Enabling Good Lives Toolbox

A collection of proven approaches and skills based on what works in current New Zealand conditions

For disability support organisations

Introduction

What is Enabling Good Lives?

Enabling Good Lives is a partnership between the disability sector and government agencies to ensure that disabled people (Throughout the document the term ‘disabled person,’ ‘person with disability’ and ‘person experiencing disability’ will be used interchangeably. The assumption is this includes their family/whānau as appropriate to that person.) have greater control over their lives. This includes having a say in how resources are used. It also creates opportunities for family, whānau and friends to gain the skills, confidence and information they need to support disabled people to live an everyday life in everyday places.

The Enabling Good Lives approach was developed by an independent group of sector leaders in 2011. It was a response to increasing pressure from disabled people, families, advocates, support providers and needs assessment and service coordination agencies (NASCs) on the Ministry of Health.

This toolbox is a combination of two separate pieces of work. They were Enabling Good Lives (EGL) in the Waikato and the Ministry of Health’s New Model demonstration of Choice in Community Living in Auckland and the Waikato.

The New Model work is informed by the same set of values as Enabling Good Lives, as agreed in the Disability Action Plan (agreed by the Ministerial Committee on Disability Issues on 11 September 2012). So this toolbox will use EGL as the overarching term when describing underlying principles and values.

New ways of doing things

EGL is about change and new ways of doing things. Central to EGL is the shifting of authority so disabled people and their families have the ‘say so’. This involves the strengthening of disabled people’s and families’ networks and the creation of individualised funding for disabled people through a cross-government or joint funding model. This is linked with a move to replace current separate disability services with a facilitation-based model that supports full citizenship.

EGL is based on a set of principles that guide development. The basis of the EGL approach is that services and supports are tailored to reflect individual strengths, preferences and aspirations. In this way, EGL will take different forms – person by person, family by family and community by community. Disabled people, their families and service providers are partners in the process of designing, implementing and monitoring the EGL approach. A disabled person’s family/whānau and friends are seen as their natural supports.

Vision and outcomes

The long term vision of Enabling Good Lives is that people with disabilities and their support networks

  • have control in how resources are used to support the life they want to lead
  • are respected and appreciated as contributing citizens.

The overarching EGL outcome is:
Disabled people have greater choice and control over supports, use more mainstream and natural supports, and disability support funding is more efficiently used.

 

What needs to change?

There are five areas of change needed for us to realise the vision of enabling good lives. They are:

  1. Building knowledge and skills of disabled people: to ensure disabled people understand the direction for change, and can take up opportunities to have more choice and control over their supports.
  2. Investing in families: to assist families/whānau to best support their disabled family member to have a good life and help them develop a vision and aspirations about what can be achieved.
  3. Making changes in communities: to ensure communities, including businesses, workplaces, schools, and religious, cultural, sport and recreational activities are accessible, welcoming and recognise the contribution that disabled people can make to enhance community cohesion and well-being.
  4. Making changes to service provision: to align organisational roles and functions, delivery models, workforce capability, accountability measures, monitoring and evaluation with the vision and principles of the transformed system.
  5. 5. Making changes to government systems and processes: to support the system redesign. Examples of this include integrated contracting, individualised funding, flexible outcomes-focussed contracting, funding pooled from across Votes (this may include Vote structure changes) and involving disabled people and families in governance.

In summary, all the EGL initiatives and strategies are aimed at building a better way for disabled people and their families to have the ‘say so’ in their lives. We will know we are getting there when disabled people tell and show us that it is easier for them to create good lives for themselves.

The process of supporting individuals to make choices will be based on what the person truly identifies as a good life for them. In the past we have offered options based on what we, as providers, could supply – these were limited or fixed options. We are now focusing on learning to facilitate the exploration and development of true choice making and contribution.

 

EGL outcomes

The EGL approach will have achieved its objectives when disabled people have greater choice and control over supports and use more mainstream and natural supports. Another outcome is that disability support funding is more efficiently used.

What might the new approach look like?

Person or group Outcomes
Disabled people and their families, as appropriate, can say:
  • I have access to a range of support that helps me live the life I want and to be a contributing member of my community.
  • I have real choices about the kind of support I receive, and where and how I receive it.
  • I can make a plan based on my strengths and interests.
  • I am in control of planning my support, and I have help to make informed choices if I need and want it.
  • I know the amount of money available to me for my support needs I can decide how it is used – whether I manage it, or an agency manages it under my instructions, or a provider is paid to deliver a service to me.
  • The level of support available to me is portable, following me wherever I move in the country.
  • My support is coordinated and works well together. I do not have to undergo multiple assessments and funding applications to patch support together.
  • I have a network of people who support me – family, whānau, friends, community and, if needed, paid support staff.
  • I feel welcomed and included in my local community most of the time, and I can get help to develop good relationships in the community if needed.
  • My family and friends are recognised and valued for their support.
Service providers can say
  • We operate with a clear set of principles and expected outcomes.
  • We negotiate how we work on a person by person and/or family by family basis.
  • We experience one monitoring and evaluation process that is developmental.
  • We operate according to a facilitation based approach. This will make it easier for individuals and families to achieve their goals by tailoring supports rather than by providing a set range of service types.
  • We work to ensure community (generic) options are exhausted before specialist services are considered.
  • We operate with significantly reduced bureaucratic restrictions.
  • The system supports innovation.

 

The principles of Enabling Good Lives

Achieving our future vision for disability supports is complex and will take time, with many details to work through. A principles-based approach will ensure we stay on track as we work towards the vision. EGL is based on a set of eight principles. The principles and their descriptions are:


Self-determination

Disabled people are in control of their lives.


Beginning early

Invest early in families and whānau to support them to be aspirational for their disabled child, to build community and natural supports and to support disabled children to become independent, rather than waiting for a crisis before support is available.


Person-centred

Disabled people have supports that are tailored to their personal needs and goals. These take a whole life approach rather than being split across programmes.


Ordinary life outcomes

Disabled people are supported to live everyday lives in everyday places. They are regarded as citizens with opportunities for learning, employment, having a home and family, and social participation – like others at similar stages of life.


Mainstream first

Disabled people are supported to access mainstream services before specialist disability services.


Mana enhancing

The abilities and contribution of disabled people and their families are recognised and respected.


Easy to use

Disabled people have supports that are simple to use and flexible.


Relationship building

Supports build and strengthen relationships between disabled people, their whānau and community.

 

The principles in action

How the principles will work in practice is shown here:

Principle Description Good practice examples – from a service provider perspective
Self-determination Disabled people are in control of their lives

Staff are:

  • skilled in a variety of communication approaches
  • aware of personal development strategies
  • able to assist people to experience new options that are consistent with their known preferences
  • knowledgeable about the impact of power imbalance and how to shift authority
  • willing to be led by disabled persons and families
  • skilled in partnership approaches.
Beginning early Invest early in families and whānau to support them to be aspirational for their disabled child, to build community and natural supports and to support disabled children to become independent, rather than waiting for a crisis before support is available.

Planning and trusting relationships inform a proactive approach.

Staff have a strong sense of optimistic expectation and potential.
Person-centred Disabled people have supports that are tailored to their individual needs and goals. These take a whole life approach rather than being split across programmes.

Approaches are timely, responsive, creative and holistic.

Ordinary life outcomes Disabled people are supported to live everyday lives in everyday places. They are regarded as citizens with opportunities for learning, employment, having a home and family, and social participation – like others at similar stages of life.

Staff have:

  • a ‘whatever it takes’ approach
  • flexibility to support people in a range of environments and situations.
Mainstream first Disabled people are supported to access mainstream services before specialist disability services. There are diverse, strong and mutual connections with community resources and networks.
Mana enhancing The abilities and contribution of disabled people and their families are recognised and respected. There are many ways for people to express their views and also a direct link between service practice and people’s expressed preferences.
Easy to use Disabled people have supports that are simple to use and flexible. Communication is appropriate and easy to understand.
Relationship building Supports build and strengthen relationships between disabled people, their whānau and community. There are multiple forums/ways for relationships to be recognised and respected.

Different principles underlie different aspects of the new approach, as shown in the following table. The principles are integrated into the topics in this toolbox.

 

Using this toolbox

The items in this toolbox cover a mix of skills, attitudes and techniques and, although written as separate topics, they propose a common approach. The first five sections cover the fundamental elements that are common to all the topics. Each section gives a brief outline of each topic. This is followed by a list of websites and other resources you can follow up if you want to know more.

We suggest that you read the toolbox together with ‘You have rights when you use a health or disability service.’

Try out the various tools – adapt them to suit the person and the situation. The tools are ways of really getting to know an individual. They will help us move from supporting people based on what we know to supporting them to follow their dreams. It is all about having a ‘can do’ attitude!

Future toolbox topics

Future topics include:

  • Supporting friendships and intimate relationships
  • Ethics and a code of practice

Please send any suggestions to john@novate19.org.nz

Resources

http://www.odi.govt.nz/what-we-do/improving-disability-supports/enabling-good-lives/

‘You have rights when you use a health or disability service’ is available from People Firstwww.peoplefirst.org.nz

Shifting Authority

Who has the say so? Shifting authority

Being able to have the ‘say so’ about your own life is something many people take for granted. But disabled people have a long history of having other people deciding on their behalf. We now know that, with information, experience and support, disabled people can and want to make their own choices. Providers and carers are learning to give back the say so and are making the transition from managing and controlling a person’s life, to supporting and facilitating change on their terms.

Why it is important

When people who use services were asked ‘What would make my life easier?’ their responses included:

  • To be heard and respected
  • Flexibility
  • Everyday things in everyday places
  • Doing more things that are important to me

People who use services want more control over their lives.

Key elements

Shifting authority means changing the focus from the provider dictating what service or programme a person will receive. In the new approach, the person says what they want and the provider helps to make it happen. It gives the person the say about how they want to live their life. Shifting authority:

  • is a core element of enabling
  • requires trusting relationships
  • enables processes such as planning to be person-directed and strategic planning, decision-making and problem solving to be shared
  • means that services are responsive and get things done
  • enables self-determination about real things
  • is not consultation after a decision is made

How it works

Acknowledging the benefits of person-directed services

Service providers have often tried to be all things to all people. This approach imposes unrealistic expectations of providers and limits the opportunities for individuals to connect with people and activities of interest to them. When providers and support networks (paid and unpaid) listen and enable disabled people to make their own decisions, then their roles and responsibilities are much clearer and helpful to the person.

Providers and support networks enable people to become the drivers of their own lives. The new approach enables providers to move towards a focus on individuals, their natural supports and community supports.

Ensuring options for those who have been previously excluded

Some people have not had many opportunities to learn about making choices. Providing opportunities and experiences is a crucial part of the process of having the say so about their own life. That means that the person is supported to make choices and decisions on a daily basis. The person can learn that making mistakes may be part of the learning process. Learning how to question and how to deal with conflict will ensure that the individual learns how to be the driver of their own life.

Encouraging involvement in strategic decision-making and planning

It is important to ensure that there are frequent opportunities for people to meet and discuss how things are going for them in ways that are understandable and meaningful to them. This includes ensuring that any training or information is also presented in relevant and understandable formats. Staff must understand that their role is to facilitate and support, rather than to do things for someone.

Reviewing the effect of power sharing

Providers and support networks will find that disabled people’s participation increases in a range of activities, issues and decision-making. Services can use the information from these people as the basis of planning for the development of the organisation and how it supports people with disabilities.

 

Potential challenges and suggested strategies

 Challenges  Strategies
Learned helplessness. Sometimes organisations have provided things that people can do for themselves. People may have been comfortable with others making all the decisions – this was safe and easy (even if not always ideal for them!)
  • Shift authority slowly and gently, not so it’s scary, but in a way that supports the person to feel comfortable and confident exercising authority.
Exposing people to risk; what if they make ‘bad’ or ‘unsafe’ choices?
  • Personalise safeguards. What do we need to put in place to make it ok for you to do this?
  • Use ‘mistakes’ as learning opportunities.
Organisations may feel defensive. But sometimes the organisation (and its extensive policies and procedures) is the reason someone’s life is limited.  
  • Recognise the importance of natural supports. The service’s role is to strengthen relationships between disabled people, their whānau and community.

What shifting authority (having the say so) may look like

Person or group  Outcomes
 

For the individual

  • I have choice and control over the support I need to go about my daily life.
  • I understanding how things work and how to get things done.
  • I have a method to communicate ideas, needs, etc.
  • I feel safe about making complaints or raising a concern.
  • I feel supported to try something and learn from it if it does not work out (learning from mistakes).
  • I am valued and respected by staff, family and friends.
  • I am part of the give and take – reciprocity.
  • I share roles and responsibilities in meaningful ways.
  • I am supported to take leadership roles.

For family/whānau

  • We are asked for information, ideas and opinions.
  • We are enabled to participate and contribute.
  • Our ideas and opinions are respected.
  • We have input into organisational planning and review.

For the organisation

  • There are transparent, easy to understand processes for decision-making and planning.
  • Roles and responsibilities are shared.
  • The process of challenging and changing current hierarchies is active.
  • Leadership is shared.

Resources

http://tuhana.org.nz/index.php/shifting-authority

O’Brien, J and Mount, B (2005) Make a Difference: A guidebook for person-centred direct support. Inclusion Press, Toronto.

www.socialrolevalorization.com

www.mencap.org.uk/involveMe

Body & Soul: Diana & Kathy A film by Alice Elliot, New Day Films, 2007.

Building Trusting Relationships

To engage in the process of shifting authority it is essential that the partners develop trust each other. This section considers some processes that will build and maintain trusting and effective relationships. These will be the foundation of a partnership approach for support arrangements.

Why it is important

Trust is one of the primary factors in how people work together, listen to one another, and build effective relationships. It is a critical link to all good relationships, both personal and professional. Without it relationships may be affected by cynicism, doubt, and anxiety. These lead to negative speculation and generally low energy and engagement.

Key elements of trust

Trusting in someone else doesn’t just happen. It is developed over time based on tangible actions. You can only get trust if you first give it. Trust develops when a person can:

  • believe in the safety and reliability of another person/organisation’s actions
  • let others know their feelings, emotions and reactions
  • have the confidence they be will respected and not taken advantage of
  • be clear about ‘What I am doing’ and ‘What I can and cannot do’ (that is, intent, scope and boundaries)
  • share, negotiate and chose
  • recognise that everyone has things to give and areas where they need support (interdependence).

How it works

Trust takes time

Take time to get to know one another, to develop and strengthen relationships with the focus person and/or the community. The pace at which each of us operates varies and past experiences may influence the time it takes to rebuild trust. If we spend time on getting the relationship right it is likely that trust will follow.

Clear and honest communication about your intentions

Be open, honest, timely and transparent. Doing this leads to you being viewed as trustworthy. Eliminate guesswork (and anxiety) when discussing your or another person’s intention or involvement. Check that you have heard and understood the other person’s point of view.

Keep records

In practice it is often useful to have a written record, especially at the beginning, to reduce or eliminate misunderstanding.

Don’t omit important facts. If you edit what you say, it may be hard to remember them later and contradictions could lead to questions about your reliability.

Respect others’ views and opinions

This is not agreement or assent but demonstrating that you value their right to their own views/beliefs. Respect another person’s confidentiality – never tell someone else’s story. People who are discreet are more trusted.

Consideration, benevolence and safety

Establish the belief that the trusting relationship is based on concern to advance/support the person’s interests – not impede them. Create an environment where people feel they can express their thoughts without fear of reprisal.

Integrity and reliability

Do what you say you will do. Trust develops when a person/organisation’s words are congruent with their actions. Aim to be objective and fair when making decisions or taking action. You need to remain neutral in difficult predicaments – don’t take sides. The more you demonstrate that you do what you say, the more that strengthens the relationship.

Admit your mistakes

Part of being in a trusting relationship is admitting it when you get it wrong – and you will! Apologising can be an effective way to correct a mistake and to restore or strengthen trust. Don’t fall into the trap of thinking that an apology reduces your mana. It doesn’t when it is genuine and timely and you work to ensure you do not repeat the mistake.

 

Potential challenges and suggested strategies

 Challenge  Strategies
Trust has been broken
  • Acknowledge the loss of trust. Then act with integrity to right what was broken. Personal accountability through consistent and trustworthy actions helps to restore trust.
  • Own up and be accountable. To create openness for trust to be restored we need to acknowledge our role. Integrity aligns actions to words.
  • Take action – be the person who makes the first move. Although it doesn’t have to be all or nothing, a gradual approach gives time for a response when each party is comfortable.
  • You may need to develop new responses, reassurances or processes which help to ensure trust is not broken in the same way again. Actions speak louder than words!

What a trusting relationship may look like

Person or group  Outcome

For the individual

  • I understand how things work and how to get things done.
  • I have a way to communicate ideas, needs, etc.
  • I feel safe about making complaints or raising a concern.
  • I am valued and respected by staff, family and friends.
  • I am part of the give and take (reciprocity).
  • I contribute.

For family/whānau

  • We are listened to without fear of reprisal.
  • We are asked for information, ideas and opinions.
  • We are confident that what has been agreed to will happen.
For the service provider
  •  There are transparent, easy to understand processes for decision-making and planning.
  • There is regular feedback and checking back in all aspects of service delivery.
  • We are encouraged to be innovative
  • We are trusted.
  • Service users and family/whānau are regularly contributing members of service planning.
For the community
  • The service does what is says it will do.
  • We have ways to interact with and contribute to the service and the people who use it.
  • The service contributes to the community.

Resources

http://www.wikihow.com/Build-Trust-in-a-Relationship

http://www.tuhana.org.nz/index.php/building-trusting-relationships

http://www.kenblanchard.com/img/pub/Blanchard-Building-Trust.pdf

Facilitative Support

Shifting authority and building trust require a facilitative approach to our work with disabled people. In a facilitation-based approach, the focus is on assisting (facilitating) the person to get what they want, that is to live their life doing the things they want to do. The person identifies and chooses what kinds of services and supports will suit them to achieve what they want to achieve. This will most likely be a range of both formal and informal supports. The focus is also on supporting one person at a time by getting to know them well and assisting them to find out what kind of things would enable them to have a really good life.

In this approach, there are many pathways as each person is unique. Some people may be very sure about what they want and need to live a good life. Others may require a period of exploration and trying things out. How else can they know what they like if they haven’t had the chance to try things out?

Staff become facilitators and help people try things out. They support each person to explore options and build networks within their communities.

This is a process of transformation. Service providers are changing from providing services to being of service. It is a learning experience for people with a disability, their families and whanau too. 

Using an appointed facilitator

As well as facilitation being a general approach, it can also be useful to have a person acting as a formal facilitator. At the moment examples of this are local area coordinators and EGL navigators.


Why it is important

A facilitation-based approach makes it easier for disabled people to have an ‘everyday life in everyday places’ because the person leads the process. The person is actively supported to participate in a range of mainstream community activities and social networks that they have selected as their priorities. The role of staff is to help with whatever it takes to achieve a person’s goals.

The main focus is to support a person and their family/whānau to make it easier for them to achieve a good life. Staff, family and community members can all take on the role of being a facilitator to help the person to find out what they like and want to be doing and to support them to do it.

Key elements

The key elements of facilitation-based support would include:

  • Self-directed planning: A facilitator can assist in building and maintaining relationships and support networks in the community. The facilitator helps the person access mainstream community-based services and activities, and identifies opportunities for them to contribute to the community. The facilitator would help the person to identify their aspirations and goals, and develop a plan to achieve these. The level and duration of facilitation support would vary for each person.
  • Strengthening families/whānau: Families/whānau are supported to assist the disabled person as is appropriate. Some examples of this include promoting family-to-family support, and family and whānau collectives.
  • Community building: Mainstream organisations are supported to address barriers to inclusion that disabled people face. Examples of these include the built environment and the attitudes of employers and government agencies. The facilitator, or providers who are enabling people to participate in the community, would do most of this work.

A facilitator’s role is to be an unbiased support and source of information. The focus is on achieving the outcomes sought by the person.

 

Facilitators work to ensure:

  • supports and services are driven by the preferences and aspirations of persons and family/whānau
  • people and family/whānau have maximum control of supports and services (rather than simply being allocated a specified service)
  • information is provided on all options (such as community groups, disability providers and self-directed funding)
  • goals are recorded and decisions made through a planning process (the process outlines the timeframes and who does what, when)
  • resources are customised to what the person is wanting to achieve
  • people achieve outcomes such as education and training; employment; being with friends; having relationships and a family; and taking part in community and cultural activities
  • natural supports/networks are acknowledged and strengthened

 

How it works

The disabled person (and their family/whānau) is linked with a facilitator to support them in a self-directed planning process. The facilitator helps the person to identify what they want and how the service can make this easier to happen. They may try out many of the tools in these guidelines to assist them. A plan may identify available community resources and other natural supports. It may also suggest areas that need additional resources or funding.

Implications for support staff

There are a number of ways that changing from a care model of support to a facilitation model of support impact on direct support staff. The key areas are in the skills people are going to need to use and some of the personal attributes that will help. Below is a list of some of these. All of them can be learned so even if you do not think you have them now, this list may help you work out your training priorities.

 

To be successful in the facilitative role you will need to:

  • work creatively and be non-judgemental
  • be a good problem-solver but a better coach – you will be able to assist the person solve their own problems
  • take the time to listen to the person being supported so they lead and you assist.be flexible in how you work and think
  • view each situation from a strengths-based approach – you will be able to look for the opportunities rather than the barriers
  • be good at responding to other people’s priorities and timetables

 

This new way of working means you also need to:

  • be punctual
  • reflect on your practice and be open to critique
  • be well connected with the community in which you work
  • be great at networking
  • be resilient
  • have a good teaching and community development skillset
  • be positive in your approach to work.

 

Potential challenges and suggested strategies 

Challenge  Strategies

The support system and/or support services do not meet individual expectations

  • Advocate for the individual and/or their family/whānau to receive the support/services they want.
  • Look for other options through community mapping, networking, social media that might meet the individuals expectations.
  • Ensure the process is flexible. It can be changed to fit individual circumstances and preferences.
  • Ensure there is increased choice and control of the process by making sure communication is clear and reciprocal.
  • Focus on honouring the individual’s choices.

Confusion and the need for clarity

  • Ensure information is easy to understand to make informed decisions
  • Assist individuals and family/whānau to have the information/knowledge to have a vision for the future, what it might look like and how they will get there – do some mapping out or informal planning.

What a facilitation-based approach may look like

Person or group  Outcomes

For the individual

  • I am asked what I want and how this can be achieved. Supporters know me and my strengths, preferences and aspirations.
  • Supporters help me network and connect based on my aspirations.
  • Supporters don’t take over.

For family/whānau

  • Our culture and preferences are respected.
  • If appropriate, we can be a part of the process.

For the service provider

  • There is a transparent process and system.
  • Staff are facilitators working with individuals.
  • It is easier to assist people to have choice, control and be active citizens.

For the community


  • More people are experiencing an ‘everyday life in everyday places’.
  • People in the community can be involved in supporting this process.

Resources

Information for this section is adapted from the Enabling Good Lives Report from the Independent Working Group on ‘Day Options’, July 2011. http://tinyurl.com/mhlgmhn

http://www.tuhana.org.nz/index.php/facilitation

Milparinka – This is a support service that assists people who have disabilities to pursue lifestyles that include the same opportunities that all members of the community expect and enjoy. www.milparinka.org.au/index.php

Melberg Schwier Karin (2012) Flourish: People with Disabilities Living Life with Passion. Inclusion Press, Toronto.

Creating Partnerships

Fundamental to the EGL approach is the idea of partnership. These are between the service provider and the person supported, the person and their family/whānau/support network and between the provider and the family/whānau/support network. These partnerships form the basis for successful support arrangements. Without it we are likely to retain services directed by the provider and therefore will miss the opportunity for really creative and self-directed supports.

The word ‘partnership’ can be described as the willingness of two or more people or groups to work together to achieve a mutually beneficial outcome(s). It requires:

  • a willingness and commitment to share knowledge, understanding and resources (both material and personal)
  • respect for each other’s integrity.

Often people will want or need to involve their family or close friends in working through what options might work best for them with a provider. This will require strong and trusting relationships to be created and maintained so that these partnerships can be effective.

Why it is important

Building effective partnerships is the key to effective services. The promise of people living their own lives within the community of their choice is, in fact, only possible if a partnership model is followed.

Key elements

Hilton Davis, who developed the Family Partnership model, described the characteristics of an effective partnership as

  • working closely together with active participation and involvement
  • sharing power, but with the [person]/parent/[whānau] in the leading role
  • complementary expertise
  • agreeing aims and process
  • mutual trust and respect
  • openness and honesty
  • clear communication
  • negotiation

In practice what this means is that as a service/support provider you must find a way to work with the person and their family/whānau/network in such a way that they remain in the driving seat at all times. This does not mean that you need to cede all power to them, but that you find a way to truly share power with the person leading the way.

How it works

Ways of building partnerships

The first thing to do is to discuss with the person/family/whānau the idea of working in partnership and what it could look like for them. This is where questions are more important than describing how you usually do things!

At the beginning of the partnership, it is good to work out:

  • what is important for all parties
  • how decisions will get made
  • what each party will do or is responsible for
  • how you will communicate and how frequently
  • how conflict and differences will be dealt with
  • what the are key tasks you, as a service provider, are being asked to be involved in – exactly what these will look like when they are successfully done and what they will cost
  • review periods and opportunities to check on progress and alter the initial plan.


Tips for working in partnership

You will find working in this new way easier if you follow some of the following tips:

  • Have a clear direction or purpose to enable all of the people involved to have a sense of what is expected and where they will be going.
  • Break things down into small and achievable steps which allow everyone to get a real sense of movement, success and clues to where they need to make changes.
  • Eagerly and constructively respond to challenge and ensure all parties feel safe to express different opinions.
  • Act as a facilitator (not an expert or controller) to assist people who are unsure or distrustful of the process to remain hopeful and involved.
  • Optimise the opportunities for face-to-face contact and decision-making to reduce suspicion and increase the chance for understanding and personal connection.
  • Ensure that all parties have the ability to participate in a meaningful way.
  • Use situations of difficulty or crisis as an opportunity to explore the effectiveness and ethics of what you are doing.


Potential challenges and suggested strategies

Challenge  Strategies

Power imbalance

  • It is important to recognise power imbalances. Partnership requires respect, a shared frame of reference and the ability to work collaboratively.

Withholding information

  • When information is withheld or only partially given, partnership becomes challenging. Ideally, each party needs to have all the information, understand it and be able to make informed decisions based on the information provided.

Attempting to connect or partner with community services or organisation in large groups

  • Partnerships and connection can be increased through supporting people to contribute and participate in the community person by person or family by family.

Connecting with the community

 
  • Develop reciprocal relationships. Ensure people ‘give to’ or ‘give back’ and are not just passive recipients of the community.
  • Prepare and plan carefully – talk to organisers before people take part in an activity, let them know why people want to be part of it and give them strategies for engaging with the person. This helps to ensure that people will be made to feel welcome and their involvement will be sustainable.

What partnerships may look like

Person or group Outcomes

For the person

  • I have a range of learning opportunities to enable decision-making.
  • My views are shared and used.
  • I am respected as a partner.

For the family/whānau

  • We are listened to.
  • Our ideas and concerns are actioned.

For the organisation

  • People are supported to make choices in their lives, with many opportunities to have the say so in their lives. They have a say in the creation, operation and review of services.
  • Consultation is a normal practice.
  • Service providers value and act on the importance of social and personal relationships.
  • Partnership enables an ethical and effective approach to providing services.
  • Partnership can eliminate duplication of resources by identifying existing assets, e.g. skills and networks.

For the community

  • Co-operation is a way of developing support and enriching each other’s lives.
  • Services support and contribute to the community not just the disability sector.
  • Communities become more diverse and enabling.

Resources

http://www.cpcs.org.uk/index.php?page=about-family-partnership-model

http://www.tuhana.org.nz/index.php/partnerships-and-community-networks

Service Agreements

When you begin working with a person and/or their family/whānau, we strongly recommend you set up a service agreement. This is a statement of how you will interact, how decisions will be made, what you will do in your support and what the person agrees to do. Anything can go in this that you and/or the person and/or their family/whānau consider important.

Each service agreement can look quite different. Some of the areas you should include are listed here. (This list is not exhaustive.)

  • A title which includes the people and groups involved in the agreement.
  • Contact details of everyone involved.
  • A comment on how you will communicate and review support.
  • A comment on who is able to make what decisions. For example, the person may wish to always involve their parents in certain decisions or they may want to make every decision on their own. Others may agree or disagree with this position so it is better to get that sorted out before it is an issue.
  • The kind of supports you will offer. It is best if these are talked about specifically for each person. Support might be to:

-  help them create a support plan and agree on goals
-  find a home to rent
-  
achieve goals identified on their support plan
-  
know how to avoid dangerous situations
-  solve problems
-  find options to plan and manage money
-  
make changes in their life as part of their plan
-  
set new goals and plan ways to achieve them
-  build networks.

You might also discuss how the support will be reviewed and how any problems will be dealt with. These might include:

  • regular times to catch up and review the support plan, e.g. monthly
  • any concerns they have about their support
  • help with new plans
  • changes to the plan if their needs change
  • ways the person can contact the service if they are going to be out when their support worker is due
  • ways they can participate in reviews of their support progress.

Communication

Interpersonal communication skills are the life skills we use every day to interact with other people, both personally and in groups. When two or more people are in the same place and are aware of each other's presence, then communication is taking place, no matter how subtle or unintentional. It is the process by which people exchange information, feelings and meaning through verbal and non-verbal messages. These include what is said, tone (how something is said), posture, facial expression, gestures, body language and dress.

Most of us use a range of communication methods to get our message across and to understand others. Some disabled people may struggle to understand and be understood in conventional ways. This means we have to find out the best form of communication process for them.

Notes

  • In this section we are looking at general ideas about communication. When working with a person with disability, it is important to know how they communicate. (See also theCommunication strategies and decision-making section.)
  • Throughout this guide the word ‘talking’ includes sign language and other forms of deliberate non-verbal communication.

Why it is important

The more organisations focus on ‘mainstream as the default’ the more staff are going to interact with a wider variety of people. Therefore there will be a greater the need for them to have good interpersonal communication skills. Our ability to communicate well with others has a big impact on our effectiveness in our work. Interpersonal communication is used when we:

  • talk, listen and interact with people
  • give and collect information
  • influence the attitudes and behaviour of others
  • network (create contacts) and build and/or maintain relationships
  • express personal needs and understand the needs of others (through actively listening to both the verbal and non-verbal messages)
  • give and receive emotional support
  • make decisions and solve problems
  • anticipate and predict behaviour
  • negotiate

To be effective in our communication we need to think about the message we want to give. This means making an effort to ensure that our words, feelings and actions match the message. We can do this by making sure that non-verbally we show both interest and respect. And the best way to do that is to listen much more than we talk!

 

Key elements for communication

The key elements for successful interpersonal communication are to:

  • create a safe environment
  • understand messages
  • listen
  • communicate clearly and with integrity
  • write with the reader in mind
  • solve problems, negotiate solutions, share decision-making

How it works

Setting the scene

When you create a safe environment, you help the person feel relaxed and free to talk. It comes from a combination of what you say, how you say it, and what you are doing when you say it.

Understanding a message

It is often said that we get the message from:

  • 55% body language (including facial expression, posture and gestures)
  • 38% tone of voice
  •  7% actual words

When we listen we are probably unconsciously doing this. We need to remember that the other person also understands the message in the same way. That is why our body language and tone must match what our words are saying for us to be believable.

Listening skills

This refers to how we interpret both verbal and non-verbal messages.

  • We need to listen more than we talk! It seems obvious but we must create space for others to communicate.
  • We need to actively listen – we do this by paying attention to what is being said and how it is being said. We can do this by quieting our inner voice that is thinking about other things or preparing our response.
  • We need to check our understanding with the person.
  • We need to be empathetic (being open to another person’s experience or point of view whether we agree with it or not).

Verbal communication

This refers to what we say and how we say it.

  • We need to speak in a way the person will hear and understand. This means using the right language or other process, the right volume, the right pace, the right complexity, and the right amount. When this is the right match for the person we are more likely to get our meaning across successfully.
  • We need the ability to use language constructively and to inspire others. Try and focus on strengths and positives rather than negatives.
  • We need to encourage the person to express their thoughts and feelings by using open-ended questions if we are asking for their answers to something.
  • We should check that they have understood what we have said.

 

Written communication

  • This should be concise and use correct spelling, grammar, etc (in most circumstances).
  • As with verbal communication, it should be used with the person in mind so that it is structured in a way that conveys your intended meaning accurately to that person.
  • All written communication including letters, reports and notes should be written in such a way that they can be viewed as public documents. Therefore they should be respectful, accurate and factual.

Negotiation, problem solving and decision-making

  • This involves working with others to find mutually agreeable outcomes and to identify, define and solve problems.
  • It is based on exploring and analysing options to make sound decisions and communicating our values, ideas, beliefs, opinions, needs and wants freely.

 

Potential challenges and suggested strategies

Challenge Strategies

People picking up ‘unintended messages’

  • Be aware of your body language and check the message you might be sending (is it intentional or unintentional?).
  • Express what can happen – not what can’t happen

Broken trust

Confusion, lack of clarity

  • Express things in a clear and concise way, using everyday language. Check that there is understanding as you go.

Lack of ‘connection’

  • Create environments where you are able to focus on the person without distraction. Listen without thinking about your response. Genuinely attempting to understand others diffuses conflict and creates connection.

Difficulty in creating rapport

  • Check you actually believe in what you are expressing and doing. Be ethical. Spend more time getting to know who the person is – their preferences, opinions and aspirations.

What good communication may look like

Person or group Outcomes

For the individual

  • People understand my strengths, preferences and aspirations.
  • I am able to communicate what I want and, if needed, I have the right communication tools to assist me to make my choices heard.
  • I am clear about what options, supports and services are available.

For family/whānau

  • We are clear about what is available.
  • Information is conveyed in a way that is understandable.
  • Our opinions are respected and valued.
  • We are encouraged to think about possibilities.
  • We have good interpersonal relationships with other people and support services.
  • Support services are able to work together.

For the organisation

  • The service constantly conveys up to date information on organisational direction and any changes that may affect the people they support.
  • They have cohesive staff teams who are on board with organizational direction.
  • The organisation’s policies and practice are aligned.
  • They have good relationships with individuals, family/whānau and other community and support services.

For the community

  • We understand what the organisation does or has to offer.
  • We are able to contact the organisation should I need to contact someone for advice or support.
  • We clearly know what the person wants from their involvement in our community.
  • We can build long lasting, trusting relationships
  • The organisation is reliable – it does what it says it will.

Resources

http://www.mindtools.com/CommSkll/CommunicationIntro.htm

http://en.wikipedia.org/wiki/Interpersonal_communication

Facilitating Group Meetings

Knowing how to facilitate meetings is an essential part of planning for a good life. As service providers transform into catalysts for change we will need to meet with a wide range of people and organisations.

Why it is important

Facilitation means – to make something, or to ease a process. With this in mind, the role of staff and service providers is to make it easier for individuals to achieve their aspirations and goals.

This is achieved by supporting individuals and family/whānau to lead the process and by providing information so that informed decisions can be made. For those who may have had limited life experience staff will need to provide a range of opportunities to try new things.

Key elements

The key to being proficient in this role is to plan and guide the proceedings effectively. The facilitator must remain focused on the group process and outcomes rather than the specific content and opinions involved.

The facilitator:

  • remains neutral throughout the process
  • demonstrates that it is expected (and OK) for people to have different views
  • keeps the content (what is being discussed) separate from the process (how things are discussed)
  • models honesty, respect and openness
  • pays attention to the physical comfort of the group
  • gives regular process checks (how are people feeling?)
  • looks for common threads and explores options
  • develops a workable strategy or outcome
  • makes sure everyone has a chance to be heard.

The components

Good communication skills (See the Interpersonal Communication section.)

  • Creating safe places where people can express their thoughts and opinions
  • Positive reframing – assisting the person to see possibilities, not problems 

Conflict management (See the Working creatively with conflict section.)

  • Win/win concepts and practices (negotiating resolutions)
  • Viewing conflict as constructive
  • Appreciating diversity

Networking

  • Comprehensive local knowledge – developing trusting and mutual connections
  • Developing relationships such as family/whānau, community resources and allied social services
  • Acknowledging and strengthening natural supports and networks

Strategic planning

  • Environmental analysis – obtaining a clear picture of local contacts and resources
  • Task analysis – breaking things down into achievable steps so that the individual will experience success
  • Asset development e.g. community, person, staff, family and systems

Matchmaking

  • Developing connections – linking individuals and thoughtfully withdrawing paid support when relationships are formed
  • Checking in – when paid support is withdrawn it is important to follow-up to ensure that everything is running smoothly

Cultural competency and optimism

  • Informed and respectful ways of working
  • Strengths-based practice

 

How it works

Establishing rapport and creating a safe place

This means making the person feel relaxed and free to talk. You may need to:

  • introduce yourself
  • say why you are there
  • explain what the meeting is about
  • explain what happens to the information.

Asking questions

You use questions to gain the maximum amount of information with the least possible intrusion. The aim is to encourage people to express all the important thoughts and feelings that they are experiencing.

Perception check and paraphrasing

The aim of perception checking is to clarify what has been expressed so you can:

  • check your own understanding
  • demonstrate to the person that you are attempting to follow what they are expressing.

Environmental management

This involves being on time and being well set up. You ensure the resources are organised, the room is organised so that participants can connect easily refreshments are provided if necessary and there is plenty of space, fresh air and light.

 

Potential challenges and suggested strategies

Challenge Strategies

Staff are unfamiliar with the role of facilitator

  • Arrange for training sessions and provide resources
  • Provide mentoring for new facilitators

Most individuals and their families/whānau are not familiar or comfortable with the facilitation process

  • Arrange for trained facilitators to meet with them to explain the new process
  • Listen carefully to the concerns of people and their natural supports – adapt the process to suit them as much as possible
  • Encourage the people who are comfortable with the new process to champion it to others

The facilitation process seems to take a long time

  • Remind everyone involved about the overal goals of EGL
  • Remind them of the principles of the new approach

What good meeting facilitation may look like

Person or group Outcomes

For the individual

  • I am asked what I want and how this can be achieved.
  • I am able to have my say in meetings.
  • Others don’t take over in groups.

For family/whānau

  • Our culture and preferences are respected.
  • I can express my thoughts and preferences in groups.

For the service provider

  • Meetings are productive.
  • Flexibility is enabled and encouraged.

For the community

  • Mutual relationships are developed.
  • Our community is enhanced by active contribution from a greater diversity of people.

Resources

Mind Tools: www.mindtools.com/pages/article/RoleofAFacilitator.htm

http://www.tuhana.org.nz/index.php/facilitation

Working creatively with conflict

Conflict is often about struggle, collision or clashing. Conflict typically occurs when we have different views about the same situation. This comes from having differing values, experiences and expectations.

In general, appropriate and necessary conflict is likely to occur when:

  • People are increasing their self-determination. It is common for people to seek to define and refine who they are through conflict. As they gain more confidence and assertiveness it is common that others are challenged. Rather than signalling failure, this type of conflict can indicate success. For example, it can show that people have developed a voice and feel safe to express their opinion – even if it is different from expectations.
  • Change: The whole purpose of many services is about creating and supporting positive change. With the change process comes conflict. There is a constant need for people/groups to clarify what is happening and where they fit in.
  • Limited resources: There is conscious (and covert) competition for attention, time, influence and resources. Even if all of the parties (groups) involved with a service are in complete agreement about what the service is doing, and how they are doing it, conflict is still likely to occur as people/groups try to ensure their needs are met.

Why it is important

Knowing how to work constructively with conflict is one of the practical ways to bring life to concepts like diversity and respect. What we feel about conflict and the skills we have learnt (over time) will be the most significant factor in determining whether conflict becomes a place of creativity, diversion or destruction.

If we attempt to avoid conflict, seek to control others or become passive when confronted, then the constructive possibilities of conflict may elude us. When we have gathered the skills and the confidence to explore conflict as being natural and potentially positive, then we can use conflict to develop partnership.

Key elements

Partnership and clarity

Genuine partnerships need conflict so that each person’s views can remain distinct. When each perspective is valued there is strength and integrity to work co-operatively. Constructive conflict is when all of the perspectives are valued and a mutually beneficial resolution is found.

Facilitation

Facilitation makes it easier for people to describe what is going on for them and helps to find the next constructive step forward. In a group process this may involve the facilitator rigidly applying a framework that provides a formula for safety, direction and expression.

Negotiation

The parties acknowledge that there are differences and consciously work together to clarity perspectives and find places of understanding and agreement. This is to ensure they develop a way to work together that is mutually beneficial. When working with people, negotiation is about having the optimistic expectation that a mutually beneficial outcome is possible.

These are the core principles – it is essential to understand them:

  • Everyone is entitled to their perspective
  • Processes must create equity
  • Respect is an active (not passive) state
  • Facilitators and paid staff have the responsibility of ensuring conflict is safe and constructive
  • Effective resolution is only possible when all parties have a willingness to clarify and resolve issues
  • There can be unity in diversity
  • The role of the facilitator is to manage the process not the content e.g. making sure everyone is heard, looking for what can be (not what isn’t!)
  • The facilitator needs to be flexible and creative – this may mean new options can be discovered
  • The facilitator does not personalise the issue. Keep your integrity. Be honest about thoughts, feelings and facts.

How it works: A group conflict resolution model

As facilitator, your role is to:

  • assess whether the conflict belongs in or out of the group
  • ensure you are open to being constructive (ie, you are not in a reactive space)
  • inform the people involved that you will be going through a set process.

(See also the Facilitative support section.)

 

The process:

Step one: Go over the key principles (eg. respect for difference, conflict can be creative and healthy, assure safety, and speak from your own perspective).

Step two: Ask for the parties/persons to identify themselves.

Step three: Ask the person/s with issue (A) to address the other person/s (B) and begin by

  • describing (not judging or interpreting) what is happening/what their issue is
  • expressing how they feel about this. Ensure they are able to describe and express their thoughts without being interrupted.

Step four: Ask (B) to respond to this by clarifying or apologising.

Step five: Ask the wider group if they have any constructive comments or feedback to either of the parties involved. Ensure people are not interrupted and that general discussion does not take place. Everyone is asked if they want to contribute. Only “I” statements and constructive contributions are requested.

Step six: Ask (A) what they would like to be done differently and how this would have a positive outcome for them. Ensure they are not interrupted.

Step seven: Ask (B) to respond to this. At this point there will either be resolution or the need for further discussion. If resolved, then go to Step 10. If there is need for further discussion then continue to Step 8.

Step eight: Ask (B) how the situation could be resolved. If OK with (A) go to Step 10. If not, OK with (A) go to Step 9.

Step nine: Ask members of the wider group what suggestions they have for a resolution. Check this out with (A) and (B). If resolved go to Step 10. If not resolved, then arrange a time to meet with (A) and (B) for a mediated session then move to Step 10.

Step ten: Ask the group for comments regard what they learned from participating in the process then conclude with highlighting examples they observed of healthy communication during the process.

 

When you need more help

Some conflicts cannot be resolved by this method. You may need to ask for input from someone outside the group, known as a ‘third person’. This person may be a mediator or an arbitrator. Mediation and arbitration are not the same! These are the differences:

Mediation

A mediator is brought in to bring more structure to the discussion and process. Mediation does not involve the mediator making decisions about what an outcome should be.

Arbitration

An arbitrator listens to all the points of view then makes a decision about the next step/s.

Potential challenges and suggested strategies

Challenge Strategies

Conflict becomes messy because people are fearful that the change will result in less than what they have or there is mistrust or misunderstanding about what is meant or intended.

  • Reassure people about the process and clarify the issues.

Control issues when one of the people or groups attempting to dominate what is happening.

  • Facilitator must be prepared to enforce agreed rules and/or develop agreements with the group regarding speaking times.

Unwillingness to participate and/or being closed to input from others or will not even consider altering their behaviour/practices.

  • Review the process and what that means in terms of expected behaviours.

Habitual conflict where a person or group is so used to fighting for what they believe in that permanent conflict is created.

  • Reassure people that the process will be fair for all concerned.

Transference when one of the parties is shifting emotions and responses from one situation to another (without realising it).

Clarification of current issues.

What conflict resolution may look like

Person or group Outcomes

For the person

  • I can voice my opinion.
  • I have the right communication tools so I can participate in discussions.
  • Creative solutions are found that value the input of everyone
  • I understand the process (and lines of communication) if I have a concern I want addressed.
  • I feel confident the organisation or service will be responsiveness to any concerns I want to address.

For the family/whānau

  • We understand the process (and lines of communication) if we have a concern we want addressed.
  • We can expect our concern to be treated with respect and to be responded to in a timely manner.
  • We are treated with respect and our opinions are valued.

For the organisation

  • We understand the process (and lines of communication) if we have a concern we want addressed.
  • We can expect our concern to be treated with respect and to be responded to in a timely manner.
  • We are treated with respect and our opinions are valued.

For the community

  • The community is confident the organisation will respond to any concerns raised.
  • The organisation has a positive community image and reputation.
  • Clear information is provided when requested.
  • The organisation promptly responds promptly to any contact/correspondence initiated by the community.

Resources

Mind Tools: www.mindtools.com/pages/article/newLDR_81.htm

Communication strategies and decision-making

When we work with people with significant impairments, particularly if they involve intellectual impairment, then both communication and decision-making can appear more difficult. A person may be able to do either (or both). But we may have to think more about how we support these two areas if the person is to have their wishes for living in the community understood.

In this section both communication and supported decision-making are briefly outlined as they are strongly related. But both are large areas of information, so we recommend you look at the additional resources for further information. (See also the Communication section.)

Why it is important

The challenge is to identify how the person communicates and what method of communication works best for them. The best people to ask will be the person’s family, support workers or any other significant person who has known them for a long period. Useful questions to help you identify and record information are:

  • How do I know when Mary (the person in question) likes something?
  • How do I know when Mary doesn’t like something or is saying ‘No’?
  • Is there a particular process that works best for Mary?
  • How do I check I have understood what Mary has communicated?

It is important for us to continually strive to support a person’s communication so they can direct their own life. We must remember that everyone has a personal style which will influence the way they communicate.

Key elements

Our understanding of a person begins when we take time to listen and engage with them. We need to notice when they understand something and when they don’t. And we will have to become adept at using a range of communication methods based on the information people who know the person well give us. These include:

  • written language
  • spoken language/speaking technology aids
  • signs
  • symbols/line drawings/communication boards
  • photographs
  • objects
  • gestures (eg pointing)
  • pre-intentional communication such as touch, eye contact and smiles ( Adapted fromSupported Decision Making: A guide for supporters Paradigm )

This is critical knowledge to have about the person if they are to have supports that meet their expectations and aspirations. It is also critical if the person is going to be able to exercise their rights to make decisions.

Supported decision-making

Making decisions about our lives, even simple ones we take for granted, such as when and what to drink, help define us. They express who we are, what we think is important, and ensure that we are in control. Some of the people you support will need help to make decisions. But this should not prevent them from exercising their legal and civic rights to control their life.

Understanding what is important to a person determines the best way to support them. This reorientation changes the roles of service users and providers. Rather than being service recipients, people become active participants in planning and obtaining the supports they feel will best meet their needs and goals. As service providers, you retain a responsibility for service quality and outcomes. But your role is more in enabling: providing advice and support to help people with a disability exercise as much choice and control as possible over their lives.

When you engage with the person at the beginning you will also need to identify if there is anyone who has guardianship for the person you are supporting. This will influence how decisions are made. Parental guardianship formally ceases when the young person reaches 18 years of age (16 for IRD). At this point the parents can still be involved in decision making but do not have the authority to make decisions on behalf of the person unless appointed to do so by a court.  You will also have to have a discussion with the person and their family/whānau about who expects to be involved in decisions of various sorts. Clarifying this can save a lot of problems in the future. For example, some families will want to have a say about all large decisions (where the person lives, if they marry, etc) and the person may be happy with that. But the person may not want their family involved in those decisions and there may be no legal imperative that it is. Then you need to have a discussion about your role in this before it becomes an issue.

There are many ways to support a person with decision-making (This information is adapted from IHC ‘Supported Decision-making’). What is appropriate will vary according to the person and the nature of the decision. Key areas to consider are:

  • Identify the information and who is best to support the person. Provide information in a form and at a rate so the person can understand, given their impairment and cultural background (examples include pictures and plain language).
  • Identify the different options with the person and allow the person plenty of time to consider and respond to each piece of information.
  • Encourage questions and discussion.
  • Be aware of non-verbal messages you may be sending and be careful not to ask questions in such a way that suggests an answer. For example, ‘You’re happier working here, aren’t you?’
  • Be aware of those people who may make their decisions from an emotional level. This can include people who are anxious to please or those who have anxiety over the outcomes of decisions.
  • Always remind the person we are here to assist with mistakes and assist with them finding a great outcome. We are never here to punish them.
  • To check whether the person has understood, go back over the information, ask the question in another way or ask the person to explain their decision to you. Be sure to reassure the person that you are checking this so that you are clear about their wishes and not because their previous answer was wrong.
  • Include a communication or decision-making agreement to help set out a clear plan and avoid confusion by other people who need to be involved in communicating with the person.

 

This information is adapted from IHC ‘Supported Decision-making’.

 

Talking Mats™ – a tool to help communication

Most of us use a range of communication methods to get our message across and to understand others. Some people rely on others to interpret their communication and have had limited opportunities to participate in and learn about decision-making. We can provide a variety of ways for people to make choices (even about seemingly minor things). Talking Mat™ is one of many tools that can be helpful.

A Talking Mat™ is a simple communication aid that is useful in helping people learn about making choices. It is a way of presenting information pictorially and in small chunks, so the person can process it and respond.

Some people seem to say (or indicate) what they think you want to hear. Others may find it difficult or be unconfident to express themselves with speech. A Talking Mat™ is a good way to discover how someone feels because it gives people the opportunity to express their opinions, in a safe, no-pressure environment.

Talking Mats a tool to help communication


How does it work?

A visual scale is made that indicates one side of the board means ‘Yes I like this’ (could be a word, smiling face, tick, thumbs up) and the other side ‘No I don’t like this’ (e.g. a word, frowning face, cross, thumbs down). There may also be a ‘Not sure / maybe’ sign or symbol in the middle.

It is helpful to teach people that it is OK to say they don’t like something. This can be done by presenting a known non-preferred item (e.g. a picture of a spider) and encouraging them to say they don’t like it and place it on the ‘Don’t like’ pile.

Information is presented in small chunks (a visual card) and the person is encouraged to put the card on a mat, in the place that indicates ‘Yes I like that’ or ‘No I don’t like that’. People’s preferences (and things they dislike) can be reviewed and further explored.

When a talking mat is completed, it can be photographed, so the person has a record of their preferences at a certain time. This can be used to promote self-advocacy; for example in personal planning. At times other people have firm ideas about what a person does or doesn’t like, and the person might not have the confidence to assert themselves.

 

Potential challenges and suggested strategies

Challenge Strategies

Presenting pictorial cards and asking people to rate them is quite a complex task. Some people might not be able to understand what the pictures mean.

  • Try showing a person some real objects (e.g. a cup of tea and a cup of coffee) and see which one they look at / seem more interested in.

The person doesn’t seem to intentionally communicate in any way that I can see.

  • Some people might need the support of someone who knows how they show that they like something or not. You can then observe them when trying new experiences to see what they are showing they enjoy.

The person can talk. Why should I use this method?

  • For some people, this gives them a chance to think about a range of options in a new way. They aren’t answering yes/no questions. They are considering what they may or may not like to try out.

What effective communication and decision-making may look like

Person or group Outcomes

For the individual

  • I have more choice to express myself.
  • I can try out a wider range of options.
  • I am more confident.

For family/whānau

  • We are able to contribute to this activity by providing support and/or information.

For the organisation

  • We no longer have to guess at what would be good or beneficial for a person. Instead we can set things up so the person is at the centre of decision-making.

For the community

  • The community is enriched by the inclusion of a person who has chosen on an individual basis to engage in an activity, event or group.

Resources

Talking mats

http://www.talkingmats.com/

Murphy, J and Cameron, L (2005) Talking Mats: A resource to Enhance Communication University of Stirling, Stirling.

Bloomberg, K Johnson, H & Wes, D. (2004) InterAACtion: Strategies for Intentional and Unintentional Communicators. Scope Vic, Victoria.

http://www.icommunicatetherapy.com/adult-communication-difficulties-2/adult-learning-difficulties-intellectual-disability/


Communication

http://www.hdc.org.nz/media/158412/making%20communication%20easy.pdf

http://www.sfcollege.edu/student/drc/?section=faculty_resources/communication_strategies

http://www.unimelb.edu.au/diversity/downloads/communication.pdf

http://www.donaldbeasley.org.nz/publications/NHC_EffectiveCom.pdf


Supported decision-making

http://www.paradigm-uk.org/Resources/9/2/9/Supported%20Decision%20Making%20(Final%20Online%20Version).pdf

http://www.dhs.vic.gov.au/__data/assets/pdf_file/0011/690680/dsd_cis_supporting_decision_making_0212.pdf

http://www.ihc.org.nz/wp-content/uploads/IHC-Supporting-Decision-making.pdf

http://www.un.org/disabilities/default.asp?id=242

Experience

Experiencing new things

Most of us learn new things by trying them out – in formal, planned ways or as spontaneous acts. The point is that we build up a repertoire of experiences that helps inform our choice making.

Why it is important

Most people can only make real decisions about what they like and want after they have experienced the options. But some people have had very little exposure to a range of activities.

These questions are valid and necessary:

  • What are your dreams and aspirations?
  • What do you want to do with your life?
  • What will make a good life for you?

 

But for many people, particularly those with previously limited experiences and opportunities to make real decisions, these are too difficult to answer. Indeed the answer might be:

  • I don’t know, what do you think?
  • What I’m doing now is fine.

Key elements

For some people, perhaps an ideal personal goal would be: ‘I want to try a whole lot of things and figure out what I like’.

This involves active exploration. Having opportunities to try out a range of activities helps the person to learn about choice making and about themselves. The supporter’s role might be to arrange a variety of experiences and opportunities with the person, and then to explore with them afterwards:

  • How was that?
  • What did you like?
  • What could make it better?

 

For some people it is necessary for a support person (paid or unpaid) who knows the person well to observe them closely while they are engaging in the new experience. The support person is anyone who has known the person for a long time. This may be their family or whānau, support worker or anyone else who knows them well. The support person has an awareness of how they respond when they are happy, and when they are not enjoying something. The support person can ask: What signals are is the person giving us now, that is, what is the person communicating to us?

 

How it works

The process of helping someone find out what they want to do has four stages:

  • establish
  • expose
  • observe
  • adapt.

You may have to repeat one or more of the stages during the process and again when the person wants to find out about more new things.

Establish a communication system and known preferences

Identify how the person communicates and what method of communication works best for them. (See the section on Supported decision-making.) Identify and record information such as:

  • How do you know when I like something?
  • How do you know when I don’t?

 

For some people, questions such as those below may help guide or prompt discussion.

What do I do during the week?

What do I want to do? What new things do I want to try?

 

   
Who (or what) do I love? What roles do I have? What do I look forward to?
     

You can use visuals, photos or real objects to help asking these questions. You can think of other ways to re-state the questions too. For example, you might assist the person to know that they are a sibling, a loyal friend, always on time at work, etc., instead of just What roles do I have? The aim is to find out more about the person – this is not about filling in the box just for the sake of it! Be creative!!

Expose the person to new experiences

For people to grow they need to be exposed to new experiences that are consistent with what you know are their existing (or possible) preferences. Many people disabilities have had limited experiences in life. Therefore exposure to new experiences, which fit in with known preferences, will help determine future activities. The person can try different things out to see what they like – these activities are known as tasters.

Observe the person’s responses and reactions

Some people rely on us to understand what they are communicating. We can observe the person’s responses to these new experiences and determine which ones can be pursued or discarded for the present. Some people may be able to articulate how they felt and why. 

The diagram below is an example of one that may prompt further discussion and learning about decision-making.

 

Taster

Date

I loved it
happy face icon

Not sure
confused face icon

I hated it
sad face icon

Comment 

Knitting group at St Mary’s church (Monday 1pm)
knitting icon

 9/9/13      X icon There were lots of old ladies and I want to be with people my own age!!

Korean culture centre – Thursday afternoons
korean flag icon

12/9/13 tick icon     Everyone was so nice! I learnt how to say hello in Korean!!

Going to concerts (Fridays, 1 – 2pm)
violin icon

13/9/13 and 20/9/13  

 tick icon   Everyone was so nice! I learnt how to say hello in Korean!!


Adapt and refine the experience or activity

We can adapt what is happening on the basis of what the person has reported, or if necessary, our observations. This usually means one of the two following options. Either we do more of the things the person likes. Or we change what they are doing (because they have communicated that they do not like the experience) and further expand their repertoire of new experiences.

 

Potential challenges and suggested strategies

Challenge Strategies

Some people may not be in a position to state their aspirations, in a way that we can easily understand

  • Using the ‘establish, expose, observe, adapt’ process it is possible for support staff to set things up in a way that ensures people have a central place in decision-making about what they are doing.

Some people say ‘Yes’ to everything

  • It is good to recognise that this might be an automatic response and not an actual choice. Trying things out and helping people recognise what they do or don’t enjoy is particularly important here.

There is nothing in the community to ‘taste’ and we’ve tried everything at the day service

  • Try doing a community mapping exercise (see the Community mapping section). You’ll be amazed at how much is out there! 

What tasters may look like

Person or group Outcomes

For the person

  • I can try a range of options that help me to have choice and control over the support I need to go about my daily life.

For family/whānau

  • We can contribute ideas, activities and people to assist the process of trying out new things.

For the organisation

  • We no longer have to guess at what would be good or beneficial for a person but rather set things up so they are at the centre of decision-making.

For the community

  • We welcome people as potential new group members, volunteers, employees, friends, patrons, etc.

Resources

With Support I Can… A film by the NZ Ministry of Health, Disability Support Services

Many organisations offer ‘have a go’ sessions or classes before people are required to commit to an activity, club, event or group – the list is endless!

Look at local newspapers, social media and the internet to find the wide range of activities available in communities.

Safety

Assisting with safety: Intentional safeguards and emergency planning

As we support people to live their life in the community in less restricted circumstances, safety can become an increased concern. It is important therefore to be thinking about how the person remains safe. They need still to have the room to make mistakes and take risks.

The best ways of thinking about creating safety for people currently is in the context of ‘intentional safeguards.’ Intentional safeguards are deliberate actions taken to help a person to be safe in their community. They include doing things to prevent harmful things from happening, such as the list referred to before. But they also build on opportunities for greater involvement in the person’s community. Intentional safeguards are designed around the unique situation of each person. They attempt to reduce vulnerabilities and increase the chances that good things will happen in a person’s life.

Safeguarding in this way, is not an extra job we do, but is integral to personal planning. It is not all about reducing risky situations. Instead it involves thinking those situations through to assist the person understand some of the implications involved. The fact is that the things that can keep people safe are really the same things that are needed to have a good life. These include having people you spend time with who care about you, participating in the community so you are known, and having control over how you live your daily life.

The importance of personal control and relationships in safety is evident if you consider how people in hospitals or rest homes are kept safe. In these situations, the person’s personal control is reduced and there is a range of legislation and policies to achieve safety. But the best way is usually to have at least one friend or family member monitor the situation and advocate on the person’s behalf if things are not right. So the best way to ensure safety for people is not to restrict their participation in activities. Instead the aim is to thoughtfully develop reciprocal, caring relationships, and assist the person to contribute to areas of their community.


Ways to develop intentional safeguards

Safeguards should be thought about in support planning. Integral to the planning process, it is a way of thinking. A support worker will constantly consider how to assist this person to be embedded in their community in a way that creates safety through linkages and relationships. The exact nature of any particular safeguard, and the areas where safeguarding is important, will relate to that person’s circumstances. They can include some or all of the following:

  • Ensuring the person has a voice in their planning and decision-making. This is the first and fundamental safeguard!
  • Thinking through potential risks and vulnerabilities and developing strategies to avoid these or manage them should they arise.
  • Developing a clear process of what the person will do in the event of some emergency such as an earthquake, fire or pandemic.
  • Involving the person with their local community, as it is more likely other people will look out for the person if they are known, valued and belong. This means the person needs to have the opportunities to participate and contribute, not just be present.
  • Assisting the person make connections and find people within their lives, their neighbourhoods, communities and support systems. These connections and relationships may range from the superficial to the significant. They are the personal relationships that will strengthen the person’s sense of belonging and will provide people to watch out for the person. Examples include relationships with the local storekeeper, a church member who agrees to give the person a lift home after church or with people who advocate for the person at Work and Income.
  • Planning as an ongoing process. Planning is integral to safeguarding. It is not something that is done once as the master plan forever. Instead it is a fluid process that changes as the person changes and grows. Also, planning can be event-specific rather than about the person’s whole life. We can encourage the person to invite others to join in planning for their future so those guests are also investing in their relationships with the focus person.
  • Developing circles of support – a very powerful strategy for safeguarding. In this situation the members of the circle all have roles to play in the person’s life and have a personal and group relationship with that person. (See the Circles of support section.)

 

Once you have developed safeguards you then need to take time to support the person to use them and to check they are effective. This is not to suggest you need to take control over a situation, but just check that the result is working for the person.

Resources

http://www.communitylivingbc.ca/wp-content/uploads/Addressing-Personal-Vulnerability-Through-Planning.pdf

http://www.mamre.org.au/sites/mamre.org.au/files/docs//articles/2010/06/10/Building_Intentional__Lifelong_Safeguards_Article_January_2010.pdf

http://www.centreforwelfarereform.org/uploads/attachment/385/a-personalised-approach-to-safeguards-in-the-ndis.pdf

Planning

Personal and support planning processes

The concept of personal planning has fallen into some disrepute. This is because the service system has used it as a tool that does not, in fact, inform the major service responses that follow. It can often be little more than a ‘tick box’ exercise.

However, if you consider planning as simply thinking about what you want and how to get it, then it can make more sense to people. Planning does not have to include a formal, written plan. However, in the context of working in situations where misunderstandings may occur, it can be useful to have one.

Why it is important

When used well, personal planning is a process to discover (and act on) what is important to a person. It can be used so people take some control of their life today in a way where they are building their dreams for the future. And from the organisation’s point of view, the plan will help inform what role it may have in supporting the person to reach their goals.

There are a number of planning tools you can use. These must fit the person’s circumstances and be agreed by them and their supporters. In all cases it will require those assisting to develop the plan to work in partnership to assist the person articulate what they want. Then you develop clear and achievable goals with the person and enlist others to support them.

Key elements

  • Self-determination and informed choice – individuals are supported to make their own decisions about what is important for them to lead a good life.
  • Person-driven – the individual and their aspirations direct the process of the plan.
  • Partnership – all parties work collaboratively to develop clear direction. This is a process of ‘doing with’ not ‘doing to’.
  • Constructive and proactive – the focus is on strengths and capabilities. What do we need to do to make this work?
  • Facilitation – ensuring the process of planning is made as easy and clear as possible.
  • Customised support – supports are tailored to suit the individual and can change as required.
  • Flexibility – plans can change as the individual grows and changes. This can happen at any time and to suit the individual.
  • Pragmatic and user-friendly – the plan is clear, understandable and do-able.
  • Monitoring of progress – a process is in place that allows both the individual and the support network to keep track of progress.
  • Allocation of resources – there is a process in place which allows for the allocation of resources which is directly related to the individual’s personal plan.

How it works

The following three steps form the critical aspects of a plan. However, before the planning you will need to do the following:

  • agree on the process and tools that fit the person and their whānau.
  • agree how the focus person wishes to feed into the plan and the planning session.
  • agree who will manage/run the planning session, and where and when it will happen.
  • agree who will attend and what roles they carry. (This can range from the person choosing to do it on their own through to a large group exercise.)

Step one – Determine the aspiration (Dream, aim)

This can include looking at the person’s strengths, skills, needs and wants. Be holistic, looking at physical, emotional, intellectual and spiritual areas. In what direction do they want to head? What is a good life for the person? What are barriers that need to be overcome? What strengths and opportunities exist in the person’s support network?

Step two – Define the steps (Goals)

Goals need to be specific, believable, achievable, measurable and desirable. Identify the stepping stones for the person to achieve their aspiration. It helps to break things down into achievable steps (which will vary from person to person). There must be a clear link made between the goals that are developed, which need to be specific and achievable in the short term (eg 1 week –1 month), and the aspiration you are working towards.

The most effective steps are sequential. When the person has completed a step this leads on to starting the next one – they can then get the sense of movement towards the aspiration.

Step three - Monitor progress

Take some time to work out how successful the person has been. Celebrate their achievements. If they have not arrived where they want to be, you can help them change their aims and objectives. Or help them to break down the goals even more.

 

Potential challenges and suggested strategies

Challenge Strategies

Clarity of purpose/vision

  • Ensure the board, management and staff are on the ‘same page’, that they have the same understanding around the intent of the personal planning process as well as how to apply those principles in practice.
  • There is organisational cohesion (between policy and practice).
  • Do we understand what we are trying to achieve? What should the process be to achieve our organisational aims?

Communication

  • Ensure all those involved in the personal plan have the right information and work together.
  • Where multiple services are involved ensure there is a process for clear communication.
  • Ensure the individual has the communication strategies/tools in place to be involved in decision-making.

Negotiating conflict

  • When conflict arises, help negotiate a resolution or win-win solution.
  • Building trusting relationships and working in partnership can help decrease uncooperative behaviour.

Getting out of the way

  • Use a facilitative approach to providing support
  • Not ‘done to’ but ‘done with’.
  • Always provide opportunities for learning and understand what support is needed.

Working with people with high and complex needs

  • Establish a communication system and discover preferences.
  • Expose to new experiences.
  • Observe the individuals responses to those experiences and determine which ones can be pursued further or discarded.
  • Adapt or refine the activity on the basis of your observations.

Planning on the basis of a building and/or programme

  • Planning must be based on the person’s own plan and this must be the basis for the allocation of resources.

See also the sections on CommunicationWorking with conflict, and Facilitating group meetings.

 

What personal planning may look like

Person or group Outcomes

For the individual

  • Supporters spend time to get to know my preferences and strengths.
  • How I communicate is understood.
  • I am encouraged to think about what I want in my life.
  • I am supported to make informed choices and to try new things.
  • People have optimistic expectations about what I can achieve.
  • I have a range of roles that are socially valued.
  • I have the opportunity to participate in a range of educational, social, recreational, employment and/or personal activities in the community.

For family/whānau

  • We are encouraged to think about possibilities.
  • Our opinions are respected.
  • Our role as family/whānau is acknowledged.

For the organisation

  •  Clear processes are in place.
  • Flexibility – planning approaches can be adapted to what is best for the individual and their family/whanau.
  • The service is responsive to changing circumstances and opportunities that arise.
  • Staff resource is allocated on the basis of what people want.
  • Progress is monitored and changes are made to ensure success.
  • The collated themes evident in personal planning contribute to organisational strategic planning.

For the community

  • Community members may be invited to participate.
  • Community assets, resources and supports are identified.
  • We may be encouraged to support someone to achieve their goals.

Resources

http://www.wikihow.com/Set-SMART-Goals

http://www.helensandersonassociates.co.uk/reading-room/how/person-centred-planning.aspx

http://pcp.sonoranucedd.fcm.arizona.edu/resources/person-centered-planning-tools/elp

http://www.mindmapping.com/

Resources

Using our resources innovatively

Innovative resource allocation refers to strategies used by the service, whatever its funding level, to make the best use of the resources it has.

Why it is important

‘Resources’ includes individual and community input as well as funding which can be used to support the plans of individuals, not programmes. These resources may include a range of funders, people, community organisations and more. How resources are used should be clear and justified.

Key elements

Resources are flexible and creative. They include:

  • various sources of funding
  • human skills and talents
  • time and commitment.

How it works

The service works in several ways.

Using personal networks to explore and learn about the scope of resources:

  • individuals, staff and family/whānau are encouraged to share their networks as possible links to resource development
  • paid support can focus on specific tasks e.g. allocated one-on-one support, planning or community building.

Using professional and community networks to explore and learn about the scope of local resources:

  • staff keep up-to-date with generic services, resources and projects
  • staff initiate research and projects towards creative resource development.

Valuing disabled persons and their skills as part of the available resources:

  • people using the service may wish to be included as a resource (this is not referring to exploitation).

Developing a culture of creative problem solving:

  • staff look at resource challenges as opportunities for creativity and innovation
  • staff collaborate with other services to develop and share resources
  • managers allocate regular non-contact time so staff can plan and build community networks

Strategic and/or service planning:

  • the organisation has a process in place so that the organisation/service can strategise how they will support the achievement of personal goals through the allocation of resources (i.e. staff/community).
  • the organisation has a system in place to monitor how effectively they have met people’s personal plan goals.

 

Potential challenges and suggested strategies

These are taken from real examples in New Zealand.

Challenge Strategies

There is no time for staff to plan and source what might be available in the community

  • Every staff member has a planning day once a week – an investment that helps us really work with people. In turn this means they don’t require as much paid support. Staff use this day for personal planning, networking, one-on-one work with clients, admin. They are encouraged to get out of the office and they provide a monthly report on how this time is used.
  • We have a key worker for each person, and each key worker has a caseload of 5-15 people depending on the situation. It’s not possible to work one-on-one all the time but we’ve found that we can work intensively with one person at a time.
  • Some activities can be run well in large groups that need minimum staff support. These times free other staff up to work one-on-one or take small groups into the community.
  • We try not to re-create the wheel or do everything ourselves. So we bring in outside specialists like a music tutor. We’ve also made good connections with local facilities like the community college. People are coming and going all the time. It means our staff can really focus on planning and support.

Finding the right environment

  • We moved the service right into the middle of town – we are near the public transport hub and people have much better access to the community. We are also visible in the community now. We are part of it, and that is helping to break down barriers for people. Some community groups now come to us and use our facilities. That has helped us discover opportunities for sharing resources with others and offsetting our costs

Transportation is an ongoing issue

  • When we connect people with local activities in their neighbourhoods, we have found that the need for transport often isn’t an issue. It’s because either the activity is close enough to walk or use public transport or others at the same activity offer transport when they become friends.

What innovative resource allocation may look like

Person or group Outcomes

For the person

  • I am offered optimal support for customised plans.
  • I am recognised as having skills that may be used in resource development.

For family/whānau

  • We expect and receive optimal support for our family member.
  • We are included in planning and development processes.
  • We are recognised as having useful skills.

For the organisation

  • There is a dynamic and creative workforce which develops a culture of creativity.
  • There is an in-depth knowledge of the range of resources available both within the sector and outside of it.

For the community

  •  There is a wide network of services.
  • There are collaborative processes for resource development.

Resources

Asset Based Community Development: This rests on the principle that the recognition of strengths, gifts, talents and assets of individuals and communities is more likely to inspire positive action for change than an exclusive focus on needs and problems.

www.abcdinstitute.com
www.inspiringcommunities.com
www.interactionz.com
ABCD in Action: When People Care Enough to Act Inclusion Press, Toronto.

Asset Register

One way we can use our resources in new ways is to draw up and use an asset register.

Why it is important

The first resources to consider are the skills and attributes within our own networks, in our colleagues’ networks and, most importantly, in the networks of the person we are supporting. The register can include board and management committees! The talents, connections and networks of everyone involved can play a real part as services move into an approach of facilitation within the community.

What skills, assets, and attributes do we bring to the table? How can we match facilitators to people to ensure that sustainable relationships and connections are forged in the community?

Key elements

An asset register works on the concept of identifying, building and using the assets and skills of the local community. This includes the connections, networks, experiences and skills of support staff, disabled people, family/whānau, board members and other relevant people or groups.

The idea of asset-based development recognises that everyone has skills and talents. The process builds on these identified strengths as part of the process of connection and community building. When skills, talents, interests and networks are identified, this information can be used to connect persons into the community.

How it works

The first step is to learn how to do this process. Staff and those using the service are asked to identify their skills, talents, areas of interests and attributes. This process affirms and many skills, talents and attributes within the group as well as provide a starting point for connecting and linking within person’s local communities.

An asset registercould be put on a large sheet of paper. This can then be referred to as the team works through the processes for enabling people to connect and build their own personal networks.

The key aim is to use the knowledge and connections of the staff as they relate to a person’s identified preferences and interests. For example, the person may identify fishing as an interest. Then their support staff may be able to use the information and contacts of any staff who have also identified fishing as a key activity or interest. Note that it does not mean that the staff member who goes fishing must take the person fishing. But rather he or she shares their contacts and knowledge to enable and facilitate links and connections that the person and their support staff may follow up.

When people start using their own knowledge and connections they also develop more skills in networking and connecting. As well, there is often an increase in awareness about the range of activities that are available for exploration.

Many organisations regularly update their asset register as a way to promote team-building. It is a way of appreciating the various skills and interests of the people connected to the service. Everyone has interests and connections and learning about each other promotes positive and vibrant opportunities for development.

 

Sample asset register

Name What I bring to the table/attributes Specific skills

Hobbies/Interests

How do I want to be known in my community?

Clubs I belong to /associate with

Mary

Humour

Looks for the positive

Cooperation

Sewing

Craft

Art/painting

Cooking

Dog training

Embroidery

Knitting

Rugby

Singing

Reliable

Approachable

A good mother

Dog training

Supporter of local rugby team

Church choir

James

Likes to know the rules

Likes documentation /paperwork

Fishing

Model trains

Hair cutting

Te Reo

Model trains

Ukulele

Tango

Handyman

Neighbourly

Music guy

Local marae

Ukulele group

Tango dance club

Potential challenges and suggested strategies

Challenge Strategies

Staff want to keep their private lives separate from work

The staff person with the interest does not have to be the person’s only contact. They might simply provide contact details or advice.

The register is out of date – we did it once, years ago, but nobody looks at it

Have it out, displayed, and updated. Other people (including individuals and families) may be inspired and add their connections also!

There are too many varied interests in our team! It’s hard to use the register as it’s difficult to locate who  is into a particular interest

Have it out, displayed, and updated. Other people (including individuals and families) may be inspired and add their connections also!

What an asset register may look like?

Person or group Outcomes

For the person

  • I can access current information about possible activities in local communities and ways to network with these.
  • My skills and interests are part of the asset register.
  • My support network is extended.
  • I feel welcome and included in my local community most of the time.

 

For family/whānau

  • We can share our skills and interests to add to any asset register as appropriate.
  • We have more information about options in the community.

For the organisation

  • The knowledge, skills, resources and cultures of the service participants and the staff team are recognised and valued.
  • There is a process to promote ongoing sustainability of any connection, relationship, activity or initiative so that it is not solely reliant on support staff.

 

For the community

  •  There is knowledge about the skills, resources and cultures of the people who use support.
  • Connections made between people and their communities are based on natural, sustainable networks.
  • Groups, clubs and organisations are no longer cold called and ‘overrun’ with disabled persons (who don’t necessarily wish to be there). Time is taken to get to know people and connect them through the same channels that most New Zealanders join clubs, groups and organisations through knowing someone who knows someone!

Resources

http://www.abcdinstitute.org/docs/CapacityInventories(1).pdf

http://www.communityactivators.com/downloads/CoreGifts20Uses.pdf

Community Living, British Columbia, (March 2009). Belonging to one another: building personal support networks (see page 9 in particular).

The Asset-Based Community Development Institute (1997) A guide to capacity inventories; mobilising the community skills of local residents

Support

Having people involved – Circles of support

One of the distinct differences between the new approach and the way residential services tend to operate is how support is organised. In residential services, support is largely provided by paid staff. In the new approach support will come from a wide range of sources.

It is important we understand who the person has in their life and who they may need in the future. This will both facilitate support and also ensure the person has the type and quantity of connections that will enable them to have a good life. One of the best ways to do this is through a ‘circles of support’ map.

Why it is important

Circles of support are the people present in a person’s life who they know. These people will enrich their life and may be able to support them in particular situations. This enables disabled people to interact more naturally in the community and creates opportunities for widening the circle of people they know. It also lessens their reliance on paid support staff. The circles map can include family, whānau, friends, peers, volunteers, work colleagues, club members, or simply acquaintances. They play different roles to varying degrees, depending on their own desire or capacity to be involved in the person’s life – and the person’s willingness to include them in their support network.

Key elements

As a starting point, time should be spent getting to know the person. The focus is on identifying:

  • who is in the person’s life
  • what the person enjoys doing
  • what their skills and talents are
  • what their dreams are.

How it works

The graphic below could be used to assist the person to identify who is in their life and the roles that they fulfil. It is good to do it with the person and their supporters. The names of people are placed in the concentric circles based on the closeness of their connection to the focus person.

 Diagram: circles of support

 

Circles of support

Once the mapping process is completed, likely people are identified and can be invited to join a circle of support for the person. This is where people may regularly meet together and discuss the goals of the person. They develop practical strategies about who will support the person to achieve each goal and how. For a very good description of this process visit:http://www.capacitythinking.org.uk/circles.html

If you are supporting a person to establish a circle of support then you will need to be very clear about your role. The major point is that you do not control the process! However, your role may include:

  • identifying people that the person has a rapport with who may join.
  • being clear about the type of support a person needs. It might be practical support like transport to an activity, or it may be a friendly and welcoming face at a particular activity.
  • ensuring that the natural support person knows who you are, who the service is and how to contact you if they need to.
  • taking time to get the person established and comfortable and then withdrawing, as appropriate.
  • being pro-active about checking in regularly with the person to make sure that the arrangement is working well.


Potential challenges and suggested strategies

Challenge Strategies

Traditional views and practices about the roles of the service and families

  • Invest early in families and whānau to support them to be aspirational for their disabled person, to build community and natural supports and to support disabled people to become independent.
  • Recognise that paid supports, by the very nature of their relationship, cannot be everything to everyone.

We can’t find anybody to be in the circle

  • Identify who already has a relationship with the person, including people who have been involved in the past. Invite family, friends, neighbours and people who have the same interests as the person. You will be amazed at the amount of people who wish to help but don’t know how to. The key is to ask.

People are too busy

  • The commitment required is as varied as the people who make up the circle. It may be regular or intermittent. Some people may give practical assistance. Others may help the person connect with their neighbours and their community.

The person has high and complex support needs

  • Everyone, regardless of how ‘able’ or ‘disabled’ they are, is capable of and can benefit from being in a relationship. And everyone (not just the person with the disability) benefits through the relationships that are formed.

What a circle of support may look like

Person or group Outcomes

For the individual

  • I know who is in my life and why they are there.
  • I participate in a wider range of activities with more people.
  • I am supported to reach my goals.
  • My relationships are reciprocal and respectful.

 

For family/whānau 

  • We know who is involved with our family member.
  • We can take holidays with peace of mind.

For the organisation

  • Paid support workers look for opportunities to connect the individual with others.

For the community

 
  • Members of the community have opportunities to come to know people from all walks of life, for who they are, their abilities and capacities, rather than as a diagnosis.
  • The disabled person may be able take on paid or volunteer positions in the community.

Resources

http://trainingpack.personcentredplanning.eu/index.php/en/circles

http://www.circlesnetwork.org.uk/

Community Living Project, South Australia. ‘Circles initiative’ 

Snow, J (1994). ‘What’s really worth doing and how to do it’ in From behind the Piano by Jack Pearpoint, Inclusion Press, Toronto.

Al Elmanski et al. (1996) Safe and secure; six steps to creating a personal future plan for people with disabilities (PLAN)

The Collector of Bedford Street – A film by Alice Elliot, New Day Films

What’s in my community? Community mapping

In the past, many social services, especially disability support services, have tried to provide everything for a person. In the process this often caused the person to be isolated from their local community and increased the problems of exclusion. Today the emphasis has changed. Rather than building separate programmes and activities, we are linking with others and making better use of the opportunities that already exist in our communities. We look at ways of finding out what is in the local community so the person supported can make decisions about what they will join and what they may wish to initiate.

Why it is important

Community mapping is a way to find out what places, people, groups and activities exist within the person’s neighbourhood. This can be by simply walking around the person’s local neighbourhood with them. As you go, identify all the people, activities, jobs (voluntary and paid), places, spaces, events and possibilities that have the potential to help the person to belong and contribute. Better still, you will enlist others from the community/neighbourhood to inform this analysis.

Remember – many people you support are isolated because services try to do everything themselves. Don’t make the mistake of using this same process to get a different outcome!!

Key elements

Mapping is done with the person involved. Some maps are made with photos. Some maps use circles. Some maps are printed from the computer; most are a mix of visuals, photos and descriptions.

Community maps identify places, spaces and activities. The key to a community map is that it must make sense to the person and reflect what they are interested in. The maps provide an opportunity to gain more information about their preferences and possibilities.

How it works

Making a community map

Start with the assets the focus person has, including material things, friends, family and attributes. As you walk with the person around their neighbourhood, you can discuss these questions:

  • Who are the people around here?
  • What associations and groups are there?
  • What are the places nearby?
  • What are the spaces nearby?
  • What industries/workplaces are there?
  • What recreational activities are there?
  • Do any of these connect with your aspirations?

What a community map looks like and how it is made will depend on the person it is relevant to. Below are three very different community maps. The important things are:

  • the map is are specific to the person (it includes the things that interest them and excludes the things that don’t).
  • the map is meaningful to the person (they understand what it means and can use it to explore and get involved in their local community).

 

Community maps


Potential challenges and suggested strategies

Challenge Strategies

There’s nothing in our community

  • Try looking on the noticeboards at shops, libraries, churches, supermarkets and shops. You’ll be amazed at how much is out there. Get on the mailing list of some community organisations to get a regular update of everything that’s going on.
  • What could the person (or the organisation) contribute to the community to make the place more vibrant?

We have no transport

  • Try starting at the person’s home. Walking around is ideal because you get to see more and have more time to process what you see and discuss them than you would if you were in a van or car. A good thing about finding resources close to home is that there may be neighbours who can assist with transport or other supports.

The person lives rurally and there are only paddocks around

  • Ask yourself: What are the paddocks used for? Who lives nearby? Where do they spend time during the day?
  • Could you try doing a community map around a more populous area?

The person is interested in everything we see!

What community mapping may look like

Person or group Outcomes

For the individual

  • I know a lot more about what is going on in my neighbourhood.
  • I can make informed choices.
  • I can meet more people in my neighbourhood.

For family/whānau

  • We can contribute with information and knowledge to assist the map development.

For the organisation

  • Sharing resources with community – eg meeting place, use of computers, invitation or inclusion of any on-site education.
  • Hosting meetings/events that promote community development.
  • Participating in community boards, local government, community garden schemes, etc.

For the community

  • The community is enriched by the inclusion of a person who has chosen to engage in an activity/event/group.

Resources

http://www.abcdinstitute.org/docs/Diane%20Dorfman-Mapping-Community-Assets-WorkBook(1)-1.pdf

http://catcomm.org/transect-walk/

A guide to capacity inventories; mobilising the community skills of local residents

Community Living, British Columbia, (March 2009). Belonging to one another: building personal support networks (see page 15 in particular)

Being regarded as a citizen is a key step in belonging and participating in a community. Once you have spent some time mapping what is in the person’s neighbourhood or community, the next step is to consider how to build and strengthen the person’s links with their community. 
Note: throughout this we are discussing community as if it is a place. But remember it can also be a group of people, such as a church community or a hot-rod club.

Why it is important

Families and friends are important for people to have a good life.

 Key elements

  • The role of services may be to strengthen and maintain relationships between individuals and their family/whānau.
  • The community, which has been kept separate and segregated from people with disabilities for generations, sometimes needs support to know what to do and how to do it well.
  • The most powerful way to teach the community about the benefits of including all people is to build personal connections, one person at a time.
  • Community participation is the active involvement of individuals in the community. This can be facilitated by a diverse range of activities, supports and connections.


Barriers from disability service agencies

Successfully supporting people to link with and become part of their community requires very different ways of operating than is usually done in disability support services. In fact it is very difficult to provide both ‘services to clients with needs’ and to ‘connect contributing citizens’.

Some of the limiting factors in creating links into the community for disability service agencies are internal rather than external. They may relate to the siege mentality we can easily get into. Examples include a feeling that the community is foreign to us and unwelcoming and we have to do this thing called community inclusion in a hostile environment. It may relate to the fact that many disability support workers are better at caring for people, and have been employed for that reason, than at connecting people. In other words, this is a skill we may need to learn.

Another barrier may also relate to a fundamental belief that the people we support are in fact largely isolated and incompetent. This will rarely be a conscious thought but will show up in how people are spoken about. For example, often disability support personnel talk about the lack of valued social roles persons have. In doing this they ignore some of the obvious roles that can be built upon – a person may be a brother, flatmate, tenant, taxpayer and cat lover. Or she may be a niece, bike owner, constituent, citizen and neighbour.

Remember that the development of networks includes becoming part of or one of the networks. It is not just about what is in the community for me, but also what I can give back to the community. Consider how the organisation can be a community resource. Developing community networks takes time and the ability to share and gather information.

How it works

Sharing gifts to develop community engagement: the strengths model

We need to move into a strengths model where we are linking people’s gifts and building on what they have. Everyone has something to give and everyone has links with the community already, even it is only through one person. Start with these assets and build on them.

We cannot create community from a position outside the community – we have to assist it happen from within. An example of this is when someone has an interest in joining a dancing club or group. It is better to have a member of that group introduce and mentor the person into the group than have a disability agency staff person do it (unless they are also a member). This is because the group member has natural authority to introduce a new person. They lend that new person credibility by association. And they know how to introduce the person in a way that fits the culture of the group.

So the task for a support worker becomes is to connect the focus person with a member of the group directly or, better still, through an existing relationship. The group member is then supported to introduce the focus person to the group and mentor their engagement. Connecting, rather than doing, becomes the role of support staff.

Practical skills and actions that will help to build links in the community include knowing how to introduce people.

  • Help the person to develop skills, using information, prompts (e.g. how to take turns in a conversation, what to say, what not to say, etc.)
  • Educate the others by being a positive role model and affirm their positive interactions.
  • Be prepared to practice and give prompts to help all involved.
  • Help others to be at ease with the person – encourage them to see past disability and connect with the person on the basis of their interests, talents, skills and merits.

Ideas for creating community links

Below is a range of ideas you can use when you are working with someone who wants to be more connected with their community than they currently are.

  • Start with one person and their gifts and aspirations. Community building is all about identifying and sharing gifts. It is not about addressing needs.

-        Ask: What are this person’s gifts and dreams?

-        A person should attend the dancing group because they want to dance not just because they are lonely.

  • A person needs to be present in the community to be able to participate. And it is through genuine participation and contribution that they will create relationships and opportunities for friendships and all that these bring.

-        Ask: Where and how does it make sense for this person to contribute their gifts and participate in their dreams?

-        The person can’t be a spectator – it isn’t enough that they are just present. If they like netball then they need to join a team or have a job or role that contributes their gifts or skills. Building community is based on sharing gifts.

  • Consider how the person will become connected to that place or activity. What are their gifts and how might they may want to contribute to the purpose or interest of the group?  Note: identifying the person as a client of a service, or needy, will impede the process.

-        Ask: Who or what is needed to make this connection of the person to the place where they can use their gifts and realise their dreams?

  • Spend time finding out who the connectors are in the person’s community or neighbourhood and enlist their help. These are the people who will be able to link the person with others who have shared interests.

-        Ask: How do we enlist and value connectors?

 

Potential challenges and suggested strategies

Challenge Strategies

Lack of physical access

  • Support organisations that have accessible venues and resources. Advocate for and challenge those that don’t.

Lack of knowledge; our community seems ‘closed’

  • The best way to teach the community is for it to have a positive experience with a person.
  • Initially you could try using the networks that the individual (or staff) already have – these are likely to be more ‘open’.

One-way expectations: people are used to receiving, having not had opportunities to be seen as having something to offer.

  • Remember that contribution is an important part of community. Look for ways the person and/or the organisation can enhance, benefit or contribute to the community.

Large groups can be intimidating for other members of the community. It can look like a takeover and prevent people from participating fully or connecting with others. It can also reinforce negative stereotypes of people with disabilities.

  • Create the conditions and situations where the personis more likely to be accepted.
  • Prepare and plan carefully. Talk to organisers before a person takes part in an activity. Let them know why he or she wants to be part of it and give them strategies for engaging with the person. This helps to ensure that the person will be made to feel welcome, and their involvement will be sustainable.

What citizenship may look like

Person or group Outcomes

For the individual

  • I am supported to contribute and participate.
  • I am connected with my natural support networks.
  • I choose experiences from a range of options in the community.
  • I experience the community as informed and welcoming.

For family/whānau

  • We are involved and enabled to remain connected through our culture, identity and knowledge.

For the organisation

  • There are practices that recognise the fundamental importance of individuals belonging to their natural networks.
  • Organisations are involved in developing relationships and doing things that result in increased opportunities for people with a disability in the community.

For the community

  • Services support and contribute to the community not just the disability sector.
  • Communities become more ‘enabling’.
  • Members of the community benefit from this process by learning to interact with disabled people as individuals on the basis shared interests, passions and ability to contribute.
  • More diverse and inclusive communities are developed.

Resources

http://www.abcdinstitute.org/docs/A%20Basic%20Guide%20to%20ABCD%20Community%20Organizing-1.pdf

http://www.abcdinstitute.org/docs/kelloggabcd.pdf

Asset-based community development

Inclusion Press and Network

www.tuhana.org.nz/index.php/building-trusting-relationships/20#7

Kendrick, M. (2001) The Contribution of Service Workers In Getting The Relationship “Right” Between People With Disabilities And Their Communities

http://socialrolevalorization.com/articles/kendrick/service-worker-contribution.pdf

John O’Brien’s Five Service Accomplishments

Kretzmann, J and Green, M (1998) Building the bridge from client to citizen. A community toolbox for welfare reform ABCD Institute

Kretzmann John P (1995) Building community from the inside out Shelterforce #83 Sept / Oct 1995

Finding a home

One of the most important decisions any of us make in life is where to live. Where and how we choose to live reflects who we are and can lead to different opportunities becoming available to us. Many of the people you, as a support worker, assist to find a home will be limited in their search by what they can afford and what is available. But not just any home will do, even if it meets these requirements. It has to be what the person wants.

There are several places to try and find a home if the person is looking to rent. These include social housing providers such as Accessible Housing Ltd, the local council, Housing New Zealand and the private rental market. If you create a good relationship with any or all of these providers you will find that you have more success at finding appropriate housing for people.

Here are some questions you may use to assist the person to consider as they approach this major decision. (Most of these questions relate to renting a property as this is the most common situation, but some are broader.)

Staff need to consider the type of decision-making agreement that the person might need and support them to arrange it. (See the Supported decision-making section.)

 

Deciding where to live

  • Who helps me decide where I live?
  • Where do I need to live to be able to get around and do what I want?
  • Does it need to be close to transport, supermarket, doctors, my family/whānau, etc?
  • What is essential and what is negotiable?
  • Will I live alone or with others?
  • How do I safely find others to share with me if this is what I want to do?

 

What do I need in my home?

  • Will I need landline phone, internet, security alarm, electronic doors, etc
  • What heating will be best for me? Heat pump, electric heating with a timer, gas, etc.
  • What is the likely annual budget I will need for utilities? (See the Finances section.)
  • Have I thought of everything – gas, water, heating, phone, body corporate, etc?
  • Can I get the power on a pre-pay system?

 

Dealing with rent and the landlord

  • If I need support, who can support me to meet the landlord and ensure I know my rights as well as my responsibilities?
  • How will I arrange the rental bond and rent payments?
  • Can I arrange direct payment from Work and Income or wages to make this easier if I struggle to manage my money?
  • Who can assist with tenancy references? Is there a former landlord, family friend, employer, etc who can do this?
  • Is it better to have a joint tenancy or have it in my name?
  • What support will I need from the organisation that is contracted to provide my support in finding, securing and maintaining my tenancy or other financial arrangements?


Note
Providers should be careful if they are involved in matching people to be tenants. If things go wrong you may be held accountable by the person and/or their family. When you do assist you should only act in the role of creating an introduction and be clear about the limits of this role.

 

Checklist

If you don’t already have one, it is worth using a checklist like the one below to assist people, so that things are not forgotten. Here is an example.

Before moving in:

Issues to consider Done

Tenancy agreement – read it carefully, noting all conditions

 

Bond – letting fee, 2 weeks rent in advance.

 

Connecting power

 

Connecting phone

 

Change address:

Notify

Done

Doctor/specialists

 

Bank/s

 

Work and Income/ employer

 

Family/whānau

 

Any other services (do support services, lawn mowing, etc need to know?)

 

Inspection of flat or house:

Issues to consider

Done

Keys for front & back doors work

 

Keys for front & back doors work

 

Oven & stovetop functions are in working order

 

Fixed heating is in working order

 

Bathroom items are in working order

 

Toilets are in working order

 

Taps are all in working order

 

Doors – bedrooms entrance, exit, linen cupboard

 

Shelving

 

Hot water cylinder – temperature reading is correct

 

Walls

 

Wash tubs

 

Blinds/curtains

 

Sink benches

 

Power points

 

Smoke detectors x 2

 

Windows

 

Other …

 

Other things to consider:

Issues to consider

Done

Does the person need assistance with an emergency survival kit?
Where will it be situated? Who will maintain it?

 

Will they have a first aid kit?
Where is it situated? Who will maintain it?

 

Who is the neighbourhood contact person in case of an emergency? (Someone in my neighbourhood who I know)

 

Where is the closest Civil Defence meeting place to the house?
What is the fire drill for this person? Does it need to be practiced?

 

Can we work with local fire brigade to help keep smoke detectors in working order?

 

When sharing a flat consider an inventory list for the person

 

Are there specific health and safety needs to take account of in the home?

 

How does the person want to celebrate moving into their new home?
Do they want a house-warming event?
Do they want the house blessed?

 

Other …

 

Two very helpful links about finding and maintaining tenancies and what to do if the person moves or things go wrong are:

http://www.trademe.co.nz/Help/Rentals/Guide.aspx

http://www.dbh.govt.nz/tenancy-index

Money & Finances

Handling money

One of the biggest decisions in life is how we choose to manage our money or our finances. It is important to plan for how money will be handled during the early planning and engagement process as this can be a difficult area of support. The best option is to find out if this is something the person can manage for themselves or if there is a family member who can help. If there is already someone who has a court-ordered role to handle the person’s money, they will have a substantial role in deciding how things run.

Everyone handles their finances differently and everybody sometimes makes mistakes with their finances. It is important that the people we support should be able to make mistakes and take risks as long as they are aware of the possible outcomes. So it is essential to assist the person being supported to know why financial information is important as a life skill. Ensuring the person has a voice in their planning and decision-making will help safeguard the person’s autonomy in this area.

There are practical skills which the person may need support to learn or to select. These may be as basic as assisting with the setting up of automatic payments, teaching PIN numbers, using Work and Income direct payments or arranging internet banking. This fundamental information can also be given by budget advice services, a supportive bank and with the creation of a good relationship with a personal banker. In the beginning these services may all require some support.

Sometimes the financial information may be more complex such as the appointing of financial managers or the setting up of trusts as part of circles of support. It is hoped that in the future, disabled people may be able to use funds to pay for financial support information. All financial information should begin early in the process in order to obtain the best results.

Support workers, from time to time, may need to help people with their day-to-day money needs or to support people further in becoming financially autonomous. However, when you do this you must ensure there are clear guidelines about how you operate to keep yourself and the person safe. It is our recommendation that you do NOT directly handle people’s money or use their PINs unless all other avenues have been exhausted.

Resources

https://www.sorted.org.nz/a-z-guides/budgeting?gclid=COb_hIfE4b0CFU0AvAodjbEAEQ

Payments available from Work and Income for community living

Important note

The information below is a general guideline. The assistance that people are entitled to is determined on a case-by-case basis. It depends on a number of eligibility and other factors. However, you can use this information to assist the person you support to maximise their payments and to ensure all the factors in their situation are considered.

Possible weekly supplements (on top of the base payment/benefit)

Supplement

Eligibility

Examples of what may be covered (This may vary from case to case)

Supported Living Payment (SLP)

Paid to people permanently and severely restricted in how much work they can do because of sickness, injury or disability.

A base payment/benefit which additional payments are then added to.

Accommodation Supplement

A weekly payment which helps people with their rent, board or the cost of owning a home. 

Helps to pay rent, board or mortgage in locations where the base payment does not cover the cost accommodation

Disability Allowance (DA)

Paid to people who have regular, ongoing costs because of their disability which are not fully covered by another agency. Each person is assessed personally based on the expenses they can prove. Usually the maximum is $60.54 per week.

  •  Doctor/specialist/hospital fees
  • Prescription costs
  • Travel to medical appointments
  • Heating/electrical bills
  • Medical alarm rental and monitoring

Temporary Additional Support (TAS)

A weekly payment which helps meet essential living costs. This added support may be paid for up to 13 weeks and then will be reassessed. (TAS payments may in some cases become ongoing.) As with DA above, each person is assessed on the costs they can prove.

 

Non-repayable supplement (in most cases)

  • Rent payment over and above what's covered by the Accommodation Supplement
  • Hire purchase (fridge TV etc)
  • Vehicle payments
  • Credit card repayment
  • Fines

Special needs grants

These grants help, in certain circumstances, to pay for something when there is no other way of paying for it.

Grant

Eligibility

Examples of what may be covered (This may vary from case to case)

Re-establishment grant

If the person has lived in a residential home for 6 months or more they may be able to receive rent and bond in advance and other assistance for furniture, appliances, connection of utilities and other personal requirements.

(Up to $1200 – may be more depending on the case)

Repayable grant(in most cases)

  • Rent in advance
  • Bond

Non-repayable grant (in most cases)

  • Furniture
  • Appliances
  • Bedding and towels
  • Toiletries
  • Clothing

Additional special needs grants

Funding may also be available to help pay for costs that cannot be met at any particular time.

(It is dependent on each person’s situation)

 

Repayable grant(in most cases)

  • Whiteware
  • Medical and dental costs

Non-repayable grant (in most cases)

  • Power (up to 3 monthly bills per annum)
  • Food (including the initial stocking of their cupboards)
  • Landline phone rental allowance (if they live alone)

Transition to work grant

If the person is able to work, they may qualify for a this grant which helps with the extra costs of moving into a job

It can help to pay for things such as:

  • Job search costs
  • Job interview costs
  • Tools or clothing needed for work

Work bonus

This payment is made to people receiving certain benefits, such as the Supported Living Payment, who choose to move into paid work Expenses that occur in the first few weeks of working

Appendices

Below are the appendices for the Enabling Good Lives Toolbox.

Primary links

The EGL Principles

Topics -  EGL Guidelines 

Self-Determination

Who Has the ‘Say So’ Personal and Support Planning - Deciding What I Want Communication Strategies - Making it Easier for Individuals to Communicate

Beginning Early

Communication Strategies - Making it Easier for Individuals to Communicate Building Trusting Relationships Creating Partnerships

Person-Centred

Who Has the ‘Say So’ Personal and Support Planning - Deciding What I Want Having People Involved

Ordinary Life Outcomes

 Experiencing New Things Citizenship What’s in My Community

Mainstream First

 Citizenship What’s in My Community Facilitative Support

Mana Enhancing

Who Has the ‘Say So’ Creating  Partnerships Communication

Easy to Use

Building Trusting Relationships Facilitating Group Meetings Using Our Resources Innovatively

Relationship Building

Building Trusting Relationships Working Creatively with Conflict Communication

Individual Outcomes

Topics -  EGL Guidelines   

Valuing of Personal Networks

Building Trusting Relationships Creating Partnerships Facilitative Support

Control of Support

Who Has the ‘Say So’ Personal and Support Planning - Deciding What I Want Working Creatively with Conflict

Aligned Support

Using Our Resources Innovatively Building Trusting Relationships Facilitative Support

Control of Resource

Who Has the ‘Say So’ Personal and Support Planning - Deciding What I Want What’s in My Community

Contribution

Citizenship Experiencing New Things What’s in My Community

Supports and/or Services

Topics -  EGL Guidelines   

Personal Networks

Citizenship Facilitative Support Using Our Resources Innovatively

Control of Support

Personal and Support Planning - Deciding What I Want Who Has the ‘Say So’ Working Creatively with Conflict

Person Directed Planning

Making it Easier for Individuals to Communicate Personal and Support Planning - Deciding What I Want Who Has the ‘Say So’

Aligned Support

Building Trusting Relationships Creating Partnerships Making use of the resources we have

Personal Relationships

Communication Creating Partnerships Working Creatively with Conflict

Increasing Expectations

What’s in My Community Experiencing New Things Citizenship

Key

Primary links

EGL principles  
  1. Self-determination
  2. Beginning early
  3. Person-centred
  4. Ordinary life outcomes
  5. Mainstream first
  6. Mana enhancing
  7. Easy to use
  8. Relationship building

 

Topics 1 2 3 4 5 6 7 8
Facilitation based approaches                
Who has the say so                
Making use of the resources we have                
Having people involved                
Experiencing new things                
Citizenship                
Making it easier for individuals to communicate                
What’s in my community                
Deciding what I want                
Building trusting relationships                
Building partnerships                
Group facilitation                
Interpersonal communication                
Innovative resource allocation                
Working creatively with conflict                

Appendix 3: Purchasing guidelines

Introduction

This section is taken directly from the Ministry of Health’s website and explains how the support funds can be used. When you read through these you may think of ways in which the support funds could be used but are unsure if they fit within these guidelines. If that happens, check with your organisational seniors, or with the needs assessment and service coordination agency (NASC).

If the NASC doesn’t know then they can help you send it through to a Ministry of Health panel where decisions are made. Please be aware that these guidelines are still very new so everyone is learning as they go. However, the Ministry is keen to be as creative as possible in assisting people to live their lives in the community. So don’t be put off because you think your query will be turned down.

The New Model for Supporting Disabled People (the New Model) is about people having more choice, control and flexibility, including over how they use their funding and the disability supports they buy with it.

Under the current system of disability supports funded by the Ministry of Health, people can only choose between different services such as Home and Community Support Services (HCSS), Supported Living or Residential Services. Some people do opt for Individualised Funding which allows them to employ their own support worker, but this option is still restricted to HCSS.

As part of demonstrating the New Model, the Ministry is introducing two new options:

  • Enhanced Individualised Funding (Bay of Plenty only)
  • Choice in Community Living (Auckland/Waikato only).

 

Under either of these options, people are allocated an amount of funding (a budget) and make decisions about what disability supports to buy with that money. To ensure that this money is used for its intended purpose, the Ministry of Health has developed purchasing guidelines, based on principles that outline what people can and cannot use their money for.

As this is public money, any spending will be subject to public scrutiny. This means that everybody involved in the process, including the disabled person for whom the funding has been allocated, has a responsibility for ensuring the money is used for its intended purpose. It must only be used in ways that are consistent with these guidelines. This means that all uses of funding must meet the following three criteria:

  1. The money is spent on disability supports (on things a disabled person needs that they wouldn’t need if they didn’t have a disability).
  2. The disability supports contribute to an outcome in the person’s plan.
  3. The disability supports are within the scope of relevant Ministry of Health policies and responsibilities.

 

Each item or type of support a person wants to buy must meet all three criteria. For example, a person may want to buy something that is a disability support and contributes to an outcome in their plan. However, that disability support will not qualify if it is the responsibility of another agency or a district health board, or is not the responsibility of government, as it does not meet the third criterion.

Needs assessment and service coordination (NASC) organisations, Enhanced Individualised Funding Hosts, and Choice in Community Living providers will all have a role in assisting people to interpret the guidelines and make decisions that are consistent with them. The Ministry will support them in this role and will make decisions, if needed, based on individual circumstances through a purchasing guidelines panel, that will include disabled people and family members.

The guidelines are only being used at this time for the demonstration of Enhanced Individualised Funding (Bay of Plenty) and Choice in Community Living (Auckland/Waikato) but may be used for other New Model initiatives in future. The purpose of these initial demonstrations is to see what works and what doesn’t. If the Ministry, in consultation with disabled people and other stakeholders, considers that the guidelines can be improved, then changes may be made during the demonstrations.

 

Guidelines on what funding can be used for

Introduction

These purchasing guidelines set out what people can buy with the disability support funding they have been allocated by a needs assessment and service coordination organisation when they are taking part in an initiative relating to the New Model for Supporting Disabled People.

Background

Under the New Zealand Public Health and Disability Services Act 2000, disability support services (disability support) include goods, services and facilities that are provided to people with disabilities for their care or support or to promote their inclusion and participation in society, and independence, or for related or incidental purposes. The Ministry funds disability support for people with a physical, intellectual or sensory disability (or a combination of these) that is likely to continue for a minimum of six months and result in a reduction of independent function to the extent that ongoing support is required.

For more information see: www.health.govt.nz/yourhealth-topics/disability-services/am-i-eligible-ministry-funded-support-services

 A core part of the Ministry’s New Model for Supporting Disabled People is the development of broad guidance on what funding can and cannot be used for, so that people have increased flexibility, choice and control over the support that is purchased with the funding they are allocated. At this time, these guidelines will apply in specified initiatives that are part of the demonstration of the New Model for Supporting Disabled People, although it is recognised that modifications may be needed to reflect the particular characteristics of each initiative.

 

Guidelines

When these guidelines apply, people who are allocated funds by a needs assessment and service coordination organisation will be able to purchase products, services and/or arrangements that meet each of the following criteria.

Criterion One: they are a disability support, and

Criterion Two: they contribute towards the achievement of outcomes that are identified in a person’s individual support plan, and

Criterion Three:
 they are within the scope of relevant Ministry policies and responsibilities.
 
Each of these criteria is described further below.

Criterion One: They are a disability support

Disability supports are goods, services and facilities (or related and incidental costs, such as recruitment, training, insurance or maintenance) that promote the disabled person’s independence and their inclusion and participation in education, paid and unpaid work, home and civic life, and the community. Purchasing these supports may result in them facing additional costs that they would not face if they did not have a disability. Those additional costs might arise if a person requires goods, services and/or facilities that:

  • they would not require if they did not have a disability, and/or
  • are a higher cost than would be the case if the person did not have a disability, and/or
  • are additional to or complement the goods, services and/or facilities they would require if the person did not have a disability, and/or
  • are a ‘payment in kind’ to people providing the person with voluntary support (eg, a contribution to petrol costs).
 
Consistent with this approach, disability supports do not include the cost of goods, services and/or facilities that the person would reasonably be expected to provide for from their own money (such as from wages or a benefit) if they did not have a disability. The goods, services and/or facilities a person would reasonably be expected to provide from their own money depends on their particular circumstances, but would normally include the following:

  • bills like electricity, gas, telephone and internet costs
  • general household fittings, furniture and white goods
  • standard electrical goods and consumer products
  • food, groceries and other household goods
  • mortgage payments, rent or rental assistance
  • general vehicle purchase, modifications or maintenance
  • house and contents insurance, vehicle and life insurance
  • tickets to movies, shows or sporting events
  • employment services
  • fuel
  • plane, train, bus or taxi fares
  • the repayment of personal debts
  • donations to charitable or church organisations
  • other non-disability related services such as legal advice
  • complementary therapies and non-government funded or subsidised health treatment.

 

Criterion Two: The disability support contributes to outcomes in a person’s individual support plan

Disability supports assist people to achieve outcomes of participating in education, paid and unpaid work, home and civic life, and in the community through assisting them to carry out their normal daily activities such as communicating, moving about, building relationships, looking after themselves and others, making decisions and finding out about things. The outcomes identified in a person’s individual support plan may fit within any of these general outcomes but will be specific to that person.
 
The following are examples only of, and are not intended to limit, the types of outcomes that may be included in a person’s individual support plan:

  • moving to independent living
  • continuing to live within their family or whānau
  • continuing to live independently
  • enabling family or carers to receive support so they can continue their caring roles
  • improving skills and capabilities to support independence and participation
  • having more opportunities for building relationships
  • having more opportunities for community access and participation
  • having more opportunities for inclusion in cultural activities
  • being able to carry out family and whānau responsibilities
  • participating in education or further training
  • improving paid and unpaid employment opportunities.

 

Criterion Three: They are within scope of relevant Ministry of Health policies and responsibilities

General policies of the Ministry affecting what disability supports can be purchased are the following.

a.    Disability supports should be the most cost-effective and relevant way to support a person to achieve outcomes identified in their plan.
 
b.    Disability supports can only be purchased when informal supports, community services and government services available to all members of the community (such as health, education, welfare benefits, and child, youth and family services) have been explored and found to be unavailable, insufficient or inappropriate.
c.    Funding cannot be used to purchase disability supports that are wholly or partly funded by other government departments or agencies, such as community participation services, supported employment, special education support, the telephone relay service or the total mobility scheme, unless the Ministry of Health and another agency have joint funding responsibilities in relation to that support.
d.    Funding must not be used to purchase types of support that are funded by the Ministry’s Disability Support Services group but that are excluded from the scope of a particular initiative unless:
( These exclusions will be determined on a case-by-case basis. It is unlikely, however, that Assessment, Treatment and Rehabilitation Services (AT&R); Child Development Services, Disability Information and Advisory Services; and Needs Assessment and Service Coordination Services will be included in any of New Model initiatives in the near future. )

  • a person has been considered for those excluded types of support, and
  • doing so contributes to cost of services that are over and above the amount that is already funded by the Ministry, and
  • doing so would contribute to a person achieving outcomes identified in their personal plan that could not be achieved in any other way.

e.    Ministry funding for disability support cannot be used for: 
  • support for conditions or injuries that are the responsibility of other government agencies such as the Accident Compensation Corporation and district health boards 
  • personal advocacy services 
  • anything that is illegal 
  • gambling, tobacco or alcohol.

f.     Family carers cannot be paid except in the circumstances that this is allowed under a family care policy.

 
This policy is authorised under Part 4A of the New Zealand Public Health and Disability Amendment Act 2000 (as inserted by section 4 of the New Zealand Public Health and Disability Amendment Act 2013), which came into force on 21 May 2013. The policy came into force on 1 October 2013. 

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