Over the past 10 years social care organisations have written, adopted or adapted a host of quality standards to answer in a fair and measurable way the question: how good are we at what we do?
Social care inspection has often been at the root of this: if you are going to inspect a service you need to have something to inspect against. However, despite the national promotion and funding, and mainly because such arrangements were not regulated, no standards existed for supported living. And yet this booming industry was crying out for some.
Two years ago the Reach standards for supported living were published by Paradigm, an independent agency that consults and develops health, housing and social care services for people with learning difficulties. Its nine standards were partly intended as a quality improvement process for supported living providers. The standards are: I choose who I live with; I choose where I live; I choose who supports me; I choose how I am supported; I choose what happens in my own home; I have my own home; I make friendships and relationships with people on my terms; I am supported to be healthy and safe on my terms; I have the same rights and responsibilities as other citizens.
For one provider the set of standards was music to its ears. “I thought this was something we should be moving forward with as an organisation, so I put together a working group from services from across the UK to look at the standards,” says Alice Drife, assistant director mental health and learning difficulties in Scotland, for the not-for-profit service provider CIC.
“Our enthusiastic team carried out a review of 14 per cent of services in Scotland which helped to inform us what we did really well (for example, staff rotas and shifts are built around person-centred plans) and what areas we needed to develop (for example, improving staff and service user knowledge around direct payments). Where possible we used service users to help us to do the audit.”
Drife adds: “The second phase was to look at the organisation and see how well its systems supported its services for supported living. This involved looking at the human resources, training and finance functions as well as operational management. Again it was focused on the nine standards. The management board has asked for reports back on the action plans and has been interested and supportive of the Reach working group.”
The final and potentially most exciting phase is now on the horizon. “The company has put money into promoting the service user inclusion agenda. We want to set up a review team made up only of service users,” Drife says.
With the closure of long-stay hospitals, there has been little shortage in potential tenants for supported living which has transformed people’s lives. Drife says: “One service user had been in hospital since he was 16. Now he’s 44 and has a key to his own house and has his own bedroom, kitchen and garden and has his own Motability vehicle, whereas in hospital he shared with 32 other people in the ward. From having to share everything he now has his own house and all things that go with that – the privacy, dignity and being part of the community. He goes to the post office and the pub. He now has friends and not just people who are paid to care or support him.”
The outcome for CIC is also positive. Drife says: “It is now more focused on the services it’s providing. It has invested a considerable sum in promoting a person-centred approach, for example through training and creating a person-centred co-ordinator post. Indeed, it’s part of our mission statement, which links into our service-user inclusion strategy. It all has to tie in to work effectively.”
Name: Alice Drife.
Job: Assistant director mental health and learning difficulties, CIC Scotland
Qualifications: RGN; registered midwife; registered health visitor.
Last job: Assistant director for CIC older people services, north west England.
First job: Nursing assistant in a psychiatric hospital.
- Find people who are keen to do it and who can see the value in it and make them your champions.
- Make sure you communicate as much as possible what the review is about – how it will affect the organisation and tenants.
- Feedback outcomes regularly – if people can see a result and see where you are going with something that will help.
- Being part of a review team – it’s just another part of the job.
- Set a plan from the off and stick to it – don’t be flexible.
- Don’t bother seeking senior management support – they are only interested in IT and finance.