“Staff were observed providing the clients with choices and honouring their rights to make decisions, including around the house, with personal care and meals. They were seen taking time to use Person Centred Active Support approaches with their clients, understanding the clients’ needs and communication abilities and preferences.”
— HDAA 2017 Auditors Report
The arrival of the NDIS requires organisations, the people who work for it, clients, families and carers to transform the way they work together.
The Tipping Foundation has been preparing for this transformation for several years and only now are we starting to see what the changes will look like.
To assist the transformation, The Tipping Foundation entered into an agreement with La Trobe University to engage in Active Support and also commenced training and the implementation of a tool called Outcome Star to gauge how and what our supports deliver to clients and families to achieve positive outcomes.
Active Support and Outcome Star are evidenced based tools that we have implemented in order for a person with disability to actively participate in their own lives and to have a much bigger say in how their services are delivered. These tools help us to support the person, in a way that they have directed, to develop the necessary skills and to measure the progress towards their (the clients) set goals.
We have put an emphasis on client directed service delivery. Historically there have been challenges and obstacles to clients directing their own service delivery preferences, exacerbated further for people with an intellectual disability. To achieve this, we have concentrated on three fundamental platforms that underpin how we now deliver services. These platforms are:
1. Zero Tolerance to Abuse
Creating awareness and genuine understanding of zero tolerance to abuse is more than just having a discussion about abuse. We all have biases, conscious and unconscious, that may influence the way we deal with these situations. All staff at Tipping are working towards this important zero tolerance to abuse and neglect.
Zero tolerance is often understood as representing physical and sexual abuse. Staff now, equally consider other types of abuse that are often more subtle yet pervasive. Examples of this type of abuse often relate to psycho-social restrictions and the exertion of control. These concepts are discussed at team meetings to embed localised cultures that replicate the organisational culture. The basic premise has been to develop an understanding that how we speak and treat people at a very basic level is essential to zero tolerance.
2. Outcome Star
To be able to support a person meaningfully, we must have a real (not assumed) understanding of who the person is and what they want to achieve through The Tipping Foundation.
Outcome Star has been an effective tool because it elicits information and understanding of a person’s ‘big picture’ aspirations and dreams. Through this process the person and important stakeholders consider where they sit in eight life domains, within the context of quality of life and what needs to be done to improve or maintain particular areas.
The broader aspirations and dreams are then broken down into smaller measurable and achievable goals to guide support workers. Support workers who are responsible for following through on service delivery are now much more involved in the formulation of goals and discussions so that we are all better aligned in our service delivery at an individual level.
Team meetings are used to discuss support related to individual goals and reflect on engagement and progress. We collectively share challenges and ideas and agree on a shared approach. The change that we notice in our teams is that they are even more engaged and creative in the way that they problem solve and adapt.
Reassessment of the person’s quality of life takes place at agreed, or required at intervals.
3. Person Centred Active Support (or Active Support)
Person Centred Active Support works on the principle that every moment matters and that people will achieve better outcomes if people are actively engaged in their life and making choices about their own future.
Previously, the process of assessment led to the formulation of goals in a support plan. Using the tools and concepts associated with Active Support, we have now been able to make agreements about how, when and what supports we apply to individuals in order to achieve their goals.
The link between the three platforms of Zero Tolerance, Outcome Star and Person Centred Active Support has been critical to transforming the thinking by our staff and ultimately our service delivery.
Service Access Unit
The Tipping Foundation’s Service Access Unit launched in February 2017 with the primary aim of providing up to date information about the rapidly changing disability sector, more streamlined processes for new clients and improving our clients’ experience from their very first interaction with Tipping. The by-product of this advice based service is an opportunity to build rapport, relationships and trust, by sharing our expertise, that enables people to secure the necessary resources, services and funding that are needed for a high quality life.
There are a large number of people in need of support and they are after information on what options are available. The majority of the enquiries to the Service Access Unit are from people who are understandably solely focused upon the welfare of their loved ones. We often have enquiries relating to the following:
- information about the NDIS
- where to refer people for support
- looking for accommodation options
- wanting our support staff to put their individualised NDIS plans into action
- general advice on how to navigate the disability sector
- advocacy and assistance with finance related matters
The Service Access Unit has also established an accommodation waiting list from these discussions. We know that this need is an opportunity and we have a range of comprehensive and creative solutions that we can work together with families to implement.
It’s all about helping clients and families to achieve excellent results by sharing information and expertise.
Positive Behaviour Support Service (PBS)
Since April 2016 The Tipping Foundation has been registered to deliver NDIS Positive Behaviour Support Services including planning and training.
What are challenging behaviours?
A challenging behaviour is a continuing behaviour that can cause difficulties and often gets in the way of a person’s ability to have a good life. Sometimes a person may use a range of actions or behaviours to be understood.
We all communicate using different tools and techniques in order for our message to be understood. Positive Behaviour Support helps to break down the behaviours step by step in order to understand the behaviour and its purpose. This allows us to develop a plan, with achievable goals and then to be able to review the progress. It’s not a quick fix and improvements won’t happen overnight but they will happen.
In order to achieve any change, it’s about having a collective approach and we work closely with all support staff and with other services and allied health professionals in order to support each client. It’s about understanding the behaviours, what triggers them and what strategies to put in place to avoid or assist with these behaviours.
What is Tipping’s approach?
We have developed a Functional Behaviour Assessment tool which aligns to the core values of the organisation, including Person Centred Active Support, zero tolerance to abuse and the least restrictive approach to supporting people who display behaviours of concern.
The Positive Behaviour Support Service has been instrumental in providing support to staffing teams within our organisation who support people with high levels of complex behavioural challenges to ensure that approaches are contemporary, positive, educational, and to help individuals develop and express themselves positively as they achieve their goals.