Lives – not services

In a tough environment of budget reductions, workforce problems and provider struggles, Rose Trustam reports from three conferences focusing on the positive:  community development, real achievement and evidencing  what works.

(NB Full conference reports available to subscribers on the website home page)

Commissioners conference (www.ncctc.co.uk)

Margaret Willcox (President elect of ADAAS) stressed the need to ‘really put the individual at the centre of working out their needs and controlling their care, with a system of care and support designed with their full involvement and tailored to meet their unique needs. …a life not a service’  

Key points from the conference speakers and research presentations:

  • More personal health budgets joined up with social care personal budgets would develop patient power and influence learning (James Sanderson, NHS England)
  • Outcome based measures don’t work – devolving judgement to the frontline, with a positive errors culture,  is more likely to improve outcomes (Toby Lowe, Newcastle University)
  • Transformative practice: the Wigan Deal‘s asset-based approach, triggered by its huge budget cut, saved £100m whilst improving outcomes for people. Its genuine engagement with its citizens and other stake-holders and investment in frontline staff, developed a workforce of community connectors, link workers and volunteers who know their community ‘patch’ and help people engage in activities.
  • A joint social care/ clinical commissioning approach in Walsall saved £750,000 by reviewing four housing support contracts and through extensive consultation developed  some resilient community and locality models, differentiating service needs including new autism befriending and community outreach services. (http://www.local.gov.uk/web/guest/publications/-/journalcontent/56/10180/7643400/PUBLICATION )
  • Social care recruitment crisis: Dependence on EU workers is highest in London at 13% (7% is average). Turnover is 33% in domiciliary care with 11% of domiciliary care jobs and 5% of residential care jobs vacant at any time. Recruiting on values reduces turnover and, when done well, can result in an experienced ‘core’ of workers retained for at least five years (55%) (Skills for care)
  • Bournemouth has established ‘Proud to Care’, a partnership of employers and stakeholders sharing solutions and innovative practices. Their initiatives include commissioners helping to promote vacancies for staff with the right values and behaviours, free NVQ training, workers able to agree flexible hours with clients, working with schools, colleges and the Prince’s Trust and using the apprentice levy.  http://www.ncctc.co.uk/presentations/nov-2016/

 British Association of Supported Employment (Base)

The Department for Work and Pensions (DWP) have published a Green Paper for consultation, Work, Health and Disability: Improving Lives, and this was a main conference concern. DWP speakers confirmed the key principles of work and health programmes delivery as personalised, integrated and localised, and intend to use BASE to test their supported employment model and then scale up. A more personalised offer will start with better trained Job Centre Plus (JCP) Expert and experienced  Community/ Third Sector partners will support job centres get the expertise. With funding significantly reduced  the Green Paper target disability group is mental health.

Key points from conference speakers and presentations:

  • Suggested  partnerships with local authority supported employment services  in learning disability and autism pilots to see what works with the most challenging people.
  • DWP intends more supported work experience for young people with mental health issues.
  • The essential values of supported employment  are real work, real work settings and real money at the going rate of pay. Supported employment  places people in jobs and trains in situ, builds a comprehensive profile of the person, does a full job analysis ,job matches, and develops a placement plan.
  • Timothy Broadhurst was the BASE award advocate for SE’s success in his work for Timpsons ltd, winning the David Grainger Award, presented by Liam Bairstow of Corrie fame.     
  • Derby Council’s active citizenship and assets-based community development (ABCD)  approach with adults with severe learning disabilities showed how engaging more widely develops the foundations  upon which meaningful and sustainable employment can be built. Local Area Coordinators (LACs) get to know people in their community, working out how to link them to get a good life. After 8 months, Derby University’s evaluation found a significant financial impact with a potential of £1.3-£1.4m savings if replicated across 10 wards.  Outcomes were 80% in volunteering/ work and Derby council have seen how developing local lives diminishes the need for formalised services.
  • For employers, Liz Stanton’s work in IKEA Edinburgh was inspirational,  turning around the business’s view of employing disabled people and overcoming staff’s initial nervousness by being present and engaging.
  • In Wales the  Engage to Change project with a  five-year £10m Big Lottery Fund grant will work with 800 employers to help 1,000 young people with learning disability and/or autism develop their employment skills through paid work placements.
  • Newham Council’s Workplace Supported Employment Team won BASE’s team award, increasing their employment rate for people with health and social care needs from 2.8% in 2011-12 to 7.8%.

For presentations of these and other workshops see http://base-uk.org/2016-conference-workshops

Supported living – a service or a life?

This was the first conference of Learning Disability England, who expressed a determination to  support and challenge in their newly  joined up voice, in the light of the planned withdrawal of funding for National and local self-advocacy forums.

Key points from conference speakers and presentations:

  • Leading self-advocate Gary Bourlet and Alicia Wood of Housing Support Alliance highlighted the increasing ‘servicisation’ of what should be people’s own secure homes. Proposed changes in supported housing funding (See p. 9) and Local Authority cuts risk pushing services towards more institutional models.
  • Suzy Fothergill chair of the Association of Quality Checkers (AQC) argued that service-type homes are not laways like other people’s homes and lack things that tell the stories of people who live in them.  Sally Warren of Paradigm emphasised that it is about having control over how you live; with whom you live; where you live; who supports you and how you’re supported.
  • Sammy Butcher a successful expert by experience and  ‘ freedom fighter’  described her journey from family home, first to an inflexibly staffed service but them eventually to her own place where she recruited her own staff and was supported by a community circle of family and friends. Sammy urged others not to give up and keep speaking out. ‘Tell your family you love them but you want to fly… if you know your rights you can push through a barrier’.
  • Rachel Mason, a mum with two sons with a learning disability and autism, told how ‘person-centred planning changed their lives’.  Using direct payments one son now lives in his own purchased home locally (through www.my safehome.info) with a 24 hrs support service designed, costed and recruited by the family. They rejected an initial social worker offer of a £1700 per-week residential placement miles away, and the son is now firmly embedded in his local community.

In the panel discussion, Rob Grieg of NDTi,  referred to Rochdale’s ‘wrong and illegal’ proposal to end supported living  contracts and effectively force people into residential care.  Policy and law support people’s rights to remain in their own homes – Valuing People and Valuing People Now, The Care Act and Equalities legislation all support the right of disabled people to live in dependently. Residential accommodation removes important rights, including control over where you live

Kate Whittaker, public law solicitor, reminded people of their rights under the law, including the power of the Wellbeing principle in the Care Act, which spells out local authorities’ duty to promote the individual’s wellbeing, including suitability of living accommodation.

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