It is very simple to speak about person centred practice. But the criterion by which we are judged is not our words but our actions; it is our capacity to live by these principles and consistently maintain the people we support at the centre of all we do.
What has made it possible at The Housing Connection to ensure a truly person centred service?
The vision and intention
When I was a young student I came across the work of Robert Carkhuff – in particular his landmark text, The Development of Human Resources: Education, Society and Social Action. New York: Holt, Rinehart & Winston, 1971. In it was one sentence that has been a guiding light to me since: “Programs that fail are designed to fail”. That puts the onus squarely where it belongs – on us as service providers.
A helping service has only one objective, one reason for existing – to service the needs of the people to whom it is responsible (Carkhuff) 1971. All staff, activities and organisational decisions are valued and regulated by this single objective. All issues and decisions are resolved by the single standard: What best serves the growth and well-being of those we serve? (Vitalo, R, 1975)
This requires both vision and the capacity to harness our energies and resources to design support that succeed in the terms defined by people with disability.
The role of the Board
Our history demonstrates that from the outset Board members were committed to this individually focused approach to support. Throughout the years, the Board has consistently made decisions that maintain those we support as the focus; distributed resources accordingly, been willing to challenge government decisions when they were not in the interests of clients and ensured to the best of their ability that staff members feel valued. We are all part of one team.
The focus on optimal outcomes for clients means that governance processes have consistently been at the highest level – without a sustainable, accountable service we cannot guarantee quality service. We also have a very special Board sub-committee – The Support Allocation and Monitoring Committee. Each client is reviewed separately by this committee and they can present their Personal Plans in whatever format they like or that is appropriate to their needs. For example, Michael does his by walkie talkie; Susan took photos to illustrate her goals and then projected her ideas onto her TV screen. This gives the Board assurance of the wellbeing and progress of each person outside of the management accountability process – providing a form of quality control.
Management
The eyes of management are focused on client outcomes and staff training and support. The central attitude is ‘how can we make it happen’ rather than why we cannot achieve something. We have been blessed with remarkable consistency with a passionate management team.
THC undergoes regular external evaluations to ensure that we remain focused on our ideals and on the outcomes for those we support.
Staff selection, support, supervision and span of control
Our staff selection processes are critical, with an emphasis on values and beliefs. We have outstanding staff with education rates above the norm for the sector.
Our management and supervision structure pays particular support to staff support, supervision and education. We have a supervisory structure that Project Co-ordinators are responsible for no more than around twelve people. This means close supervision of direct support staff and intimate knowledge of each client on the part of the direct manager.
In turn, Project Co-ordinators receive close support from Senior Management – there is always somebody to turn to.
The net result of this focus on staff (including generous staff training and clinical support) has meant that we have outstanding results in terms of staff retention. Over half our staff have been with THC for four or more years; half of these have bee with us more than seven years, some much more than that.
Policy
As I have highlighted above, the policies of The Housing Connection place clients at the core. While we had to revise the original document following the early guidelines of the Disability Standards, we have not strayed from this course.
Working with families
We believe that it is essential to work in close co-operation with families – they generally know the client best and often have access to informal support networks. Yes, our clients are adults and if their needs compete with the wishes of the family we will challenge this, but generally co-operation is the best course. Also, some of those we support do not have family members they can draw on for support. However, where possible, they are invaluable.
Willingness to challenge structural barriers including government policy
Often, for example, we hear about what we cannot do, ‘because of government policy’ or other barriers. We don’t buy that – it is up to us to create the changes we want. For example, one of our first projects was a group home, initially set up as a transitional home to enable individuals to develop skills until they could live more independently in the community. Later, as people living in the home clearly needed 24 hour support for the rest of their lives, this became a permanent house. However, over twelve years ago, we realised that compatibility issues meant that the four people living there could not continue to do so. We therefore negotiated with the government funding body to enable two people to move out and live separately. So – although funded as a ‘group home’ the designated clients live in three separate locations.
Through our primary mode of operation is of course to work co-operatively with government departments, we have, where necessary lodged complaints both within the department and with the NSW Ombudsman, when we believe the best interests of those we support are being subverted by rules and procedures.
Flexibility and capacity to think outside the square
Truly, we have no rules, other than ‘what is in the best interests of the person we serve’. This means we ensure we find a way to say ‘Yes’, not a reason to say ‘No’. I think the presentations by Charlotte, Michael and Susan have shown this.
Although we too face the heartbreaking and frustrating context of underfunding and unmet need, when somebody comes to us, we try to help as many as we can before we receive funding, for example through assistance to obtain funding, housing and other resources and including people in our social activities.
Community Development approach
Another central plank on which we base our approach is the community development model we use in organising support. We regard ourselves as part of a community and have a rich network of relationships with individuals and organisations that play meaningful roles in the lives of those we support. For example, one of the local pharmacists serves as a community centre for a group of our clients. He knows them individually, takes a keen interest in their lives and in their health, has offered employment opportunities, participates in our social events and includes our clients in his lives – celebrating for example the birth of his baby.
Another local organisation provides us with full use of all their music facilities (for performance and recording) and invites us to a number of their social events. We focus also on reciprocity – our clients giving back to the community. For example, they run BBQs and morning teas for cancer organisations and collect groceries for drives for disadvantaged people in the community.
We have a strong program of social events and consider ourselves to be a community of interest. Many people – ex-clients, ex-staff and ex-Board members, local community people, friends and family – attend our functions.
Organisational model
As an organisation we steer clear of systems driven services – the culture, leadership and organisational structure are aligned with person centred approaches. While there are clear lines of accountability, we try as far as possible to minimise power differentials and to operate the organisation in keeping with this community development ethos. In this way each individual, no matter their position, is able to contribute ideas and bring their unique skills to the work. It is the person with a disability that drives the way we structure our work.
Table of Contents
2. Person-Centred Practice
3. Person-Centred Practice – 3 Client Presentations
4. What Makes Person Centred Practice Possible?
5. Person-Centred Practice – Where to From Here?