where do your dreams take you? come with cfs to a place where person-centered thinking is the way to...

Where do your dreams take you?

Come with CFS to a place where

Person-Centered Thinking

is the way to do business…

Becoming Person Centered Becoming Person Centered OrganizationsOrganizations

ServiceLife

CommunityLife

• Important for addressed

• No organized effort to address important to

• To and for present• Active circle of support• Included in community life

• To and for present

• Closest people are paid or family

• Few real connections

Moving from Service Life to Community LifeMoving from Service Life to Community Life

A Good Paid Life

Focus on connecting, building relationshipsand natural supports‘Important to’ present

‘Important to’ recognized

© The Learning Community for Essential Lifestyle Planning, Inc. 2006

Learning about what isn’t working for system Learning about what isn’t working for system changechange

Learning about what isn’t working for system Learning about what isn’t working for system changechange

• Best practice models don’t infect all of typical Best practice models don’t infect all of typical practice and cause changepractice and cause change

• Pilot efforts work but become another programPilot efforts work but become another program

• The “tick box” approach to person centered The “tick box” approach to person centered planning improves the quality of the paper more planning improves the quality of the paper more than the quality of livesthan the quality of lives

• Change by memo has no effectChange by memo has no effect

Learning about things that workLearning about things that workLearning about things that workLearning about things that work

• You have to change how people thinkYou have to change how people think

- It has to be everyone - top to bottom, side to side- It has to be everyone - top to bottom, side to side

- New ways of thinking have to become habits- New ways of thinking have to become habits

• Organizational culture has to reflect the values and Organizational culture has to reflect the values and support the skillssupport the skills

• All of the efforts have to be integratedAll of the efforts have to be integrated

• Changing structures and policies have to arise from Changing structures and policies have to arise from and reflect the learningand reflect the learning

Introduce and apply person centered Introduce and apply person centered thinking skillsthinking skills

Introduce and apply person centered Introduce and apply person centered thinking skillsthinking skills

Formal training for –Formal training for –

• All managers – senior, middle, front lineAll managers – senior, middle, front line

• Selected direct support staffSelected direct support staff

• Key players, the “opinion molders” among the Key players, the “opinion molders” among the

- self-advocates, family members, board members, - self-advocates, family members, board members, funders, inspectors, service coordinators, etc.funders, inspectors, service coordinators, etc.

But there has to be more than trainingBut there has to be more than trainingBut there has to be more than trainingBut there has to be more than training

• Training introduces skillsTraining introduces skills

• Without more than training the impact diminishes Without more than training the impact diminishes over timeover time

• Skills are learned but not regularly applied and Skills are learned but not regularly applied and then largely forgottenthen largely forgotten

• The remnants of the skills are in the forms that The remnants of the skills are in the forms that have become empty ritualshave become empty rituals

Two ErrorsTwo ErrorsTwo ErrorsTwo Errors

•Just training plan facilitatorsJust training plan facilitators

•Thinking that training without Thinking that training without structured practice is enoughstructured practice is enough

Not just better Not just better plans…plans…

Help people get better Help people get better liveslives


There has to be an effort that takesThere has to be an effort that takes the skills from training to habit the skills from training to habit

There has to be an effort that takesThere has to be an effort that takes the skills from training to habit the skills from training to habit

Skill become

shabit

Formaltraining

Informal

training

Structured

practicewith

feedback

Reinforce

Those who take skills from Those who take skills from training to habit are training to habit are

coaches, person centered coaches, person centered thinking coachesthinking coaches

Those who take skills from Those who take skills from training to habit are training to habit are

coaches, person centered coaches, person centered thinking coachesthinking coaches

Coaches help the skills become habits Coaches help the skills become habits Coaches help the skills become habits Coaches help the skills become habits

• Support the pervasive and routine use of the skillsSupport the pervasive and routine use of the skills

- In day to day work- In day to day work- In problem solving- In problem solving

• Use the skills to develop “living descriptions” of how people Use the skills to develop “living descriptions” of how people want to live through partnerships with –want to live through partnerships with –

- Those who use the services- Those who use the services- Family members- Family members- Those closest to the person- Those closest to the person

• Make and celebrate level 1 changesMake and celebrate level 1 changes

• Create optimistic discontentCreate optimistic discontent

Supporting Dreams

Being “Mindful” & Recording Learning

Recognizing and Sorting Important To and Important For& Finding the Balance Between

Them

Defining Staff Roles and Responsibilities

Matching Staff and Those Using Services

Learning, Using and Recording

Communication

Supporting Relationships, Community Connecting

• Learning Log• The 4 Questions• Working/Not Working

What are the skills needed to support people?What are the skills needed to support people?


Sorting Important to from Important Sorting Important to from Important for for

(and finding a better balance between them)(and finding a better balance between them)

Sorting Important to from Important Sorting Important to from Important for for

(and finding a better balance between them)(and finding a better balance between them)


Important to Important for

What is important to a person includes only what people are “saying”:

with their words

with their behavior

When words and behavior are in conflict, listen to the behavior.

Important to


What is important for people, includes only those things that we need to keep in mind regarding–

Issues of health or safety

What others see as important to help the person be a valued member of their community

Important for


Importantto

Importantfor

Importantto

Importantfor

Importantto

Importantfor

BalanceBalance


USE JUDGEMENT& CREATIVITY

CORE RESPONSIBILITIES

NOT OUR PAID RESPONSIBILITY

The Donut SortDefining Staff Roles and Responsibilities

© The Learning Community for Person Centered Practices, Inc. 2008, adapted from the work of Charles Handy

Supports wanted and

neededSkills needed

Personality Characteristics (Present/Absen

t)

Shared interests

(nice to have)

Matching StaffMatching StaffMatching StaffMatching Staff


for each person what are the:

Communication ChartLearning, using, and recording communication

Communication ChartLearning, using, and recording communication

What is happening Person does this We think it means We should



4 + 1 Questions4 + 1 Questions((focus on learning and act on it)focus on learning and act on it)

4 + 1 Questions4 + 1 Questions((focus on learning and act on it)focus on learning and act on it)

What have we tried?

What have we learned?

What are we pleased about?

What are we concerned about?

And then, what should we try/do based on what we have And then, what should we try/do based on what we have learned?learned?

What works/makes senseWhat doesn’t work/make

senseP

ers

on

’sp

ers

pecti

ve

Fam

ily’s

pers

pecti

ve

Sta

ff’s

pers

pecti

ve

What works/makes senseWhat doesn’t work/make

senseP

ers

on

’sp

ers

pecti

ve

Sta

ff’s

pers

pecti

ve

USE THIS INFORMATION TO BUILD THE

AGENDA

FOR THINGS THAT ARE TO

STAY THE SAME

USE THIS INFORMATION TO BUILD THE

AGENDA

FOR THINGS THAT NEED TO

CHANGE

Disagre

emen

ts

If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.

-Albert Einstein -Albert Einstein

If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.

-Albert Einstein -Albert Einstein

www.learningcommunity.uswww.learningcommunity.us

for more information go to:for more information go to:

Michael Steinbruck

[email protected]

732.235.9308

or contact:

How we weaved Person Centered Thinking into the

Rounds Process in our Residential Department

Clinical Meetings

What we did then - focus on compliance issues

What we are doing now - moving towards helping consumers achieve a more meaningful life

Person Centered Thinking Approach

Working/Not Working Tool which we renamed to Team Meeting/Consumer Rounds Worksheet (page1)

Records information in a more person centered way

TEAM MEETING/ CONSUMER ROUNDS WORKSHEET page 1 Consumer Name: Date: Presenting issue:

From the Consumer’s Perspective

What Is Working Right Now? 1.Enjoys working at Pathmark 2.Likes having control over his money 3. Likes being able to refuse to go on his appt for Drug counseling. 4.Taking his Viagra when he wants it

What Is NOT Working Right Now? 1.Doesn’t like to have team meetings all the time 2.Doesn’t like getting positive drug test results 3. Everyone pressuring him to go to see his counselor

From Staff Perspective

1. Team meetings gain only temporary cooperation 2. He remains employed.

1. Has high blood pressure and not knowing his drug or alcohol level 2. Concerned about mixing Viagra with high blood pressure and drugs.

Team Meeting/ CONSUMER ROUNDS WORKSHEET page 1 Consumer Name: Date: Presenting issue:

From the Consumer’s Perspective

What Is Working Right Now?

What Is NOT Working Right Now?

From Staff Perspective

Developing a Person Centered Thinking Plan

Utilizing the “4 + 1” Questions Tool which we renamed the Team Meeting/Consumer Rounds Worksheet (page 2)

Based upon What’s Working/Not Working Tool, we began to use this tool to answer the questions in order to formulate a plan

TEAM MEETING/ CONSUMER ROUNDS WORKSHEET page 2 Consumer Name: Date:

What have we tried: 1. Restricted his independence in the community 2. A relapse protocol was put in place 3. Transporting him to and from work. 4. Driving him to Counseling sessions

What have we learned? 1. He has access to drugs and alcohol at work during breaks. 2. Pathmark will not intervene unless it interferes with his work performance. 3. Doesn’t like to be in group with other “slow” people.

What are we pleased about?1. He tries to respond, he wants to stay sober. 2. His employment has not yet been effected.

What are we concerned about?1. Effects on his health

What should we do now?1. MSC will look into a residential drug program for him2. Talk to MD about discussing the dangers of mixing drugs with high blood pressure.3. Explore finding educational video for him to watch4. Explore having attend regular AA meetings.5. Meet again in one month.

Team Meeting/ CONSUMER ROUNDS WORKSHEET page 2 Consumer Name: Date: What have we tried:

What have we learned?

What are we pleased about?

What are we concerned about?

What should we do now?

Results

The tools became a living document We moved away from a focus on

compliance and towards meeting the real life needs of the consumers

We have more successful paper We have eliminated obstacles to creating

happier lives

Day Hab Overview

Day Habilitation Without Walls (DHWOW) is a community based one to one program. The program is geared towards individuals who were in traditional day programs that were unsuccessful in helping them achieve their goals and need one to one support. DHWOW is not site based and focuses on volunteer and recreational opportunities in the community. As a result the program participants are able to work on their goals hands on and in real time.

Problem Areas

1. Differences between desires of the consumer and advocate

2. Continuation of the same goals that did not result in much change in the consumer’s life

3. Ways to record learned information

What we were doing before…

Planning

for the consumer

instead of

with the consumer

Tool Used

Before we would bring something to the table and have the consumer/ advocate choose from our options

Important To/ Important For – helped develop more meaningful goals for the consumers, during planning meetings

Important To – what the person is saying in their words or behavior

Important For – issues of health or safety, “what others see as important for the person to be a valued member of their community”

Important To/ Important For

Important To •Important For

Oscar’s Story

Problems – discrepancy in how goals are addressed

Helping Agent – important to/ important for tool

Positive Outcome – Oscar currently volunteers twice a week at a senior center

Oscar’s Important To/ Important For

What is important to Oscar To help others Having a “regular” job

(like people without a disability)

Working at one site Working indoors Same daily routine

What is important for Oscar To gain work experience Healthy and safety

environment

A PERSON CENTERED DESCRIPTION ABOUT ______________________

I. What are some great things about the consumer? (What do people like and admire about the consumer? How does the consumer like to be

introduced? What does the consumer like to do? Where does the consumer like to go? Whom does the consumer like to spend time with?)

II. What are things about the consumer that is important for others to know or do

in order to best support them? (What does the consumer dislike? What are things that the consumer has to do (or have) to keep

him/her happy? How does the consumer need to be supported at home, at work, or out in the community?)

III. What do you and other do that makes the consumer happy? (What qualities and traits do you possess that the consumer likes? What qualities and traits do other

people possess that the consumer likes?)

IV. Is there anything else that you can share that we would want to know about the

consumer?

Written by: __________________ Relationship to consumer:_________________________

Person Centered Description Tool

Compilation of several PCT Tools Tool is completed by staff, family, consumer or

other involved parties Supervisor then utilizes this information to create a

person centered description with graphics as a background

Future goal is to utilize this description as the cover of all of our habilitation plans

A person centered description about OscarA person centered description about Oscar

Oscar enjoys being around other people and helping them if possible. He enjoys watching Wrestling and his favorite wrestler is Stone Cold Steve Austin. Oscar also collects Wrestling DVD, games, posters, and other memorabilia. Oscar’s favorite places are Nintendo World, Sony Wonders, and the Circus.

Oscar enjoys being around other people and helping them if possible. He enjoys watching Wrestling and his favorite wrestler is Stone Cold Steve Austin. Oscar also collects Wrestling DVD, games, posters, and other memorabilia. Oscar’s favorite places are Nintendo World, Sony Wonders, and the Circus.

Oscar also enjoys going on group trips with his peers, and talking to them about his favorite wrestlers. Oscar loves spending time with people he went to school with, friends from his Day Program, and his mother. Although usually shy at first, Oscar freely expresses himself once he gets to know a person.

Oscar also enjoys going on group trips with his peers, and talking to them about his favorite wrestlers. Oscar loves spending time with people he went to school with, friends from his Day Program, and his mother. Although usually shy at first, Oscar freely expresses himself once he gets to know a person.

Oscar does not like it when people use curse words, walking long distances, or being outside for long

periods of time. Oscar prefers to have a routing schedule and be

around friendly people. Oscar needs to know about an event before participating in it and map out his bus route before traveling because he gets anxious. He is unable to travel in the community independently, but is learning how to with help from his DHS. Oscar needs to contact his mother when he makes changes to his schedule.

Oscar does not like it when people use curse words, walking long distances, or being outside for long

periods of time. Oscar prefers to have a routing schedule and be

around friendly people. Oscar needs to know about an event before participating in it and map out his bus route before traveling because he gets anxious. He is unable to travel in the community independently, but is learning how to with help from his DHS. Oscar needs to contact his mother when he makes changes to his schedule.

To best support Oscar a person needs to know that Oscar is quiet when upset and has a hard time verbalizing his feelings. Oscar’s mother is his biggest support and it is important for him to call her when he gets home from program each day.

To best support Oscar a person needs to know that Oscar is quiet when upset and has a hard time verbalizing his feelings. Oscar’s mother is his biggest support and it is important for him to call her when he gets home from program each day.

Results

Way to record information learned so all new staff can access meaningful information in a more timely fashion

Less paper, more information More meaningful goals for the consumers

that result in better lives

where do your dreams take you? come with cfs to a place where person-centered thinking is the way to...

Documents

learning community

person centered planning

skillsformal training

essential lifestyle

learning log

present closest people

better planshelp people

service life