Made in Saskatchewan Approach to Person-Centred Cultures of Support
Tools and resources to support Saskatchewan’s disability services sector in strengthening person-centred practices and culture.
The person-centred journey in Saskatchewan has come about from the grassroots level, evolving to include a system level approach. Our work in Saskatchewan has been informed by research into many other jurisdictions as well as extensive consultation and collaboration right at home. What we have developed with the Saskatchewan Person-Centred Framework is what works for us as a province and community. It is the result of government and communities working together.
There is a synergy that has been created as several separate pieces are now becoming connected. The guiding principles of the Comprehensive Planning and Support Policy (CPP&SP) in 2007 set the stage for our vision of quality disability supports. A review of this policy in 2012 further informed how we could move forward in the spirit of continuous quality improvement. The Saskatchewan Disability Strategy solidified and confirmed the vision we have as a Province today for services for people experiencing disability. Our framework is further evidence of how services are evolving towards a common vision.
The framework aims to support the disability community in becoming more person-centered through the development of an understanding of how person-centered culture could be experienced from the point of view of the individual, their family and other stakeholders. It provides the opportunity for self-reflection and the development of a mutual understanding from a variety of perspectives.
The development of a person-centred culture is further supported by the “Saskatchewan Disability Strategy: People Before Systems: Transforming the Experience of Disability”. In 2012, Government committed to developing a disability strategy in consultation with the disability community. It is a 10-year comprehensive strategy that articulates the vision and actions needed to move our disability service system forward to better serve people who experience disability to live the life they choose. The strategy recommendations were developed jointly by a Citizen Consultation Team, and seven ministries (Social Services, Advanced Education, Economy, Education, Government Relations, Health and Justice & Corrections).
Four drivers of transformation to support the strategy have been developed:
1. Impact of Disability
This approach shifts away from the medical model (diagnosis) of disability to an understanding of disability based upon its impact on the individual. While most disabling conditions can be permanent, the “experience of disability” can be reduced by the way society responds to it. Changes can be made to reduce the impact that environment and circumstances play in the experience of disability.
2. Promoting and Protecting Human Rights
People who attended the consultations expressed they are exhausted over their fight for fair treatment. The rights of people with disabilities must be better understood, observed and protected. The strategy will help our province address the obligations contained in the United Nations Convention on the Rights of Persons with Disabilities.
3. Accessibility and Inclusion Benefit Us All
The typical approach to designing buildings, communities, programs, and services uses a standard or normal range of human functioning. There is a tendency to address an individual’s disability by focusing on the exceptional or special needs that fall outside the normal range. The strategy aims to change systems and environments to reduce and, where possible, eliminate the need to adapt to individual circumstances. Investing in accessibility to meet a broader range of functioning will create a more convenient and better citizen experience for all. Universal design is an example.
4. Person-Centred Service
This is about simplifying our unnecessarily complex disability service system to be more fair, transparent and responsive. Disability programs and services are often designed with system needs as a priority. People are required to adapt to program rules and processes in order to receive support. Feedback from the consultation sessions informed that Government systems are too complex and difficult to navigate.
In addition, “Putting People Before systems” is one area outlined within the strategy with recommendations reflecting the desired outcomes indicated below:
Personal outcomes identified for this area include:
System outcomes for this area include:
Some of the actions in the strategy related to person-centred systems and services include:
Services and Supports for individuals experiencing intellectual disability are guided by the Comprehensive Personal Planning and Support Policy (CPP&SP). The CPP&SP establishes policies that guide Community Living Service Delivery (CLSD) staff and third-party service providers who are contracted, licensed or certified by the Ministry, in the provision of effective and ethical supports to individuals with intellectual disabilities in Saskatchewan. The CPP&SP was developed in collaboration with community stakeholders and implemented in 2007.
In addition to outlining standards for the delivery of services and supports, the policy also provides guidance in the provision of support for people with challenging behavior and complex support needs. The philosophy of the CPP&SP emphasizes arranging flexible and responsive supports according to individual need in a manner that allows people to live meaningful lives in their communities.
Actions reflect the equal worth of all people.
Each person has unique and shared intellectual, spiritual, social and physical needs.
All interactions convey respect for the value and gifts of each person.
Opportunities for each individual are consistent with the range of what is available to and experienced by others in their community.
Optimum learning, growth and change take place in enriched environments with people who respect and value the individual.
The CPP&SP is comprised of 15 policies which have been organized into four key concepts outlined below:
All people have the right to be treated with dignity and respect. Service providers shall interact with individuals in a supportive and respectful way. Recognition and acceptance of a person’s preferences, decisions, strengths and differences is essential.
Supported Decision-Making (SDM) reflects the fundamental right of all Canadians to be self-determinant. Individuals regardless of their abilities have the right to make their own decisions. SDM is a framework which service providers and others can use to engage with the person to assist them to make their own decisions. It empowers people to assume their citizenship rights and respects their right to dream, plan and be heard.
Person-centred Planning (PCP) refers to the planning of coordinated supports that assist the individual to realize their goals, dreams and aspirations to enhance their development and quality of life. The principles of PCP guide service providers to ensure that the individual is at the centre of all activity and that all plans, decisions, actions and supports are guided by and reflect the visions of the individual. Accountability for all actions is to the individual and is facilitated by clearly written objectives, plans, responsibilities and time frames.
The policies contained within CPP&SP regarding Person-Centred Planning are as follows:
This is an approach utilized to support individuals who may engage in challenging, dangerous or harmful behaviour. The objective of Comprehensive Behaviour Support (CBS) is to facilitate meaningful lifestyle changes rather than to solely reduce the frequency, duration or intensity of challenging and/or dangerous or harmful behaviours. It outlines a process which is used to develop a Comprehensive Behaviour Support Plan which is rooted in assessment and contains multi-element strategies to support the individual in a variety of environments.
A review of the CPP&SP policy in 2012 further informed how we could move forward in the spirit of continuous quality improvement. Through this review it was demonstrated that although people said they were aware of the requirement for person-centred planning, the evidence to support implementation of these policies was not present. A shift in the mindset from the “development of a plan” to the cultivation of a person-centered culture was required.
As a result of the review the following recommendations were identified:
As a next step to the implementation of these recommendations, the Person-Centred Culture Committee (PCCC) embarked on the development of a made in Saskatchewan framework of person-centred culture. The PCCC has representation from the Ministry of Social Services, Community Based Organizations, Saskatchewan Approved Private Homes Inc., Inclusion Saskatchewan and SARC.
The objectives of the PCCC are to:
Through the development of this framework, a common definition of person-centred culture was developed:
❝Person-centred culture is rooted in a common set of beliefs, values and behaviours in which it is clear and evident that people direct and are at the forefront of their own lives. Supporting all people to have choice and control, meaningful relationships and a full community life where their gifts and contributions are welcomed and celebrated is at the heart of a person-centred culture.❞
The intended goal of the framework is to help stimulate thoughtful reflection to continuously guide everyday actions in the advancement of person-centred thinking and practice. This framework was implemented in July 2017. To further support the continued development of a person-centered culture, the committee decided to develop a Person-Centred Culture Tool Kit.
The Person-Centred Culture (PCC) Framework provides a common direction and understanding of PCC and those components that are found at the core of a person-centred culture. It seeks to stimulate thoughtful reflection, from a variety of perspectives, to continuously guide our everyday actions in the advancement of culture and practice.
The Framework can be used to guide and direct policy development and changes to programs and services. To serve this purpose, we must understand the Framework and consider how it can impact our work. This requires us to continuously reflect on the Framework and incorporate it in our everyday work.
A sense of belonging
Individuals Served: I feel a sense of belonging with those around me; have a close circle of friends and feeling companionship. I feel valued by those in my life.
Being heard and supported in personal choices
Individuals Served: My voice is heard and my choices are respected. I am supported in my journey to achieve my personal goals and dreams.
Being included in the community and recognized for contributions
Individuals Served: I am included and experience comfort in knowing that I have the ability to engage in meaningful activities without barriers; to participate fully in community life.
Being supported by those who share similar beliefs and values
Individuals Served: I am supported by someone who shares similar interests and values in life.
Advocacy and support to explore new possibilities
Individuals Served: I have the ability to explore my dreams and know there is someone to advocate and support me in doing so.
Having choice and control in life
Individuals Served: I have choice and control over my life.
Teams, family and service providers working together
Individuals Served: I know my support team will engage with any and all possible supports and services that could help me achieve my goals.
Learning is lifelong
Individuals Served: I have the opportunity to be exposed to a variety of life experiences and learning opportunities.
Needing others and being needed
Individuals Served: I want to be with others; not afraid of people with whom I live; not afraid to go outside; feel relaxed in interactions with others. I feel like people in my life need me as much as I need them.
Sense of pride in one’s life
Individuals Served: I am recognized as a person and feel a sense of pride; I am comfortable expressing personal gifts, talents and satisfaction with life.
Being supported to reach goals and personal growth
Individuals Served: I define my own goals by exploring opportunities and discovering hopes and dreams. I am supported to work toward my goals and have a feeling of inner harmony and spiritual well being.
Do you have suggestions, ideas, or additional resources to share? Interested in becoming part of a facilitator network? Connect with us to help grow this resource hub for Person-Centred Thinking and Cultures. Our goal is to expand this website to include interactive resources, videos and additional downloadable materials. We hope you will connect with us!