Active Support Workshop Jen Rhodes Principal Clinical Psychologist Northumberland Tyne & Wear NHS Trust Steve Wilson PBS Practitioner Tees Esk & Wear Valley NHS Trust

Aims & Objectives To provide participants with an overview Active Support and who it would benefit from it To provide participants with the opportunity to observe an activity and generate feedback To outline how the approach can be implemented To consider some of the challenges of implementing Active Support

Exercise 1: Your life Complete a timetable for a typical day in your life (be prepared to share with the group!) Time A typical Monday… 7.00   7.30 8.00 8.30 9.00

Feedback What sort of activities fill your day? Must do activities Should do activities Things for fun Spending time with friends Helping others We have busy lives, but unfortunately the same can’t always be said for the people we support

What is Active Support? Active support is a way of getting people with learning disabilities more involved in their lives. It helps people, who may need staff support, to do things like cooking, washing up, making drinks etc.

Person-centred active support Providing enough help to enable people to participate successfully in meaningful activities and relationships People gain more control over their lives, gain more independence and become more included as a valued member of their community Irrespective of degree of intellectual disability or presence of extra problems

Why do we use it? A lot of people with moderate learning disabilities spend a lot of time doing nothing. This isn’t good enough. People with learning disabilities should have busy lives with lots to do. If people are not doing things, they are more likely to engage in behaviour which is considered challenging.

Engagement in meaningful activity Helps us keep fit and mentally alert Gives us a sense of personal worth Allows us to express who we are Establishes common interests with other people Develops our talents and allows us to show what we can do Demonstrates our independence and autonomy Is the means by which we look after ourselves and our daily needs Provides the basis for friendships and living together Welsh Centre for Learning Disabilities, 2000

Why do we use it? Some people with learning disabilities need staff to help them to do things. Staff are often busy doing other things, like paperwork or cleaning. Active Support teaches support workers new ways of helping the service users

Every moment has potential’ Not, “which activities can they be involved in?” but, “how can I help involve them in this right now?” Find parts of activities person can do Fill in the gaps with your help to ensure they succeed

What do we do? We teach all staff about Active Support in a workshop 2. Two trainers coach every member of staff individually. We watch them, give them feedback and then try some things out with them. Aim is to change staff behaviour ………. It’s a whole house/system approach!

Staff Workshop A 1 day workshop Introduces the ethos of active support Introduces the structured timetables and recording charts. This helps staff to begin to think about timetabling activities before the interactive training starts Ideally, the workshop would be facilitated by 2 AS trainers

Interactive Training Each member of staff has an interactive training session, which is facilitated by 2 AS trainers (lead & support trainer) Interactive training involves: Observing a member of staff Providing them with feedback Coaching Observing them again

Lead trainer: Narrative Recording

Observation & Feedback Giving Feedback is a crucial aspect of active support. Base your feedback on the narrative recording charts Needs to be sensitive but honest Try and include positive elements, as well as areas to improve on

Feedback Consider commenting on: Task preparation and presentation Providing support and assistance Making participation rewarding Style

Coaching Don’t be afraid to get involved! Some of the most effective coaching is when the trainer gets involved themselves It’s easy to tell people, but try showing them! Don’t be afraid to get things wrong! This will improve learning.

What have we found? Service users are more engaged in activities after Active Support n=136

What have we found? Staff are more engaged with service users after Active Support n=136

Case examples Ted Before AS, staff did all of his personal care. After AS, staff handed him a flannel and used hand on hand to help him wipe his face. Kate Before Staff did a big shop every week, and put away shopping. After AS, staff supported Kate to go to the shop for items for lunch and then supported her to put items away.

What else have we found? Staff have enjoyed it and said it helps them to be better at their job: “I feel bad that I’ve never done this before. X can do so much more than I thought” “It was scary to start with but it’s really helped X” “the coaching was really helpful. It made me smile to see how much X can get involved in things. I didn’t realise that before.” “It’s the simple things that you learn from the training that really make a difference. I’ll never do that [activity] in the way I used to.” The effect of changing staff behaviour ……… There has been a significant increase in job satisfaction in direct care staff following AS training (Rhodes & Toogood, 2016)

Creating Capable Environments Integrating person-centred approaches Person-centred planning – important for co-ordination and development over time Person-centred thinking – Helps to promote the right attitudes – puts the person at the centre of their own lives and of staff activity Person-centred funding – can improve control over who supports them, how and in what activities. Empowerment model NOT Hotel model

Challenges Getting wider system on board. Need to ensure: Sign up from management. Commitment to workshop and coaching. Staff to be available. A relatively stable staff team. Adequate staffing

Overcoming Challenges Train the Trainers Training Seniors/ Managers to deliver the approach Evidence that model has more longevity if senior/ managers are involved (can be used as second trainers)

The future We think it really helps both staff and service users. We hope to do more of it!

Active support…… Is the enabling relationship between staff or other carers or supporters and the people they support It is what staff do and how they do it, whenever they support someone Whether for one minute, one hour or a whole day

Active Support Training Resources Jones, Perry, Lowe, Allen, Toogood & Felce (2009) Active Support: A Handbook for supporting people with learning disabilities to lead full lives. Available free of charge as a download from ARCUK arcuk.org.uk/wales/999095/en/active+support.html

Mansell, Beadle-Brown, Ashman & Ockenden (2005) Person-centred Active Support: A multi-media training resource … Available from Pavilion Publishing Company

Related Resources Toogood (2010) Interactive training: supporting people with severe and profound intellectual disabilities in meaningful activity. Available from Pavilion Publishing Company

Related Resources Toogood (2010) Person-centred Planning: Implementation manual for promoting positive outcomes for people with learning disabilities. Available from Pavilion Publishing Company 30

References Rhodes, J.A., & Toogood, S. (2016). Can active support improve job satsifaction? Tizard Learning Disability Review. 21,2,54-60. Stancliffe, et al. (2008) Active support; a critical review and commentary. Journal of Intellectual and Developmental Disability. 33,3,196-215 Totsika, V., Toogood, S., & Hastings, R.P. (2008). Active Support: Development, evidence base and future directions. International Review of Research in Mental Retardation. 35, 205-249