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

The implementation of a model of person-centred practice in older person settings
how they contribute to an empowered team. None the less the advantages of
starting with this framework and getting to grips with the prerequisites early on in
practice development provides an invaluable guide to shaping person-centred work
and care cultures.
The implications of growing empowerment and the resulting assertiveness and
confidence that this brought about within the PD groups proved challenging for some
managers and impacted on the programme work occasionally. The evidence is
showing that managers need preparation and development to prepare them for their
involvement in this programme and so that they can offer the necessary support that
staff need to become more empowered and knowledgeable in the very complex area
of older persons care.
Resident/Guest Involvement
In the three sites, changes were more successful and sustaining when
residents/guests were invited to participate and where there was real engagement.
This was not a straightforward process and did necessitate shifting the power-base
and many participants found this very challenging. There was a lot of overcaretaking
where staff felt that residents/guests were not capable of making
decisions about their environment or that they didn’t like to be asked. The first ‘real
conversations’ exercise with residents/guests was a steep learning curve where the
feedback received was not necessarily the feedback anticipated. The realisation that
all wasn’t right in their service and that residents were not necessarily happy with
everything was a shock for most participants. Hearing from residents/guests about
how they felt about their care and their environment was powerful in moving on the
programme goals. The ongoing difficulty for the groups was to get the same reaction
from their colleagues in the workplace so that change could take place.
Undertaking structured evaluations that engaged residents/guests was new and
daunting. The fear of hearing expectations that they could not meet was a big issue
and the fear that workloads would increase was real. However the learning from this
level of engagement was very powerful and gradually groups did not need reminding
that they needed to engage with residents about proposed changes as it became
automatic. This was a huge change in the three groups and learning about what was
actually important to residents/guests as opposed to what staff thought was important
was a steep learning curve:
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