Residen al Care Staff Percep ons of the Psychology Service in

Residen)al Care Staff Percep)ons of the Psychology Service in Leeds Community Learning Disabili)es T eam (CLDT) Harriet Bibbings, Psychologist in Clinical Training, University of Leeds Doctoral Course in Clinical Psychology Commissioner: Dr Stephen Linacre, Clinical Psychologist, Leeds and York Partnership Founda-on Trust (LYPFT) CLDT Supervisor: Dr Ciara Masterson, Academic Tutor, University of Leeds Doctoral Course in Clinical Psychology Aims
s Aim a) What does the Psychology service Introduc)on Method Result
•  The CLDT has 3 locali-es and 3 -ers within these. Aims were therefore to gather detailed informa-on •  The brief online survey was sent to 25 services. offer? Each locality is mul-disciplinary and has a from services with varying levels of sa-sfac-on on: •  5 responses were received. •  Input suppor-ng tenants with challenging behaviour psychologist working into it. a) what staff understood about what the CLDT •  All stated they had received behaviour plans. •  Behaviour management plans •  The CLDT Psychologists frequently work with psychology service offer •  3 agreed to be contacted about a focus group •  Reviews of these (e.g. in rela-on to restric-ve carers in residen-al care provisions. b) staff views on their experiences (posi-ve and and a manager interview: 2 of these rated input prac-ce) •  This is o_en to support staff to manage nega-ve aspects) ‘very helpful’ and one ‘neither helpful nor •  Liaison with other MDT members behaviours and may be with managers and c) what they would like or could be different unhelpful’. •  Looking at PRN medica-ons (monitoring?) frontline support staff. about the service they receive from psychology. •  Manager interviews completed in 2 provisions, •  Support considering appropriateness of placement •  Residen-al staff o_en deliver plans made by •  Also to gather overall ra-ngs of helpfulness from focus group in one of these with 5 support staff. •  1:1 emo-onal support for clients (different to that psychology and it is therefore important to all/as many homes as possible (through an •  Thema-c analysis (Braun and Clark, 2006) was provided by staff) understand their views. online survey). used to analyse data. More responses here from managers than support staff. Results Aim b) Views on experiences. Both posi-ve and nega-ve reported experiences are grouped into key themes here, with “collabora-on” as an overarching theme linking aspects of service delivery and the rela-onship. Key for quotes: M= Manager S= Support staff NB: quotes are not sequen-al and come from different interviews Ra-onale Rela-onship Service Delivery Person-­‐Centredness Communica-on Collabora-on Listening Being respected and valued S: “I think it’s really important …that they M: “if you don’t agree with it (psychologist) know them as a person” M: “people have appreciated that we’re a specialist M: “…they’re giving you ideas and when you say, I don’t really think we M: ”
lots o
f g
ood c
ommunica-on…through e
mail, p
hone. I
f y
ou you can’t deliver it can you” service, we spend 24 hours a day suppor-ng the could implement that, so long as they understand it’s fine. Whereas wanted a
dvice y
ou c
ould c
ontact t
hem j
ust t
o a
sk a
q
ues-on…or tenants” S: “felt certain decisions were made out of [another -me] a bit non-­‐nego-able” they’d g
et i
n t
ouch” S: “some of the things… like a text book” seem quite bizarre” M: “it seems quite authoritarian” M: “You could discuss everything and you felt like you were working M: (
talk a
bout c
hanges m
ade t
o p
lans) “
it s
eems l
ike i
t w
ould b
e M: (in past) “have taken an interest over together to get the best outcome” beVer t
o s
ay e
verything i
s o
kay” S: “we’ll do it because we’ve the years and enjoyed their journey” S: “it doesn’t feel like we’re on an equal foo-ng” been asked to do it” M: “they don’t seem to be listening to what staff are saying” S: “
I d
on’t a
lways f
eel t
hat s
ome o
f t
hem w
ant t
o s
peak t
o u
s a
s S: “took what I had to say on board” S: (about a plan)“about a person…not this support w
orkers” M “I’ve thought about person who lives here” S: “feels like at points someone’s coming in and dicta-ng” reasons why they might S: “their manner was very condescending really… I felt S: “
I t
hink i
t’s r
eally i
mportant t
hat t
he w
hole s
taff t
eam’s v
iews want to...make massive M: “if they spent -me with the client, the S: “it’s almost like unless we give the answer that’s being wanted we’re just like I had to be very careful of everything I said…almost are t
aken i
nto a
ccount b
ecause o
ne p
erson’s e
xperience c
an b
e changes” constantly challenged as though what we were doing person, they might get to know the client going to keep going round being asked the same ques-ons” different t
o a
nother’s” wasn’t right” and where we’re coming from” Results Aim c) What par)cipants would like or could be different Support staff: •  S:“Grass roots” input, involving support staff “not just what’s on paper and talking to a manager and making a decision” •  Observa-ons S:“get to know what they are actually like” M: “watching in the background, seeing how people respond” •  Finding prac-cal ways for support staff to be involved, suggested a forum with a representa-ve taking collected views to the psychologist, or the psychologist aVending person-­‐centred review mee-ngs already held within the service. Support staff to liaise with managers to pass on views/find ways to be involved. (S) •  Training courses (e.g. on challenging behaviour generally) (M) •  Feedback: S: “a proper honest conversa-on with the psychologist” Recommenda)ons •  Psychologists should discuss from the outset how the input could be delivered and who should be or would like to be involved (although support staff wanted to be involved, it was recognised that there may be prac-cal difficul-es that should be discussed). •  There should be some flexibility in how input is delivered and how different people within services are involved (e.g. aVending person centred reviews, or a mee-ng with a support staff representa-ve, or sending ques-onnaires to staff). •  Ra-onale that relates to the person should be communicated clearly to support staff as well as managers. •  A flexible communica-on and feedback mechanism should be in place to allow any issues to be addressed throughout input. Discussion and Limita)ons •  Par-cipants mainly referred to experiences of behaviour plans although were aware of other services offered by psychology. •  When describing their experiences, feedback about rela-onships with the psychologist was core to the way input was received and was very intertwined with other aspects of service delivery. •  ‘Collabora-on’ captured this in that par-cipants wanted psychology staff not to tell them but to work together, bringing different things. •  The data was collected from only a small number of services and may not therefore be representa-ve. It is possible that the managers who agreed to take part may have had more nega-ve experiences that they wanted to share, but this is not known. Reference: Braun, V., & Clarke, V. (2006). Using Thema-c Analysis in Psychology. Qualita*ve Research in Psychology, 3, 77-­‐101