage conversations about what is important to people.



5. When Sue talks to Joyce about aqua aerobics it stems from a conversation about the beach. The adviser’s role is to assist the consumer to make informed decisions about their support. Are there other options you could have explored with Joyce around her love of the beach and water?

Walk on the beach, visit to the beach. If the family are at the discussion it could be a good trigger for

them to discuss whether or not Joyce could be included in family holidays or outings to the beach. If

Joyce were interested in fishing then those options could also be explored.

6. In the conversation about Joyce trying aqua aerobics Sue asks Joyce “Is there anything I could do to help with that?” How do you rate this question? Do you think it elicits helpful information from Joyce? Can you think of a better question?

Joyce suggests the adviser speaks with Sarah who will then speak with Claire. Perhaps the adviser

could have said “can you think of a way you could access the aerobics class to just see what they do

and what it is like?” This means the ‘problem solving’ rests with Joyce who may suggest she call Sarah

and discuss with her. The more the consumer gets involved in taking control of what they would like to

do the less case management is needed. In this way the adviser is truly facilitating the consumer’s

j ourney and the consumer has maximum choice and control. Remember that consumers are all

different and will require greater and lesser degrees of control.



4.2 Activity – Budgets video 1 and 2

Picture source: CommunityWest

1. What do you think of Sue’s explanation of the costs of the service? What was good about it? What could be improved about it? Do you think this is a question consumers will ask?

Think of how you might explain what it means to a consumer and write down some notes

for yourself. If you are struggling have a chat with your manager or one of your peers for

suggestions.

2. In the budgets conversation with Joyce – how do you think the conversation went? Is there anything you would do differently? Why? Why not?

Perhaps the adviser could slow down the explanation a bit, it may be complex information

for Joyce to take in, particularly if it’s new to her and bearing in mind that she is feeling

unwell. Also using the iPad to show information may not be the best idea as Joyce may be

used to hardcopy information. Use simple language – if there is a different way of saying

‘contingency fund’ then say that.

Each consumer is unique and therefore each conversation will be different. There is no

one way to have a conversation, but multiple ways.

Home Care Today PW CDC Conversations Module 4 - Consumers Continuing Control of their Lives Page 24 of26

4.3 Activity – New types of support

1. How does the adviser explore how things are going for Joyce?

Sue asks two separate questions… How is that working out for you? (in relation to Jane (support worker)

coming to do housework) & then asks “Is there anything you can think of which is not working for you?”

The first question elicits a good response from Joyce about how well she is getting on with Jane and the

second question elicits some information about support she needs with the computer. This then allows

the adviser to assist. The adviser doesn’t limit Joyce to her options but outlines them for Joyce to

consider.

2. Did you notice any helpful questions Sue asked Joyce?

Where would you like to go from here?

Do you feel you would need support to do the class?

Both are respectful of Joyce and very much facilitating Joyce’s choices while giving her all the control.

4.4 Activity – Budgets video 3

1. Did you notice that Joyce is prepared to pay a bit extra for Jane? Why do you think this is?

She feels comfortable with Jane, they get on well together and Jane knows ‘how she likes

things’. This illustrates how important the client/worker relationship is and

demonstrates that some consumers will pay a premium for what they want – just the

same as we do when we shop.


4.5 Activity – Other considerations for advisers

Picture source: CommunityWest

1. Can you suggest 2 or 3 key things to bear in mind when working with a consumer with a culturally or linguistically diverse background, especially those with limited English language skills?

Make efforts where language barriers exist, to communicate in the most effective way. Seek

assistance from interpreters or other persons as required.

Know what culture(s) the consumer identifies as. Be respectful every client is an individual. See

resource list for available national training and resources available.

2. The needs and preferences of carers and consumers don’t always coincide - have you got any suggestions for how service advisers could handle this?

It is important for the advisers to try and balance the relationship.

Prioritise what the consumer wants and needs because they are the person you are there

to support. Sometimes advisers roles will be diverse and include advocacy, mentoring and

sometimes mediation.


3. Do you have any suggestions on how to preserve consumers’ rights to exercise choice and decision making in a meaningful way when the person has dementia?

It’s about gathering enough information about the consumer, about their history and their life. If there is

a power of attorney, you must include them but you must always ensure the person is included in the

conversation. It is important you do not exclude the person accidentally, they must be included as much

as possible.

4. Older people who identify as Lesbian gay bisexual transgender and intersex (LGBTI) can sometimes be fearful about sharing this information. Are there any strategies you can engage to work in this sensitive area?

People who identify as LGBTI will decide whether or not to disclose their sexual orientation, sex or

gender identity. Their self-identity if declared needs to be respected and maintained. Recognise the

value of approaching everyone as individuals, within a CDC approach. Consideration of a consumer’s

individual needs requires an appreciation of their history, health status (including HIV status), culture

and experiences.

See resource list for available national training and resources available.
