Promoting Independence and Strengths
Scope of this chapter
Independence: Freedom from the control, influence, support or help of others.
Strengths: Skills, personal attributes, and available resources.
Being independent is one of the ways that we maintain a sense of wellbeing, dignity, and control in our lives. Our ability to be independent increases when we understand and apply our strengths and not our shortcomings.
This chapter will help you to use a strengths-based approach to promote independence. It will also explain some of the other ways in which independence can be promoted, through enablement and technology.
Doing all we can to promote independence and maximise strengths is a core principle and value. This means that it applies to everyone and is always relevant when planning for or providing care and support.
Relevant Regulations
Related Chapters and Guidance
A strengths-based approach has a specific focus on a person’s positive attributes (strengths). It helps the person to recognise their own strengths and then consider how they can use those strengths in any given situation to be as independent as possible and achieve any goals. A strengths-based approach very much sees the person as expert in their own life and assesses risk in a positive way.
It is important to understand strengths before providing support to the person, so that they can continue to use their strengths to maximise independence and control and reduce the risk of becoming deskilled or developing an unnecessary dependence on the service.
Strengths can broadly be placed into 2 categories: Personal strengths and community strengths.
|
Personal strengths |
What are you good at? What would others say? What is working well for you right now? |
|
Community strengths |
Who supports me now? - family, friends, advocate, church How do they support me? What do I like to do and where do I like to go? |
When a person’s strengths are understood, the person can then be supported to think about how those strengths can be used to promote their independence. This could be physical independence, but also independence of thinking (see below). This approach can also be used to help people to problem solve and build resilience.
Potential questions to promote independence
What level of independence would you like to have?
How can you use your own skills, knowledge, and experience to achieve this?
Do you need any support from others?
What support do you need from others?
Who do you think could provide this support?
Do you think you need to use a service to achieve your aim?
How will you overcome any difficulties?
Potential questions to problem solve
What outcome would you like to achieve?
Have you experienced a problem like this before? If so, what does your experience tell you about practical options?
How can you use your own skills and knowledge in this situation?
Is there anyone else that you can talk to about it?
What do you think will help most, if not to make things better, then at least to prevent things from getting worse?
Who would you like to support you with this?
SCIE have comprehensive online information and guidance about using strengths-based approaches in a range of settings and circumstances.
Whenever care or support is provided, it should be done in an enabling way.
This means:
- Never doing something for someone if they can do it for themselves;
- Providing the right level of support at all stages of a task - this could vary;
- Encouraging people to try and do things for themselves;
- Recognising achievements and success;
- Recognising potential for independence;
- Helping people access services or equipment that could increase their independence e.g., OT services;
- Managing risks to independence e.g., from the environment.
Assumptions should never be made about a person’s ability because of their age, disability, medical condition, or any other personal factor.
- Taking risks is part of everyday life. The benefits of doing something should be considered alongside any potential risk of harm. If there is a benefit to a person doing something independently (or with minimal support), every effort should be made to facilitate this. For example, supporting a person with a learning disability to make their own cup of tea;
- Factor enough time into a task to ensure the person’s independence can be promoted;
- Always encourage people to be as independent as possible with their personal care, even if they need some support;
- If there are a range of options for doing a task, try to always use the one that will promote independence. For example, if a person needs more support in a shower than a bath, a bath may be the best option;
- Keep to a person’s preferred routines, so they know what they need to do, when and are more likely to engage with support;
- Accept that a person has a right to refuse consent and can say no to support;
- Support the person to be as independent as possible by making tasks easier. For example, preparing microwave meals;
- Aids such as eating utensils, walking frames, shower rails, stair lifts and rails, raised toilet seats and electric wheelchairs can support people to stay independent for longer - if you think these would be helpful you should support access to OT services;
- Adaptations can also support people to stay independent. For example, kitchen or bathroom adaptations;
- Technology can promote independence and provide reassurance to people when service providers are not present (see below).
Technology (including Telecare, Assistive Technology, and other technologies) is reforming how care and support is provided. However, technology should always be used to complement other services, rather than as an alternative.
Used well, technology can promote independence, dignity, and safety.
| Technology | How it can be used |
|---|---|
|
Personal alarm |
The person can call someone when they are needed. These alarms can be fitted in a care home or a person’s own home. |
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Telehealth |
These can monitor the person’s health condition remotely, such as diabetic sensors, blood pressure, oxygen levels and pulse rate. A health professional can then arrange to see the person if they have a problem. |
|
Key safes |
Staff can access the person’s home if they are immobile or cannot open the door due to an accident or illness. |
|
Sensors |
Used in a range of ways to alert staff when something specific is detected. For example, a door sensor will detect when someone leaves or enters a room/building, and epilepsy sensors can detect when someone is having a seizure. |
|
Whiteboards and apps |
These can provide alerts or step by step prompts, enabling the person to complete a task independently. They can be voice activated and use pictures or texts. Examples of tasks include when to get up, have a wash, when to brush their teeth, when a favourite programme is on TV and to give the person reminders of appointments. |
|
Connecting online |
Tablets and laptops can help a person stay in touch with family, friends, and support services. It can also enable a person to be independent with shopping, finance and to request help if needed. |
|
Video assisted guidance |
Videos of how to do tasks can be useful if the person has trouble remembering things. They can watch what to do whilst they are completing a task. For example, how to boil an egg or load the washing machine. |
|
Video cameras |
Surveillance technology can help protect the person’s safety. For example, from the risk of unsafe care or treatment, keeping the person’s premises and property secure, and to help the person stay safe without restricting their activities. |
Jacob is living with autism and loves technology. He used to live in a care home and got frustrated with his possessions being stolen. Jacob now lives in a supported living property with three other people. He put a video camera up in his room. He had epilepsy so did not want to put a lock on his door in case he needed support. All staff were made aware of the camera and were happy for Jacob to record them when they were supporting him. The camera also helped the diabetic nurse view Jacob’s seizure patterns.
Reg had a stroke and is living with dysphasia. Reg lived in his own home and had support from a home care provider. He never had any money as he was giving his money to people that he thought were his friends. He would invite others into the house. He was physically attacked on a few occasions, but Reg did not know who was assaulting him as they were associates of the people he thought were his friends. Reg did not know what his friends’ names were, other than nicknames. This was dealt with as a safeguarding concern by the local authority. With Reg’s permission, cameras were installed at the front of the house to keep him safe, and so the police could identify who was assaulting him.
Questions and things to consider:
- How to involve the person in the decision about using technology;
- What outcome/need will the technology help the person/service to meet?
- Are there other options to meet these outcomes/needs?
- How will the technology be used?
- Whether the service will be able to measure the impact of the technology;
- What impact will the technology have on current levels of support?
- Are there any legal issues we need to think about e.g., surveillance?
- What are the potential benefits of using technology?
- Are there any risks?
- Does anyone disagree with the use of technology?
- How easy is it to install/set up the technology?
- What are the training needs around the new technology for the person, family, and staff?
If technology would be beneficial, staff should obtain consent from the person to support them to access it. This may be through the local authority social work or Occupational Therapy service. The provision of technology is not always free and can be subject to a financial assessment by the local authority.
For further guidance see:
There are 2 types of surveillance:
Overt: Everyone knows that surveillance is being used and has consented to it.
Covert: The use of hidden cameras or microphones that some or all people are not aware of.
Rules around the use of surveillance are set out in the Regulation of Investigatory Powers Act 2000. They must be adhered to. Unfortunately, the Act is extremely complex, and the kind of authorisation required and level of oversight available depends very much on the kind of surveillance.
The Care Quality Commission (CQC) recommends obtaining legal advice before using any surveillance equipment.
When equipment is being used, the registered person should be aware that, depending on how the equipment is being used, its use is subject to 2 different sets of regulations:
- With respect to how the surveillance is being used, CQC regulations under the Health and Social Care Act (Regulated Activities) Regulations 2014 (Part 3);
- With respect to how any recorded data is stored, the Information Commissioners Office (ICO).
For further information see CQC: Using surveillance in your care service
Independent thinking is about having choice and control over decision-making. We should always support and encourage people to have choice and control.
See: Choice and Control
Last Updated: September 12, 2022
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