In this week’s blog I will be covering the topic of Active Support, what it is, the benefits and how it can be implemented. At the end of this blog you can watch a video of my younger self, carrying out Active Support with an individual from Brighton. Trust me it’s not one to miss if you fancy a laugh!
Active support is an approach to supporting people with learning disabilities and autism to be involved in everyday life as much as they are able. This includes day to day activities related to cooking, cleaning, shopping; as well as community-based activities which aim to promote access to work and leisure. The emphasis is on accessing ordinary everyday settings and facilities as far as possible. This requires support staff to be active in identifying local community resources and creative in relation to negotiating adjustments to ensure that the activity is accessible to the individuals we support. For example we may be able to negotiate some voluntary or paid employment for someone we support but agree with the employer that a support worker remain with the person at least until the person is comfortable with the role or the work environment. As well as promoting engagement in real and meaningful activities; it should also support people to be part of wider communities and social networks.
Good levels of activity and engagement promote physical and mental health for the people we support. It allows people to remain physically fit and mentally alert, it promotes the development of skills or shared interests, encourages people to make decisions and choices, to have greater control over day-to-day decisions, promotes the development of friendships and relationships, and allows people to develop a sense of worth, self-esteem and understand their value within their communities
Active support has a number of key approaches or strands these include:
Every moment has potential: use every opportunity that you can to involve the person in the activity at hand, if you are planning to go out swimming or to a café; could the person be supported to gather up their swimming costume, towel and purse? What support does the person require to communicate with the pool staff and to pay for the activity?
Little and Often: Some individuals might be able to concentrate on a task for a short period only; other for longer periods. However, it is the engagement in real and meaningful activities that matters, not the time taken to complete that activity.
Graded Assistance: We need to consider the level or type of support that people need to be involved in a task and provide appropriate support. This might be using visual guides or prompts, verbal direction or hand over hand support.
Maximising choice and Control: It is important that support staff understand the best approaches to communicate with and support individuals to make choices and decisions. Staff also require a good understanding of promoting positive risk-taking and the Mental Capacity Act.
It’s important to remember that active support should be an approach that we use with everyone that we support. The approach can and should be adapted to peoples differing levels of need or abilities and indeed preferences.
CMG and Regard will deliver active support training to new staff as part of its week long induction process. The daylong training will introduce staff to the principles of active support and give them an opportunity to practice the skills in a simulated situation.
Please email Darryl.Chapman@cmg.co.uk for advice on how to implement active support in your service or with the people you support.
Case Study – Bosley House – Regard
When L moved into Bosley House six months ago her personal hygiene was extremely poor and her domestic skills were non-existent. Since moving in with the support from staff L has learnt how to prepare and cook meals.
L required support and several prompts a day to make her bed, open her curtains and to do simple tasks such as brush her teeth. L can now use the microwave, oven, kettle, and dishwasher and washes her own clothes. L will ask for the hoover and cleaning products and will clean her home environment almost daily without any prompting.
Since living at Bosley Road L has been on her first holiday to Blackpool and is now planning her next trip to Spain with support from staff. L is involved in all aspects of the planning of her holiday abroad. L is learning small Spanish phrases in order to prepare her for a holiday in a country where people speak differently as L can present challenging behaviour when there is a communication barrier. L does not like loud noises so in preparation for her trip she has been listening to loud aeroplane noises on You Tube to get her ready for the sounds she may hear.
L had very little knowledge into healthy eating but over the last six months has stated that she would like to lose weight. With support L is learning about healthier meals and cooking from scratch and will now buy plenty of fruit and vegetables which has replaced sugary snacks.
It was always thought by health care professionals that L would always have to live in a supported living situation, however after L’s six month review it has now been recognised that with the support and time L could live independently in the future.
This is an amazing example of active support and also what can be achieved with the right encouragement and support from staff.
Case Study –South Hill – CMG
One of our Home Managers at South Hill, a supported living service has undertaken a piece of work to increase the independence of one young woman in relation to handling money. Previously support staff provided considerable support in this area, for example staff would hold the individuals purse or debit card and would make transactions or purchases on her behalf. The young woman was not involved in this process. However, Michelle suspected that the person could develop skills in this area and should have greater control or involvement in relation to managing her money.
Michelle, set out to plan and undertake an assessment of the individuals understanding of money. As the young woman does not use verbal communication, the assessment needed to be completed using photographs. The assessment (which was undertaken with the local authority as part of a wider Mental Capacity Assessment, though planned by Michelle) indicated that the person had a good understanding of where her money came from, how to get money from the bank and understood the values of various coins and notes. Michelle concluded that whilst the person had not previously been handling her money; she had likely learned the processes involved through observing her support workers. Consequently, the person is being supported to have greater independence in relation to handling her money.
At the same time Michelle has been working to improve the communication support provided to the individual; who relies on signing as well as visual communication tools. In particular, Michelle has been working with Tobiidynavox (https://www.tobiidynavox.com/en-gb/) to introduce the use of a tablet based communication device. It is likely that the individual will initially use their symbol based software initially.
This is an excellent example of Person Centred Active Support being worked out in a service on a very thoughtful and planned way. It is essential that managers and support view the Mental Capacity Act as a tool to support the independence and decision making by people with learning disabilities.
Click here to see a hilarious video of my younger self carrying out Active Support with someone from Brighton.