Guide
to Active Support and Building Better Lives at Beechwood College
Engagement for all
We know that engagement in meaningful activity creates more opportunities to enjoy life which promotes positive physical and mental health and wellbeing and includes:
Having good relationships with friends and family Having control and choice over their own lives
Having the opportunity to learn new skills
Being involved in a range of different activities
Being part of the community
Being treated with respect and as an individual
These opportunities to make decisions and be part of a community at college and home support self-confidence and growth.
So how do we achieve this at
Beechwood College?
Active Support
A method of positive opportunity planning throughout the day
Coaching skills and maximising choice
Setting personal goals that support living at Beechwood College.
Building Better Lives is a framework that supports students with the assistance of staff teams to identify the skills and activities they want to participate in. It also monitors their progress as they work to develop these skills.
Building Better Lives has four skill building themes that include:
Looking after myself
Keeping myself safe
Examples: Eating healthy foods at regular times, making sure I drink enough water, having enough sleep, toileting needs, wearing the right clothes for weather, using the right resources to keep me warm when in my room. Showering and cleaning my teeth. Taking care of how I look. Engaging in exercise. Taking my medication.
Examples: Being treated like everyone else. Getting the support, you need through communication styles. (PECS, Makaton, iPad symbols). Being part of my Positive Behaviour Plan. Knowing what’s going on in my home. Managing my mental health needs.
Getting on with others
Examples: Having the opportunity to feel like a member of the community, keeping in touch with family and friends. Being part of college meetings. Respecting others and doing my best to be part of home living.
Getting involved
Examples: Being active in my educational placement. Trying new activities in the community and my home environment. Having active support to balance quiet time with active time. Getting involved in activity planners and review meetings using appropriate communication tools. Attending my therapy sessions.
How does Building Better Lives fit using Active Support?
Active Participation and Active Support are methods on how to achieve functional skills that meet client centred goals and create positive outcomes. The process of monitoring Building Better Lives goals makes ‘every moment count’ when engaging with an individual.
Person Centred Practice. When we are person-centred, we incorporate the whole person into positive planning and goal setting with an aim to increase confidence and self-esteem and reducing challenging behaviour as a part of Positive Behaviour Plans.
Many students may have limited communication and not be able to state something that they would like to achieve.
Through knowing, listening, watching, and talking to a network of people who know the student we can create a best guess when creating structured opportunities.
At Beechwood there are different plans for the students that are worked towards by different disciplines.
Education and Clinical Residential Team and Clinical
To achieve a student engagement we use many different methods which may include intensive interaction, various forms of communication adaptations and pictures as well as participation in everyday opportunities through the use of active support system.
Building Better Lives Process
1 5 7 3 4 2 6
Gather students goals using Building Better Lives Easy read form
Create a weekly planner of activeopportuties that are aimed at meeting the goals
• Populate the Building Better Lives one page profile
• Personalise Building Better Lives profiile with photos if student would like to
• Main document is held in appropriate folder for access to updating
• Each weekly checklist of active participation is scored and saved for monthly evaluation
• At the end of each 4 week period the weekly scores are made into a summary graph and imported into building better lives reflection sections
• Shared in students MDT
• The Building Better Lives booklet goal section is reviewed in monthly MDT
• Re populated as stage 3
• Recording evidence of weekly progress towards Building Better Lives Goals can be made in Nourish
• Activity Planners can also reflect Building Better Lives meaningful activities that are linked to goals set
• After 3 months Building Better Lives Goals can be reveiwed in relation to changes in motivation, engagement and achievements
• All meaningful activities can be incorparated into Building Better Lives and include contact with external agencies such as dentists, doctors, advocacy, occupational therapy, psychology and attending college
Section 3 Getting Started
1. Gather client’s goals using Building Better Lives Easy read form
Looking after myself
Examples: eating healthy foods at regular times, making sure I drink enough water, having enough sleep, toileting needs, wearing the right clothes for weather, using the right resources to keep me warm when in my room. Showering and cleaning my teeth. Taking care of how I look. Engaging in exercise. Taking my medication.
These sections are repeated for all the themes. From this form, goals can be established from the ‘I want to be able to’ sections.
I am OK at:
I need active support with:
I want to be able to/best guess (based on knowledge of skills):
These are my goals (no more than 4):
2. The goals from the client goal form from each skill building area can be used for the Building Better Lives Profile and written in a SMART/ Functional person-centred format.
Building Better Lives Plan for
Looking after myself
Keeping myself safe
I am going to…
• Have a shower every day
I am going to…
• Let my staff know how I am feeling using my communication cards every day
Getting on with others
Getting involved
I am going to…
• Call mum every day
I am going to…
• Attend my Speech session on a Monday
Goal Setting and SMART
So, what do we need to know about goal setting?
• We know that having goals is important for motivation and self-confidence.
• They give a sense of purpose and something to achieve and continue to improve upon.
• They allow a student to help organise and manage their time in their own way with what they want to achieve.
• Goals need to be risk assessed if needed.
SMART Goals
When working together with students, they need to feel like their goals are achievable. A way of doing this is by using SMART goals. This means:
For example, Mary wants to have a shower every morning. This goal would need to be:
Specific
One task, e.g. Mary is only having a shower, not also going to the toilet
Measurable Daily, Weekly, Monthly
Attainable
Relevant
Time-bound
Realistic, so this must be within Mary’s abilities
Connected to the client’s goals, so supporting Mary’s personal hygiene needs
Deadline for achieving the goal e.g. Mary will shower every morning at 9 a.m. for the next two weeks
Goals need to be personalised.
“I would like to have support daily to shower at 9 a.m. so that my confidence can increase. I will discuss my progress in my next MDT”
Functional goals are goals that promote participation with a person-centred approach.
Functional goals are important because they are more likely to be achieved when the goal includes activities that are meaningful to the client.
Here are useful ways to identify functional goals:
1) Determine the desired outcome
2) Develop an understanding of their self-care, leisure activities and environments in which these activities occur
3) Establish goals with them that relate to the desired outcome
So how do we write functional goals?
Functional goals need to contain the following elements:
Here is an example of a functional goal using Mary again:
Who
What
Under the condition
How well
By when
The client, e.g. Mary
The activity, e.g. showering
This refers to a measure, like a distance or time, e.g. Mary will shower at 9 a.m.
Level of assistance, e.g. Mary needs to be reminded when she wakes up to shower at 9 a.m.
Deadline for achieving the goal, e.g. Mary will shower every morning at 9 a.m. for the next two weeks
In terms of person-centred care, the goal would be written like this:
“In discussion with my support worker, I would like to be reminded daily to shower at 9 a.m. so that my confidence can increase. I will discuss my progress in my next MDT”
They are also like the SMART goals, therefore they can be linked and used interchangeably.
Recording forms to monitor change Section 5
Examples of recording form:
1 Ability decreased
Jo refuses to go into the shower after verbal prompts on a daily basis.
2 Present ability
3 Goal
Jo needs verbal prompts to have a shower daily.
Jo would like to be able to shower every day at 8.30 am independently (with no verbal prompts)
4
Exceeded the goal with reduced support
5 Bullseye!! Smashed it!
Jo completed the goal of showering daily at 8.30 am independently for 1 week.
Jo is able to engage in this activity independently and on a daily basis with no verbal prompts.
Participation Checklist
Name: Week Commencing: 01/04/2024
Inserted above is an example of a weekly participation checklist. The aim of a GAS score and recording is a method of scoring individual goals on a scale. Goal attainment scaling (GAS) is a method of setting and evaluating goal achievement.
Collecting the data each week over a 4 week period enables staff to create a graph to support discussions in MDT, support visual achievements with students and creates a basis of change in developing new goals.
Planners
At Beechwood students have both educational planners and residential planners. These may be part of Nourish.
Active timetables can be used to record the activities for the day, whilst also slotting in other relevant information, such as appointments and self-care activities. This is useful for establishing a flexible yet manageable routine.
Participation checklists can be used to record engagement in self-care activities, such as brushing teeth in the morning and night, showering, cleaning bedroom etc. They can also be used to record a range of different activities, such as cleaning, cooking, leisure and community activities.
These are all functional skills, therefore by recording the engagement, the functional skills can be tracked across weeks and months to see progress.
Reflection; What Worked, What Changes… Section 6
Individuals can fill out this page with the support of staff or on their own or staff can complete using appropriate visuals and wording.
The aim is to create a positive environment that enables students to reach their potential. This is their page to know what they are aiming for.
Building Better Lives Plan for
Looking after myself
Keeping myself safe
I am going to…
• Have a shower every day
I am going to…
• Let my staff know how I am feeling using my communication cards every day
Getting on with others
Getting involved
I am going to…
• Call mum every day
I am going to…
• Attend my Speech session on a Monday
Section 7
Active support
Active Support is a method that is fundamental to providing effective person-centred practice.
According to ‘United Response’ providers of active support resources:
“the essential outcome of Active Support is engagement so the way it looks in practice will vary, depending on the individual requirements of the person being supported, the situation and the skills of the people around them”.
The Four components of Active Support:
• Every moment has potential
• Little and often
• Graded assistance
• Maximising choice and control
It suggests that when individuals are not engaging over a period, we need to review the situation… and try a new approach.
Within our daily lives our activities are made up of small steps and when we work together with individuals, we can identify the steps that;
• Can be completed independently
• Can be completed jointly with staff
• Requires full support from staff/ Occupational Therapy advice
For the individual to achieve, staff can offer opportunities to be part of something by using:
We all need different levels and approaches of being supported and we can do this through the way the environment is set up, verbally, using visuals and gestures.
Below is an outline of this approach.
Examples: ASK
INSTRUCT
PROMPT
A verbal prompt which lets someone know that it’s time to do something or that something needs to be done.
A series of verbal prompts which tells the person what to do one step at a time and helps guide a person through the activity.
A clear gesture or sign to tell the person what to do next, for example, miming an act can provide a lot of information for the person to follow.
Demonstrating what needs to be done. This gives more support that prompt because it is showing the person what to do.
Giving direct physical assistance to do something. Such as hand over hand to turn the washing machine on.
ASK
For some, this level of support may be all they need to do the activity. Here are some different ways of using this level of support:
“Would you like to start peeling the potatoes for dinner now?”
“How about peeling three potatoes for the dinner now?”
“It’s time to peel the potatoes for dinner now, can you help me?”
INSTRUCT
Instruct works well when a person can physically do the activity but just needs to be reminded about the steps. Here an example making toast:
“Put the bread in the toaster… Push down the lever… Wait… Watch the toaster… (the toast pops up) … Take out the toast.”
PROMPT
Prompt works well when a person does not know what to do but is able interpret and follow gestures or respond to signs of what to do next. Here are some examples:
Point to the potato peeler and then miming peeling a potato.
Pointing at a cup that needs to be put away and then to the place in the cupboard where it needs to go and saying, “Put it here”.
Gently nudging the person’s arm behind the elbow to indicate the need to move the arm forward to pick up a spoon.
SHOW
Show works well when a person does not know what to do but is able to imitate. Here are some examples:
Putting one fork away in a drawer, handing the next fork to the client and pointing to the right compartment in the drawer to put it in.
With the client holding a potato and potato peeler, putting the potato in a bowl of water, pulling it out and saying, “Do that”. Then showing how to position the peeler to start and waiting until the individual has copied. Then pulling the peeler to take of a strip of peel, saying, “Like this”.
GUIDE
Guide works well when a person needs a lot of support. Here are some examples:
Guiding a person’s hand at the wrist to align the bread over the slot of the toaster, saying, “Put in the bread.”
Putting one fork away in a drawer, handing the next fork to the client and guiding their hand so that the fork is over the right compartment in the drawer, letting go so the client can finish the step unaided.
Taking steps to engage in an activity
The degree to which a task is broken down can vary, from a few larger steps to many smaller steps. Talk with staff and the student when establishing the steps and figure out how large or small the initial steps need to be.
Once in place, support can be given to lessen the number of steps as they improve. Each step can be supported using Ask, Instruct, Prompt, Show, Guide.
Here are two examples for making toast, one with fewer larger steps and the other broken down into more, smaller steps:
Fewer, larger steps
1) Get bread out
2) Put bread in toaster
3) Switch toaster on and set dial
4) Start toaster
5) Get plate
6) Get butter or jam
7) Get knife
8) Put toast on plate
9) Spread butter or jam on toast
10) Eat toast
More, smaller steps
1) Open bread bin
2) Pick up packet of bread
3) Put bread on table
4) Open packet and take out 1 slice
5) Put bread in toaster
6) Switch toaster on and set dial
7) Press lever down on toaster
8) Open cupboard
9) Pick up plate from cupboard 10) Close cupboard door
11) Put plate on table
12) Open fridge 13) Pick up butter or jam and put on table 14) Close fridge
15) Open drawer 16) Pick up knife and out on table 17) Close drawer
TOAST IS READY AND POPS UP
18) Take toast out 19) Put toast on plate on table
20) Open butter dish or jam jar
21) Pick up knife
22) Scrape up lump of butter or jam
23) Spread butter or jam on toast 24) Put knife down
25) Pick up toast
26) Eat toast
Active Support and Building Better Lives
When setting goals within Building Better Lives, activities within the themes can be broken down. For example, in taking care of myself, showering can be broken down:
Fewer, larger steps
1) Tell staff you are going to have a shower
2) Collect things you will need (towel, shower gel, shampoo etc.)
3) Go to the bathroom and prepare for showering
4) Turn shower on and adjust the heat
5) Get in the shower and get your body and hair wet
6) Put shampoo in your hair
7) Rinse shampoo out of your hair
8) Use shower gel to wash your body
9) Rinse shower gel off body
More, smaller steps
1) Tell staff you are going to have a shower
2) Collect things you will need (towel, shower gel, shampoo etc.)
3) Take these things to the bathroom
4) Go to the bathroom
5) Take off your clothes only in the bathroom
6) Turn on the shower and adjust the heat
7) Get in the shower and get your body and hair wet
8) Pick up shampoo
9) Put a blob of shampoo on your hand
10) Put down shampoo
11) Put shampoo in your hair
12) Rinse shampoo out of your hair
13) Pick up shower gel 14) Put a blob of shower gel in your hand
15) Put down shower gel
16) Use shower gel to wash your body
17) Rinse shower gel off body
10)Turn off water 18) Turn off water 11) Get out of the shower 19) Get out of the shower
12) Dry your body with the towel 20) Dry your body with a towel
When a student has a goal, for example, ‘I want to shower every morning’, there may be obstacles that might prevent the student from performing this task.
What obstacles might they encounter?
Water too cold/hot
Student likes their own smell and doesn’t want to lose it by showering…
Another student already in the bathroom
We’re aware of these obstacles. But how do we support others to problem solve and take the first steps?
1) Communication
2) Preparation
3) Setting the scene
4) Motivational feedback on completing tasks
5) Reviewing goals and adjustments with student
Prompting questions and Ask, Instruct, Prompt, Show and Guide can be used to say that a task needs to be completed.
Thinking in steps can be used for preparing the individual for a task so that they understand how to do it.
Planning the activity with the individual, like agreeing a time, making sure they have everything they need, e.g. shower gel for a shower.
Positive reinforcement can be used to motivate clients, so praising them for completing a task.
Discussing with the student how often they want to do the task and adjusting according to their progress.
6) Review risk processes and achievement/ participation in MDT
Reviewing the goal and the agreements made in their MDT meeting as well as assessing any risks associated with the goal. Establish any changes that need to be made and add changes to their BUILDING BETTER LIVES profile
Section 9 Resources
Resources are available regarding Active Support on various websites. Additionally, resources are available on Iris Care Group SharePoint.
There are many resources available, and these can be individualised to the student’s needs, or you can speak to Speech and Language Therapist, Occupational Therapist, Dietitian or Psychologist for additional support.
