Chapter 8 - Use of person-centred thinking tools to resolve complaints

Put simply, person centred thinking is a way of assisting people to work out what they want and the support they need, and helping them get it (Department of Health Guidance, 2008).

Tony’s story

A father lodged a complaint with the service provider about his son Tony’s day service. Tony has an intellectual disability and autism. His father complained that the day service program wasn’t meeting Tony’s needs, because it lacked structure and routine. He complained that Tony wanted to learn how to handle money and how to read and that the service wasn’t supporting Tony to develop these skills.

When Tony’s father raised this with the service they explained that people using the service voted on the types of activities they wanted and that Tony enjoyed the various social and recreational activities offered. They didn’t feel that Tony wanted or needed the type of program suggested by his father.

As Tony’s father felt the issue had not been resolved to his satisfaction, he contacted the DCS Community Partnership Team for assistance. The Community Partnership Team contacted the service provider asking about Tony’s support plan and whether people knew what was important to Tony– in terms of what he enjoyed doing and what was a good day for him? What activities were offered that reflected what was important to Tony, compared to the group as a whole?

Tony’s father, Tony and the service provider were able to identify things that were working well for him in the program, for example which of the social activities he enjoyed and which he did not. Tony’s father put forward that Tony was often stressed and anxious about going to the day service. The service provider and Tony agreed that this could be because Tony needed more predictability and routine in his day. The service provider also learned from Tony’s father that Tony had been able to count money and had learnt to read signs in his previous program. He appeared to have lost some of these skills and was now less confident when going out and shopping. Tony particularly liked going to milk bars, and being able to choose and pay for snacks. The service provider hadn’t realised this and talked about how they could develop a program with a regular routine of Tony going to a nearby milk bar and working out his money to pay for snacks.

Through taking a person centred approach to the complaint, the service provider agreed to work with Tony and his father to develop a support plan that reflected a balance of what was important to, and important for, Tony in their program. The program was individualised to meet Tony’s needs and goals.

Person centred thinking provides an opportunity to broaden the understanding of what quality of life means for each person and what good quality human service practice is for each individual. The particular challenges are to make this goal a reality with limited time and resources.

Success therefore requires ‘new’ skills and a critical look at existing roles. These ‘new’ skills are referred to as person-centred thinking skills. ‘New’ does not mean these skills are not currently practised by many people, rather that they are not yet systematically taught to people in the context of their day to day work. The skills referred to are ones that will help providers to have better information on which to base their response to a complaint.

Person centred planning has now been in use for 20 years and research has found its application does make a difference to the quality of life people experience. Research from the UK found that:

Very little change was apparent in people’s lives prior to the introduction of person centred planning. After the introduction of person centred planning, significant positive changes were found in the areas of: social networks; contact with family; contact with friends; community based activities; scheduled day activities; and levels of choice.

(Robertson et al, 2005)

Whilst this is significant, experience has also shown it is not the mere presence of a person-centred plan that makes the difference. The factors that make the difference include:

• the degree of learning that occurred as a result of the plan
• the commitment of people around the person to implement what is learned
• the knowledgeable support of those with power and authority.

(Robertson et al, 2005)

Therefore, whilst your organisation needs to ensure you have person- centred plans for people using your services it is equally important that in the context of complaints your staff know how to:

• engage all of the critical people in doing this work – the person, family members, carers, significant others in the person’s life, and managers
• develop person-centred assessments that synthesise and organise the learning so that it describes not only what is important to and important for each person but also describes the balance between them
• listen, learn and understand what is important to and important for each person when responding to a complaint, and
• see the complaint as contributing to the ongoing learning process, rather than as a one off event.

(Thompson, Kilbane and Sanderson, 2007)

Other person-centred thinking skills which are useful to apply to complaint resolution are available at  www.learningcommunity.us