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5786 V4

Develop, implement, evaluate, and adapt personal diversional therapy care plans

Name _________________________________________________

Careerforce reference number _____________________________

This work is licenced under a Creative Commons Attribution-NonCommercial Licence. You are freeto copy, distribute and transmit the work and to adapt the work. You must attribute Careerforce as the author. You may not use this work for commercial purposes. For more information contact Careerforce www.careerforce.org.nz


US 5786 Version 4 Level 4 Credits 5

Name ________________________________________________

Employer _____________________________________________

NZQA number _________________________________________

Date _________________________________________________

“All the answers in this workbook were completed by me.”

Signed _______________________________________________

4 Getting started

9 Diversional therapy care plans

12 Consent forms

16 Holistic assessments and social history

32 What is a personal diversional therapy activity?

36 Setting goals with the person you support

42 Developing the action plan

45 Risk management scenario

50 Implementing the diversional therapy care plan

55 Final evaluation after the activity

5786 V4


4 Develop, implement, evaluate, and adapt personal diversional therapy care plans

Getting started

Look before you leap!Take the time to go through this workbook before starting on the activities. Read the sections and make notes as you go.

Welcome to Develop, implement, evaluate, and adapt personal diversional therapy care plans: one in a series of workbooks especially developed for support workers in the CPQ (Career Pathway Qualifications).

Before you start Think about what you know of •the care plans developed by diversional therapists for the people they support.

Read the Resource Book for •Readings (Diversional Therapy) provided with this workbook.

Pre-requisite Unit standard 23918 Describe the philosophy, purpose, and benefits of diversional therapy, and the role and skills of diversional therapists is a pre-requisite to this unit standard.

This means that you must have successfully completed the assessments for Unit Standard 23918 before being assessed on this unit standard.

How do I use this workbook?Use highlighters to identify •the important ideas.

Take your own notes.•

Complete activities as you go •through the workbook and write answers in the spaces provided.

What will I learn about?When you have finished this workbook you will have learned more about:

Developing and implementing •personal diversional therapy care plans.

Evaluating these care plans. •

Adapting these care plans. •

5Develop, implement, evaluate, and adapt personal diversional therapy care plans

Acknowledgements This workbook has been designed to support your learning and prepare you for the unit standard assessments.

The contents of this workbook include scenarios, learning activities and activities for general health and disability settings. They are not specific to any setting and should be used as a general guide for learning.

Careerforce would like to thank the people who have contributed their time and effort into this workbook in:

Research and content validation.•

Advice and expertise.•

Testing of activities and assessments •and their personal experiences.

In particular, we wish to thank:The staff and residents at:

Bainswood Rest Home•

Metlifecare Merivale•

Rosewood Rest Home•

And John McCombe, photographer, who took photographs at the above locations.

Getting started


Getting started

Stop activitiesYou will also come across this icon in places where you are asked to STOP (see the graphic on the left) and record your current knowledge or impressions, as a reference point to return to later.

Pause and Rewind activitiesPauses are for summarising, questioning, and reflecting as a reference point to return to later. Rewinds take you back to a PAUSE, STOP or TEST YOUR KNOWLEDGE and give you an opportunity to add to, change or validate some of your initial thoughts and ideas.

Learning activities These help you understand the content, and will help you with workplace verification tasks. The instructions and answer panels for learning activities have a light yellow/orange background like this.

Trainee assessment portfolioThe trainee assessment portfolio contains assessed activities and workplace verification which must be completed to meet the requirements of the unit standard. These questions or tasks must be completed by you and signed by your workplace assessor in order for you to be credited with the unit standard.


TEST YOUR KNOWLEDGE

Before you go any further in this workbook, think of what you know about personal diversional therapy care plans...

Why is it important that diversional therapists write diversional therapy care plans?

If you have, what did it contain?

Have you seen an individual’s diversional therapy care plan? Yes No


What is the advantage to people when the diversional therapist develops individual diversional therapy care plans for them?

Why do you think diversional therapists write diversional therapy care plans for individuals?


Diversional therapy care plans To be assessed for this unit standard, you need to complete two diversional therapy care plans.

The first care plan is for an everyday activity for one person.

The second care plan is for a special occasion. This plan is also for one person, but friends or family may participate as well.

The two diversional therapy care plans can both be developed for the same person, or developed for two different people.

Both diversional therapy care plans will require:

The person’s consent. •

Completing a holistic assessment. •

Checking the person’s service delivery plan.•

Setting goals with the person.•

Checking workplace policies and •procedures to make sure that the activities planned meet workplace guidelines.

Writing an action plan to achieve the goals. •

Evaluating the planned activities. •

Running the planned activities with •the person.

Evaluating the outcome of the activities. •

Making modifications to the activities •or environment.

Making written recommendations for •change for running these activities in the future.


Which people who you support are you going to complete the two plans with? The size and focus of your workplace service will affect the options you have.

After consulting with your supervisor, you have selected one or two people who you support who you feel would enjoy and benefit from participating in individually planned diversional therapy leisure activities.

What is the next step towards developing the personal diversional therapy care plan?

Discuss with your workplace supervisor which people might enjoy participating in an activity that is required for your training and assessment.


Step one: Introduce

If you are not already known by the person or people you have selected, introduce yourself.

Next, explain:

Your workplace role as a diversional therapy trainee.•

The qualification you are working towards.•

That, for your assessment, you need to create individual diversional therapy care •plans with people and carry out the activities.

Ask the people if they would be interested in taking part in this part of your training and assessment.

Answer any questions. You may need to give the people time to consider your request and arrange to see them on another day to get their answer.

Step two: Consent

The people have agreed to participate; now you need to formally record their consent.

Your workplace may have a form for this purpose, or you could use the sample consent form in the following section.

Who can sign the consent form? This might be the person directly. Or, someone else may have to sign on the person’s behalf – a family member or the person with power of attorney. You will find this information in the person’s service care plan.


Consent forms provide evidence of the •choice given to the people to participate in planning, setting leisure activity goals and participating in the planned activities.

Consent forms are usually filed in either •the person’s service delivery plan or in the personal diversional therapy care plan, depending on the guidelines given in the workplace policies and procedures.

Consent formsIf the same person is going to participate •in a future diversional therapy care plan activity with the trainee, a new consent form will need to be signed at that time.

There may be range of health and disability •related circumstances which could prevent a person signing the consent form. Check with the workplace service team leader/manager to find out who is the appropriate and legally recognised person to sign on behalf of the person involved.

Have you read what is said about the right of choice in the UN Principles for Older Persons, and in the Code of Health and Disability Services Consumers’ Rights, in the Resource Book for Readings (Diversional Therapy)?


Consent forms

(Service provider’s name)

(Participant’s name)

I give my consent for:

(Trainees’s name) will develop a personal diversional therapy care plan with me. This plan will be used in the trainee’s training and assessment towards Unit Standard 5786.

Participant’s signature Date

If your workplace support service has a consent form, use that form

Consent form – sample


Why is it important to have the person sign a consent form before you start planning activities with them?

Where in your workplace do you file the signed consent form?


How would you go about assessing the diversional therapy needs of a person you support?

What are the key points of information you need about the person?


To begin a holistic assessment of a person’s diversional therapy needs, we need to start with reading the person’s service delivery plan.

The service delivery plan is where all the core information about the person is recorded. This document will provide the person’s full name, gender, age, family status, health status and/or conditions, safety issues, and the reason why this person was referred to your workplace service.

It may also identify community organisations providing support to the person.

Collect (take notes on) the important information from the service delivery plan. This saves the person from having to repeat details needlessly or explain again any situation that may be upsetting.

Next, arrange a time and place to gather the person’s social history.

Take time to think about the person you support, and about the workplace service you are employed in.

Where in the facility would be the best place for a private conversation with this person?

You need to consider:

Where would the person feel •most comfortable?

Where can you avoid interruptions •or distractions?

Can you make sure that the conversation •will not be overheard by any other people, including visitors and staff?

Holistic assessments and social history

Diversional therapists use holistic assessment to identify people’s diversional therapy needs.The areas covered by the holistic assessment are:

Physical•

Sensory •

Emotional•

Social•

Cognitive•

Cultural•

Sexual•

Spiritual•


Where in your workplace/facility would be the best environment to meet with a person and complete his/her social history?



Before the social history session Explain to the person what a social history is, and how you will use it in planning that person’s personal diversional therapy care plan. Reassure the person that the information is confidential to the care and support team and will be kept in the person’s diversional therapy care plan.

Next make a time or several times

that suit the person for this social history gathering to take place.

Fatigue levels or attention span may limit how long the person can participate in this activity at one time.

Take brief notes – don’t rely on your memory.

Plan what you are going to gather for the person’s social history. Remember the range of information you already have from the person’s service delivery plan.

Do not use a checklist of what the person likes or doesn’t like! You will only end up with a list of “yes” and “no” answers, without gaining the real picture of what is important to this individual.

During the sessionA good starting point is: “Have you always lived in this area?”

Other topics might include where people grew up, work roles they have had, and sport and leisure interests they have had over the years.

People may share family information and talk about siblings and friends and events they all participated in. Older people often share information about children and grandchildren.

Focus on gaining information from a conversation with the person, not on a pre-prepared list of questions. Building on the answers people give, you can carefully encourage them to share information that is important to them.

You have to be a little bit of a detective to get the full picture.


Holistic assessments and social history So, if someone says “I used to play rugby when I was younger”, you need to follow that statement up with more detailed questions, for example:

“Who did you play for?” •

“Once you stopped playing, did you •coach or belong to a supporters group?”

“Do you get to watch your local team •play now?”

“If it were possible, would you like to watch •your local team play at a home game?”

“Do you watch the big games on TV?” •

This rugby example works for all topics – sports, travel, hobbies, volunteer roles, family roles, community roles, education, gardening, music, pets etc.

People may say things like “I can’t play sport now” or “I don’t belong to [name of a club] any more”. Then, you need to clarify that former roles and interests are important. This information helps the diversional therapist to understand the person’s past and present interests, and can be used to plan current and future leisure activities.

After the sessionWhen you have finished a session with the person, read back the brief notes you have taken, check that the person is happy with the information you have recorded, and make any changes requested.

Thank the person for participating in this information gathering session, and arrange another session if required.

As soon as possible after the social history interview, write your brief notes into a full version on your individual diversional therapy holistic assessment record (a sample follows later in this section).


It is always best to interview the person concerned to gather that person’s social history. But can you describe a possible situation where you would gather this social history information from the person’s family instead?

What do we do about information which the person gives that is about other people from the past?


Social history record – samplePlease add extra categories or pages as required to record all information.


Personal details

Name: Date of birth:

Place of birth:

Preferred name: First language:

Family

Spouse, partner: Children

Next of kin:

Parents Siblings

Grandchildren Other significant people



Family information (overseas or out-of-town contacts etc)

Places and homes of personal significance

Employment, occupations and roles of personal significance

Lifestyle details of personal significance



Spiritual or religious practices and celebrations of personal significance

Cultural practices and celebrations of personal significance

Personal preferences

Holiday and travel events



Organisation, club and society affiliations, current and/or past

Memorable events

Community and volunteer roles, current and/or past

Special skills



Leisure and recreation preferences and history (eg music, sport, hobbies, pets, literature, arts, gardening, cooking, creative crafts, computing, any other recreation and leisure interests...)



Gathering information for the holistic assessment

Information type Where you gather this information from

Name The person’s service delivery plan (SDP)

Age The person’s SDP

Address The person’s SDP

Health status/physical You should be able to gather some general wellbeing information from the person’s SDP, including safety issues, falls risk, low sugar diet, fatigue levels, mobility and aids used, pain levels, positioning to limit pain, assistance required, what the person can do independently, vision and hearing.

You may also need to check yourself:

Vision: record what the person needs glasses for and any other •adaptations in use.

Hearing: does the person use a hearing aid? In which ear, or both?•

Social history Gather this information by interviewing the person.t

Family and loved ones Note any information, particularly about any recent changes in the status of relationships with family or significant others, eg recently widowed, daughter/carer has shifted away etc.

Sensory Taste, smell and touch. Record any impact on the person’s level of function.

Emotional Add your own observations.




Social From your observations, how does the person interact with other people and staff in the workplace service?

What social opportunities does the person have outside the workplace service?

Cognitive Add your own observations. Level of cognitive functioning: what level of instruction can the person follow – complex, moderate or simple?

Does the person require written instructions, a demonstration of the task, or the instructions given in steps with verbal prompts?

Cultural Does the person identify with a particular culture? If so, is this a high priority for the person?

Does the person have access to own cultural traditions and values?

Spiritual This is not just about the person attending religious services. However it does include all religious and spiritual traditions and practices that are important to the person.

From your observations and conversations with the person, record the person’s spiritual priorities, which may include personal religious practices such as:

Grace before meals.•

Dietary requirements (eg no pork).•

How the person chooses to observe celebration days or the •spiritual traditions associated with family or culture.

The need of time alone for “quiet time”, meditation or reflection. •


Holistic assessments and social history Information type Where you gather this information from

Preferences From conversations and the social history interview, record the person’s leisure activity preferences and the activity options that appeal to that person.

Abilities/capacities From your observations of the person and the social history interview, record any abilities and/or capacities that should be taken into consideration when developing the personal diversional therapy care plan.

Limitations Are there any risk factors or limitations to the person’s abilities/capacities that must be considered when developing the personal diversional therapy care plan?

Sexuality From your observations, record information that clarifies how the person sees himself or herself. This is about self-perception, relationships with others, and how the person likes to look, dress and behave.

Examples:

Janine, who is 35 years old, likes to wear modern fashionable clothes and jewellery; she does not like to be seen by others without her makeup on. Her favourite activity is shopping for clothes.

Jill and Andrew have been married for 45 years. Jill has been in a rest home since experiencing a stroke eight months ago. It is important to both Jill and Andrew that they can have time together in the privacy of Jill’s room in the facility.




Sexuality (continued) Phillip, a 78-year-old former businessman, prefers to wear trousers, collar and tie. He became really upset when, on a social relief stay in a facility, a carer dressed him in track trousers.

Cynthia lives in a shared community residential house. Over the past year she and Graham, another resident in the house, have developed a relationship. They are very excited about moving to another community house soon. The new community house can provide them with a large room so they can live together as a couple.

Angela, who is 55 years old, becomes distressed if seated beside men.

JJ is a 33-year-old with cerebral palsy who lives in an ownership flat. Chris is JJ’s support person and same gender partner. They have experienced negative comments about their relationship from some staff members at the support service programme that JJ attends one afternoon per week. Other attendees at the afternoon support service programme have been very supportive of JJ and Chris’s relationship.

Amy, who is 18, refers to all the male staff of the support service facility as her boyfriends.

Joe and Anna live in a residential facility dementia unit. They are happiest when together, and spend the day looking after each other in a very caring way. Anna’s children are not happy with this relationship and have asked the facility management to keep Joe and Anna apart.


The importance of holistic assessmentsCollecting information from all the areas of function listed in this section provides the diversional therapist with a holistic view of the person to work from, and from which to develop the personal diversional therapy care plan.

The information documented in a holistic assessment identifies the person’s abilities and capacities and the areas of functioning that need to be addressed for the person to participate in the leisure activities of personal choice.

Holistic assessment information helps the diversional therapist to identify areas of a particular activity that need to be modified or adapted to assist the person’s participation and ensure that there is a good outcome for the person.

Holistic assessments are also valuable as the benchmark when monitoring and reviewing the person’s progress. These assessments document the person’s abilities at the time, allowing comparisons to be made with recently observed abilities and capacity changes.

Information gathered for a holistic assessment can also assist the decision making of the support services multi-disciplinary team.



Holistic assessment record – sample You may want to create your own table using some or all of these headings, or else copy and enlarge this table.


Name Address

Age

Health status

Social history

Physical Emotional

Sensory Cognitive

Social Sexual

Cultural Preferences

Spiritual Abilities/capacity

What is a personal diversional therapy activity?


Any daily task, hobby, leisure interest, community or family interest can be developed into a personal diversional therapy activity. It may be an activity that:

Is valued by the person participating •in the activity.

Is chosen after discussing the person’s •preferences (likes and dislikes).

The person has a history of participating in.•

Is part of the person’s daily routine.•

Meets some of the social needs of •the person.

Is a new thing the person wishes to try.•

Gives the person the opportunity to use •existing or previous skills and knowledge.

What is a personal diversional therapy activity?


How might this activity benefit the person?For older people, according to many studies, the more activities engaged in and the more roles played, the greater their life satisfaction.

What is a purposeful and positive activity experience for someone? The answer will be different for every person you work with.

Participation by people in activities of their choice stimulates and motivates levels of participation, promotes self-esteem and improves self-image, functional ability and quality of life.

Resource planning Planning activity options requires the diversional therapist to consider resources.

Who will supply these resources?•

What will be the cost of the resources •required, and who will pay for them?

Does the person already have access to •the resources or materials for that person’s chosen activity?

Will the person’s choice of activity require •extra staff or volunteers?

Is the environment suitable for the •chosen activity?

Will there be suitable access to the •environment in which the activity is to take place?

Will accessibility to equipment and •resources be a problem for the person?


Think about the topics covered in the previous pages, then answer the following questions.

How much money is budgeted for an average week’s or month’s programme of activities in your workplace/service?

List resources you keep available for running activities for the people you support:

What choices of environment do you have available in your workplace or service in which to run activities for people?

What is the cost of an average individual activity with a person you support? What additional funding is available for

running special occasion activities for people?

Weekly budget:

Monthly budget:


Describe the benefits to a person when a diversional therapist modifies an activity the person used to enjoy, to make it achievable for the person once again.

If a person’s choice of activity required additional staffing or volunteers, how would you organise this in your workplace or service?

Describe how a person might benefit from an activity that involves participating in a local community event.

Setting goals with the person you support


Re-read and reflect on the information 1 gathered in the holistic assessment.

From this information, what activities do you believe this person would enjoy and benefit from doing?

Consider the person’s preferences. Did the person mention any activity that particularly appealed?

Create several activity options for the person to choose from.

Now consider the abilities of the person 2 you support.

Are the abilities at an appropriate level for the activity options you’re suggesting?

Consider how the activities could be modified or adapted to result in an achievable outcome for the person.

Have you identified any risk factors? 3

How do you plan to control or overcome these risk factors?


Why is it important that you complete the three stages on the opposite page before you discuss the choice of activity with the person you are supporting?



Writing diversional therapy activity goalsNow it is time to meet with the person to discuss the options for his or her choice of activity. The person chooses an activity from the discussion with you and the options you provided. The person also selects a timeframe for this activity.

Allow enough time to complete all the planning and documentation of the personal diversional therapy care plan before running this activity.

Now you need to write the person’s choice of activity as an achievable goal.

What is a goal? It is a simple statement of what a person will do, and where and when this will happen.

The diversional therapy activity goal does not mention what the diversional therapist is going to do – it is only about what the person will do.

Always check that the goal states exactly what the person is expected to do to achieve the planned diversional therapy outcome.



We need to be specific in how we word goals, so that goals can be achievable and measurable. This means that we can look back and see if the goal was achieved or if a percentage of the goal was achieved.

Can we measure the goal in example 1?

Did James go to the RSA clubrooms at •2pm on Friday 14th?

When James was there, did he play •indoor bowls?

The phrasing of this goal means that we can measure and record whether:

James attended and participated, or •

James attended without participating, or •

James didn’t attend.•

We need to consider carefully how we word goals.

Goal example 1

“James will play indoor bowls on Friday 14th at 2pm at the RSA clubrooms.”

Goal example 2

“James will attend indoor bowls on Friday 14th at 2pm at the RSA clubrooms.”

Look at Goal example 2. By changing one word from Goal example 1, the whole goal has changed.

What is James now expected to do according to this re-worded goal?

The goal has changed from playing bowls to attending the bowls session; so if James is in the RSA clubrooms at 2pm when the bowls session gets underway, then his goal is achieved.



Goals need to be “SMART” “SMART” stands for the words in the column on the left. The column on the right uses James’ Goal example 1 to show you how to apply the SMART principles:

Specific Specifically: James is to go to the RSA clubrooms and play indoor bowls.

Measurable This goal can be measured: James either plays indoor bowls at the RSA or he does not.

Achievable Always choose a goal that is achievable for the person: indoor bowls is achievable for James.

Realistic Is it a realistic goal for the person? In other words, are there any possible barriers or issues that could make the activity an unrealistic one?

Timebound The timeframe here is Friday 14th at 2pm.

Sometimes the timing can be about when a person achieves a goal, eg six weeks after a fall the person is once again playing bowls.

Name of a diversional therapy activity or event:

Is your goal “SMART”? Use the letters below to check.

Write a person’s goal for this activity or event:

S _____________________________________________________________________________

M _____________________________________________________________________________

A _____________________________________________________________________________

R _____________________________________________________________________________

T _____________________________________________________________________________



You have considered the information gathered in the social history and holistic assessment; the person has chosen an activity option; and you have written the goal. Next, you need to plan how you will carry out the activity to achieve the person’s goal.

The action plan is a written record of how the chosen activity will be structured, adapted and run to promote the person’s safety and enjoyment, and also ensure that there is an achievable activity outcome. You will need to:

Record the activity the person has chosen 1 and the purpose of this activity.

Briefly explain how this activity matches 2 the person’s preferences and choices.

Developing the action planAnalyse the planned activity and check 3 what the person will need to be able to do to participate successfully in this activity, for example:

Does the person have the hand −strength needed?

Can the person understand and follow −the activity instructions?

Are the person’s vision or hearing levels −appropriate for this activity?

Does the person need to be mobile? −

What are the safety issues? −

Record the benefits to the person of 4 participating in this planned activity.


Developing the action planCheck policies and procedures to ensure 5 that the planned activities fit within the organisation’s guidelines.

Record how you have evaluated this 6 activity and identified adaptations needed in the activity, equipment, or environment to promote an achievable and enjoyable activity outcome for the person.

Record the benefit to the person of any 7 adaptations made.

Identify and record any potential 8 safety issues.

Plan and record how safety issues will be 9 dealt with.

Organise a time and place for the activity. 10 In some support facilities you may need to book the area and equipment you plan to use.

Notify management of any additional 11 staffing or costs involved.

Check whether the person is still happy 12 with the plan, including the planned activity, timeframe and area to be used.

Organise all the materials and equipment 13 to be used.

If the activity is a group activity, has it been 14 published in the weekly plan or timetable so that other people are aware that they can attend?

What is your plan “B”: your alternative 15 activity if a last minute difficulty prevents the running of the original activity?

You need to record all of the above points in your action plan.

What might an organisation’s policies and procedures state about people participating in activities in which they prepare food?

Describe how adapting the activity, equipment or environment could benefit the person you are supporting.



Risk management scenario Sarah is 48 years old. She has rheumatoid arthritis. Over recent years this condition has worsened and impacted on her mobility. Sarah experiences pain and loss of a range of movements. She is slowly adjusting to these changes.

The diversional therapist at the arthritis support group has one hour each Wednesday and Friday afternoon set aside to work one-on-one with people. Sarah’s hobby was making handmade greeting cards, but this activity has been more difficult for her as her arthritis worsened so she has not made any cards recently.

The diversional therapist asks Sarah if she wants to continue with her handmade cards. Sarah takes time to think about it and later tells the diversional therapist that she would like to make a card as a trial to see if she can manage. The diversional therapist reassures Sarah that she can be helped with this activity.

The diversional therapist and Sarah plan the activity. They decide that it will take place on Wednesday afternoon. They think it might take two sessions to make the first card.

The diversional therapist identifies the main areas of potential risk that will need to be addressed before working with Sarah on this project, which are:

Physical •

Time duration •

Risks to be considered for any proposed activity may include but are not limited to:

Physical •

Time duration•

Environmental•

Possible behaviour of the person•


Risk management scenario

The diversional therapist’s risk assessment of carrying out an activity with Sarah As a starting point, the diversional therapist assesses the physical risks involved in carrying out an activity with Sarah (shown below).

Risk analysis and identification

Risk evaluation (clarifies the potential risks)

Management strategies to overcome identified risks

Communication and consultation

Monitoring (while the activity is taking place)

Evaluation and recommendations for future change

Physical Sarah needs to use a “Lazy Boy” chair for support and comfort.

How can she work from her chair without over-stretching and causing more pain?

Sarah has a limited range of movement without pain. Work materials will need to be positioned close to her to prevent pain from stretching.

Provide Sarah with a cushioned lap tray to work on from her “Lazy Boy” chair.

Additional materials are to be placed on a side table and handed to Sarah as she requires them.

Consult with Sarah’s physiotherapist

about Sarah’s pain levels and the impact of her medications.

Discussed with Sarah the use of a cushioned lap tray, and the order in which she will use the materials.

Observe any changes in Sarah’s pain levels.

Check the stability of the lap tray work surface.

Check that the materials are available as Sarah requires them.

Evaluation of what was effective The cushioned lap tray provided a lightweight work surface for Sarah to work on without stretching.

Recommendation Materials should be pre-sorted into small boxes so that the correct item can be quickly handed to Sarah.

This assessment is the necessary first step towards assessing the specific risks in the card making activity (shown in the table on the next page).


Risk management scenario

The diversional therapist’s risk assessment of carrying out a card making activity with Sarah

Risk analysis and identification

Risk evaluation (clarifies the potential risks)

Management strategies to overcome identified risks

Communication and consultation

Monitoring (while the activity is taking place)

Evaluation and recommendations for future change

Physical Sarah’s arthritis has affected her hands and dexterity. Using scissors is difficult. There is a risk of accidentally cutting herself.

Sarah’s handgrip is not steady or strong. There is a risk of Sarah accidentally cutting her fingers while trimming the card.

Under Sarah’s supervision, the diversional therapist will pre-cut the materials that Sarah will need for the afternoon’s activity.

Discuss with Sarah before the activity what materials she will need and how she wishes them to be prepared.

Observe the process used by Sarah to make a card. Do the pre-cuts work?

What other materials could be pre-prepared?

Sarah found the pre-cut materials worked well. This preparation reduced some of the frustration she usually experienced with this activity.

Time duration There is a risk of overtiring Sarah if the activity takes too long to complete.

Rheumatoid arthritis limits Sarah’s activity tolerance. Some days this is worse than on other days.

The card making activity can be broken down into small steps giving Sarah the opportunity to rest between each stage.

Discussed with Sarah her health status and pain levels, checking if it would be appropriate to engage in this activity today.

Observe Sarah’s functioning for indications of increased pain or tiredness.

Sarah completed one card then chose to stop.

Recommendation Set a flexible plan so that a card does not need to be completed each time.


Think about Sarah’s scenario and the potential risks.

Describe three or more benefits of the risk management strategies for Sarah.

Identify two possible impacts on Sarah if these potential risks were not managed.

1

2

1

2

3


The diversional therapist consulted with Sarah’s physiotherapist before proceeding with the planned activity. Write a description – not a list – of the type of information that the physiotherapist could provide that the person might not be able to give?

How did the diversional therapist demonstrate accountability for risk management when running this activity?

Why does a diversional therapist need to provide evidence of risk management accountability?


Implementing the diversional therapy care planOn the day of the activity, remind the 1 person of the time and place where it is to be held. Check whether the person needs assistance getting to the activity.

Set up the activity before the person 2 arrives. Be ready to welcome other people to the activity if this is planned.

Run the activity as written in the 3 action plan.

Monitor the identified safety issues 4 or concerns.

At the end of the activity, thank those who 5 participated and assist any people who need help leaving the activity area.

Tidy away the equipment and 6 materials used.

Reflect on how the activity went. Did the 7 person achieve the identified goal?

Evaluate the outcome of the activity and 8 goal, recording any changes to this activity you would want to make for the future.


Person’s name: Date:

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Task Task detail Date completed Comment

Person’s consent

Brief history

Holistic assessment

Consultation

Develop goals

Analyse activity



Planning

Evaluation


Person’s name: Date:


Person’s consent Consent form to be completed. 29.10.09

Brief history This should be no more than a paragraph giving a brief account of the person’s history (family situation, employment history, health status, and recreation and leisure history).

29.10.09

Holistic assessment

Holistic assessment – describe seven dimensions (physical, sensory, psychological, social, cognitive, cultural, spiritual, sexual).

Identify the person’s recreation and leisure needs and document the person’s current interests, abilities, preferences and limitations.

29.10.09

Consultation Discuss options with the person. Choose an activity in accordance with the assessment information and person’s preferences.

2.11.09 Eg, the person is happy to have the opportunity to engage once again in this choice of activity.

Develop goals Record goals. The goal describes what you expect, from whom, and where or in what situation you expect it to happen.

2.11.09

Analyse activity Analyse the activity and the environment where the activity will be held, identifying the need for adaptation.

4.11.09



Planning Document the following:

What the activity is •

Where and when it will take place •

How the person will be involved in the activity•

Health and safety concerns involved•

What resources will be required •

4.11.09

Evaluation Document in this diversional therapy care plan a summary of the person’s participation and comments. Describe the strengths of the session and the areas you would change.

You may also need to document in the person’s progress notes how the activity and/or the environment was altered to meet the person’s needs, and your recommendations for change to this activity for the future.

6.11.09


Final evaluation after the activityConsider the following points:

Did the person appear to enjoy the activity?•

What was the person’s verbal feedback •about this activity?

Did the activity meet the expected •purpose for the person?

Did the activities undertaken match •the preferences and personal choices of the person?

Did the planned activity respect the •person’s individuality?

Did the person complete the activity or •participate for the full time of the activity?

Did the person require more or less •assistance than you expected?

Was the time allowed for this •activity sufficient?

Was the environment suitable?•

Was the equipment suitable for the •purpose of the activity?

What went really well in this activity?•

What didn’t go so well in this activity?•

Did the activity achieve the expected •benefits for the person?

What changes would you recommend •when running this activity in the future?

Record all of these evaluation results in the personal diversional therapy care plan for future reference, so that you can look at them again when planning to re-run this activity or run a similar activity.


Final evaluation after the activity

Evaluation is an important tool used by diversional therapists to monitor the programmes they provide for people they support.

Identify some diversional therapy activity programmes or events that require regular evaluation.

What are the key points requiring evaluation in the diversional therapy activity programmes or events you have listed above?

How often should diversional therapy activities be evaluated?


Final evaluation after the activityYou need to complete two personal diversional therapy care plans in order to be assessed for this unit standard. One plan is for a special occasion, and one is for an everyday activity. Both plans could be for the same person, or they could be for two different people.

An everyday diversional therapy activity planThis will be an activity that the person chose following discussion with you after you completed the person’s holistic assessment. This activity will be within the range of normal leisure diversional therapy activities provided for by your workplace support service. Costs, resources, staffing etc should also be within the usual range for people’s activities.

A special occasion diversional therapy activity planThis special occasion plan is for a special event for one person, although it may also include a few friends or family members. It is not a large-scale event for a large group of people you support (this type of event is covered in Unit Standard 5788). The special occasion will be important to the person and will be an activity of his/her own choice.

Examples:A celebration of something the person •has achieved, with one or two friends or family members.

An outing facilitated by the diversional •therapist for the person to buy a gift or special personal purchase.

Hosting a special visitor with a meal or •afternoon tea.

Making a creative art item to acknowledge •an important milestone in the life of a friend or family member.

Sharing an event such as a holiday or family •video with a friend or family member.

Both the everyday personal diversional therapy care plan and the special occasion personal diversional therapy care plan will contain all the assessment, planning, adapting, recording, and evaluating elements described in this resource book.


Personal diversional therapy action plan – sample You may want to create your own table using some or all of these headings, or else copy and enlarge this table.


Name The activity chosen by the person you are supporting:

Address

Briefly explain how this activity matches the person’s preferences and personal choices:

Analyse the planned activity:

Person’s abilities/capacities: Adaptations required following your evaluation of the activity:

How the person will benefit from the activity: How the person will benefit from the adaptations to the activity:

Policies and procedures checked: Consent form completed:



Identification of potential safety issues: How potential safety issues will be dealt with:

Activity environment booked: List the equipment and resources required:

Equipment and resources booked: Event publicised in the weekly timetable (if relevant):

Check the person is still happy with the planned activity: Contingencies: “Plan B”:

Record each step of the diversional therapy care plan: Evaluate the completed activity (care plan):


To page 7Do you agree with your initial thoughts and ideas?

yes

no

yes

no

If yes, do you have anything you would like to add?

If no, what would you change?


When you have completed the trainee assessment portfolio and have been signed off as competent by your assessor, your assessor will complete a Certificate and give it to you.

If you wish, you could frame it for display or mount it in a record book.

Check the following:

Please check over all the activities to make sure you have completed them.

Complete the trainee assessment portfolio and remember to sign your assessment portfolio in the place provided, verifying that you are the one who has completed all the assessments.

You have come to the end of the workbook for:

Develop, implement, evaluate, and adapt personal diversional therapy care plansNow you have finished this workbook you will have learned more about:

Holistic assessment of individual people •you support.

Setting diversional therapy activity goals •for people you support.

Evaluating activity goal outcomes.•

Recommending and/or making •adaptations to diversional therapy activity goals and care plans.

All rights reserved. Careerforce (Community Support Services ITO Ltd) is the owner of the copyright of this publication. Other than as permitted by the Copyright Act 1994, no part of this publication may be reproduced, copied or transmitted in any other form or by any means, without prior written permission of Careerforce, PO Box 25 255, Christchurch, New Zealand.

Date _________________________________________________

“All the answers in this workbook were completed by me.”

Signed _______________________________________________

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You have now completed

5786 V4 Develop, implement, evaluate and adapt personal diversional therapy care plans:part of a Careerforce learning series designed for support workers in a health or disability setting.

Disclaimer: The images contained in these workbooks are visual illustrations only and are not representative of actual events or personal circumstances.

Careerforce 2010

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