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Active Support is a systematic approach to assisting people with disability to become engaged in a range of everyday activities that are meaningful to them and enhance their quality of life. It is a person-centred approach, in that the support provided is individualised according to the interests and needs of each person supported. Furthermore, it is an evidence-based approach to providing support.
Over the past 30 years research has consistently demonstrated that where Active Support is implemented, people with disability do become more involved in everyday activities, acquire new skills, show improvements in mental health and show positive changes in their behaviour. Importantly, Active Support can benefit people with a range of support needs.
However, some of the greatest successes have been observed when it has been applied to the support of people with extensive to pervasive support needs and/or severe challenging behaviour (Stancliffe, Jones, Mansell, & Lowe, 2008).
Jones and colleagues (2010) define Active Support as a service model designed to make sure that people who need support have the chance to be fully involved in their lives and receive the right range and level of support to be successful' (p. 3).
Essentially, Active Support involves training staff in specific skills and procedures to focus their work on the direct support of people in meaningful activity, and to establish formal systems that allow for the ongoing evaluation and modification of service provision informed by measurable outcomes for individuals.
Active Support provides both a philosophical and a structural framework tor organisations and their direct support staff. These various aspects of Active Support at an operational level are summarised by Mansell and colleagues (2002) in terms of:
• Everyday activities - People with disability are offered a wide range of everyday activities to become involved in, both in their home and out in the community.
• Teamwork - Support staff work together as a team to generate ideas and plan for available opportunities. This requires staff to plan activities and collaborate to determine who will do what and when, to ensure that opportunities are not missed and that support is provided in a consistent way.
• Recognising every moment has potential - Staff recognise that the people receiving support are able to engage in parts of every task or activity, through appropriately tailored support to achieve completion of individual parts.
• Outcome measures - Staff closely monitor and record the level of engagement in everyday activities of the people being supported and the form and level of support required to achieve maximum engagement. Regular person-centred meetings provide staff with opportunities to monitor their own service achievements and update colleagues on how to implement new strategies.
Whether to address the needs of people with high support needs, people with behaviours of concern, or people with disability more generally, to sustain the changes made at the individual level the organisation as a whole must look at systems and procedures to ensure they are compatible with Active Support. Personnel practices that encourage staff development and teamwork at all levels are essential, to ensure an environment that is knowledgeable and skilled, and which promotes opportunity, choice and respect for human rights. A developmental and action learning focus in which the organisation is committed to obtaining important measures and holding itself accountable to further and continuous growth is also essential to keep Active Support fresh and viable.
Purpose of this guide:
There are a number of good resources already available to support the professional development of staff in Active Support. However, this guide is the first to specifically address organisational and management issues relating to the establishment, implementation and continuous growth of Active Support at an organisational level.
To date, organisations have typically drawn on either one or a combination of two training resources. The training package developed by Jones et al. (1996/2010) focuses on the practical application of the Active Support principles and includes designs for the delivery and recording of meaningful activities and opportunities.
The training materials developed by Mansell et al (2004) place an emphasis on staff culture and the philosophical values behind Active Support. Both training packages emphasise opportunities for «art to develop specific skills to enable the planning, delivery and evaluation of support for people with disability, and both emphasise the importance of delivering these professional development opportunities using structured workshops conducted in conjunction with on-shift mentorship programs.
Furthermore, details of how to conduct mentorship programs, sometimes referred to as interactive training, are described in Toogood(2010).
However, much more than just staff training is needed to establish and sustain Active Support. Indeed, Active Support is much more than just an approach to staff training and direct service delivery. It is both a philosophy and a system to advance major organisational development in services supporting people with disability.
Consequently, there needs to be a well thought through organisational approach, and a soundly established organisational infrastructure. Discussion among service providers in Australia and elsewhere has highlighted that the different cultures and available resources within support services has resulted in the widely varied implementation of Active Support across organisations.
Successful organisations will often have a certain level of readiness prior to engaging in Active Support. Much of the background information needed by organisations and the practical details of what needs to be done to prepare for, implement and sustain Active Support to date has been passed by word of mouth via various trainers, or discovered by organisations as they go about the implementation process - often when unforseen challenges have been encountered.
This guide has been prepared to help fill that information gap, with respect to the organisational issues that affect the success of Active Support.
Without being prescriptive with respect to how Active Support is to be implemented, the guide provides a menu of implementation options that will support organisations to adapt Active Support to their own settings and cultures, while still remaining consistent with the procedural integrity accessary to achieve the well-established person-centred and evidence-based outcomes associated with Active Support.
As this resource is focused entirely on how to implement Active Support at an organisational level and how to go about setting up services and preparing individuals for the implementation of Active Support, it is not intended to replace the existing training packages.
Rather it complements these training packages by supporting boards of management and service managers to prepare and plan for a consistent service response prior to commencing staff training, during the implementation of Active Support, and when embedding and sustaining it within their organisation.
For further reading on how to implement staff training in person-centred Active Support, we recommend reading:
• Person-centred Active Support: A multi-media training resource for staff to enable participation, inclusion and choice for people with learning disabilities (Mansell, Beadle-Brown, Ashman, & Ockenden, 2004).
• Active Support: A handbook for supporting people with learning disabilities to lead full lives (Jones et al., 2010)/
• Interactive training: Supporting people with severe and profound intellectual disabilities in meaningful activity (Toogood, 2010).
"The impetus to always keep CRUs looking clean detracts from the need to provide support to residents" - see attachment from the OPA.....