The Implementation of a Model of Person-Centred Practice In Older ...

The implementation of a model of person-centred practice in older person settings
“I really like this way of learning, it’s more inclusive usually when I attend
study days I just sit and don’t get involved to much”.
In summary, the existing culture in the sites was such that at the beginning of the
programme sustained attention had to be given to enabling each person, regardless
of their role, an opportunity to believe in their self-worth, find and use in positive ways
their voice both in the programme days and in the workplace. Further, the morale of
the groups tended to be very low and the self-belief also very low. Participants lived
with a huge gap between what they wanted to do for residents and how they actually
worked. Participants tended to express high levels of powerlessness and very low
levels of engagement and empowerment.
There was a huge focus on
concerns such as rules, perceptions about management and what wasn’t allowed,
obstacles and reasons why things couldn’t be done. The most common themes were
lack of staff and lack of time. There was a variety of evidence indicating that staff
worked to a routinised even ritualistic culture that was in many ways harmful even
brutal for them and for older people. Examples from the programme records from
different participants at four sites:
“We won’t be able to deliver on what we promise”
“It’s too much work”
“I don’t think other staff will take to this”
“What if the managers won’t allow this to go ahead?”
Day three
The participants, by this time, were generally easily re engaging in the learning ethos
of the programme days and there was evidence of trust and team effectiveness
emerging from the programme day evaluations. The groups “Terms of
Engagements” were starting to be effective as a means of creating and sustaining
“group norms” and were being used to set an agreed level of behaviours which
guided participants on how to interact with one another. Some quotes from the
participants about the “Terms of Engagements” included the following:
“Participants feel more confident having these”
“Permission to say things – I did not have this before”
“More together as a team”
“Opened up minds to new ideas to find ways to change” “Important
to apply this to the whole team - outside and in the room”
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