Talking Mats has adopted day 69 of the justice for LB Campaign. This campaign was started was after Connor Sparrowhawk drowned in the bath whilst staying in  an assessment treatment unit .  In the words of his mum Connor was ‘a beautiful, hilarious and loved beyond words dude’.  So, after decades of trying to improve services for people with learning disability, closing the long stay hospitals, bringing in person centred approaches, we are left in 2014 with huge inequalities in the health and life opportunities  for people with learning disability and life’s like Connor are cut short in such a shocking, unnecessary and untimely manner.

How many more tragic deaths are we going to see before residential services for people with learning disability are going to change?  We need to see at the heart of  service culture an ability to really listen , put the views of the patient at the heart of planning and see the families as key partners. Sometimes I think people see listening as a ‘soft issue’. Other things get measured but does the quality of listening ever get measured? It should because in my view it is a critical patient safety issue.

Over the last few years I have had the privileged of working with a diverse group of people with a range of communication support needs. They have developed an interactive workbook for NHS Education Scotland. They share their experiences of contact with services to help staff understand how to improve communication and listening skills. They created 10 vision statements for staff of the things that were key to them. They told powerful personal stories to illustrate those statements. The stories illustrate both good and bad practice. You can download the free resource at http://goo.gl/QdOOev .

Listening to people what strikes me time and time again is the lottery of service delivery. There are some great stories where people have received quality treatment and interaction but that is not universal for there are stories where you are left questioning the compassion and humanity of staff in so called ‘caring’ roles. The question for all of us is how we shift the culture so that we can all experience a person centred and listening health service. I hope the energy and impetus of #107 campaign ignites the flame of change so that ‘all dudes’ gets a safe and quality service. If you want to join the campaign then please follow @justiceforLB .

Has Talking Mats been used in court ?

This is a question that we have often been asked and up until now we have been until able to give examples. On a recent training in Belfast there were two registered intermediaries, their role is to assist vulnerable witnesses and defendants with communication difficulties in the criminal justice system. The registered intermediaries scheme was set up in England and Wales and more recently was established in Northern Ireland. On the course they talked about two cases where Talking Mats was used as part of the achieving best evidence (ABE) interviews.

1. The first case was the case of R versus James Michael Watts http://www.bailii.org/ew/cases/EWCA/Crim/2010/1824.html . Here the clinical forensic psychologist used them to support an individual with severe disabilities to express her view of what had happened.

2. The second case that was discussed was the work of a registered intermediary, Catherine ‘O’Neil where she used them with a young man called Tim  in his early twenties who had been severely stabbed and suffered a severe head injury which resulted in locked in syndrome. He had some very limited movement of his hand.  Initially, Catherine worked with him to establish a yes/ no and then went on to assess Tim’s ability to use Talking Mats.   The focus of the first Talking Mat was to find  out about his interests and to enable Catherine and Tim to engage and interact with each other.  Catherine said ‘he  seemed totally relieved to be able to communicate his narrative. This allowed us to get to know him and his likes, dislikes and interests. Tim had never been a great friend of the police and in the like/dislikes/ don’t know mat, I included many pictures including Basketball, which went slowly but immediately to YES; Snakes under No and Police he joked and eye pointed to the door.!’  Catherine went on to use Talking Mats and these were used jointly with the police in 5 ABE interviews. This did enable evidence to be gathered in terms of the assault weapon, people etc. Through the support of a skilled registered intermediary Talking Mats contributed to enabling the victim to have a voice at the trial where otherwise none would be had. In this case a conviction was made.

We like to keep up to date about how Talking Mats is being used. You may well know of other cases where Talking Mats is being used to support people with communication disability to access justice. If so we would love to hear about them so please let us know.

The Talking Mats Team is increasingly  asked to help ascertain a person’s capacity to express their views from a non-biased perspective. We are also asked to carry out service evaluations  and are therefore developing independent consultancies to individuals and organisations. Our team of experienced Speech and Language Therapists, who have an in-depth knowledge of communication difficulties, are well equipped to do this.  

The following are examples of independent consultancies which we have been asked to carry out:

1.  A lawyer asked us to work with a man who had had a severe stroke to ascertain his capacity to make decisions ranging from simple ones such as where he would like to go on holiday to complex ones such as who should control his finances.  Using Talking Mats we were able to determine that he could make decisions about simple, concrete situations but wished his wife to make more complex decisions such as finances. check
2. A Social Work department asked us to work with a woman with dementia and aphasia who had been sectioned. They needed to ascertain if she could understand why she could no longer live in her own home. We worked closely with her social worker and through using Talking Mats ascertained that she was unable to give informed consent.
3. A Health Service facility asked us to evaluate the degree to which their patients felt involved in their care planning.
4. A Care Home asked us to use Talking Mats with a 91 year old resident with dementia to find out her views about receiving dental treatment. There had been problems in the past and both the staff and her son were unsure if she understood the reasons and implications for dental treatment. Using Talking Mats, she was able to explain her thoughts about her teeth and dentures and clearly said that she was unhappy about opening her mouth for the dentist but that if her son were with her she would feel much better. We received this comment: “If you were to show the first few minutes without Talking Mats you would have thought this lovely lady lacked capacity,  however the change and her engagement is noticeable.”

The following points explain with whom and how we can carry out the Talking Mats consultancy:

• Children or adults
• Family members, friends, professional staff
• Individuals or groups
• With or without a carer present
• At a venue and time which best suits the individual
• On any topic – we already have a comprehensive range of topics for both adults and children – but can create tailored symbol sets for any situation
• To find out someone’s views on a particular topic or situation at a specific point in time
• To help determine the capacity of an individual to make their own decisions
• To compare someone’s views over time
• To compare different people’s views e.g child and parent, person with dementia and carer
• We provide a detailed report with a copy of the person’s completed mat/s

To find out how we can help you and for discussion of costs please contact us at info@talkingmats.com or phone us at 01786 479511

Talking Mats has been working with Survivor Scotland.  They are the organisation that oversees the National Strategy for Survivors of childhood abuse in Scotland. They have focused their work on a whole range of people but recognise the incidence of abuse within Learning disability is very high and that people with a learning disability often don’t have the resources or skills to tell their story and get the support they require. Survivor Scotland are anxious to address this and develop appropriate resources for this group of people.

.In our current project with Survivor Scotland  we have developed 3 sets of Talking Mats that would allow conversations to be had with people with a learning disability. These sets were developed from a previous project that had been conducted in NHS Fife;‘the 6D Cards’ and with the input of staff experienced and skilled in working with survivors of abuse. The sets cover general issues but within those issues, patterns of concern may emerge that would allow people to discuss concerns further.

We then ran 3 training courses. These courses gave participants space to think about disclosure, encouraged them to become trauma aware and built their confidence in supporting and dealing with disclosure. Specific training in Talking Mats was also provided. The training was run jointly with Kingdom abuse Survivors Project, Survivor Scotland and ourselves and was funded by the Scottish Government

The 3 courses have now finished and 40 people have been trained in the resource. They came from all over Scotland from the Western Isles to the Borders and represented a range of professions working with people with a learning disability and with an interest in preventing abuse in learning disabilities: therapists, nurses, social workers, consultants, advocates  They will use this resource in their practice  and it will be evaluated later in the summer