The SHARED Approach

Castlebeck’s SHARED Approach is a model of care based on eight processes or steps which establish an efficient and consistent care plan. S.H.A.R.E.D. stands for Supportive Help Achieving Realistic Effective Development and that is what we do. Castlebeck’s greatest resource is its people and everyone at Castlebeck has been trained in the SHARED approach. We continue to train our staff so that they can develop and continue to provide quality care by sharing the knowledge and experience with those individuals we support.

The eight steps are Assessment, Aims, Strategy, Plan , Resources, Implement, Evaluate and Recommend.

One size does not fit all and by learning and understanding the SHARED approach all of us can help the hopes, dreams and achievements of people become a reality.

Assessment When people come to Castlebeck we find out as much as can about them.

• Ability • Skills • Experiences • Health • Needs

This includes: family history, previous living arrangements, history of challenges, known prevention factors, health: both physical and mental, treatments and interventions which have been known to work. It is important during assessment that we factor in the ability and insight of each individual, their personal ambitions and goals but most of all what everyone is entitled to: privacy, dignity and care. From this we can create a truly person centred plan.

• A plan does not have to be linked to an individual’s clinical or social needs, it can simply be a personal wish, a challenge, ambition or dream.

Aims The SHARED approach has developed because we understand that the people we support at Castlebeck require understanding, compassion and a commitment to development. We also realise that staff who communicate appropriately with a full understanding of an individual’s behaviour have been shown to have the most successful outcomes.

• The SHARED Approach is a duty of care, based on an individual approach which has been researched and proven to work. • We look for the most comfortable method for those we support, where there are no threats or punishments; implied or otherwise. We simply act in the person’s best interest. • We use the least restrictive methods which afford each individual the privacy, interaction and freedom they require in an environment suited to their needs.

Strategy The strategy we use to deliver the SHARED approach is a balance of environment, positive behaviour reward and structured therapy. To enable social integration we look at these factors:

• Is the environment age appropriate, therapeutic, functional and of choice • How to reward positive behaviour and effort, look at control of triggers • Develop social, communication and living skills using systemic instruction over time • Develop coping and tolerance strategies, active listening and relaxation amongst a few

Plan Each individual we support contributes to their own personal plan. This is done by using that individuals preferred method of communication so we can ensure they have understanding and ownership of their plan.

• Who – key worker, multi-disciplinary team and associate worker system has to be in place to support and monitor the plan. Actions should be agreed, scheduled, observed and measured. Here the responsibility lies for consent, capacity and communication. • What –Planned actions are there to address the function of behaviours and to teach new and in some cases more appropriate means of behaving. • Where – In the most least restrictive environment. • When – For the time the individual is supported by us and beyond, it is the structure of their days and the basis of their lives for as long as we can deliver it. • How – by using the style of communication most suited to that individual and by having structure in all we do, basic routines, timelines, goals and constraints. Resources • Appropriate levels of staff support with expertise, understanding and a willingness to care, learn and develop alongside those we support. Team work, energy, self discipline and positive determination are the main resources needed to deliver the SHARED Approach. The resources available to implement the care plan are already in place or can be sourced. These are a combination of equipment, people, knowledge and skills.

• Personal hygiene, shopping, meal preparation, cleaning, laundry etc. • College and access to other training, libraries, gym or swimming • Friends, family, advocates, previous carers, those who can help motivate and be included in carrying out the plan. • Access to specialist clinical staff; Nurses, Psychiatrists, Psychologists, GPs, OTs, SALTs, Behaviour Therapists, Social Workers and Education Professionals

Implement In order to carry out the plan as agreed, consistency and communication are imperative; the feedback of all difficulties, changes and achievements has to be shared. Consistency checks are there to ensure the plan being followed and that those people responsible for it are staying positive and motivated.

• If things are not working do not be afraid to adapt, acknowledge things that have not worked or review your approach. Castlebeck’s no blame culture helps us to focus on realistic goals, achievement and success. Communicate your concerns or recommendations for change. • Any alterations to the plan should be noted in writing and recorded to the MDT but most importantly to the person we are supporting giving the reasons why. • Ensure the review tool is in place and reviews are scheduled and adhered to. • A plan can cease if it is deemed detrimental.

Evaluate What does progress mean for this person? The progress, effectiveness and quality of each person’s care plan are determined using individual progress measures, periodic service reviews and multi-disciplinary working. The people we support are at the centre of this approach so we would evaluate by looking at the interaction between core distress or low self esteem and impact of distress against environments, staff skills, structure and opportunities to learn, develop and own their own space. Tools which help us evaluate are:

• The individual we support • The individual’s key people • Periodic Service Review • Baseline and progressive data • CPA and ratings review

Recommend Castlebeck’s MDT meet and consider progress, PSR data (?)and any difficulties the programme may be bringing to the individual. Focus is given to each section of the model from assessment through to recommendations. The plan can be adapted at any stage of the process and if it is felt necessary to re-evaluate and begin again, then this is encouraged. Throughout each stage the individual who we support is informed and involved their plan, suggestions are welcomed, listened to and added to a plan when appropriate. Family members, referrers, social workers and other key people will be central and involved in the implementation of the plan. It is therefore fitting they should be privy to the recommendations and developments of the plan at CPA stage. Recommendations are ascertained and recorded on CPA forms.

“Behaviour usually serves a communicative function. It needs to be understood, learned and developed like any language.”