How does Iris Care Group deliver personalised care?

At Iris Care Group we have developed our own bespoke frameworks to support the delivery of evidence-based, person-centred care that caters to the needs of people with the most complex needs.

The challenge in services like ours is in ensuring that the service, the staff, and the service user are supported to focus on what is most important – quality of life – as well as ensuring that the service is able to safely respond to any periods of increased challenge and difficulty.

We know that standardising the processes used to support people enables the right care to be delivered. To do this we have designed two systems to support the development of individualised care plans: Building Better Lives (BBL) and RISE.

Both are specifically tailored either for individuals with learning disabilities or for those with mental health conditions. Each outlines a clear and simple process, using evidence-based materials, to help these individuals develop the skills they will need to succeed in the community and prevent them from returning to hospital.

Elaine Chaplin, our Head of Therapies, explains how we have embedded BBL and Rise in our care provision.

Putting Quality of Life at the fore

Mental health outcomes traditionally focus on symptoms or, for complex services, rates of challenging behaviour. For RISE and Building Better Lives, outcomes are instead focused on quality of life. Both frameworks measure improvements in key quality of life indicators, like hope, autonomy, self-perception, belonging, wellbeing, activities, and physical health.

RISE uses the Recovering Quality of Life Measure (ReQol) measures a patient-reported outcome measure which captures changes in a service user’s perception of their progress towards recovery. Similarly, Building Better Lives uses the Maslow Assessment of Needs Scales – Learning Disability (MANS-LD), which is another service user-reported quality of life indicator.

Both measures are completed on a quarterly basis, reporting service users views on a number of quality of life statements such as:

• I am happy with where I live
• I am happy with how I spend my time (e.g. jobs, college)
• I feel able to trust others

The importance of goal setting

Setting clear goals helps provide focus and structure for staff and service users on the purpose of the placement. We believe that meaningful goals underpin progress as well as supporting the development of healthy and adaptive behaviours.

In both BBL and RISE, service users are asked to set their own goals with support from staff within 4 goal setting areas:

• Physical health and wellbeing
• Belonging and relationships
• Choice, control, and autonomy
• Activities

Goals build on these themes and can be anything from wanting to try new recipes, exercise, or socialise more. These goals are centred around the individual’s quality of life – their ability to keep themselves safe, build friendships and relationships, and make their own decisions.

Making a goal SMART

To make sure these goals are achievable, they are written in a ‘SMART’ manner. A ‘SMART’ goal is one that is Specific, Measurable, Achievable, Relevant, and Time-bound.

For example, a service user may choose a goal to improve their physical health.

We then add some timing and structure around the goal. In this case, specifying how often they will exercise and discussing with the service user different ways the goal can be achieved; “What kind of exercise do you enjoy?”

The final suggested SMART goal may then sound like this:

“Okay, so each week you would like to exercise three times for 20 minutes, twice for 30 minutes, or once for 1 hour. You would then meet your month’s goal of exercising for 4 hours per month. How does that sound?

Reflection and review

All goals are then tracked in a monthly planner with actions taken to meet the goal being recorded.

At the end of each month, service users have the opportunity to reflect on their progress. What worked well for them? Do we need to make any changes to ensure that the goal is achievable?

Some goals may not be a good fit, and sometimes our service users’ priorities shift – this is OK! Giving people the opportunity to reflect, review, and change their goals means they can set goals that grow with them and their potential.

Trained and committed staff are essential to success

It is important that people feel supported as they work towards their goals. Achieving a goal is a fantastic feeling, but working towards one can be stressful. Trying new things or forming new routines can be difficult, and there may be an element of trial and error.

RISE is focused on Mental Health Conditions, so our staff are trained to provide support that combines empathy, validation, and redirection.

When struggling to meet a goal, negative feelings can surface. Staff needed to be able to identify when this occurs and redirect the service user to refocus their behaviour, attention, or thought processes; it’s important that our staff know when to support people to focus on another activity or area of need that is less distressing or demanding.

However, our Building Better Lives programme is focused specifically for people with Learning Disabilities. It is the means by which we deliver Active Support to support service users to acquire new skills.

BBL guides staff on how to deploy different levels of tailored support dependent on how difficult the service user may find an activity.

We believe that all of our service users are capable of progress. We are dedicated to their rights to equality, dignity, independence, and fulfilment. Their journey to enhance their quality of life should be unique to them, and we support our service users by providing this tailored and achievable approach that allows service user control and choice.

At the same time, BBL and Rise are active facilitators for our staff; giving them the skills and knowledge they need too to achieve their own career goals to support service users to thrive and live happy and productive lives.