Choice Lives in Ordinary Moments

An ordinary moment is a moment of choice. Maintain choice in decisions about pace, sequence, privacy and participation.

There are often large planning meetings about person centred support, but the practice of person centred support is often lived in the small moments: which shirt, which route, whether to pause, and who goes into a private space.

Worker-led routines can creep in when the workers are focused on efficiency, and they are going about them in familiar ways. The task gets finished, and the person's control is lessened.

Why this matters for support workers

In the eyes of the support worker, quality is a combination of hundreds of small decisions taken in another person's home and community. While having a plan is important, consent, appropriate vocabulary, observation, and keeping to role are also important. Consistency does not need to be “rigid” when workers are aware of the reason behind a routine, and when the person can guide the support they want.

What better coordination looks like

Real choice requires options that are accessible, sufficient time to make a response and respect for a decision that is not the worker's choice, but is not immediately life-threatening.

Offer real options

Use the person's preferred mode of communication, offering two or more options, rather than just a single option or answer.

Support decision-making

Divide information into small chunks, incorporate visuals or demonstrations as needed and provide processing time.

Respect changes of mind

Ensure consent is sought at all levels of individual and community support, and record preferences that should inform future decisions.

Make the change last

A helpful change is distinct enough to practise, and manageable enough to review. Decide who will make the first move, where to note the decision and when to ask the person if they have felt it helped. When relying on multiple services, ensure each party's readiness for each service individually, not upon mutual buy-in during a meeting. Keep what is working, change what isn't and eliminate temporary solutions that are no longer needed to achieve a desired outcome.

Questions for the next review

What would “offer real options” look like from the person's point of view?

What is the part that is confirmed and what is the part that remains an assumption or pending request?

What will be seen that will indicate to the person and team that this is successful?

Keep the boundary clear

Having a choice doesn't mean it's safe to overlook any imminent threat, legal obligations or approved plan. In the case of a mismatch between risk and preference, stick to the agreed approach, do not impose a new rule; include the person in review.

A practical example

A worker used to take the fastest bus. They asked the participant, and they were told that they would prefer a slightly longer walk as it was calmer and left them more settled. It was still about the same objective, but it was a different experience.