1. Slide 1

2. What Makes a Good Conversation?
Be Mindful
Mindful of the facts … Be curious
Mindful of self Feel engaged
Mindful of role … Be aware of your privileged advantage,
so do the prep
Mindful of others Dignify and value their participation
Mindful of time/situation Listen without prejudice
Mindful of place Respect and appreciate their environment
Mindful of being Practice cultural competency
Mindful of connectivity Strive to build positive relationships
Mindful that Co-Design is founded on Empathy and Trust
Slide 2

3. Slide 3

4. Video 1 – This shows a meeting between Jessica and her
social worker as Jessica’s GP has just requested home care
support for her. Jessica who has broken her ankle
whilst out in her garden feeding the birds.

5. What was good about the conversation?
Exercise:
What was good about the conversation?
What do you think could have been
improved?
What else would you like to ask Jessica?
How do you think Jessica felt?
Slide 4

6. Slide 5

7. Video 2: A different conversation
As you watch think whether it is service led or outcome focused.

8. How do you think this compares with the first Conversation?
Exercise:
How do you think this compares with the first
Conversation?
Is the conversation service led or outcome
focused?
How is Jessica being treated in this
conversation?
Slide 6

9. Key points
Positives:
Some positive aspects,
‘describe a good day’
timebanking
What’s important to you?
Better listening
Negatives:
Still very service led in places _OT/ Physio/Alarm
A good number of closed questions
Some areas cut across, for example Jessica’s raising of driving was ignored
Still focussed on deficits. E.g. in respect of confidence
Slide 7

10. The Exchange Model of Assessment1
Slide 8
Figure 1: Smale and Tuson’s exchange model (adapted)

11. Negotiate and agree outcomes
Hopes:
What else...
Instead of...
What difference...
Describe:
Negotiate and agree outcomes
(exchange model)
Prompt questions; T.E.D
Person’s story
Acknowledge:
Exceptions:
Coping:
Listen to issues
Slide 9

12. Techniques- see handout
Prompt Questions- typically open, “conversational approach- T.E.D. e.g.: Tell me about your health; Explain to me, what’s a typical day for you?; Describe for me, with as much detail as possible, what you need support with?”.
Acknowledging- acknowledge concerns without needing to fix it.
Exceptions- There are always exceptions to a description of problems (When is the problem not happening?; When is the problem different?)
Coping- Asking questions which support people to reflect on their strengths, abilities to cope, endure, get through (how are you managing to get through all this?)
Slide 10

13. Techniques
Hopes- Many people generally respond with “I don’t know” and
need support to think, using a range of questions.
What else?- Look for what can change to cover a wide range of outcomes. Restore hope, that the person can work towards or achieve something similar to what they had done before.
Instead of? - Establish what the person wants, not what they don’t want.
What difference- will support with.... make to you?
Description- lays the foundation of the planning process. Help the person describe in detail the life they want to be living- identifying outcomes, as this increases motivation to act and be involved.
Slide 11

14. Exercise: So what difference will this action make?

15. Exercise: Can people become dependent on care services?
Discuss in groups

16. Improving your confidence Being treated as an individual
Being able to see friends and family
Being listened to
Reducing your symptoms
Having a say/
choices
Living where you want to
Feeling safe
Being treated with dignity and respect
Getting involved in your community
Improving your mobility
Having people to rely on
Having things to do
Being in control and responded to
Staying well
Improved skills
Slide 12

17. What is important to you in your life
Focusing on outcomes means that you (the person) are supported to identify:
What is important to you in your life
Why these things are important (outcomes)
How to go about achieving these things
Who will be involved, including you, other people in your life and community, and services?
Also when and where etc
Therefore the outputs (use of services, if required) come at the end, once clarity is achieved.
Slide 13

18. As part of assessment/ support planning, utilise ROPES:
Resources- Family & Friends; Organisational; Community; Services.
Options Present focus- Emphasis on choice:
What can be accessed now?
What is available and has not been tried or utilised?
What’s already working?
What’s already been changing?
Possibilities- Future focus; Imagination; Creativity; Vision of the future:
In three months time, what would you want your life to look like?
Exceptions-:
When is the problem not happening?
When is the problem different?
How have you survived, coped, endured, thrived?
Solutions Focus on constructing solutions, not solving problems; Learning
from the past-
What’s working now?
What are your successes?
What are you doing that you would like to continue doing?
Slide 14

19. Slide 15

20. Exercise: What skills could I bank?
Work in pairs to identify your skills and what you could
swop with each other.

21. SMART Principles S - Specific (or Significant).
M - Measurable (or Meaningful).
A - Attainable (or Action-Oriented).
R - Relevant (or Rewarding).
T - Time-bound (or Trackable)
Slide 16

22. SMART
Proposed
Mrs Williams wants to be supported to attend a social activity of her choice.
What social activities?-
Assessment
Can you measure it?- review
Is there any barrier?-
Assessment
Agreed Outcome
Mrs Williams wants to attend the Fairfield Social Club every Wednesday, as she wants to maintain contact with her friends.
When would she like to go?-
Assess/plan
Transport/ who’ll take her?- planning
Slide 17

23. Exercise: Identify SMART outcomes