Care planning and thinking like a pirate and writing like a playwright

Anyone who has attended Shropshire Council’s sessions exploring direct payments knows that the call to, ‘think like a pirate', is meant to be a challenge to be brave and different. Our latest challenge is about our spoken and written language when we work with people who use council services.

Dreaming big about direct payments

This is important to us because Shropshire Council's Adult Social Care Service is dreaming big about direct payments. As part of this we have had a couple of events with people who work with and receive direct payments and members of Think Local Act Personal, the leadership organisation for personalised care.

Mary Hastings, co-chair of our local direct payments board showed us a brown envelope, something which usually fills us with dread and then out of this envelope flew (yes, flew) a delicate, mechanical, paper butterfly – a thing of beauty and not the expected bill. Simple but powerful. We were gripped! We were challenged to open our minds to think differently.

The language we use in communicating with citizens

Lorraine Currie, who is both professional lead on the Mental Capacity Act for the council and also supports her twenty-something daughter, symbolically took off her council badge to deliver, amongst other things, a powerful critique of the language we use in communicating with citizens.

She asked, why write a support plan that talks of ….

“progress to initiate and undertake all of her personal care needs (which notably includes the ability to put on her foot splint independently) without prompting or assistance”.

When really, what it meant was …

• Dry myself with no verbal prompts
• Sequence the Clinique face routine, step 1,2, 3 with no verbal prompts
• Do my own make up with support only when I ask, using both hands
• Straighten small section of my hair myself
• Find a successful way to put socks on
• Progress to getting dressed in total apart from shoes with no-one in the room

We don’t get a sense of the real person if those words are just about bodily functions, rather than the actual real person who has those 'identified needs'.

Playwrights like Shakespeare knew how language could make people real. Our words go to places that we cannot go. They have life for good or for bad. This repeats the idea in the previous sentence. We might feel that only certain words or phrases will impress our managers and help make the case for the person we are working with.

Previously I helped people fill in forms for disability living allowance. I prided myself on using their words rather than mine. There was a tick box asking if they needed help to prevent them from self-harm I could have added typical jargon, but I used the persons own words: 'The only reason I haven't killed myself is because there'd be no one to look after my cat'.

The difference a well-written support plan can make

A well-written support plan, with clear language and real outcomes helps me when there are financial things to look over. Recently there was a young person who was hyperactive with boundless energy; his family were seeking weekend support to manage all this energy by taking him to outdoor pursuit centres basically to use up all his energy, otherwise it would have shown itself in disruptive and destructive ways.

This simple information in the support plan was enough for me to identify additional costs (we call this 'Disability Related Expenditure' by the way). I didn't have to challenge the already challenged family, nor ask them to provide proof of why this cost was needed. It was there, plain as day.

If I should ever suffer an injury or accident which means I need to receive care and support, I'd like it noted that I like ground, not instant coffee, I sometimes like a little hazelnut syrup in it, I want to feel the rain on my skin, and smell the spume blowing off the waves, and that I want to hear 'You' by VAST at least once a week, and that you can expect me to cry when I do so. My mind also needs to be looked after.

Using richer more ordinary, everyday language

I'm not stating that we should all write like Shakespeare, but we maybe could use the richer and more ordinary, everyday language that we would use when talking about our own lives to describe the lives and needs of those we work with. How much better this would be than the meaningless descriptions, plucked at random that we don’t need to think about and which are almost worn out through overuse.