Person-centered support for adults with learning difficulties: an evaluation

Abstract

This paper describes an evaluation of a Personalisation Programme provided by the UK Charity Choice Support for adults with learning difficulties.

Personalisation, synonymous with patient-centred care, means thinking about care and support services in an entirely different way. This involves starting with the person as an individual with strengths, preferences and aspirations and putting them at the centre of the process of identifying their needs and making choices about how and when they are supported to live their lives. It requires a significant transformation of adult social care so that all systems, processes, staff and services are geared up to put people first.

The Choice Support Personalisation Programme had three main features: Person Centred Planning; Individual Service Funds and Better Nights, a new form of night support which encourages greater independence. Person Centred Planning means exploring in detail what each individual wants and needs and planning support accordingly. An Individual Service Fund represents a notional allocation of money to each individual for support based on individual need and preference as opposed to a block grant and a standard support for all. Better Nights was a shift from ‘Waking Nights’ with support staff available and monitoring individuals throughout the night to ‘Sleep In’ where the care staff followed normal waking and sleeping patterns together with the individuals thus encouraging a more normal life style with greater independence.

The Social and Health Evaluation Unit (SHEU) of the Buckinghamshire New University, UK, has completed two programme evaluations; one of Better Nights and one of personalisation more broadly. In each case the Unit’s Trident method was used focusing evaluation questions on outcomes; process and stakeholder perspectives. Data from the evaluation were assessed together with the substantial savings achieved.

Specially devised audit tools were used to assess quality of life and risk management. Overall the results of these audits showed a maintenance or improvement in quality of life for the service users and effective management of risks. The process of implementation was described in sufficient detail to allow replication, learning and continuous improvement. Stakeholder perspectives were surveyed from care staff, parents and relatives and social services staff.

Overall the programme had achieved its stated outcomes in person-centred care with substantial savings. For the minority of service users whose quality of life did not appear to improve, further detailed analysis and planning is being undertaken.