Personalisation, values and the CPA
By the end of this unit of study you will:
- Appreciate the emphasis that ‘values based practice’ has in national mental health policy
- Understand how values underpin every aspect of CPA
- Evaluate what ‘personalisation’ means to you and your role in CPA
- Relate the 10 Essential Shared Capabilities to your own practice
1.i Question: What does the term ‘personalisation’ mean to you? Think about its meaning in general terms and also within the context of health and social care. Write your response in the Exercise book before continuing with this unit.
It is likely that your response includes a number of values. Personalisation is a concept that encapsulates fundamental human values such as control, choice and respect. These are values that impact on our life experiences daily. We know that service users and carers often use these values as indicators to evaluate their experiences of health and social care services.
This is why the refocusing of the CPA is grounded in values and principles that are central to personalisation and encapsulated in the 10 Essential Shared Capabilities (DH 2004), Human Rights in Healthcare (DH 2007) and the ‘Three Keys’ (CSIP/NIMHE 2008). These values underpin the process of CPA and should inform all aspects of its day to day application.
The New Horizons report (DH 2009) outlines a shared vison for mental health in England. This vision is grounded in the following key values:
- equality and justice
- reaching our full potential
- being in control of our lives
- valuing relationships
The CPA is at the heart of this personalisation focus. Personalisation of care provision starts with an examination of the core values which underpin CPA. It is no accident that the ‘Refocusing CPA’ guidance begins with a statement of values, nor that this learning resource follows suit. This unit aims to promote greater consistency in how attention to values and principles are applied in CPA practice.
Choice’ and ‘personalisation’ are now watchwords for NHS and social care and they underpin the refocused CPA. The review of the NHS in 2008 by Lord Darzi notes that:
‘Personalising services means making services fit for everyone’s needs, not just those of the people who make the loudest demands. When they need it, all patients want care that is personal to them. That includes those people traditionally less likely to seek help or who find themselves discriminated against in some way’ (Page 9)
The Ten Essential Shared Capabilities (10 ESC)
As previously stated, the principles of personalisation and values based services are articulated in the 10 Essential Shared Capabilities.
Click HERE to view a summary of the descriptors of the 10 ESC. We recommend you print out this summary for the next exercise.
Question 1.2 Personal Reflection point: The 10 ESC descriptors outline what high quality mental health care ‘feels like’ from a service user and carer perspective. Spend a few minutes to consider and record your attitude toward the 10 ESC in the Exercise book. Include a short section on how they influence your practice?
Challenges to values based practice
Most people do not argue with the 10ESC in principle. The difficulty for service providers is to apply them consistently in systems and situations that sometimes challenge their capacity to do so.
Question 1.3 Personal Reflection point:
- Think of occasion(s) when you feel/felt unable to act in ways which are consistent with the 10 ESC . What factors influenced this? (these may relate to you as an individual or to organisational or other external factors)
- Consider any occasions when these values may have been in direct conflict with each other. How was this tension resolved?
(record your reflections in the Exercise book…… try and be honest to yourself in this exercise after all it is for your eyes only)
The important aspect of values based practice is to understand the reasons (and there may be many) we have for being inconsistent in our values and behaviour. When we become aware of this we may be in a position to recognise the characteristics in the future and change our approach to one which is more suited to the values we hold.
Values as drivers of social policy
Over the past decade a great deal of health and social policy has had an emphasis on values (see notes 1,2,3, 4). Key triggers include the prominence of consumerism and service User representation across the health and social care delivery spectrum (see notes 5,6,7).
Recovery and CPA
CPA has a critical part to play in supporting a ‘recovery’ ethos in mental health care. Definitions of ‘recovery’ integrate a range of opinions including: recovery being the ‘absence of symptoms’; social recovery; an ability to live as independently as possible even with symptoms of mental health difficulty and ‘self recovery’; living well even within the context of long-term mental health difficulties.
Whatever the definition, a recovery ethos promotes practice which supports a person to explore strengths, attitudes, goals, feelings, skills and roles as well as their needs and difficulties. It promotes hope, self confidence and meaning in peoples’ lives. A recovery approach prompts a view of the individual ‘in the round’, taking into account the diversity of role and needs including family, parenting, relationships, housing, employment, leisure, education, creativity, spirituality,self management and self nurturance.
A recovery approach to mental health practice should apply to all participants concerned and so practitioners of mental health services may need to explore the issues above as much as the people they support.
Question 1.4 Personal reflection point: Consider your role in CPA as a promoter of ‘recovery’ in mental health care. What does having aspirational goals, developing new skills and reinforcing existing skills and roles mean for you and secondly mean for the people you are working with? Record your answers in the Exercise book.
It is clear that values and principles inform positive practice and social policy. Consequently, they underpin every aspect of CPA for all the workforce. The integration of these values into your practice is critical but also poses challenges for you and the systems that you work within. Values-based practice relates to the understanding that we do not share the exact same values and that they are expressed in different ways in practice.
Click HERE to read the statement of values that is included in the Refocusing the CPA guidance (DH 2008). This statement incorporates the concepts addressed in the unit of study.