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Leading Practice Guidelines
Supporting Choice & Control
Guideline: The organization supports people to have choice and control over their services and life choices. People are actively asked for input and feedback. People are informed of relevant information and options in a manner that is understandable and accessible to their unique communication style. People’s wishes and opinions are respected, listened to and acted on. When this is not possible, people are informed of the reasons why.
What does this look like?
The organization has a policy and statement of commitment in place to describe their systems for active promotion and support of each person’s right to choice and control over their service and life decisions. This may include reference to:
- Stated commitment and expectation that people will be respected and listened to:People are recognized as an expert in their own experiences, needs and wishes.
- People are empowered and enabled to be as independent and as in control of their lives as they want to and can be.
- Each person is listened to with care and respected by staff and the organization. Their views are taken into account in all decisions.
- People receiving service are facilitated and empowered to exercise choice and control across a range of daily activities and to have their choices and decisions respected.
- People are encouraged to work out a structure to their daily lives that best reflects their goals, activities, and needs and are assisted in doing so, if required.
- Encouraging and welcoming people to serve in leadership or advisory roles within the organization.
- People’s right to refuse a recommended action or activity, where appropriate
- Providing information and options:
- Providing support, information and advice in a format or language that is appropriate to the unique communication style of each person.
- Information is provided at the earliest opportunity and as required thereafter to enable people to make choices and decisions.
- Providing information on options and support accessing services from alternative services when the organization cannot meet the person’s needs or they wish an alternative option.
- Providing needed supports for choice and decision making:
- Each person has a documented description of the supports they need and desire to make decisions and choices successfully.
- This includes identifying people’s preferred communication methods, who they rely on to make decisions or ask advice from, and behaviour and body language that demonstrate pain, distress, or discomfort (when the person is unable to express these directly or clearly).
- Active involvement of an advocate of the person’s choice and/or their decision maker(s). Where people do not have this support, the organization will make ongoing and active efforts to assist them in developing supportive relationships.
- Involving family members and significant others to assist with making choices and decisions, where appropriate.
- Access to and/or information about equipment, aids or technology that increase independence, strengthen current skills, and support communication and decision making.
- Assistive technology and communication supports are provided to facilitate contact with family and friends, as appropriate.
- Providing information about how to access independent advocacy, support and advice when this is needed or requested.
- Active Solicitation for Feedback and Input:
- People are consulted about and make decisions about the services and supports they receive and their views are actively and regularly sought by the organization.
- Each person’s means of expressing their preferences, choice and decision will be sought and shared to ensure that people are given the maximum opportunities to express their wishes, ideas and choices.
- If people are unable to make their own decisions at any time, the views of those who know their wishes, such as their family, support network, independent advocate, formal or informal decision maker are sought and taken into account.
The organization provides training, guidance and supervision to staff to ensure that there is a robust understanding of the expectation and practice of supporting choice and control for people served within the organization.
Staff receive required instruction and information on each person’s preferred method of communication, how they make decisions and choices and what support they require or wish in order to be successful.
The organization provides support and information to people served by the organization and their families/support network on the supports they can expect, training and skill development opportunities in the area of choice, decision making and self-advocacy and any limitations that may exist related to directing their services and support. This information is made available in an accessible format they can understand.
The organization monitors and evaluates whether people experience opportunities for choice and control, gain support to make decisions and feel in charge of their service and lives.
How would you know this is happening? (Evidence)
What you see in systems:
- Written policy/statement of commitment and expectations related to people’s right to make choices and control their support decisions
- Training content and records of completion
- Documentation reflects the involvement of people who use the service, staff, family members and other stakeholders
- Documentation includes people’s right to refuse a recommended action or activity.
What you see in actions:
- Staff demonstrate an understanding of each person’s right to choice and control in services and life decisions.
- Feedback from people supported and their families indicate that they have been supported to exercise choice and control in service-delivery decision making, along with people’s right to refuse a recommended action or activity without retribution or consequence.
Resources to support achieving guideline:
- Manitoba Vulnerable Persons Act
- The Essentials of Supporting Choice – The Council on Quality and Leadership
- It’s My Choice Toolkit – Inclusion Melbourne
- What’s Worth Working For? – John O’Brien (PDF)
- Video “Speaking differently at Disability and Decision Making” – Michael Bach (Canada)
- Autonomy, Empowerment, and Supported Decision-Making - CQL
- Engaging People Who Receive Services – Best Practice Guide – August 2020 – NCAPPS (PDF 434KB)
- Sample Choice and Control Policy Statements – [To be added soon]
- Sample Curriculum for Strategies for Supporting Choice and Control – [To be added soon]