Welcome to the brand-new Voyage Care Podcast! For season one, we’ll be focusing on how we delivered person-centred care to the people we support. In this episode, we’ll be hearing from Olivia England, Service Manager, Tracey Hurt, Deputy Manager, and Anushree Mehta, On-site Behavioural Therapist. They all work at Ruddington View, one of our residential care homes in Nottinghamshire. They’ll be chatting about what person-centred care means to them in a residential care home setting, and why it’s so important for each and every person we support.

Learn more about our residential homes

If you’d like to learn more about person-centred care in our residential care homes across the UK, please visit our web page.

Can’t listen right now?

Read the transcript of the podcast below.

Anushree Mehta:

Hello. Welcome to the Voyage Care Podcast. I’m Anushree Mehta. I’m the behaviour support practitioner based at Ruddington View. Today I’m joined by Olivia and Tracey, and we’re going to be talking about how we provide person-centred care at Ruddington View, the residential care home. I will give the ladies a chance to introduce themselves. Olivia?

Olivia England:

I’m Olivia England, the registered manager here at Ruddington View. I’ve actually worked for Voyage Care now for 13 years and I started as a deputy manager in a residential home for learning and physical disabilities. I was there for I think it was about just over 11 years and I’ve been now at Ruddington View for just over a year and a half, I think it is, and working for Voyage Care I have learned a huge amount. I don’t even know where to start, but I have been supported to progress in my role, move up from deputy to registered manager, as well as being supported to do my level five.

Tracey Hurt:

Yeah. I’m Tracey Hurt. I’m the deputy at Ruddington View.  I’ve worked with Voyage for about eight and a half years. I started in learning disability with physical disability. I did that for six years. And then fancied a bit of a change, so came over onto the mental health side. I’ve been here now for three years, where I’ve learned an awful lot around person-centred care and the different diagnoses that people get and how different and adaptable you have to be to each individual. Within that time, the amount of training that luckily Voyage provide us has been immense in my role.

So we’re also really lucky in our service. We have Anu, who’s our onsite behaviour therapist, who works here four days a week. Anu, did you want to say a bit about your role?

Anushree Mehta:

Most of my role is supporting staff and working together with Liv and Tracey and doing support plans and coming up with strategies to use to manage people with supports behaviour. I’ve been at Ruddington View for just over two and a half years. Prior to this, most of my experience has been with children with autism and learning disabilities. So coming to Ruddington View has been brand new, very informative. I’m still learning constantly, like with Olivia and Tracey, it’s very different here. We’re always on our toes, ready to modify what we’re doing and adapt and use new strategies in supporting the people in our care.

Anushree Mehta:

Today we’re going to talk about person-centred care. What would you say is person-centred care to you, Olivia, maybe, go first?

Olivia England:

It’s basically, to begin with, it should be about getting to know the person, that you support them, their likes, their dislikes, things that are important to them, and empowering them, giving them a sense of belonging and opportunities to go out into the community to do things that they enjoy and do tasks that they enjoy and live a healthy, independent lifestyle as much as possible.

Anushree Mehta:

Right, thank you. Tracey?

Tracey Hurt:

Yes, so similar to what Olivia was saying, I think it’s about recognizing a person’s strengths and abilities, enabling them to use these to maximize their independence. Because we are a residential home, I think it’s really important so that we can try and move people into more independent living than maybe where they’re currently at.

Anushree Mehta:

Definitely. Great. What are some things we do here at Ruddington View that encourage that sort of person-centred approach?

Tracey Hurt:

Yeah, our service is quite specific. We cater to a lot of different diagnoses and conditions, and so we have to be very person-centred because we deal with people with autism, brain injury. We have one resident with Prader-Willi syndrome and we deal with mental health issues. It’s not one rule works for all. It has to be person-centred to that individual to help. It’s about respecting the individual and what’s unique to them.

Olivia England:

We’re constantly learning.

Anushree Mehta:

Yeah, every time we get an admission, especially with the unplanned base the way it is, we’re just learning literally on the day they come in and every day from that, and getting to know that individual, what works well for them, what we need to do to change, and how we support their and meeting their needs.

Tracey Hurt:

Yeah. So like autism, before I started here, I didn’t realize quite how varied the range of the autism spectrum was, how because one thing works for another wouldn’t necessarily work for somebody else.

Anushree Mehta:

I think when we talk about person-centred approach, a lot of times it’s about the person, but it’s just as important to consider us as carers and staff and how important it is for us to be flexible and modifying our approaches and changing how we support that individual based on what we learn about them and continuing to keep changing that.

Olivia England:

We work closely with the MDT of the person that moves in, don’t we, as well, and their families and get to know them that way, which helps as well.

Tracey Hurt:

Yeah, so like for example, the lady that we had move into one of our self-contained apartments, we’d modified her environment to what she wanted. She’s one of the ladies that we have with Prader-Willi, so she requested for the kitchen to be removed because it brought on her anxieties. I think at the minute she’s painting it the colour that she likes.

Anushree Mehta:

So just continuing to use her as an example, can you think of any other things we’ve done to support her personality and individual traits, individual likes and dislikes?

Olivia England:

She’s got her own garden, so she’s able to choose how this is done. She goes out to the garden centre and makes the garden look really nice. We also liaise with her MDT and dietician especially around her menus and make sure that she’s heavily involved in those, and she changes it quite often if she fancies something different or trying something new on her menu.

Anushree Mehta:

How can we tell if care is person-centred? What are some things you’d see in how you’re supporting that individual?

Olivia England:

Using an analytical approach, so working closely with external health professionals like we said before to understand what’s important to the person, supporting them to make decisions that were in their best interests around the care and treatment and identifying and helping them to achieve any goals that they might have.

Tracey Hurt:

I think you can tell with the individual. They’ll seem happier within the service. Hopefully behaviours and things will decrease with using the active support. It helps, gives the meaning to their day and gives them things to strive towards.

Anushree Mehta:

You’re encouraging that freedom of choice and giving them a say in what they’re doing, whether it’s with meals or activities or decorating, like you used the example. Do you think person-centred care impacts staff and their daily performance when they’re supporting the people in our care?

Olivia England:

I think it helps that the staff know the people support well and to get to know them well so know what works best for them.

Tracey Hurt:

And everybody’s doing the same thing.

Olivia England:

Consistency.

Anushree Mehta:

Working to the same goal. I think it’s helped build staff confidence as well when they feel they’re helping that person achieve something that’s important to them and hoping it meets a need.

Tracey Hurt:

Yeah, and that in turn then makes staff happier.

Anushree Mehta:

To promote staff to work as a team, because you’re working together to achieve that same goal, and also I think just that moving away from caring for the person to doing things with and encouraging them to build their skills and gain confidence and have a sense of accomplishment, which in turn, like you were saying, if the person you support is in a good mood, that’s going to then translate into staff having that positive attitude as well.

Tracey Hurt:

Yeah. I think that’s especially true with autism.

Anushree Mehta:

Tracey, you mentioned autism. Are you thinking of anyone in particular you’d like to talk to us about?

Tracey Hurt:

Yeah, so we have an individual with autism who’s in one of our self-contained apartments. He came to us about three years ago. He was deemed to be one of the most unplaceable residents in- in Nottinghamshire at the time. He’d had around 35 placements throughout his lifetime, and so when he came to us, it was quite obvious that he needed structure and care centred to him. So even though we like to develop and make people more independent, he was having a lot of behaviours and changing behaviour, a lot of verbal and physical aggression. So we had to sort of tailor our care to his needs and he liked the containment and boundaries, which took a lot of time. It was a lot of consistency, a lot of the same communication with staff, so that we were all telling him the same thing. It took months and months, but eventually we’d noticed that his behaviours were decreasing to where we’re to a point now where he probably has one every couple of months because of the staff consistency and the person-centred approach we use with him.

Anushree Mehta:

I think everyone using that same approach and giving him that structure worked well for the staff as well, because they knew how to respond to him when he was escalating in behaviour, and that consistency meant the person you were supporting knew what to expect, knew he would be getting the same responses from staff, so engaging in different behaviours wouldn’t result in him getting the outcome that he used to in the past.

Tracey Hurt:

Yeah. And then that was the same, so certain activities that he enjoyed, obviously as he’s got older, his mobility’s decreased. So we’ve altered some of is activities to suit his needs now. So he always wanted a garden, so we really want to get some raised flower beds for him that are just outside of his apartment. He doesn’t like people generally in his space and environment, so he’s got his own little fenced off area.

Anushree Mehta:

I think even with that, because initially the garden was going to be far down towards the back of the main garden, but considering the walk that he would have to walk down to the back, it just made sense to have it closer to him and he can kind of attend to it more regularly and he can see it just out his window. It’s there in front of him.

Tracey Hurt:

Yeah, yeah. It’s something that he’s always wanted, unfortunately never really had somewhere where he could call a home until he came here.

Olivia England:

He does call this home now as well, doesn’t he?

Tracey Hurt:

He does, yeah. It’s taken a long time, but he’s settled.

Anushree Mehta:

I was just thinking, this is my first and only real experience in a residential care home setting. Both of you have had lots of experience in a residential care setting that’s a lot different from here. Do you want to share anything about how maybe person-centred care has changed over time? Or have you noticed any differences or any improvements?

Tracey Hurt:

I think as you said earlier, it’s a lot more around not so much what you can do for the individual. It’s what you can do to help them. So I came from learning disabilities, same as Olivia did, with more physical disabilities and less of the mental health, and because people were in wheelchairs and didn’t have as much mobility, you tended to find a lot of people did things for them instead of encouraging what they could do for themselves. So even simple things like making a drink, they couldn’t necessarily fill the kettle, turn it on, use the hot water, but what they could do is use a spoon to put sugar into a cup. Yeah, I think person-centred, along with the active support, was really important in breaking down tasks and helping them in the areas that they could.

Olivia England:

Even small things, like hand on hand support and offering a sponge into their own personal care just even slightly, you could always see the joy it gave somebody to be able to be independent.

Tracey Hurt:

Yeah, I remember one individual… I was a key worker, too, and to paint her bedroom, because she wasn’t able to pick out colours and she was non-verbal, we put different colour nail varnishes in front of her and she picked which bottle of nail varnish she liked, and that was the colour that we chose for her bedroom.

Anushree Mehta:

That’s what it’s all about. You’re encouraging that individual to have that sense of belonging in that place that they’re in, not knowing obviously the background of each person and their life story, but when they come to us when they’re in your care, you want to do the best you can to make them content, to make them have a sense of fulfilment and well-being and overall.

Tracey Hurt:

Yeah, as you say, it’s less doing for them and more…

Anushree Mehta:

Making them feel empowered.

Tracey Hurt:

Yeah, yeah, building them up and helping them in the areas that they can.

Anushree Mehta:

What’s an example of something we’ve done to encourage those small achievements?

Olivia England:

There’s different ways obviously. Just naturally somebody did something and they’re happy about it, you join in that joy with them and cheer and celebrate it. But more recently here, we’ve learned that a gentleman that is support likes to be given physical certificate to say that he’s done something well, which gives him the joy.

Tracey Hurt:

I think praise as well, just praising them for a job well done, positive interactions. I think you do have to celebrate little things. I know when I first started in care, and some interactions with some professionals, they tend to focus more on the big things and less on the little things. I think it’s about recognizing and praising what somebody else might not see as a big achievement is really important to them.

Anushree Mehta:

It’s those little steps that’s going to help you get to the ultimate goal, whatever that person’s working towards, and celebrating that is what’s going to encourage them and give them that motivation to keep going and maybe try a little harder, do a little more the next time, and that’s going to develop that skill and give them that encouragement they need.

Anushree Mehta:

What are some ways that you can measure person-centred care?

Olivia England:

We hold person-centred reviews for the people we support that live in the main house every year, and then you’re documenting where they were at last year and what they’ve achieved this year and what their goals are moving forward. It’s slightly different in our unplanned care beds.

Tracey Hurt:

We’re quite unique, so we have unplanned beds, which are three month stays. So that’s where people come in in emergency crisis situations. It’s really evident, I think, you do have to be person-centred, and it’s easy to see from when they come in to when they leave after the 12 week stay what sort of an impact person-centred care’s had on them, why they’ve been here, because they do come at the toughest time in their life, and when they leave, they’re in a different place, a better place, and they’re able to move on or go back home. When they come here, we have goals set out by the MDT and things that they hope to be achieved over that stay. We do feedback forms too around what sort of care they’ve had and what things have worked while they’ve been here.

Anushree Mehta:

During their stay, the goal is also, are they moving back to the placement they’ve come from? Are they moving back home? I think during the whole stay, you’re constantly assessing what’s going to be right for that person. I think that’s the purpose of their stay becomes person-centred care, because you’re helping make that decision about what’s going to be right for them moving forward.

Tracey Hurt:

Yeah. And then we’re involved in really quick transitions, it’s transitions for them to come, transitions for where they leave to go back to.

Olivia England:

What do you think you’ve learned around person-centred care while working at Voyage Care?

Anushree Mehta:

I think respecting the individual’s needs and wishes, obviously that’s the main goal, but also adapting our perception and our thinking really to understand what that person’s going through and why they’re presenting behaviours and what’s the reason behind them, and looking for the function and looking for what we can do to help manage their anxieties and alleviate that stress. Just finding suitable alternatives, looking for options of what we can do to help that person meet that need that maybe for whatever reason isn’t accessible at that moment. Working together as a team, building our communication, and that’s kind of a constant goal as a team, and working together to maintain that collaborative approach and consistency within us.

Anushree Mehta:

I think again, that comes and goes when there’s different reasons for that person being anxious and working with each other, so staff communicating with us and us communicating with staff when there are changes.

Anushree Mehta:

I think focusing on positive risk taking, that’s something that sometimes gets kind of under the radar, where if someone’s settled and engaging and following your routine, you might just get used to it, whereas we need to remember to be setting new goals and pushing the limits and encouraging them to try new things or set new goals that we can support them to achieve.

Tracey Hurt:

Yeah. I think Anu’s been really helpful in the management after incidents as well, so debriefs have been vital with staff being able to analyse why an incident happened in the first place and what we could have done differently, what we can change for the future I think has really helped not only the people we support to minimize their behaviours, but also to help with staff. They feel listened to and they’re given the tools to change things for the future, to stop these things from happening.

Anushree Mehta:

Thank you, Olivia and Tracey. It’s been great talking about person-centred care at Ruddington View with you two. I think we try our hardest and continue to do a good job, the best we can every day, and working together to help the people we support reach their potential. Thank you for listening. If you’d like to learn more about person-centred care in our residential homes, please visit our website at www.voyagecare.com. Thank you.

If you’d like to learn more about person-centred care in our residential care homes, please visit our webpage.

• 
• person-centred care
• podcast
• residential care
• season 1