1. Active Support “It ain’t what we do it’s the way that we do it” Norma Wood Claire Reynolds adapted with kind permission from Alison Branch

2. Ordinary Life: We’re engaged 99% of time …
Women spend 277 minutes day doing ordinary stuff; men spend 146 minutes a day (Gershuny, 2007)

3. Engagement and Social Contact in Staffed Services
Engagement
Contact
Average
Range
Small Homes
48%
8 - 74%
15%
5 - 31%
Hostels
25%
6 - 54%
9%,
2 - 17%
Hospitals
14%
2 - 23% 4%
3 - 16%
(Emerson & Halton, 1994)

4. Since 1994?
Average baseline in active support research studies is 31%
Engagement is predicted by client ability and assistance from staff
Staff assistance is often inversely related to the behavioural ability of clients
Structural change has not been enough
We need to do something else as well

5. How much support?
Fifteen supported housing services in Wales - contact from staff average 15% of the time (Felce & Perry, 1995)
Amount of support received - about 9 minutes in every hour but facilitative assistance 1- 4 minutes an hour on average (Mansell, 2007)
Staff not interacting with people they support in a way that enables greater levels of independence, participation or integration (Mansell, 2007)

6. A Vicious Circle of Disempowerment The Hotel Model
Staff do most things for people rather than create opportunities for people to participate
People do not participate in valued activities and spend most of their time doing nothing
Staff cannot think of goals or activities people could do. They see their role as a ‘domestic worker’ rather than as an ‘enabler’
Staff perceive people as dependent. They do not spend time interacting with or assisting people and are apprehensive about trying new things
(Mansell et al 2005)

7. What does this mean for people we support?
Passive and disengaged
Lack of opportunity
Lack of choice and control
Lack of development
Loss of skills
Loss of self confidence and motivation
Behaviour that we find challenging may occur

8. What is Active Support? Supporting people to engage in
meaningful activities and relationships
Using ordinary everyday activities
to encourage choice, engagement & increase independence.
Working with people to promote optimal engagement, irrespective of degree of disability.

9. Key Elements of Active Support
Every moment has potential
Little and often
Provide just enough support
Choice and control

10. It is always easier for 10 members of staff without a learning disability to learn one way of doing the same activity, than it is for one person with a learning disability to learn 10 different ways of doing the same activity

11. With just the right amount of support
Participation is
doing part or all.
With just the right amount of support
Some times the person needs a little support and some times the person needs more support.
This could change with each person and even with each day.
As support workers we should adapt to the persons needs and provide just the right amount of support needed.
For example: can we modify the equipment and tools and our own assistance required to promote independence?

12. Positive Staff Support
Hierarchy of Assistance
Graded assistance
ASK - INSTRUCT - PROMPT- SHOW- GUIDE
The level of support increases.....
2. Thinking in Steps – Task Analysis
Breaking activities down INTO STEPS and
doing one step at a time (every activity has
some easier bits)
3. Reinforcing Participation – Positively
reinforcing & maximising naturally occurring
rewards

13. A Virtuous Circle of Positive Interaction & Empowerment - engagement
Staff interact positively with people and provide opportunities for participation
People participate successfully in part of the activities
Staff perceive people as more competent. Give more respect control & attention & consequently feel more confident, successful & eager to try new things
Staff think of new ideas for more goals and activities. Staff see themselves as enablers
(Mansell et al 2005)

14. Organisational commitment is Essential
Linking all elements of the organisations activity
Person centred planning
Positive Behavioural Support
Health & Safety
Risk Management
Learning & Development
Human Resources
Quality Assurance

15. Active Support Increases
quality of life
independence
choice and control
connectedness
staff satisfaction
(Jim Mansell and Julie Beadle-Brown et al. 2012)
see Mansell and Beadle-Brown (2012) for review, Beadle-Brown et al. 2015
See slide for positive of Active Support

16. Active Support decreases
behaviours of concern
mental health issues (depression, anxiety)
Mansell and Beadle-Brown (2012), Beadle-Brown et al. (2015)
* see Mansell and Beadle-Brown (2012) for review, Beadle-Brown et al. 2015
Summarising feedback from tables
See slide for positives to Active Support

17. Activity
See sheet

18. Thank you For more information please contact: norma.wood1@nhs.net