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“A significant learning experience is one in which the student has acquired knowledge and/or skills or where the experience has informed or shaped the student’s social care values and beliefs”. Throughout the course of my placement there have been many cases upon which I have experienced significant learning. These include conversations with both staff and service users, as well as sitting in on various meetings and programs. The main learning experience I enjoyed was in relation to Personal Centred Planning folders or PCP’s.
“Personal Centred Planning is a way of discovering how a person wants to live their life and what is required to make that possible” (NDA, 2005). Personal Centred Planning primarily focuses on the person as opposed to a disability. It is about the whole person and their life, not just their disability. Personal Centred Planning is not an assessment of service users.
PCP’s are, an extremely effective method of helping service users meet their goals in life and also, for keeping track of their basic daily activities. It was a very interesting and useful method to learn how to use. Person centred planning is based on shared action, about finding creative solutions rather than categorising people and about problem solving and working hard over time to achieve goals. It’s about changing a person’s life (Sanderson 2000). PCP’s seek to craft a vision for a person’s life in which they can play an active role in their local community or any organisation of their choice. It also describes the action necessary to make this vision come through (McGinn & Cassidy, 2006).
This is accomplished through some basic stages. Firstly you must discover, understand and then address the core issues for the individual involved. Secondly you must explore choices available to the individual before you then alert and involve the individual’s entire social network. A balance must then be reached between what is important for the individual and what is important for their social network. Ideally, the individuals goals for themselves are the ones most focused on and not the goals that the individuals friends and family have for them (McGinn & Cassidy, 2006).
There are six key principles that underpin person centred planning. These are that PCP’s are an individual’s perspective, creative approach to planning, uses all the resources available to the person, requires serious and genuine commitment, an art and not a science and that the development of the plan is not the objective. There are also several advantages to using Person Centred Planning. Some of these are that it sets out important goals for the future, provides a forum to make choices, it provides encouragement and support and may be viewed as a lifelong process and support (McGinn & Cassidy, 2006).
“Person Centred Planning is based on completely different way of seeing and working with people which is fundamentally about sharing power and community inclusion (Sanderson, 2000). A good caring service mobilises all its resources to assist people with disabilities to increase control over their lives. They also set goals that are personally meaningful and express personal preferences. They offer guidance to the individual. It is only through organisations like this that the PCP’s are a success (McGinn & Cassidy, 2006).
There are many issues to be considered when supporting people who have difficulty in making choices. Some of these issues are if you take a different perspective than that of the person, if you develop a different understanding of the person and risk assessments must be carried out. The service user also requires certain support and assistance from the PCP process. Some of these include interpreting the environment, understanding other people’s expectations and conditions for cooperation and to figure out satisfying ways to pursue what they want (McGinn & Cassidy, 2006).
Person Centred Planning has one plan per person. The service user’s key worker drives the process. The first step the key worker must take is to get to know the person. This includes getting to know their personal history, family, friends, health, hobbies and other personal details. You must talk to the person in order to gather this information. You must observe them in their natural environment too in order to get your own vision of the persons personality. A good way to add to this vision is to speak to the persons family and friends to get other opinions of the service user’s personality and goals in life. Finally reviewing previous documentation on the service user will give you other opinions on the service user, this time from a professional view (McGinn & Cassidy, 2006).
The second step is to discuss the persons own goals and dreams for the future with them. This involves sitting down with the service user in what they feel is a safe environment, so that they can reveal their dreams to you without feeling threatened or embarrassed about them. You then document the service user’s goals in their PCP file and move onto step three which is to plan a meeting. The meeting is entirely the service user’s choice. They get to decide who attends, where it is, when it is and what exactly will be discussed. It is simply our job to facilitate them by giving them any help or support they might need. The meeting itself is then step four. In the company of the service user and whoever they had wished to have at the meeting you work out what has to done is the coming weeks and months to achieve the service user’s targets.
The fifth and final step is to implement everything that had gone before. It is now that the staff starts working on achieving the agreed goals. Any progress gained should be recorded in a progress plan form. A review sheet must also be completed at the end of each month and at the six month review meeting (McGinn & Cassidy, 2006).
The staff involved in the Person Centred Planning process, play a crucial role and have extremely important responsibilities in ensuring the process is a success. “Person centred planning requires that staff adopt a flexible and responsive approach to meeting people’s changing needs and circumstances, guided by general principles of good practice rather than standard procedures” (Sanderson, 2000). It is important that the staff do not underestimate the scale of the task and should allow sufficient time for it to be completed. Initially the process involves identifying people who are likely to support the idea and then, running some information and basic training sessions for everyone likely to be directly involved, impacted or called upon for support (McGinn, 2006).
The unit manager also plays an important role in the Person Centred Planning process. “Managers have a significant role to play in enabling staff teams to adopt a person centred approach” (Sanderson, 2000). Sanderson advocates that managers extend the principles of person centred planning to their staff teams, in order to develop what she describes as person centred teams (McGinn, 2006). There are characteristics that a person centred team leader needs in order to be successful. Some of these include being able to bring the best out in people, having a clear vision and direction, encouraging personal involvement with the people being supported and investing in community connections (Sanderson, 2003).
The leader of this process needs to develop a very clear understanding of the key principles and processes of Person Centred Planning (McGinn, 2006). The leader must ensure that staff work together as a team and not as individuals which will only drag the process in different directions, accomplishing nothing. They must ensure that there is good, ongoing communication at individual plan level. It is also their job to maintain and update plans over time or assign somebody the role of doing so.
At a more general level, it is important to establish a routine process of monitoring, evaluating reviewing and developing the way person centred planning is being done, so as to ensure it is having a positive effect on lives and services. Every effort should be made to ensure that the role and responsibilities of every individual, group and organisation participating in the person centred planning process is clearly understood and agreed by them and adequately supported (McGinn, 2006).
Success will be achieved will the Person Centred Plan if the staff team ensure that the needs of the service user are met to the greatest extent possible, consistent with their responsibility to assess risks involved and ensure that they are acceptable and considered. It is also necessary that they build a closer relationship with the service user in order to become more acutely aware of their needs and wishes. The staff team must ensure that all risks are identified and action is taken to minimise them. They must seek to maximise opportunities for the service user’s self development, self esteem and independence in order to realise their fullest potential (McGinn, 2006).
Finally the role of the Key worker is crucial to the success of the Person Centred Plan. The Key worker’s objectives are to develop a close and positive relationship with the service user. They must also work co-operatively with other staff, family, external services/professionals etc, on the service user’s behalf to ensure that a quality service is provided. The Key worker’s team role is to enable the team to effectively support the service user. To do this the Key worker must listen to others, respect and support team members, maintain commitment and communicate effectively. The Key worker enables the service user to advocate for themselves, develop new skills and build enjoyable relationships with others (McGinn, 2006).
There are of course challenges to implementing Person Centred Planning. The need for everyone to develop a new perspective on people with disabilities is defiantly one of the larger ones. For a goal like that to be reached it will take a global effort and one that is not easily achieved. Other challenges include the need for a new general perspective on services, resistance to change and risks and learning curves (McGinn, 2006).
All of this was being carried out on a constant basis in RehabCare Cavan while I was there. Sitting in on meetings between the key workers and the service users was an eye opening experience. It also really stood out to me just how much Unconditional Positive Regard is used in services and why it is so crucially important in a programme such as Person Centred Planning. Without it the programme would be a complete failure.
The entire PCP programme worked well while I was on my placement. It was being managed very sufficiently and all staff members had an excellent relationship with each other. I personally felt that I helped the staff to show unconditional positive regard towards the service users when they were finding it tough. Most importantly I have learned and witnessed just how positive an impact the PCP programme can have on the service users when managed properly. Seeing the delight on service users faces when they achieved goals which would have been impossible without Person Centred Plans made me realise how much they need the programme and educated social care workers to manage it for them.
Critical Reflective Paper
My twelve week placement in RehabCare Cavan provided me with sufficient opportunities for learning and to enhance my social care knowledge, skills and values. Throughout the duration of my placement I enjoyed the experience of working with a vast variety of service users most of whom had disabilities and problems that were completely unique to themselves within the centre. I also had the chance to compare my skills as a social care worker with a number of people from different occupations including social care workers, community nurses and psychologists. They all both worked together as a team and then as individuals. Overall my placement in RehabCare Cavan was an immensely enjoyable and positive experience. There were however, a number of difficulties to deal with along the way. These included challenging behaviours from the service user’s and limitations from the staff. Altogether though, I believe my placement would not have been as educational had it not been for the combination of positive and negative factors.
The part of my placement which I feel most facilitated my learning was working with the inter-disciplinary team. This team consists of a list of professionals from different occupations and also collaborates with the parents or friends or next of kin for each of the service users. The service user decides who they wish to have present at the meeting from their family or friends. There are strong positive relationships between the different members of the team. At the beginning of my placement I found it quite overwhelming and complicated to understand how a team consisting of so many people managed to perform sufficiently and how mistakes weren’t made. I also struggled to understand how there was need for so many individuals and how they each had their own unique role within the group. At first I just sat in the corner of the room and observed the team meetings. I felt I didn’t know the clients well enough to make contributions and that the staff didn’t know me well enough to be able to justify accepting my contributions. It was my job for the first few weeks to simply sit, observe and analyse what was being discussed and proposed within these meetings.
Over the following days and weeks I started to become more familiar with the staff, the service users and the cases. I began to feel more confident interacting with the staff and service users and believed I had a place within the centre. I could see advantages of using the interdisciplinary team system, however I quickly realised too that mistakes were made. These mistakes were few though and no system or person is flawless so they were generally accepted as small human errors and rectified. Each team member had adequate knowledge of the other team members, their profession and their disciplines. This allowed each team member to answer questions and give guidance, even if was only to tell the person involved which team member was most likely to solve their problems. As my placement progressed I was able to become more involved with the staff as I became more aware and familiar with each case. By having the opportunity to observe and ultimately work with the different professionals involved I was able to gain valuable knowledge and skills relevant to each discipline which will prove valuable throughout the rest of my course and beginning of my own professional career.
One aspect of the service or the centre which limited my learning was unfortunately due to cutbacks. Due to lack of funds the service was severely understaffed which meant there was an extremely heavy workload on the remaining staff members. This in turn meant that there were long periods were they had work to do and I was unable to participate. During these periods I would socialise with the service users, talking to them, playing games with them and helping them in whatever way possible. Although from a professional perspective this reduced my learning experience, personally it greatly increased it. It was during this time that I got to know the service users, their likes and dislikes, their personal ambitions and most importantly, what it was like for them individually growing up in the community with their disabilities and how RehabCare has greatly improved their lives and self-esteem. I felt that it was this information that would help and inspire me to progress through my placement and academic years ahead.
While on my placement I took a leading role in facilitating a few programmes in particular for the service users. As I have a great interest in sport personally I became involved in all sport related programmes with the service users. Every Tuesday six service users went swimming and I accompanied them. I observed how much excitement and pleasure they got on a weekly basis out of this one simple activity. I also got involved with a soccer programme with the service users. As I have a good knowledge of the game I took some training sessions with them and helped them develop their skills. They are hoping to compete and win out a regional RehabCare Soccer tournament in the New Year.
I also became heavily involved in programmes that were not sport related. I helped set up a woodwork programme which had not existed before I arrived. I trained the service users in the basic skills of carpentry and through this they learned how to work on a project as a team, but most importantly they could see that they were making a difference and that their project was evolving into beautiful furniture. I witnessed a sense of pride amongst the service users that was almost unprecedented. A pleasure as small as completing a piece of furniture was enough to have them busting with pride for days. Overall the programme was a remarkable success. I am particularly proud of this group as I feel this is an area in which I was able to apply a lot of knowledge and skills to that nobody else in the centre could have.
One other Key programme which I participated in was the Writing skills programme. The activities or skills that were focused on during this programme were writing, pronunciation and basic maths skills. Under these heading we worked on different needs of each client which included spelling, counting and oral communication skills. As this was a continuous weekly programme I had the opportunity to observe these service users as week by week they worked in their weaknesses and I could observe a marked improvement from when I first arrived. I was able to monitor their progress and have evaluated that it was a very effective programme. I was able to contribute my knowledge towards the class which meant that more progress was gained in the same length of time.
One aspect which I feel contributed positively towards my learning was working with and witnessing the staff handle particular cases which involved serious and cautious matters involving the service users. Examples of these cases are when violence is threatened by service users or a case where one service user was being unfairly manipulated into giving away the money they earned on social benefit. The staff team in RehabCare are quite a close-knit team and conduct their work very professionally. Working alongside them was an extremely positive experience and I had no problems in asking them questions when I had queries. The staff all worked together in serious cases and did not just leave it to the service user’s Key worker. I could see that this was an extremely effective and positive way for them to operate as each staff member brought their own ideas and together they were able to formulate a plan more effectively than if it were just one of them. Initially I was too nervous to make contributions myself but as the weeks passed I began to make a few suggestions some of which were used in solving certain cases.
As a result of my experiences on placement I have significantly enhanced many of my social care skills and values and expanded my knowledge. One particular area in which I feel more confident in is my communication skills with a range of professionals and services, especially when communicating with people who suffer with intellectual disabilities. I gained experience and built my ability to show empathy and unconditional positive regard, particularly when being on the receiving end of insults. It is essential that social care workers have the ability to demonstrate empathy to allow them to be more responsive to the service user’s needs and build better relationships based on trust and honesty.
Learning about the Person Centred Planning approach was probably the most valuable information I gained. I saw firsthand how well the plan works when managed sufficiently. It is a goal based system, focusing on what the service user wants to achieve in their lives. It is person focused which is the secret to is success and why it is so popular.
The medication procedures in the supported accommodation branch of RehabCare were extremely interesting. The service user had to put their pills into an egg cup and then swallow them all. The support worker then had to check the service user’s mouth to make sure they were all swallowed. I realised then the extreme of the medication policy within RehabCare. I found it rather unsettling that the support worker had to look into the service user’s mouth to make sure the medication had been swallowed. Previous to distributing the medication each daily dose had to be counted to make sure that the pharmacy didn’t make any mistakes while distributing it. It was surprisingly frequent how often the pharmacy had made mistakes.
In conclusion my time spent on work placement has been an invaluable experience to me. I have learnt and developed many skills that will be a great attribute to me in my career as a social care practitioner. Some of these skills have included learning how to manage a Person Centred Plan, gaining practical experience in solving a wide variety of cases involving people with intellectual disabilities, improving my overall knowledge on disability awareness and most importantly learning that I can make a positive impact in any social care field that I wish to pursue. I am fully aware that becoming a successful, fully trained social care worker does not happen overnight but takes years of hard work and practice. However, seeing the positive impact that I can make of people’s lives with my career is the inspiration I need to go on and succeed. It is a long journey to get where I want to be, one that started years ago and is set to continue for a good time to come. This journey will change who I am, will change who I will become but only for the better. With the knowledge that I am gaining from my social care class, the lessons I am learning about myself I am sure that I will evolve into a fully competent and successful social care practitioner.
Personal Learning Account
For the purpose of this placement, I have received a position in RehabCare Cavan, working with the Programme Facilitators at the facility. RehabCare is the health and social care division of the Rehab Group. Their aim is to enhance the lives of all of their clients through the provision of high quality, flexible, person centred services. They presently provide and are developing a number of services, including Resource Centres, Residential Services, Respite Care, Supported Accommodation and Home Based Services for people with disabilities. The role of the Programme Facilitator in the facility is to report to the Community Service Manager through the Programmes Supervisor. The Programme Facilitators facilitate service users in their choices, developing programmes within the context of a person centred model of service delivery. The programmes may include independent living, personal development and occupational and leisure activities within the context of a quality of life model.
For this placement, there are a number of personal attributes and learned knowledge which will assist in getting maximum benefit from completing placement with the Programme Facilitators.
Some personal attributes which play an important role in the social care role are patience, understanding, kindness and the ability to apply learned knowledge to a specific situation. Having talked to one of the Programme Facilitators I also became aware that being open-minded, compassionate flexible and a good listener play particularly important roles in this service. These are all equally important attributes as at different times they can individually and collectively be the difference between dealing well any given situation in comparison to dealing poorly with it. Due to the unfortunate discrimination that, many of the older service users received when they were younger, the Programme Facilitator must take an understanding therapeutic approach when working with these service users. For this to be successful the Programme Facilitator must apply Carl Roger’s conditions for the outcome to be successful. Rogers created three conditions which a service user must believe are present before a therapeutic relationship can develop. These are empathetic understanding, congruence and unconditional positive regard (Sherry and Lalor, 2009).
The skills and knowledge that I gained through Creative Studies (both art and drama), will play a great role in helping me assist the Programme Facilitators, in trying to ensure the service users get the best experience possible from the service. Arts and Crafts as well as drama are programmes which receive a lot of focus from the Programme Facilitators at the facility. A good understanding of people with disabilities which I gained from modules, such as Issues in Social Care and Theories in Social Care along with, reading Applied Social Care by Perry Share and Kevin Lalor will assist me throughout my placement. Also the knowledge that I gained doing woodwork in secondary school will be of great benefit, as the Programme Supervisor is planning on starting up a woodwork programme for the service users but no Programme Facilitator has any experience in the field.
Communication plays a crucial role in working in RehabCare or any organisation which is designed to fit the needs of adults with intellectual disabilities. Listening is a function which we do every day without paying much notice to the information we are obtaining. However, in a facility such as RehabCare the ability to listen to clients and then digest what they are saying is of crucial importance. The ability to listen attentively to service users problems and concerns and to then support them in whatever form necessary is a skill that cannot be replaced. Considering the fragile state of mind of many of the service users you must always be compassionate when listening to them and your response must be swift.
Within the learning contract there are a number of objectives identified as part of key learning. Enclosed in the professional learning objectives, the task is outlined of using and critiquing social care theories. As a second year social care student I felt that it was important for me to identify theories and then critique them and recognise limitations within the theories structure and their application to real life situations. My personal learning objectives surrounded interactions with the service users. I was lacking confidence and very unsure of myself when I first started my placement. The staff were very supportive though and within a few days I found my confidence improved dramatically and with it so did my effectiveness in helping the staff and having a controlling but compassionate authority over the service users. I became firm and assertive when dealing with problematic service users and fights between them. I hope my abilities and confidence continue to grow in this area which will leave me in a very strong position by the time my placement is completed.
Showing Unconditional Positive Regard towards some of the service users is something I struggled with for the first few days. It was left difficult when service users were constantly rude, disruptive and fighting. I have felt myself improving though and believe over the next few weeks I will have perfected it. During my induction week I had numerous policies and procedures to familiarise myself with. There are policies and procedures regarding health and safety, fire evacuation, risk management, prevent and control, child and adult protection, swine flu, confidentiality, medication policy and staff supervision etc. A basic knowledge of these policies and procedures is paramount in order for me to play an effective and positive role during my placement.
Action Planning and Activity
Throughout the course of this placement, I shall partake in a number of activities with the service users, which will assist me in meeting my learning objectives. Areas of activity include practical work such as arts and crafts and woodwork while sports and drama both play key roles in the centre too. Communication skills and independent living skills have a high priority too, as RehabCare is an organisation, designed to bridge the gap from full support to independent living.
Assisting the programme facilitators in training the service users through these programmes, I felt I would meet my learning objectives. The programmes are usually done on a 10(service users)-2(programme facilitator and myself) basis. I will have several opportunities to practice my communication skills as I will have to give my input and express my opinion in different cases involving different service users and different programme facilitators. Through the communications programme I will also get a chance to train some of the users in the basic forms of communication, i.e. teach them how to, write a letter to a friend, use the telephone and practice various verbal and non- verbal communication skills.
During the placement it is highly important that I test a number of theories which I learned through academic means. Through applying theories to real life situations, and recognising when a theory is used, the applicability and usefulness of the theory should be examined. As a social care student, the ability to recognise the limitations within theories will assist in identifying the best practice for the service user. I can practice this in different programmes and in free time that I spend just talking to the service users.
Throughout placement knowledge of policies and procedures surrounding disability awareness will be obtained through dealing with the different cases and service users. I will have to familiarise myself with all government and RehabCare policies and procedures. I shall also become aware of them through hands on work throughout the duration of my placement.
A consideration of the learning goals following the completion of the placement, there is a sense of achievement as I believe all learning goals were reached and an in dept knowledge of disability awareness and the role of a programme facilitator were gained.
I believe I successfully completed identifying and applying theories. I was very happy with my supervision classes as I was able to discuss with my supervisor what I did well and what I did not so well. I was able to discuss troubling issues which I had witnessed and discover the background stories and mental reasons for such incidents arising. Treating the service users with empathy and unconditional positive regard proved crucial time and time again as I managed to keep the service users trust in compromising and threatening situations. It also allowed some of the service users to open up about their feelings and their lives. Due to their mental disabilities some service users wouldn’t disclose such information while others would have without being treated with empathy or unconditional positive regard. They didn’t know any different. An example of where these theories didn’t work was when a service user threatened violence against both myself and the staff members in the centre. This situation arose on numerous occasions.
There was a considerable improvement in my communication skills throughout my placement. I was slightly shy on my first day in the centre both with staff and the service users. It took me the length of the induction week to overcome this shyness and be able to give a genuine account of myself. By the time my placement was completed shyness was a problem of the past and communication was free flowing between me and the service users. An example of this communication is when I took programmes with up to ten service users and took a teacher like approach with them. I regularly took the writing skills programme which involved me stand
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