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Person-Centredness and the Social Services and Well-being Act 2014
The SSWA represents a step-change in our approach to health and social care . In other words, it is NOT an incremental or gradual change but something more challenging and dramatic. A shift in culture, and professional practice. Well that, at least, is the intention!
The first area in which this shift is apparent is in the adoption of the Well-Being concept, which we visited in our blog post dated Sept 8th, and the person-centred focus which this brings to the heart of things. Now, 'person-centred' is a term which has been much used and abused over a lengthy period (decades), to the extent which it has lost some of its meaning and credibility. The new legislation however appears serious in its intention to deliver on services being genuinely person-centred.
The person-centred concept owes its origin to the humanistic psychology movement of the late 20th century. This movement believed that if you can provide an individual with a healthy and supportive personal environment, they will naturally grow and evolve towards their personal goals. It is predicated on a highly personalised approach, in which it is necessary to see and understand the client as an individual with their own life-story and narrative. It is often contrasted with institutional patterns of service which adopt a 'one size fits all' approach.
Real and imaginary constraints, however, have often impinged on person-centredness. There are always limits to how far a service and the available resources can reasonably stretch to accommodate an individual's needs or wishes. A respite-break for a hard pressed family carer, whilst reasonable in itself, is unlikely to stretch to a gourmet meal and a West End show.
So balancing real life constraints with person-centred wishes is the name-of-the-game. But 'growing' person-centred care out of services which have previously had a more institutional or regimented focus, can sometimes place the bar too low. Staff become familiar with providing an established range of services. Even if something else is reasonable - if it falls outside of what is on offer, it may not be provided. I think this is one area in which there is a clear shift with the SSWA. It is asking us to be a "shade braver" (to steal a term from a hair colouring advert), to be more therapeutically optimistic, to aim higher.
This person-centred focus has clearly occupied much time in the committee rooms at Cardiff Bay, being hammered out and honed through a lengthy drafting and consultation process, leading up to the SSWA. A laudable and modern concept has been achieved...the question becomes how will it be realised in practice?
In my next blog I will start to answer this question by looking at some of the person-centred issues around assessment and goal-setting relevant to the SSWA.