Walking the walk, not just talking the talk

Person Centred Care is nothing new and is a term used widely in healthcare. When I ask people what their understanding is, responses are varied, which is not really a surprise as there are many definitions in use.  Ultimately, they all mean the same thing; putting the wishes of the person at the centre of their care and understanding what matters to them. But do we ever stop to reflect and ask ourselves, are we truly being person-centred?

The UK Health and Social Care Act 2008 states our obligation to deliver care to be person centred.

‘The intention of this regulation is to make sure that people using a service have care or treatment that is personalised specifically for them. This regulation describes the action that providers must take to make sure that each person receives appropriate person-centred care and treatment that is based on an assessment of their needs and preferences’.

It is not always easy decide if our care is really person centred. We believe we are doing our best, but taking a step back to look closely may help to see things differently, re-focus on what is important and would make a difference to people we care for.

Sensitive and creative communication is one of the most important skills we use to build a relationship and develop a deeper understanding of those in our care and it may mean involving family and friends too for those with a reduced capacity. It is a foundation to person centred care, allowing us to develop a rapport and gain an understanding of the person, making their care meaningful alongside the clinical tasks. Emotional intelligence plays a huge part in nurturing these positive relationships, being aware of our own emotions and those of others.

With so many pressures on healthcare, it’s easy to become stressed by the ongoing focus on being person centred, but if we start at the beginning with planning care, we are on the right road. All too often I see care plans that have been written in a task-orientated way to meet clinical needs, with an emphasis on what the person can’t do, not what they can do or would like. A care plan with a holistic approach is the beginning of great person-centred care and should be based on values such as individuality, independence, respect, privacy, choice and dignity. All these values can also be talked about a lot, but we need to make them more than just words on a page, but the lived reality of people we support.  It should be written with the person, not just about them and their clinical needs. Care plans should become just as important as a medication chart – one prescribes medication whilst the other prescribes the care, specific to that person.

The Care Quality Commission in the UK also provides helpful guidance:

 ‘Care planning is focused on the person’s whole life, including their goals, skills, abilities and how they prefer to manage their health. Where appropriate, Health Action Plans may also be in place.

People are empowered to make choices and have as much control and independence as possible.

The service enables people to carry out person-centred activities and encourages them to maintain hobbies and interests.’

Of course, having a good care plan is one thing, we then need to implement that care, adapting with the changing needs of that person. This takes a whole team approach with ongoing support, learning and development to ensure we continue to deliver the best care that we can. It is important to continuously monitor outcomes too, allowing us to assess levels of care are right. This can be in many forms such as qualitative measures, for example, reduction in falls, MUST/weights, well-being tools, Geriatric depression scores, use of medications (psychotropic and analgesic), hospital admission rates, infections etc, which can all be key indicators of just how well we are doing. This should be used in conjunction with feedback from end users and relatives, taking appropriate action on the outcomes. It will highlight what we do well and where we can improve further, but we must be open to change.

Being person centred means different things to different people. We just need to remember every person we care for is unique and individual and we must take time to understand them and their needs – investing time to plan holistic care with effective outcomes which ultimately equals both happier people and a fulfilled team.

BECCY MULLINS
Associate Nurse Consultant, MCM

References

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9

https://www.cqc.org.uk/guidance-providers/adult-social-care/person-centred-care-good

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