NDTi good conversations and creative support planning

1. Good conversations and creative
support planning
Jon Ralphs
NDTi Associate

3. A pint of
demand
A half pint of
resource

4. 80% 20%
Four days a week practitioners are doing administrative tasks

5. What matters?
What the person
brings?
Aspirations

6. Now have a conversation together to find out from each
other’s rants;
What’s important to you?
What matters to you?
You might need to flip the negative rant e.g. people don’t
listen - its important that people give full attention it
makes me feel valued
What matters?

7. Referral Put in touch with / connect with
Assessment Talk with you about your situation
Service packages Let’s think about your support
Respite Have a bit of a break
Reablement Help you to be the best you can be
On going support Help when you need it
Outcomes What you want in the future
Review See how you are getting on
Service user People
Placement Where you are going to be / live

8. Share the happiest memories of your life so far

9. Describe a real problem that you’re struggling with

10. v.
Motivational Interviewing – when people are
resisting change

11. Drawing on the techniques of Motivational
Interviewing
• Resist the ‘righting reflex
• “Goal of the practitioner is to minimise resistance
by not actually fighting against it and to avoid
engendering it by trying to fix the problem”
• Understand the person’s motivation
• “We need to listen for and actively seek
information about goals, beliefs and aspirations
and then explore how these relate to present
circumstances.”

12. • Listen to the person
• Expressed through ‘reflective listening’ and an attitude of
acceptance of the person’s feelings and perspectives.
• One way to know you’re in that empathetic stance is to be
able to look at the world from the person’s point of view
and say truthfully “That makes sense. I can see why you
view it that way.” Acceptance is not agreement or
approval.
• Acceptance facilitates change where attempts to
pressure change provoke resistance
• Empower the person
• Support persons belief that they are capable, have ideas
for solutions and can enact changes if they decide to do
so.
• It is important that practitioners actively cultivate a
stance of hope and communicate that hope to people.

13. • Think about a time when you have
employed one or more of these approaches
in your interactions with someone:
• “Resisting the righting reflex”
• Understanding the person’s motivation
• Supporting the person to feel empowered

14. Share what really matters to you

16. Share something that makes you really unhappy

17. Share your qualities, strengths and assets

18. Share a real aspiration you have for your own life

19. To think about what
matters
Questions

20. What would you save
from your house if it
was on fire?
Assuming that everyone is safely
out of the house

21. Who are the most important
people in your life?
Where do you see them?
What do you do together?
People

22. Good and bad days
Good days can tell you what
matters to you.
Bad days can tell you about best
support.

23. What would you miss if it
didn't happen?
I usually…
I always…

24. What would you never leave home
without (in your manbag handbag ,
or pockets)
Possessions...

25. What matters?
What the person
brings?
Aspirations

26. Who can I share my gifts, talents and
contributions with?
What resources can I share?
Where can my contributions thrive?

27. What matters?
What the person
brings?
Aspirations

28. What’s your North Star?
If I could I would…
This is why I get up in the
morning.
My passion is…
The direction in my life is…

29. Support
Belonging
Decisions

30. Ged & Pam
Charlotte
Jenny
JanePaul
Georgie
Brian and Shirley
Paul RMum
Liz
Gareth
Jaz
Bri
Lou
window
cleaner
Braid
Nick
Family
Robbie
Jill
Karen
Work
Friends
Paid
Support
Karen
Roy
Sergey
Ellen
Andrew

31. Friends
Family
Community
Brian and
Shirley
Ged & Pam
Jane
Paul R
Mum
Liz
Paul
Georgie
Ged & Pam
Charlotte
Bri
Karen
Sergey
Racheal
Gary next
door
Ralph & Jason
life class
PACA
Maxine, and
the boys
The gym

32. Support
Belonging
Decisions

33. Ged & Pam
Charlotte
Helen
Jo
Jane
Paul
Georgie
Shirley Brian
Paul RMum
Liz
Gareth
Jaz
Bri
Lou
Michelle
window
cleaner
Braid
Vicky
Family
eric
and
dave
John C
Gill G
Karen
Work
Friends
Paid
Support
Karen

34. Decision making profile
This is how I
like the
information
presented to
me
This is how
to present
choices to
me
This is how
you help me
understand
the
information
presented to
me
These are
the best
times to ask
me about a
decision
This is when
it is not good
to for me to
make a
decision
Visual and in
colour,
Not too
much text,
3 at the most How does
that fit in
with my
North Star
Wiifm
Pros cons
1 week
before.
When I’m
relaxed
Mornings
(before
coffee)
busy / full
working week
that includes
traveling

35. Important decisions in
my life
Who would be involved
or how I would be
involved in these
decisions
Who makes the final
decision
Going self employed Talk through with Ged
at the gym. Talk to Jane
over a meal with glass of
wine
Jon / Jane
New car Ask Brian to research
and come back with 2-3
options
Jon

36. How I like the
information
presented to
me
How to
present
choices to me
How to help me
understand the
information
presented to
me.
Best time for
me to make a
decision
Worst time.
For me to
make a
decision
Talk to me.
I can read a bit
but prefer to
listen.
Give me some
information that
I can look at
after you have
gone.
Let me know I
have to make a
choice.
Keep if limited
this or that
Give me time to
think about it and
then give the
information again.
Let my best friend
tell me as well as I
trust her
After I've been
visited by my
best friend
When I've come
back from the
shops.
When I'm
talking to you
and giving you
eye contact.
When I have my
hoody up and do
not give you eye
contact.
When I'm self
harming

37. Important
decision in my
life
Who would be
involved and how
would I be
involved
Who makes the
final decision
Moving to my new home
from a hospital setting
I would have a meeting
with my key worker and my
befriender when I'm well to
agree the move
Me with my social worker
I would be told that I'm
moving three days before I
move

38. Outcomes

39. Check
Now
Prioritise
Success
Test it
What’s stopping you?
Action
Record
1
2
3
4
5
6
7
8

40. WHAT MATTERS
Relationships
Things to do
Things to have
Positive rituals &
routines
Rhythm and pace of
life
Things that make me
happy
BEST SUPPORT
Healthy and Safe
What must happen in my
day to stay well
(e.g. exercise,diet,
medication,
how I must be physically
cared for, etc.)
What are your Aspirations?
If I could I would…
1

41. 2 How
are
things
right
now?

42. What’s working
Keep
Maintain
Grow
What’s not working
Change

43. Person
Family
Staff
Others

44. Prioritise
3

45. What would success look like if we:
Changed the things that are not working,
Built on the things that are working,
Moved toward the persons aspirations?
Success

46. Test it

47. A Person Centred Outcome…..
• Is a personal goal not a service goal
• Is something you have influence/control over
• Is measurable and specific
• May have obstacles in the way of achieving it
All these make the outcome well formed

48. Does it keep something that is working?
Change something that isn’t working?
Does it move towards a future you want?

49. A Solution …….
• Is there resource you need to achieve your
outcome
• It can be an item or an activity
• It can have a cost associated with it, or be
free

50. Questions to test is it an outcome or a solution
If you got your outcome…what would it...
• Give you?
• Do for you?
• Make possible for you?

51. To have a car
What would that:-
• Give you?
– Get me from home to where I want to go
• Do for you?
– Let me go and see my friends once a week, go into the
city shopping and get to work experience
• Make possible for you?
– I can just do it - without mum and dads help
– I have four friends
– I know the shops in MK
– I have work experience to travel to

52. To have a car
So what is the real outcome?
To go and visit my friends, once a week
Go into the city - shopping every weekend by myself
(To work five days a week) To get to work experience on
time.

53. 3 hours of speech and language therapy
What would that:
Give you?
Time with a speech therapist
Do for you?
Help them be more easily understood by their friends
when they are at the community centre?
Make possible for you?
Friendships, taking part in things, feeling more confident
with other people.

54. 3 hours of speech and language therapy
So what is the real
outcome?
" l am understood by my
friends and I can do activities
with them in the at the
community centre three times a
week”

55. What is getting in the way or stopping it
from happening right now?
What’s stopping you?

56. Important ... outcomes...
Personal People
Places
And
Spaces
Public
And
Paid

57. Action
Clear targets
SMART actions
Who, will do what,
by when?
Assign resources
7

58. Record

59. So which bit of what we do is
actually the “outcome”?
Outcomes are the reason we do stuff,
not the stuff that we do.

60. • Outcome = the reason we do stuff.
• Input = the stuff that we have or
do.
• Output = the stuff we can
measure.
Or put simply

61. Where I feel good
Where I’m a customer
Where I’m a member
Where relationships can
be strengthened
Where new relationships
can be made (3rd places)

62. After an hour on the minibus
Mo goes to base group at
his special school.
Mo’s off to his lesson in the
special needs portakabin
in the main stream school.
Mo is supported to join in A
GCSE science practical.
Specialist
Place
Disability
Group
Inclusion traffic lights
Community
Place:
Disability
Group
Community
Place:
Used by
everyone
The inclusion traffic lights help us
think about the places people go
and the people they connect with.
Sometimes people need specialist
support, but that doesn’t mean
they should find themselves ex-
cluded from the opportunities
others benefit from. We can define
communities as places that people
come together.
Nadia makes her own lunch
in the life skills session
at the day centre.
Between 10am-2pm Nadia
volunteers as a cook at
the disability drop-in cafe.
Nadia works in the kitchen
at a local pub.
Residents loved to watch
Brenda sorting out the Herb
window box at the care home.
Brenda was the first to check
the runner beans on
the outreach project.
It was the first time Brenda
had seeds to swap aT the
allotment AGM meeting.

63. In community building, the third place is the social
surroundings separate from the two usual social
environments of home ("first place") and the
workplace ("second place"). Examples of third places
would be environments such as churches, cafes,
clubs, public libraries, or park

64. No Support
Tech that helps
Natural support
Paid Support