The Ten Essential Shared CapabilitiesSupporting person-centred approaches

A learning resource for health care staff

Introduction to the Resource

Contents

© NHS Education for Scotland 2012. You can copy or reproduce the information in this document for use within NHSS-cotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES.

AcknowledgementsWe would like to thank the members of the working group who have contributed to the development of the resource.

Dr Dorothy Armstrong Programme Director NHS Education for Scotland Clinical Nursing Adviser Scottish Public Services Ombudsman

Dr Maggie Grundy Programme Director NHS Education for Scotland

Kristi Long Equality & Diversity Adviser NHS Education for Scotland

Audrey Taylor Education Projects Manager NHS Education for Scotland

EditorsSusanne Forrest Programme Director, NHS Education for Scotland

Alex Mathieson Freelance Writer and Editor

The learning resource is based on work originally taken forward in England to develop the 10 Essential Capabilities for Mental Health learning materials [http://www.lincoln.ac.uk/ccawi/ESC.htm].

We developed the resource for mental health workers in Scotland and have now done so for a wider audience. Our thanks go to the original authors of the materials underpinning this resource, particularly to Ian McGonagle, University of Lincoln.

Pilot work undertaken in NHS Lothian informed the development of the learning resource. We would particularly like to acknowledge the contribution of Juliet MacArthur.

We would also like to acknowledge the contribution of the working groups and authors who developed the 2008 and 2011 versions of the 10 Essential Shared Capabilities for Mental Health Practice (Scotland) in shaping this wider educational resource [http://www.nes.scot.nhs.uk/media/351385/10_essential_shared_capabilities_2011.pdf].

The “Making a difference: a challenge in the workplace” form at the end of the learning resource was developed by Paul Smith, Clinical Nurse Educator, NHS Fife.

Welcome

WelcomeWelcome to the Ten Essential Shared Capabilities (10 ESCs) Learning Resource (Scotland).

The 10 ESCs training and learning has been widely disseminated in Scotland, particularly among mental health nurses as a result of Rights, Relationships and Recovery: the report of the national review of mental health nursing in Scotland [http://www.scotland.gov.uk/Topics/Health/health/mental-health/RRRmentalhealth]1 Thousands of mental health nurses have now completed the training.

This version of the learning resource builds on the successes of the original mental health learning resource. It has been informed by findings from the evaluation of that resource and has been updated to reflect the evolving policy and legislative context driving improvements in health and social services in Scotland, and the increasing influence of values- and rights-based care.

The main emphasis of the learning resource is to support cultural change in services (alongside a number of initiatives we will discuss later) by promoting person-centred, rights-based and values-focused practice.

The resource has been designed to meet the learning needs of a wide range of people working in adult health and social services. A version focusing on meeting the needs of children, young people and families is also being developed.

The resource is action focused, as we believe there is little value in learning that does not translate

into developing better services for people and their families and carers. To that end, the activities that appear throughout each of the modules will play a key part in helping you further develop the knowledge, skills and attitudes that are central to your role in health and/or social services.

Introducing our charactersThe learning materials introduce five people and their families and friends. While these characters are fictional, the circumstances of their lives and the challenges they face can be considered representative of those encountered by people who access health and social services.

Jim (67) and his wife Mary (65)

Jim is a retired joiner and Mary did lots of part-time jobs while raising their two children. They have three grandchildren.

Mary has Parkinson’s disease, which limits her mobility and creates some problems with her dexterity. Generally, however, she manages pretty well. Mary used to run the local girl guides and is still active in her church community, helping with fund-raising and other activities. She is a keen and very accomplished cook.

Jim plays bowls regularly, an activity he has pursued all his adult life, and is secretary of the committee at his local bowling club. He also enjoys reading and likes to keep up to date with politics and current affairs. He is a keen gardener and has an allotment which he enjoys. Jim has won competitions in the past for the fruit and vegetables he has produced. He is finding, however, that he has gradually worsening short-term memory loss, which is leading him to feel very down in mood.

Welcome

Jackie (22)

Jackie is 22 years old and is unemployed. She recently broke up with her boyfriend. She struggles to keep her weight down, is a smoker and has type 1 diabetes. Jackie has a two-year-old daughter, Tracey, to whom she is devoted. They live together in social housing but Jackie has difficulties in paying the rent, despite receiving benefits. Jackie’s ambition is to complete a college course to enable her to work with children. Her mother, Helen, is very supportive to both Jackie and Tracey.

Mina (26)

Mina is a 26-year-old Pakistani Scottish woman who married Aasim a year ago and is now pregnant with their first child. She’s a practising Muslim. On her marriage, Mina moved from a city in central Scotland to live with Aasim and his parents and extended family in a remote and rural area, some distance from any of the major cities. Her husband’s family is more traditional in outlook than Mina’s, and Mina has a tense relationship with her mother-in-law, Zainab. Mina misses city life and the circle of friends and activities she previously enjoyed and feels quite isolated. She is a qualified pharmacist and really values her job. She currently works part time in a community pharmacy in her local town.

Sheila (50) and Nan (75)

Sheila lives at home with her mother Nan, who is widowed. Sheila, who is 50, has a learning disability. She works in a cafe run by an organisation that supports people with learning disability. She is particularly fond of swimming and dancing, attends local clubs for both activities and has a wide range of friends through work and leisure activities.

Nan is 75. She was a Sunday school teacher and remains an active member of her local church. She has a particular interest in art and occasionally paints watercolours as a hobby. Her sister, Claire, lives in London but they remain in regular contact by phone. Claire tries to visit as often as possible and has always had a close relationship with Sheila.

Nan’s contribution to supporting Sheila is vital. It is she who ensures that Sheila carries out daily tasks such as managing her hygiene, dressing appropriately and preparing and eating food safely. Nan is keen to support Sheila to maintain links with the local community

Derek (42)

Derek is an occupational therapist (OT) who works with his local authority. He lives with his partner, Angus. He has a lifelong interest in rugby and was an accomplished player when younger. He now coaches rugby at community level.

Derek sustained a back injury in a former career as a physical education teacher in a secondary school: the injury continues to give him chronic pain that is getting progressively worse. Derek’s job as a community OT involves a lot of driving, and he is finding his back is becoming particularly uncomfortable when in the car. He is becoming worried that if he can’t drive, he can’t work. His fear is compounded by the fact that his back pain has caused him to take frequent short-term sickness absences over the last year, and he suspects that this is creating resentment among his colleagues.

Introduction

IntroductionWhat are the Ten Essential Shared Capabilities (10 ESCs)?The 10 ESCs were originally developed and published in 2004 by a partnership involving the Department of Health, the Sainsbury Centre for Mental Health, the National Institute for Mental Health in England and the NHS University. These organisations worked closely with service users and carers to develop the ESCs to ensure that they reflected their priorities.

We have amended the 10 ESCs slightly from the original versions to widen their applicability. They are listed below and are explored in much more detail in Module 1.

The 10 ESCs

1. Working in partnership2. Respecting diversity3. Practising ethically4. Challenging inequality5. Promoting recovery, well-being and self-management6. Identifying people’s needs and strengths7. Providing person-centred care8. Making a difference9. Promoting safety and risk enablement10. Personal development and learning

The aim of the 10 ESCs is to set out the shared capabilities that all staff working in health should achieve as best practice; they should also be relevant to staff working in social services. In addition, it is intended that they will enable

people using health services to develop increased awareness of what to expect from staff and services.

They are defined as capabilities rather than competencies. The notion of competence is widely used in health care to express:

• what individuals are able to do in terms of knowledge, skills and attitudes

• the ability to perform a complex task or function effectively

• the ability to transfer skills and knowledge to new situations.

Competencies are generally observable and measurable and can be open to forms of assessment in the workplace.

Capabilities focus on the extent to which individuals can adapt to change, generate new knowledge and continue to improve their performance.1 Capability is enhanced through feedback on performance, the challenge of unfamiliar contexts and creative learning experiences that focus on reflection and group discussion.

The 10 ESCs:• are about attitudes, behaviours, expectations,

and relationships • describe the values and principles that should

be demonstrated in the way services are commissioned, planned and delivered

• are derived from, and reflect, how people who use services and those who support them want and expect to be treated

Introduction• outline values and principles that should influence

the actions and outcomes that people working in services should be seeking to achieve.

The ESCs learning remains important in the wider policy, legislative and service development context in Scotland, and we make links to these wider agendas throughout the learning resource. In particular, they support the delivery of:

• the quality ambition of person centeredness that is central to the Healthcare Quality Strategy for NHSScotland [http://www.scotland.gov.uk/Publications/2010/05/10102307/0]

• Scotland’s human rights-based mental health (and wider) legislation

• The Patient Rights (Scotland) Act 2011 and the health care principles underpinning the Act.

The content of the learning resource is designed to be stimulating, engaging and accessible to individuals who are new to work in health and social care and to those who are more experienced. The learning outcomes for the modules and the learning activities have been written to reflect Level 8 of the Scottish Credit and Qualification Framework. The focus is on practical applications of the ESCs and reflective practice.

How to use the learning resource The ESCs learning resource consists of five modules and this introduction. It is important that the modules are studied consecutively, as each module builds on and develops the one preceding it.

The materials are relevant to people in all roles and settings who are involved in health work. This includes people who use services, families and carers, managers, practitioners, volunteers and all workers within the wider health and social care community. The focus is on practical applications of the ESCs and reflective practice. Each module includes links to further learning for people who choose to explore issues in greater depth.

The modules are shown below.

Notes for trainers and facilitators Support for learnersWe have designed the resource so that it can be studied in a way that involves elements of self-directed study and reflection, but we strongly recommend that opportunities for group discussions should be offered to help learners put individual experiences into a broader context and enhance learning. Learning will be significantly enhanced if people have a chance to share and discuss ideas with others. This can be

The Learning Resource Modules

Module 1: The Ten Essential Shared CapabilitiesModule 2: Values-based practiceModule 3: Involving peopleModule 4: Equality and diversity – respecting differenceModule 5: Inclusion, assets and outcome-focused practice You should complete the modules consecutively

Introductionachieved through:

• setting up a learning group • using existing opportunities such as supervision,

reflection, team meetings or away days.

Learning support and opportunities to consider issues in supervision should be provided for the duration of the programme where possible.

Learning can be greatly enhanced if different groups of disciplines, workers, practitioners, people who use services and families/carers can come together to learn and discuss issues that the learning raises. The direct involvement of people who use services and carers in delivering some of the materials and facilitating learning groups will also enhance learning.

Notes for learnersWhy study the ESCs?A range of policies and rights-based health legislation in Scotland focuses on improving the experiences and outcomes of care for people who use health and wider services and their families/carers. These have been very influential in informing wide discussion about the focus and direction of services in general. There is an increasing recognition of the need to examine the values base of all health and social care delivery and to focus strongly on improving people’s experiences in all settings. We will explore through this learning resource how developing your practice in the 10 ESCs can support this policy drive and provide the basis for high-quality, person-centred

care in your own area of practice.

All workers, whatever their role, have an important part to play in promoting positive practice. The ESCs are equally applicable to the way we work with colleagues as they are to the way we work with people who use services, people who care for others and people within the voluntary, independent and all other care sectors.

During the learning, reflection on your own practice is essential, with the goal of reinforcing and building on existing good practice and uncovering practice that is not beneficial.

If you are planning to access further study (at a college or university), your ESC learning may support your application. Potential students are sometimes asked to demonstrate that they have the ability to study at their chosen level or may be able to submit evidence of prior learning and prior experiential (work-based) learning for consideration in relation to their course of study.A You will also find that your ESC learning will assist you in future personal development planning.

Learning activities Learning activities are a feature of all the modules throughout the learning resource. You may complete these activities on your own, but you will find it helpful to discuss your ideas with others. You

A You should note that accreditation of prior learning is offered at the discretion of individual further and higher education institutions. You should contact your target college or university for further information and advice.

Introductionmay be able to do this through:

• a learning group• meetings with your supervisor, line manager or

mentor• an informal arrangement with a colleague or

peer.

You will find on discussing your ideas with others that although they may share many of your own hopes, concerns and values, there may also be surprising differences.

The first two learning activities below are examples.

Activity 1 The importance of recognising and respecting differences between us while “‘owning” our own personal hopes, concerns and values is a theme running through the ESCs. In addition to Respecting Diversity (ESC 2), this is also the key to Working in Partnership (ESC 1), Promoting Recovery, Well-being and Self-management (ESC 5) and Providing Person-centred Care (ESC 7). Values-based practice, which is introduced in Module 2, gives us the skills to do this.

To start the process, please answer these two brief, but important, sets of questions.

Hopes and concernsConsider your hopes, personal values and goals – the things you hope to get from this programme and why it is important for you:

Consider your concerns – things you may not like, or may find difficult:

Note: if you can, share some of your concerns with group facilitators or your supervisor.

Activity 2Coming into health work

Why did you first become interested in health work?

Consider the experiences that influenced your interest in health and social services.

IntroductionWhat is the most important thing you have learned about work in this area?

Please note some good learning experiences in your current or previous roles:

Have you had any experiences that have changed your initial perceptions?

What do you hope to get from working through this ESCs learning resource?

Having completed this activity, you may want to talk to your line manager, supervisor or mentor about creating (or updating) your own personal development plans.

Now that you have completed this introduction, you are ready to move on to Module 1: The 10 Essential Shared Capabilities.