Active Support

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Active Support is a methodology that enables staff to support people with intellectual disabilities to take part in their own lives and learn new skills, at home, and in their community.

Certain principles of how to support and enhance the quality of life of people with an intellectual disability have become widely recognised. Central to these are the notions of ‘ordinary living’ and the right to a lifestyle valued by society. Relationships, skill development and opportunities to engage in every day activities, all contribute to having an ordinary life as defined by Bellamy et al 1990. “’People with intellectual disabilities have the same right as everyone else’ (United Nations, 1975).

To have these rights in practice, people often need help. This help needs to be tailored to each person’s individual situation. It needs to be person centred’ (Mansell et al, 2005). People need support not only in their own home, but in their community, with building friendships and relationships and support with those responsibilities that come with having an ‘ordinary life’.

Nobody is too complex, too disabled or too challenging to be supported to take part more in their own lives .  This ‘ordinary life’ can only be achieved if people are supported by staff who use, and understand, an enabling style of support such as Active Support and associated PCP and communication tools. For many staff supporting people in this way, will not come naturally and they will need support to learn how to do it.

Active  support methodologies show staff  how to use daily activity and support plans, learn to provide graded assistance and begin to see opportunities for engagement and participation. The team discuss ways of working so that the process of an activity will be consistent.

‘Its always easier to show ten members of staff without an intellectual disability, how to make a cup of tea, rather than, a person with intellectual disabilities to have to learn 10 different staff ways of making a cup of tea!

Active Support is a universal approach and is applicable to all support settings. It turns person centred plans values and personally important agendas into person centred action.   (Jones et al, 1999;Mansell et al 2005) and makes policy aims, a reality in people’s lives (Mansell and Beadle-Brown 2012) .

For people who display behaviour of concern, huge amounts of money are expended on forms of services that are designed to contain and control behaviour. Professor Jim Mansell’s report (‘Services for people with Learning Disabilities and Challenging Behaviour or Mental Health Needs’ 2008) was particularly clear that the cause of challenging behaviour most commonly lies at the door of poor services.

Mansell noted that:

  • The dominant model of support in services for people with learning disabilities is relatively unskilled caring and ‘minding’.
  • Environmental risk factors (such as poorly organised and trained staff) are widespread among services
  • The evidence found that staff do not generally interact with the people they support in a way that enables the person to achieve greater levels of independence participation or integration.

Below are outcomes from a recent study by Avenues Trust who implemented Active Support within their services:

  • Increase of 94% in engagement in meaningful activities
  • Increase of 300% in assistance from staff
  • Increases not just in participation at home but also in the community and in choice-making (e.g. ironing up from 3-22%, gardening up from 9-62%)
  • Decrease of 24% in repetitive/self-stimulatory behaviour
  • Decrease of 53% in self-injurious behaviour
  • Better planning and support was noted by managers during an activity.
  • Practice leadership increased overall
  • Percentage of staff reporting manager usually or always modelled good support increased from 42 to 78%;
  • Propensity of staff to leave decreased from 34% to 10%.

It has been apparent for over twenty years that practice leadership by first line managers play a vital role in the successful implementation of Active Support. Research shows that no amount of organisational policy or staff development will have any impact on implementation if practice leadership is absent. This is something that does not always happen and many first line managers do not always have the skills and understanding to coach their teams, and they will need to learn how to do it. (Anderson 1987;Jones et all 1987;Beadle-Brown et all 2013, Jones er all 2001 Hewitt et all 2014 larkin & Larkin 1996 Sturney 1998)

Where services use active support they will be able to evidence, very clearly, the functional activities they deliver to achieve quality outcomes for people in their service, as well as their basic elements of provision (for example, buildings, staff resources etc). This will support services to be commissioned clearly on what they deliver and not necessarily on what they say they deliver.

Where services are implementing Positive Behaviour Support it will become more effective and quicker to embed if the service is already successful in using Active Support. Positive Behaviour Support is dependent on a number of characteristics that are inherent within Active Support. (McGill & Toogood 1994; Mansell et al 2005; Jones et al. 2013)

Active Support constantly  shows that  it makes a positive difference in people’s lives, even where people have multiple and complex support needs.  Research in everyday settings has demonstrated it is possible to increase people’s engagement in a range of ordinary activities so that their skills increase, their health can improve and that they can exhibit less behaviours of concern.  However, to achieve these ends requires committment, effort and patients.  Active Support is not  just about changes in the lives of the people supported, but also changes in the organisstion that facititate that support.

 If you would like to discuss further please contact Christine Rose

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Turning plans into action