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

The implementation of a model of person-centred practice in older person settings
House of Care Principles
Carrigoran House developed a set of principles that challenged some staff attitudes
and beliefs about the approach and environment that care is delivered and called
them ‘House of Care Principles’. The work was a culmination of structured
conversations with guests on their preferences and choices about their care along
with what staff were beginning to realise about the meaning of person-centredness.
The house represents Carrigoran House and each individual brick in the house has a
message from guests to staff. This work was undertaken during a PD programme
day and shared with colleagues for their feedback and how it could be implemented.
On first seeing the poster it looks simplistic and almost child-like but when each
message is read and the significance of these messages to staff is appreciated it is in
fact quite a complex and challenging culmination of feedback from the guests. This
work built on the group’s growing ability to be creative and reflective and a sense that
they can make a difference. It was another means of creating a standard approach
to care that works with common values and beliefs and a means of challenging staff
that were, and in some cases still resistant to embracing person-centred care
practices.
Group Process Review
As the work progressed, a group process review was undertaken with the PD groups.
Undertaking the group process review exercise was a powerful learning activity and
was the first time that the groups had to engage in feedback that was outside of their
comfort zone. In essence the exercise required each group member to give each
other feedback on their contribution to the group, what they liked best and least about
that contribution and then each individual sharing with the group what piece or pieces
of feedback had the greatest impact on them and what they had learned about
themselves. When the exercise was introduced there was reluctance from the three
groups to undertake it. It was obvious that there was a great deal of discomfort about
doing the exercise and some members wanted to leave the group rather than take
part. This required careful facilitation to unpick the issues and reassure individuals
that this would be a positive experience being undertaken in a safe environment.
Reluctantly everyone did engage in the activity.
During the debriefing session it was obvious that a significant change had taken
place particularly in two groups. The hierarchy within one group dissolved and care
attendants were comfortable with giving feedback to nurses and challenging issues
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