Page 9 - Community Living Magazine 34-3

3,000 lIVES 3,000 lIVES

WHy ATUS and a normal life because they don’t speedy job of ‘treating’ a person and A good plan & Support Alliance have developed
The importance of good planning can’t
do normal things in ATUs. In a risk-
getting them home.
guidance and a training pack ‘Life
DoN’T WorK averse culture, a large group of people Shutting families out be emphasised enough in getting a Begins at Home’ that will help
professionals think through
good life for someone when they
cannot be risk-assessed. The kitchens,
bathrooms and cleaning cupboards are But what is most damaging is that when leave an ATU. This planning needs to housing issues and solutions:
often locked so an understanding of a people go into an ATU they are ripped happen as soon as they are admitted https://www.housingandsupport.
By their very nature ATUs are not set person’s abilities to look after away from family, loved ones, friends and should be based on the person’s org.uk/life-begins-at-home
up to work with people in their familiar themselves has to be based on and their familiar places. This in itself hopes, dreams, skills and talents.
environment and rehabilitate them; historical information. is devastating but is often compounded It should involve exploring what a life A budget
instead, they seek to remove and treat with The ‘problem’ isn’t resolved by by the professionals then subtly or that makes sense to them looks like. Money is seen as a big problem,
sometimes blatantly closing ranks and
especially in this climate of austerity,
Planning has to involve the person and
an extremely small toolkit, says Sam Sly removing a person to an ATU. shutting families out of learning and those people who know them well. but until we stop wasting public
The problem will still be there when decision-making. Families start If you don’t have a good plan you money on ATUs and poorly thought
the person goes back. In nine times to be seen as a problem if they won’t get a good life – simple as! through discharge solutions we
ver a year ago I was Why don’t ATUs work? out of ten it would have been better to challenge things, are often written can’t use austerity as an excuse.
oasked to write about An ATU is an institution based on a have targeted resources to prevent the out of the person’s future and their Partnerships The flexibility and adaptability of a
getting people out of medical model of ‘assessment’ and problem escalating. importance disregarded. To make discharge work well those package of support needed to meet
Assessment & Treatment Units ‘treatment’ which in itself has a involved have to work together on the often fast changing needs of a
(ATUs) but didn’t get around to multitude of problems. Many people I have huge issues with the reasons What is needed to get an equal footing when it comes to person just discharged from an
it so when I was asked again I admitted to ATUs have autism or other people are admitted to ATUs in the people home decision-making. And those people ATU can only, in my opinion,
thought I would reflect first on learning disabilities and it is argued first place. When I have done life We, the professionals, have made involved are the commissioners, be met through the use of an
the changes I have seen in a that these conditions cannot be planning with people and heard their getting a person home difficult. the local community team but also, individual social care/health budget
year. Then I will look again ‘treated’ in a traditional way. stories it is rarely because someone We have over complicated things crucially, the person, the family and (IB or IHB) or the support provider
at why I think people aren’t has suddenly become unsettled and and developed the barriers so we the support provider. And equal holding an individual service fund
home and what needs to By their very nature ATUs are not set unmanageable but usually because are totally responsible for the mess footing means exactly that. (ISF) on behalf of the person.
be done. up to work with people in their familiar the family have asked for help for and broken, wasted lives we have Power, if not shared with families,
environment and rehabilitate them; years and been ignored or given the created. We also bandy about is incredibly destructive when it This then puts the power and control
To be blunt, as far as professionals instead, they seek to remove and treat wrong help. words like ‘person-centred’, comes to someone getting home. for decision-making and design back
getting people back home to their with an extremely small toolkit, namely ‘co-production’, ‘individual budgets’, Partnership where it belongs
families and communities are drug therapy including ‘injected as The prism of a medical model ‘supported living’ and don’t do any of working with the person
concerned, I cannot see that a huge required’ medication and behavioural When people are in an institution it properly, tarnishing what started out should start and their family.
amount has changed. There are a lot therapy including restraint and they quickly become institutionalised, and could still be the cornerstones of with the ATUs have absolutely Sadly, I have seen
more checks and balances with the seclusion. This means that sensory as do the staff. When staff work in great lives. planning, no incentive to IBs and IHBs used to
Care & Treatment Reviews and and communication needs are often institutions they find it hard to see and can be discharge people; make a challenging
NHS England is asking for more overlooked or not assessed at all and any other way of supporting a person Getting a person home isn’t hard in helped by the private ones family ‘go away’
updates on progress. There has been the person is lost completely. Some of especially as the person is reacting to theory but does involve a lot of work the use of make huge profits from and ISFs are little
a raft of policies and procedures the methods used, such as ‘intravenous the environment and the person is and thinking outside of ‘serviceland’ individual keeping people in for as known about by
and more money has been thrown as required’ medication and prone seen only through the prism of a which some professionals find difficult. budgets. long as possible. either professionals
at the problem but in reality the restraint, cannot be used in a normal medical model. When discharge is It is hard for or providers
people returning to a home that house in a normal street making it being planned the ATU staff are relied Thinking ‘serviceland’ professionals and families.
suits them, with support that is difficult to discharge people. on heavily for their views on where the The professionals who make decisions to relinquish
right for them, isn’t happening often, person should live and often they about where someone should go after power – they can dress it up in all Good help
or quickly enough. The environment does not lend itself have no other experience than being in an institution like an ATU work sorts of guises: duty of care, statutory Good help needs to come not just
to helping the people it contains. their institution so recommendations in and think ‘serviceland’. If we don’t responsibility etc., but to make good from a support provider or personal
People who shouldn’t be in ATUs are Many have experienced difficulties are based on similar models. think differently solutions will always decisions about sometimes risky assistants but also from the
still there and the biggest scandal is living or sharing space with others and The people themselves also become be targeted at what is already there; dangerous behaviour everyone has local community learning
that these are not just adults but many now find themselves with many other institutionalised and for some which care home? what respite centre? to be in agreement about the way disability/mental health team.
children too. Spending your formative people every day, many of whom show leaving after many years can be a which block provider contracts are forward and people and families have These professionals need to be
years in an ATU is a certain precursor they are unhappy by hurting themselves scary prospect. already in place? to feel they really are in control of working as partners together and
to a lifetime of problems. and others. These people need space their lives. the community support often
indoors and out to meet sensory needs; When a person lives side by side with We pretty much know, through things needed is 24 hour hands-on
Family activism instead, by default of a mental health others with behaviours that challenge going wrong and re-admission to A home help and advice, especially in the
The positive changes I have seen, act section, they are locked up. Lots of they will learn new negative ways to ATUs, that the people who challenge A person has to have somewhere to first 12-18 months after someone
however, are with families of people these people have sensory needs and communicate and show their boredom, us don’t fit into ‘serviceland’ – it is live that works for them. This requires comes home as this is how long
in ATUs and interested members react badly to noise and crowds and frustration and feelings. People go into like fitting a square peg into a detailed planning around the person’s it takes to unlearn the bad things
of the public galvanising themselves yet are put in environments that have an ATU with one behaviour and come round hole. needs. Slotting someone into a experienced in an ATU.
into action and protest, mainly through alarms going off day and night and out with a handful that then takes years residential setting because there is a
social media, an amazing way to people shouting and screaming. to change. By planning well and involving the vacancy won’t work, nor will setting up Good help can also be provided by
highlight the problems and get results. It’s hardly surprising that their right people solutions tailored to ‘supported living’ with people sharing people that are especially picked,
It has been inspiring to watch the rise behaviour deteriorates. ATUs have absolutely no incentive to individuals can be found or developed whose only connection is having by the person, to work with them.
of family activism and I believe that discharge people; the private ones and pretty much every time these won’t challenging behaviour. There are so Matching workers to a person’s
this, and not professional intervention, It is nigh on impossible to assess and make huge profits from keeping cost anywhere near as much as the many options available within housing attributes, hobbies and interests often
may in the end be the turning point that give a person the skills they will need people in for as long as possible and expensive ATU placements they have but still many people end up living in enables great, positive relationships to
ends the use of ATUs. for discharge back to a normal house there is no pressure on them to do a come from. traditional group settings. The Housing (Continued overleaf)

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