OUTCOMES : WORKSHOP 1

1. OUTCOMES : WORKSHOP 1

2. Outcomes Project • Funded by SW RIEP • Follow on from the CUBA project • Designed to develop a generic outcomes training pack • 2 pilot sites (Plymouth and Wiltshire) to test LD materials • Materials will then be made generic and tested with a range of organisations • Will run a train the trainers pilot to test generic materials • Generic pack will be published in the Autumn • SW RIEP will run further train the trainer events

3. Agenda • Introduction (9:30am) • Quality of Life • Break • National themes and Issues • What is an Outcome? • Lunch (12:30pm) • IPC Model of an outcomes based approach • Break • Outcomes based specifications and contracts • The challenges • Close (4:30pm)

4. IPC OUTCOMES WORKSHOP : DAY 1Quality of Life

5. Exercise 1 Question: Think of something you like, that makes you smile, that you enjoy doing? Instructions: • Write it down on a piece of card. • When asked: come up, introduce yourself and put your card up on the board and explain what it is and why.

6. Quality of Life Domains • Physical: safety, mobility, health • Material: housing quality, possessions • Social: relationships, integration, acceptance • Productive: personal development, choice, meaningful engagement • Emotional: Self-esteem, mental health • Civic: Legal rights – privacy etc

7. Exercise 2 In small groups discuss: If you had a learning disability…. • What negative experiences might increase in frequency or intensity? • What things that are important for your quality of life might be less available?

8. Statements made by service users • ‘I am too old to go to the Theatre now’. • ‘I want to have friends’ • ‘I haven’t left my house for years’. • ‘I could work if I had the right support’ • ‘Now and again I would really like eggs on toast for my breakfast but the carers never have time to cook it with me’. • ‘I want to live in my own home’ • ‘I get frustrated when professionals and agencies don’t accept or value my expertise about my own needs’.

9. Initial impairment Vicious Circle: when a person is devalued Prejudiced belief: incompetence Greater impairment Low expectations Diminished or negative experiences Deprived of learning or developmental opportunities

10. As a result …….. “…we have established services for what people are not, rather than for who they are.” (Lovett, 1996)

12. And we forget that….. “An institution is not just a place [building], it is some kind of mental category [attitude] that affects perceptions and interaction rules” (p.77, Tøssbro, 1996)

13. Exercise 3 You are in a hot air balloon which is losing height rapidly and will soon crash because it is over weight; therefore you have to get rid of two of the passengers! Who would you choose? The passengers are:

14. Exercise 3 contd. A single mum who is an alcoholic A middle aged man with a severe learning disability A lady who is 82 years old and very sprightly A young offender (15 yrs old, female, crime: burglary) A male war veteran who is now a drug addict A female prostitute A male illegal immigrant from northern Africa A male paranoid schizophrenic A 50 year old homeless person An ex ‘Big Brother’ contestant

15. Unhelpful attitudes towards service users • People who use services have limited ability and willingness to contribute to the community as equals. • People who use services are problematically sick and vulnerable • People who use services are a burden • People who use services are a problem to be solved • People who use services are ‘patients’ whose rights are restricted by their need to accept health or social care services.

16. Generic Specific Societal Values Service Values Personal Values Support Provided Service User

17. Example • Generic: Your status depends on your job. • Specific: People with Severe Learning Disabilities cannot learn the necessary skills or do them without support so are not capable of working / having a job. • Societal: Segregate people with Learning Disabilities as they need looking after and have nothing to contribute. • Service: Day Centres. • Personal: It is not realistic to put ‘I want on a job’ on her PCP. • Support Received: Service User attends the same day centre for 20 years – they have no control over their own life. They are never allowed to dream.

18. Exercise 4 – Part 1 On your own • Think of something you have achieved in the past that you are proud of • Think of something you would like to achieve in the future

19. Exercise 4 – Part 2 Think of one of the service users you support: • Name one thing they have achieved in the past that they are proud of • Name one thing they hope to achieve in the future

20. Exercise 4 – Part 3 Questions: • Did you find it difficult to think what the person you support is proud of or/and what their dreams are? • Are their dreams and achievements very different from your own? • Has this exercise highlighted any issues in relation to assessment, support planning or service delivery?

21. Ways Forward….. • Start with a positive image • Start with what the person CAN do • Everybody has strengths, gifts and preferences as well as needs • Lack of success in achieving may simply reflect OUR inability to: • teach successfully • provide the right kind of support • offer services fit for purpose

22. Working in an Outcomes Focused Way is about……. • Starting with what the person wants to achieve • Thinking about what they can already do • Negotiating the best ways of supporting them to achieve the outcomes and hence quality of life they want • Designing services that are flexible