Keyworking and Support planning

The process of assessment is an on-going and organic one, in that it evolves constantly and will require regular review. Once a sufficient amount of information has been obtained, and a sufficiently trusting partnership between client and their day centre worker or keyworker has developed, you can move into support planning and task centred keywork sessions to address the issues you have (jointly) identified, and formulated as being achievable and important. This section takes you through the next stages of the process.

Outline of section

Introduction

Keyworking is just one of the roles that can be carried out by staff in day centres and it can be a way to carry out assessment and support planning. It is not the only way to assess and support plan with clients and indeed it can be a challenge to co-ordinate if the day centre has an open door policy. See here a discussion of types of provision in day centres that includes case studies that meet this challenge. As they demonstrate, a keywork system is far from impossible in day centres and has real benefits in terms of developing a relationship between a day centre worker and a client, and continuity of care.

It is way of working, through which each client has allocated to them one day centre worker, known as their keyworker, who will be their main source of professional support during their when they visit the day centre. Keyworking is about supporting the client in their efforts to meet their needs and achieve personal goals within the mission and objectives of the day centre. The model described in this section is the ‘classic’ keyworking model of one keyworker to one client. However, this should not be regarded as the only way of achieving the aims of keyworking. Some providers are experimenting with other approaches to offering an in-depth support service with client.

Values of keyworking

The values underpinning keyworking include:

person-centred working
honesty
being non-judgemental
respect
consistency
empowerment
promotion of rights
professionalism
anti-discrimination
team work.

Evidence that these values are more than mere good intentions will be in found keyworking sessions and in the general interactions that take place in the project. It is by putting these values into practice that the keyworker can ensure they are acting in the ‘best interests’ of the client. Through training, team and client meetings, staff and clients might find it helpful to explore how these values can put into practice in all interactions in the project, but especially in keyworking sessions.

See more on the Relationship and skills for the job

Models of keyworking

As an area of practice that largely takes place in one-to-one situations with clients, keyworking can tend to elude the scrutiny of the quality and good practice agendas. Developing good practice in keyworking demands that assumptions, theoretical traditions, models, practices and measures of success are made explicit.

The diversity of day centres probably prohibits, at least for the time being, the development of a model for the whole sector. Rather, each day centre should, over time, explore and make explicit their own keyworking model. The model should be:

written up
based on the real experiences of staff and clients
appropriate to the particular day centre and clients
explicit about the values and traditions on which it is based.

By making the model explicit, day centres will be able to develop quality measures and good practice. In the early stages of implementation of a keywork system, it will be subject to regular review and adaptation.

Policy and procedures

Day centres should develop a written policy on support and care within their projects, including their “philosophy of care”, and how this fits with their overall mission and aims. The policy should set out the values that underpin its work with clients. Ideally, they would develop this through consultation with staff and clients. Day centres should also set out procedures for keyworking, describing what clients can expect from the service. The procedures might include guidelines on allocating keyworkers, frequency of keywork sessions and so on. This should be made available to clients. In developing these procedures, providers will need to consider establishing realistic caseloads for keyworkers.

The Role of Keyworker

Keyworking is just one of several roles played by staff in day centres. The other roles may be more practical, or advice centred. Some services have the luxury of creating separate jobs, but in most staff switch between them in their day to day work.

The role of keyworker includes the following elements:

advocate
informal counsellor (emotional support)
adviser
facilitator
teacher
motivator.

Keyworkers also act a conduit between the team and their key clients, passing on information to the client and feeding back comments on the service to the team.

Procedure

Keywork normally consists of a series of one-to-one meetings between the client and their keyworker, taking place on a regular basis. Ad-hoc meetings or informal ‘chats’ will invariably take place in-between these formal sessions. The frequency and amount of time available will depend on the staff to client ratio, shift patterns and how often the client comes to the day centre. The intensity of keyworking will depend on the needs of the client. Where clients have multiple needs, keyworking capacity will have to be higher than where clients have few needs. The staff team should be honest and realistic about the level of support the project can offer the client. This should be made clear when the person comes first accesses the day centre. Timing of keywork sessions will have to suit the client’s schedule.

When planning new services or evaluating existing ones, day centres should take into account the capacity to carry out effective keyworking in staffing levels, budgets and funding streams.

Formal keywork sessions should take place in a private space, as free from interruptions and distractions as possible. Offering a comfortable and relaxing environment, with comfortable chairs, a desk or table, telephone for outgoing calls and so on, will create an atmosphere conducive to working together on the issues.

Planning

Planning is about making decisions about how we get from where we are to where we want to be. Or in this case, how the client and the day centre worker will prioritise the needs and goals identified in the assessment and how they will go about addressing them.

The day centre worker should help the client to establish and describe their personal goals. This is like creating a ‘vision’ of their future or a ‘scenario’ of how they want things to be. The role of the day centre worker will be to help the client think about their plan and decide if it is realistic. Staff should be encouraging and honest.

The next step is identifying the tasks or changes that are necessary to achieve the goals. To do this will require bringing together the strengths and resources and the needs and issues identified in the assessment. It will also require developing the client’s network in a way that will support them in their new scenario. An important part of planning will be identifying and exploring options.

Plans should be written down (See sample action plan)

They should include:

longer term goals
what tasks are necessary
who will undertake the tasks
dates that the tasks will be done
review dates.

There should be space on the plan for adding comments afterwards about whether the tasks were completed and any learning for the client and the day centre worker.

Milestones

Identifying ‘milestones’ is often useful. Milestones seek to answer the question, ‘how will we know if we are making progress? They are ‘mini-goals’ or events along the road to the larger goals that show that we are travelling in the right direction, give us a sense of achievement and encourage us to continue.

Support plans should be signed by the day centre worker and the client and dated and review dates should be agreed in them.

In practice, the process will involve smaller loops within this overall process, building on initial assessment.

implementation

Evaluation

Planning

assessment

In day centres a significant element of support planning may be about resettlement. (See Resettlement and support plans in the Resettlement Handbook. Each project should look at how the support planning functions fit in with the resettlement process.

Implementation

Support planning should be about increasing the control the client has within their lives and about learning. This implies that the client should have as much responsibility as possible in carrying out the tasks in the plan. There will be some tasks that only the day centre worker can do, but taking too much control is disempowering. Having said this, we all need help in some areas of our lives; and knowing how when and how to get help is an important skill.

In addition to empowerment, the day centre worker and client may have to work around issues of motivation. Ideas and techniques in building motivation to change developed in working with addictions can be useful and staff should seek to develop their skills in motivational interviewing.

Implementation of the support plan will involve getting help from other agencies, such as housing providers, alcohol or drug services, furniture projects, advice centres and so on. (See Working with other organisations for good practice in this area.)

Where another agency is taking the lead in supporting a client, the support plan should explain this and provide contact details. Assessment and support planning sessions could be then used to ensure that the support being provided is meeting the client’s needs. The day centre worker may take an advocacy role if the support seems to be inadequate or is breaking down. Staff may also be responsible for the client’s resettlement, including arranging for referrals to housing providers and seeking a Community Care assessment to get funding for on-going support.

Review

The support plan and its implementation will form the basis of ongoing sessions. Over time the plan may have to be revised and new approaches taken. This review should be a shared learning process for the client and day centre worker.

Supervision

In supervision, line managers should review files with the day centre worker. This is an opportunity for workers to:

Get support around issues coming up in assessment and support planning
Reflect on approach and practice
Identify training and personal development needs
Check progress against day centre objectives and quality standards.

Evaluation

Each day centre should seek to evaluate its assessment and support planning services. The evaluation should consider the whole model and should be based on feedback from clients as well as input from the staff involved. Since some of what happens takes place in private one-to-one sessions, day centres should consider how approaches can be properly evaluated. For example, with the permission of the client involved, external evaluators may be called on to sit in on a formal session, interview the client separately and provide feedback to the day centre worker and the team.

Outcomes

Day centres should consider what they view as success in assessment and support planning and the kinds of evidence that might be available to show that it is achieving what it is supposed to.

A range of indicators might be used, including evidence of:

Written assessment and plans agreed between client and day centre worker
Tasks agreed in the plan were carried out
Milestones and goals in the plan are achieved
Evidence of learning
The client has made positive changes to their situation
The client feels positive about the assessment and support planning and the service they are receiving

Good practice from the Booth Centre suggests compiling a portfolio of the client's achievements, attendences, thanks for volunteering, photos and writeups of activities and trips. This is in itself a record of successes of the keywork process, outcomes the day centre provides generally, and can serve as a reference and demonstration in interviews and applications in future.

For more information on what outcomes are and how to develop them see the Quality section in Creating a positive Environment. See also the Invest to Save model in Fundraising.

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Created by beth.coyne
Last modified 2007-05-01 02:28 PM

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