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Peter: [00:00:00] Welcome to Community Living Out Loud brought to you by Community Living Mississauga. I'm your host Peter Reynolds.
On this podcast we celebrate the lives of people who have an intellectual disability and the incredible work being done to advocate for them and their families. Through conversations with experts, advocates and people with lived experiences we hope to inspire and educate listeners on the importance of building strong, supportive committees
Like anyone else, people with an intellectual disability have the right to make decisions about their lives. To have control over their choices. Respecting their autonomy and self-determination is a fundamental aspect of treating them with dignity and respect.
In today’s episode we're going to talk about personal outcome [00:01:00] measures and how organizations like Community Living Mississauga use them to personalize the care they provide by identifying the goals and dreams of each person and the services required to help them achieve those goals and dreams.
And joining me is someone who I’m pretty sure has always dreamed of being on this podcast, and that’s Nicole Farrell, manager of the Outcome Support Team at Community Living Mississauga. Nicole, welcome to Community Living Out Loud.
Nicole: [00:01:32] Thank you Peter. It’s exciting to be here.
Peter: [00:01:35] So Nicole, maybe we could start with the most obvious question, what are Personal Outcome Measures?
Nicole: [00:01:43] The Personal Outcome Measures is a quality enhancement tool that we use here at Community Living Mississauga for the last 20, 25 years. It’s part of accreditation review set out by the Council [in? 00:01:52] Quality and Leadership. The tool itself is set to within 21 different areas that are defined by the person and for the person by themselves. It’s a fact-finding conversation. There's two parts of every interview, one that measures the quality of one’s live, and the quality supports that they provide.
These outcomes are designed with a series of indicators that allow for a clear definition on how somebody wants to live. It’s a way to get to know what social rules they have, their participation level, and their social connections. It’s also very important to know that it’s only possible to make a determinations if an outcome is present by first talking to the person. We need to find out the person’s definition and we can't define it if we haven't talked to them first.
Peter: [00:02:41] So he measures, it’s not just about finding out their answers to the questions, it’s getting their input on the questions themselves?
Nicole: [00:02:49] There’s a set of questions that we ask. So there’s a manual that we follow, a process that allows us to say, “Yes, this is present in someone’s life,” “No it’s not.” But ideally the questions are just that to ask what is important to you as somebody who receives support? Everybody’s different.
Peter: [00:03:08] Absolutely. And this has been a theme throughout the podcast of really treating each person as an individual. And it we've come obviously a long way from the sort of institution approach where everyone is treated the same. And it really seems like at every opportunity you’re trying to find out what is the best way to provide service for the people that you serve for what they want as opposed to what you think they want.
Nicole: [00:03:42] Absolutely. Because if we don't ask we're not supporting them in the way they want to be supported. It also looks at part of people’s stories. It’s an important process. I think I've been using Personal Outcome Measures for 20 so 25 years, but on the outcomes team for the last 17. I think it’s an important process that gives people a voice to share that story with each other.
Peter: [00:04:03] So who administers the interview?
Nicole: [00:04:08] Right now we have three employees on the Outcome Support Team. Myself, the manager, Jennifer [Ticosto? 00:04:12] [unintelligible 00:04:13] support worker and Amy Shaw. So the three of us are all certified with the Council on Quality and Leadership able to do the interviews. We're the only employees within the organization that have to have an annual review. And what that looks like is just a representative from the Council will come out and sit with us while we provide an interview and a follow-up. And we have to we have to have an 85 per cent accuracy so people can make the determination. So basically we ask the questions, somebody watches us do the interview, and then we have a discussion afterwards saying, “Is this outcome present for the person from the information that was shared? And is support being provided?” and when we are, then we can say that we are accredited.
Peter: [00:04:58] So walk me through it a little bit in how this information is then used by the organization.
Nicole: [00:05:04] Right now the process right now gives us a lot of opportunity to learn about trends across the organization. So not only on an individual level, but it really allows us to be able to say, “OK, what supports do the support staff need for ongoing training to making sure that people are living their best life?” We really want to make sure that the information that is shared is shared with the whole team to provide a holistic type of support. We just don't take this information and say, OK. OK. We had our information. Now Nicole, Jennifer, Amy know what somebody wants in their life, but use it for planning, trends of the organization, opportunity to look at things that people want in their life that maybe they haven't had the opportunity to express before.
Peter: [00:05:52] Can you give me an example of something that somebody has wanted that perhaps the organization didn't expect and that they've had to shift the way they provide their service?
Nicole: [00:06:07] I think one thing that comes to mind sometimes is that we take for granted someone’s participation level in their community. We think, “Oh yes, somebody went out three times this week and that’s enough.” But this outcome actually looks at the type and scope and frequency. Is it enough? How do we know if we don’t ask?
You know, a great story of a lady who was busy five days a week, but she always had time on a Sunday to sit and say, “You know what? If someone asked me I would do it.” You know, we share these experiences with people and say, is it enough? How do you know if you don't ask?
Peter: [00:06:42] A hundred per cent. How do you deal with factors beyond your control, like during COVID?
Nicole: [00:06:51] Well you know, COVID was an interesting time. Our interviews went virtually so we were still checking in, and that’s really what Personal Outcome Measures is, is a check-in point. And we did that on Zoom and that kind of format. And really what we found out was the people didn't have the opportunity for technology before. Maybe it wasn't just something that we’ve never thought about or maybe they couldn't afford an iPad or computer or phone, per se. So there was some great opportunity to purchase those things through different funding options throughout the region.
Also too what we looked at was that, you know what? It gave people the opportunity to change things that they wanted in their life. A great example is, I may have worked 15 years in a job and all of a sudden the pandemic hit and I realized, I don't really like that job anymore. I want to do something different. It also looks at the relationship with the family [00:07:51] members. You know, before we would sit and say, you know, “Do you see your family enough?” and “Oh yes, when my mom or dad are free I get see my siblings per se.” And what had happened was now that gave the control that said, “You know what? I can call my siblings whenever I want because I now have the tool to do so.”
But it also looks at participating in the life of the community. Obviously with the pandemic people were doing things in their home. It gave an opportunity to say, “I'm going to try something new. Parks and Rec is offering a virtual class and I'm going to try it because I’ve been a little shy to go or I don't have transportation to get there. I tired the class and now I really liked it.” So it shifted our way of thinking and provided a different type of support that we weren't doing before.
Peter: [00:08:35] Yes, the check-in is – it’s very interesting because I can imagine for an organization when you're serving a lot of different people with a lot of different needs, you’ll create a system or create a routine that's working. And just like in any family home, once you have a routine that’s working, it’s very easy, let’s just keep going with that. And that ability to say, “No, wait a second. Yes it might be working for us, but is it working for them?”
Nicole: [00:09:12] Absolutely. And that’s really the basis of the Personal Outcome Measures tool is to sit and say, “You know, we may know things because we've asked 15 years ago,” but we all change, we all grow, and hopefully that gives us the opportunity to sit and just figure out what they want in their lives. And hopefully it changes from time to time. It gives us the opportunity to sit down for a good couple of hours, because that’s how long the process is, and really be the focus of that interview. It’s about you and the things that you want and your relationship to your participation level, your social rules, your connections. And when we do that and give people the voice, then it’s our job as the Outcome Support Team to evaluate and give back that feedback for planning, you know, looking at the whole support that people receive in a different perspective.
Peter: [00:10:08] Well we’ve been talking about the people you serve an giving them the choice and the opportunity to speak for themselves, so I think this is the perfect opportunity to bring in as a guest for this episode someone that is served by Community Living Mississauga and that’s Jessica [Portalnoce? 00:10:24], I hope I'm pronouncing that correctly Jessica. And Jessica’s not only supported by Community Living Mississauga, she is a Community Living Mississauga board member and sits on the organization’s rights committee. Jessica to Community Living Out Loud.
Jessica: [00:10:44] Thank you and thank you for having me. It’s been an honour and a privilege to be on this channel.
Peter: [00:10:51] Jessica, perhaps you could walk through personal outcomes interviews from your perspective. What they involve, what it’s like to be on the other side of the interview.
Jessica: [00:11:03] Jennifer and I have been meeting every two years. We set up a time, Jennifer came to my house and completed this interview. She explained the process. This interview is all about me and what I want and what I have and what I need. This interview is easy, it’s more on a conversation. I did this interview all by myself and I like to be independent. We spoke about my goals and the things I am proud of. My friends, family, my work, my health, and my rights. I know all my rights.
That interview lasted almost two hours. When the interview was over Jennifer said she would be meeting up with my support worker Cheryl to speak about [00:12:03] my support. Jennifer shared the results with my manager and director and Jennifer is also helping me, and Cheryl, find something to do.
Peter: [00:12:21] So it’s very interesting talking about the fact that it’s not just about giving you choices, but letting you know about your rights and the fact that you do have the right to control how the services are provided to you. Can you talk a little bit just about the importance of people at Community Living Mississauga doing these interviews? Like, how much of a difference does it make in your life?
Jessica: [00:13:01] I get to share my success. I get to talk about myself and what I'm doing and what I want to do. In this, I get to talk about people in my life and the different roles I have. If there’s something I want to do, we can make it a goal and look towards achieving it. That interview is important to me because I get to be on my own advocacy. Jennifer said that she also enjoys meeting me and see how far I've come and how my accomplishments and how independent I am. My family is also very proud of me and I am very proud of myself too.
Peter: [00:13:59] Nicole, and Jessica’s been talking about working with Jennifer who is on the Personal Outcome Measures team.
Nicole: [00:14:07] That’s correct. She’s one of our support staff. So she’s certified by the Council on Quality and Leadership to be able to ask those questions and make determinations.
Peter: [00:14:17] And Jessica was mentioning that she talked to Jennifer every two years. In terms of that sort of consistency of working with a member of the team over a long period of time, how important is that, that they can work with an individual over a certain amount of time.
Nicole: [00:14:36] I think it’s very important to build that relationship. I think that as the support staff go out and interview over a hundred people a year, it’s important that they’re consistent with their determinations that people feel comfortable for the conversation. As quality insurance measures for checking in, we don't only just provide the support to Jessica and her team, but also as an organization we take the data and look for ways to be able to provide support to all employees.
Peter: [00:15:08] So what one person might suggest or might comment on is something that could apply to multiple people that they might not have thought of.
Nicole: [00:15:19] I think it’s a great time. And when we talk to a lot of people we hear all these great stories and successes and goals that people are hearing that it really gives us a brighter future to sit and say, “Hey, I heard somebody who did something similar and this is the steps they took.” So we're gaining that knowledge as a team, breaking down barriers for people, looking for community resources, building relationships with not only the people that receive support but the support team and the management as well.
Peter: [00:15:51] Jessica, I know you touched on a few of the goals that you've talked about with Jennifer. Could you give us a couple of examples, or one example of s goal that you started two years ago perhaps, and where you are today with it and how it’s changed?
Jessica: [00:16:08] I wanted to go back to [unintelligible 00:16:11] community center. I want to travel. I've been to Disney four times. And I want to go back – I am a Disney fanatic and the next thing I want to meet is the [unintelligible 00:16:28] ride. I've never been on that ride before [unintelligible 00:16:30]. But the end of September I am invited to the Community Living Mississauga conference in Ottawa. On board of directors I am looking forward to this experience too. I enjoy being busy.
Peter: [00:16:52] Jessica, can you talk a little bit of personal outcomes at the board level? Because I know Nicole talked about how it impacts decisions that are made across the organization. Can you talk a little bit about it as a board member?
Jessica: [00:17:07] The board of directors talks about outcomes every time we met. We talk about the result of people’s outcomes. We talk about the trends. Ty talk about any theories they may have been – the board knows that the people supported by Community Living [unintelligible 00:17:35] wise the board needs to know that we are getting the right support.
Peter: [00:17:46] Terrific. And can you tell me again why your independence is so important to you, Jessica?
Jessica: [00:17:54] My independence for me is to, like, making sure that I take more time for myself and all that. For the past two years since the pandemic happened I've been having two family member losses, my dog passed away then my grandfather passed away. So it's been ups and downs for me. But since I have a new dog and now it’s been a lot easier, but I've been pretty busy with doing kick boxing class. I'm doing, like, paintings, just trying to keep myself occupied through those times. But I get to do, like, bingo nights with my mom and my stepfather. So get to do that and I get to have fun with them, and go for walks every day and try to keep myself busy.
Peter: [00:18:58] And how important is it to be able to make your own mistakes. Because I can imagine people watching this, parents, this idea that we want to keep our children safe. Or organizations want to keep the people that they support safe. And not necessarily physical safety but just to make sure that their life is totally smooth. And can you tell me a little bit about the importance of just being able to make your own mistakes.
Jessica: [00:19:31] Sometimes if I – everybody makes mistakes once in a while, but you get to learn your mistakes, and just make it like a goal. Just make it, like, get rid of the barrier part and just make it a goal. Just achieve it.
Peter: [00:19:48] Nicole, would you agree with that?
Nicole: [00:19:52] Absolutely. You know, we talk a lot in our training that we provide to all employees, so new hires get POM, Personal Outcome Measures and Building Social Capital Community Connects training within the first six months of being hired. So we talk a lot about that protection level that we say, “Oh my goodness, maybe somebody can't do that.” And then we say, “Why not?” we're support workers for a reason. So sometimes it may be looking at what somebody wants to do and instead of assuming no, look at the steps to achieve the goal.
Peter: [00:20:26] Jessica, any final thoughts for people out there watching right now?
Jessica: [00:20:32] Sometimes if I weren't to do, like, ideas, like planning trips and everything, sometimes me and Cheryl write, like a list of things to do. Like, I can give you one example. Next Friday, April 26th I'm going to see Mama May I ask. So that’s to me like a goal for a lot of people out there that can do, like, go to Niagara Falls. Go to like a movies. Go and have fun. You know? Go bowling. It’s fun too.
Peter: [00:21:11] The sky’s the limit.
Jessica: [00:21:13] Exactly.
Peter: [00:21:15] Nicole, any final thoughts.
Nicole: [00:21:17] I think the outcome process really looks at this holistic approach to supporting people and understanding that the 21 indicators is just really the beginning and we can measure for ourselves. You know, there's been times I’ve looked at the outcomes for myself and said, “Is this enough? You know, am I telling people that they want more in their life, but I'm not achieving it for me.” So I think it’s one of those things that we use the tool to grow and to understand what people want. But also so they have a voice. And I think that’s key to mention that that voice is heard by many different levels of the organization, and not just the person supported but their families, their support team, their management team, senior management, the board of directors. We really look at making sure that we provide resources that are available in our community that are totally integrated and they're inclusive.
It’s an important piece to understand what somebody wants in their life and being able to see people grow and achieve new things has been pretty exciting over my 30 years of working at Community Living Mississauga.
Peter: [00:22:26] Wow, so the commitment is definitely there, Nicole. Thirty years we. My goodness. So you really have seen the organization evolve.
Nicole: [00:22:36] Absolutely. When we first started working with Personal Outcome Measures, I mean if you were involved in the accreditation review interview, so that would be somebody you provide support to got picked randomly to have an interview through the Council on Quality and Leadership you really didn't know what working on outcomes was. And I remember sitting down at the time going, I've got to support someone to learn about outcomes and I didn't know what they were for myself. And once I started to understand that I needed to ask questions. I needed to facilitate what I was hearing, to be able to give people a definition what that outcome was. And not from my personal perspective, but what they want. You know, I know that someone’s family’s very important to them, but if I haven't asked them if they're seeing their family enough then I'm not really supporting them to look at the whole outcome.
Peter: [00:23:23] Well this has been a wonderful conversation, and the word that really jumps out for me is choice. Making your own decisions, being able to make your own mistakes. You can't have independent living without the word independent. And it’s nice to know that organization like Community Living Mississauga are taking this seriously.
Jessica, Nicole, thank you so much for your time today.
Nicole: [00:23:48] Thank you Peter, it was a great opportunity.
Jessica: [00:23:51] Yes. Like I said I've been at [unintelligible 00:23:54] for 10 years, almost 11 years, so I've been working really hard there.
Peter: [00:24:01] Fantastic, fantastic. Well thanks again and thank you of course to our audience and we really appreciate your continued support. And whether you’re listening to this on your favourite podcast app or you're watching on YouTube, don't forget to subscribe and leave a comment and share the link with your friends. And of course if you’re listening on Apple Podcasts and wanted to leave a 5-star review we would not complain about that. It does make a big difference.
So for our guests and everyone at Community Living Mississauga, I'm your host Peter Reynolds. You've been listening to Community Living Out Loud. And until next time, stay loud.
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