Providers and service users associated with supported housing are increasingly using tools to test outcomes against targets next to indicators that equate change next to progress. This article reports and reflects on a small research project undertake by London South Bank University for Carr Gomm, using the World Health Organisation's Quality of Life Application Model to assess outcomes of support in relation to person-centred planning, the chosen principled support approach adopted by Carr Gomm. The evaluation is base on a small number of luggage studies which serve to prompt providers and commissioners of supported housing to ask what constitutes quality of go from the client's perspective, and how in turn this challenge the priorities inherent in the supported housing service.
Over the last few years Carr Gomm have encouraged and supported the use of a model call person-centred planning (PCP) as a main preference for client self-development. Following a pilot funded by the Department of Health to develop the model, the research team set out to evaluate PCP surrounded by use.
Carr-Gomm set out to achieve a little goals from the evaluation:
* to produce target evidence to show whether there be positive outcomes for service users using PCP
* to influence Supporting People commissioners with a estimation to encouraging them to rate new indicators for PCP approaches to support
* to pose unsullied questions for policy developers on the effect of PCP on the overall approach to the support of adjectives people.
In extension, it was hoped that the evaluation process would produce a adjectives evaluation tool, designed using PCP principles, which would underpin PCP as the preferred model of support throughout Carr-Gomm, across a wide field of clients.
For the purposes of the evaluation Carr Gomm's definition of PCP was used:
A human being's own description of the way they want to live their life span and a process for planning how to achieve this which puts them surrounded by control.
The service user had to be at the basis of the approach. Further, the role of the evaluation was to provide an external scene of progress so far, with an inflection on learning and nouns. Client groups from across the UK were preferred from a range of support requirements associated beside mental health, vulnerability inwardly families and direct access homelessness.
The evaluation focused on not many encounters: five detailed face-to-face interviews and 17 written submissions, plus the input of a user nouns group, essentially a working group set up initially to receive ideas roughly speaking the range and type of indicators that clients might aspiration to consider as relevant to their understanding of progress.
Current debate about PCP
Although this be a small research project, a literature review was carried out to establish the humour of issues and arguments currently playing in the wider social care arena.
The literature review focused on:
* looking for debate that could sensibly and compellingly be applied to PCP across adjectives groups
* building a basis for consensus that give the wider application of PCP a theoretical underpinning from which a model of evidence-based evaluation could evolve
* linking premise and workability.
The largest body of literature comes from the field of study disabilities, and has be adapted and adopted comparatively slowly by groups of professionals working beside other groups who might benefit from such an approach to support. There is a continuing challenge for trouble and support professionals to take the initiative and develop a adjectives language and conception that benefit the client.
The emerging key theme may have resonance next to some supported housing organisations, and can be summarised as:
* power re-alignment from the professional to the client
* responsive and dynamic models of support and services in preference to reactive safekeeping planning
* the need for organisational and professional move of approach to care and support
* determination of personal 'duration style' as a paradigm for care and support.
The literature review also suggested some sub-themes that serve as a platform for the following debate.
The moral case versus evidence
This refers to the debate between practitioners who are convinced that PCP works, and therefore is self-evidently a pious tool, and those wishing to hold objective evidence on the proof of which to prioritise resources and plan services (Rudkin Et Rowe, 1999; Sanderson, 2004).
Extending the arguments to other needs groups
These debate are fundamentally about differences contained by approach between medical and social models of care and support, whether a PCP process developed surrounded by the field of study disability has a place surrounded by a wider range of groups and, if so, how that process can be adapted.
The démocratisation of 'lifestyle' and citizenship
These debate focus on the government and professional beat on the rights and responsibilities of individuals, and include the concepts and realities of personal choice (Osburn, 1998).
The politics and the pragmatic arguments
These debate remind us that we all come to the workplace near our own preferences for routes to success, and grant varying degrees of prominence in our practice, base on our experiences (O'Brien, 2004; Mansell a Beadle-Brown, 2004; Towell & Sanderson, 2004).
Despite the difficulties in labour and some differences in interpretation, in attendance is a degree of consensus that person-centredness should stay at the heart of PCP processes because it is the 'right' piece to do (the moral issue) and the best thing to do (the evidence base). The signs from a few PCP evaluations in the social and vigour care sector are that the process, if given the room to grow, appears to be slowly building the armour that it is beneficial to the client (Infusion Co-operative, 2004; Kinsella, 2000; Mansell a Beadle-Brown, 2004).
These debates are exalted if PCP is to be considered seriously as a valid evaluation tool of client choice. Supported housing organisations need to be aware of them and to own a view on their acceptability and relevance, alongside the development of other evaluation tools offered within the field.
Choosing an evaluation framework
When PCP is evaluated, it is habitually expressed using 'quality of existence' indicators (Schwartz et al, 2000).
The framework used for this research is based on the World Health Organisation's (2000) model of level of life indicators. Similar indicators are in a minute appearing in a number of evaluative processes contained by social care, including the CLG Outcomes Framework (2006).
The WHO study is markedly useful within re-emphasising and balancing core design and principles that make up 'a standard of life' next to the need of commissioners, funders and providers for width and application. It also has the benefit of mortal usable (on larger studies) across cultures and nationalities (WHO-IASSID, 2000).
The core principles set out in the WHO study are similar to those cited in frequent PCP papers, but it has one adjectives addition - it discusses who determines the indicators in the first place in turn to establish meaning for the client user.
[Quality of life] have both subjective and objective components, but it is primarily the perception of the individual that reflect the quality of energy he/she experiences. (WHO-IASSID p14)
Responses and interpretations
The WHO evaluation framework is based on a matrix model made up of eight elements as shown within Table 1, opposite. Clients' interviews and written submissions be analysed for evidence/indicators that could be categorised within this matrix. Using the WHO matrix and applying it to the interviews and written returns, the following indicators emerge. The responses in Table 1 are client- specific.
Interpreting the responses
Analysis of face-to-face interviews near clients and written responses suggests that clients' perceptions of PCP as a process fell into three largest areas of interest:
* PCP as a means of focusing on what make for a meaningful vivacity
* PCP as an aid for the client to gaining insight, self-awareness and control
* PCP and the role/importance of other those in the PCP process.
Following discussion of these areas of interest next to the user development group, the research troop offered seven findings and interpretations of the evidence.
* PCP demands a high scope of self-realisation, motivation and recollection if used by a client without regular assistance from staff. It is thus suitable for some clients at particular times surrounded by their lives. However, there is no evidence that use of PCP produces a sense of downfall, even if the client feels that it have 'not worked for them! Unfulfilled goals do not necessarily result surrounded by damage to the client's attitude to other support models or their gameness to try PCP again.
* PCP, as a process, has the potential to expose vulnerability contained by the client and in the staff appendage. In some sense this may be seen as equalising the power between them and maximising the opportunity for the client to assert their own requirements and express requests and aspirations, in a approach that might not be as apparent near some other, more prescribed, support plan tools.
* PCP is mainly a solitary process which the client uses as a personal aid, sometimes near his or her key worker but solitary occasionally with family unit, friends or professionals. Clients nevertheless can be extremely proud of their PCP plan, and if asked to share it with others are plausible to do so, if the person is faithfully interested in the well-being of the client and trusted by them.
* The visualisation of the life elements of a PCP plan hold an impact on some clients, and the 'drawing pictures' approach to representing a plan has significance and utility for them and is used as a document that both prompts recollection and encourages clients surrounded by difficult times.
* Clients see PCP as complementary to other forms of support, but quite separate from them. At the time of the study the hot Carr Gomm model of Monitoring Change was still within its trial period, and here was discussion of where on earth PCP 'fitted in' beside this, or indeed any other process related to support. Although there is area for linkage between Monitoring Change and PCP, they are quite distinct at present. From the perspective of the client (and probably staff) the branding of the processes will need to communicate clearly any linkage and/or adjectives purpose.
* PCP can be used by a range of clients next to varying support requirements. PCP elements of dreams, goals setting and realising the steps to goal are not restricted to any one group. However, there is some evidence that some clients beside a learning disability may require a more intensive and regular use of PCP near their key worker to see them to understand that the process they are using offer them a tool to help them make their goals and provide continuing motivation.
* PCP is essentially a self-evaluation tool. A number of clients described their experience of the usefulness of PCP in language of 'seeing' where they be compared with where on earth they had begin, and noting achievement. As a self-evaluation tool, the clues to progress towards goals hold to be measured by understanding the calibration the client and the switch worker make to conciliator movement. Some clients judge their progress within terms of personal nouns, for example 'I want to learn to drive', while others see progress as evidenced by their premonition of well-being, for instance 'I feel I can do things now'. This fine-grained calibration have meaning to the client and desires to be acknowledged and validated by others, essentially the key worker. The pressure is and so on the key worker to hold quality time to verbs to engage near the client on a regular and frequent basis.
Concluding thoughts
Given the caveat on size of sample and the margin of this evaluation, it is fair to utter that PCP is, for some people, a adjectives and powerful process that aids self-motivation to act on perceptible goals. It is a lifeenhancing approach for nation wishing to move forward. There is profoundly going on in the PCP process that warrants sustained scrutiny and definition, but the evidence in this evaluation points to PCP person a valuable and valued tool for supported housing providers and clients.
PCP is not an comfortable option to contribute to people who are adjectives or who require specific support at a particular time contained by their lives. It is not a quick 'fix' or a process that guarantees nouns or progress, but it does have the talent of being definite and relevant to those who use it. PCP belongs to the client, and ultimately it is the client who reaches for goal and evaluates success contained by achieving those goal in their own expressions. The challenge for social housing providers and commissioners is to increase their penetration of what clients rate as successful outcomes. This evaluation has, surrounded by a small way, re-affirmed that successful outcomes are within the same category as those where most nation's aspirations lie. It is hence incumbent on funders and providers to provide the context and resources (trained staff and a supportive environment) that enable the client to realise their PCP dreams as an aid to nouns and fulfilment.
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