Choice and control
Making choices about who supports you, when and where you get support, and what kind of things you get support with can make a huge difference to people’s sense of dignity and their quality of life. The amount of choice and control people exercise may vary depending on their circumstances, but making efforts to ensure people always have opportunities to exercise choice and control should be at the heart of how services work with people.
Dr Ossie Stuart - Equalities Consultant
Simon Stockton - Strategic Consultant in Health and Social Care
Vicky Clarke - Contracts Manager, Surrey Continuing Healthcare
Carol Taylor - Manager, Garth House care home
Alison Hardy - Manager, Athol House care home
Dr Ossie Stuart: People who receive social care services are beginning to think - hang on a sec, we should have a greater role to say in how social care is shaped, who's it for, and all those questions like that. And for people like myself who use social care services I find it very difficult to be told what I should and should-n't have.
Simon Stockton: Choice and control matters for everyone and it's only really sometimes that we notice it when it's not there.
Moving into a care home can be one of those instances where choice and control over the little things in your life that you don't notice because it's part of the background suddenly is disrupted and those little things are the things that really matter for people so being able to decorate your own room having a choice about when you have a cup of tea and how you take your tea, when you get up in the morning, when you go to bed - taking time to get to know people and what they used to do what they used to enjoy doing and helping them retain that sense of being able to make little choices that will affect their environment in ways that help them to feel at home is really important.
Dr Ossie Stuart: It means that I should be the one who should decide how services that are available to me should be organized and arranged and designed around me. That's what it basically means to me.
People think independence which is part of that the concept of personalization is about doing things for yourself - it's not, it's about being in control and deciding things for yourself so for example Yvonne put my trousers on - I can't put my trousers on - but that for me doesn't make me independent, if I can or can't - what makes me independent is I decide when, what color and how those trousers are put on for me.
Carol Taylor: We all want choice and we all want control and I think if we lose control we become frustrated and frustration can lead us then to lose the ability to take advantage of the opportunities that are offered to us.
A lot of people see care homes as being God's waiting room and they're not. They are a new chapter and for a lot of people it's a new lease of life so it's letting go and I say to people think about it is it an opportunity you don't have to worry about shopping, housework, making your bed. Fantastic - I'd love people to be waiting on me and looking after me. Think of the opportunities that that provides us with so although I might be losing control over the control of a household I'm actually getting more control over what I can do with my life.
Vicky Clarke: During my career I've seen a couple of really bad examples where that choice and control has been taken away. And as a result of that the people involved have had really bad experiences which can be upsetting not just for the person themselves but for their families, their friends. I've even seen examples where a person wasn't able to wear the clothes that they wanted to wear and to see somebody treated like that is really distressing.
Allison Hardy: We offer a 24/7 service and so if someone decides that they want to sleep all day and be awake all night then we can just work with them and support that. We have people, residents who really won't get up before 10 or 11 o'clock in the morning and then they'd like to listen to music and then they'll start to get ready for the day. And it's very important that we work with individuals not to try and break that but it's their choice and we're here to support them.
Simon Stockton: The challenge for people who are working in care homes and managing care homes is to try in different ways to make the experience for people who are living there as close to that sense of it being their own home as is possible.
For the time that they're there it needs to kind of reflect who they are and what's important to them.
Choice and Control: Points to Consider
- Encourage people to decide what they want support with. Take care not to over support people.
- Help people explore what would enhance their sense of choice and control.
- Consider the every day choices that can help people feel at home and in control.
Use the care home action plan – it’s free!
A MySCIE account is required to gain access to your care home action plan and answer the question on Choice and control.
Designed for managers and owners of care homes for older people, use this care home action plan to:
- Build a shared understanding of what personalisation (or person-centred care) means in a care home setting
- Identify and plan practical improvements that will make your home more personalised
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