Excellence Network winners in self-directed care

Older People
Bell View Brokerage Project

In the isolated communities of rural Northumberland, social services were facing two distinct challenges: providing more care for an increasingly elderly population, and improving scarce employment opportunities for parents and carers in need of flexible local work. In an innovative joint venture, Bell View charity, Northumberland Care Trust and the local Sure Start team came together to solve both problems with a single initiative.

Following research, they established a directory of care workers in rural areas, accessible to both direct payments recipients and private funders. This directory put service users in direct contact with trained care workers, allowing all negotiations over work, hours and so on to take place without the need for statutory intervention.

The project demonstrates the advantages of taking an intergenerational approach to community problems. Sure Start was able to use its contacts with local children to access parents in need of work, while Bell View provided specialist knowledge about the local elderly population. The project also cut across statutory and voluntary boundaries, as Northumberland Care Trust worked with Bell View to map existing clients in the area. The care trust’s direct payments team also provided information about employer responsibilities and helped establish Criminal Records Bureau checks.

The project has massively increased the choice and control of both care workers and service users. It has provided much needed employment, improved community cohesion and increased the take-up of direct payments.

Unexpected benefits have also emerged, as pre-existing care workers who have joined the scheme have gained access to extra work and support.

Jane Field, services development manager, Bell View Resource Centre, says: “I feel this work is really valuable – not only are we looking to support older people to live independently within their rural community and enable them to have some choice over their care provision, we are also providing access to flexible, local employment for people living within those communities.”

Learning Disabilities
My Way

The My Way team, run by the charity MacIntyre, is developing self-directed support for young people with learning disabilities in Milton Keynes. These personalised plans aim to establish sustainable systems of care for those making the transition into adult life.

The team starts by working with the young person and their family to create a comprehensive outcome support plan. The facilitator then goes one step further by brokering the links necessary to implement the plan, making sure that each user’s individual choices are put into action. One father summed up the experience: “It’s rather like having a suit made – we have always had to fit our son into services before. This approach is inspiring.”

Following a two-year pilot, the My Way service, including individual budget plans, is now available to all young people in local residential schools. It has boosted demand for self-directed funding and stimulated the local provider market. My Way’s experience shows that putting individual budgets into action requires focused one-on-one support in both designing and “brokering” the plan. Team members have also stressed the advantages of keeping documentation clear and easily accessible for users, as well as the importance of support from those higher up the professional hierarchy.

For those who want to know more about MacIntyre’s approach to personalised budgets under the My Way team, there is a conference being held on 28 April at Manchester United FC. The event will bring together various provider organisations and commissioners with the aim of sharing best practice and innovative ways of working.

DISABILITIES
Individual Budgets National Pilot Team

When Essex Council became one of 13 individual budget pilot sites, employees seized the opportunity to push the frontiers of individual decision-making. They decided that users shouldn’t just be given materials to help create personalised budgets; they should also play a role in designing those support materials.

When the formal team of nine began developing the tools required to make personal budgets a reality – in particular the self-assessment questionnaire, the resource  allocation system and the support planning and review process – they did so in partnership with user-based organisations and individuals themselves.

This collaborative approach led to the establishment of a service-user led community interest company. The organisation now works to support service users through the personalised budget process, while helping to build peer mentoring. The team’s readiness to adapt resources and procedures in the face of increased knowledge and experience was key to their success. Working closely with internal stakeholders was also important, with the team highlighting that these systems are often those most in need of change.

A recent evaluation day, also conducted with the active participation of service users, suggests that results have paid off. One user reported buying an air conditioner to help with a lung disorder, while another bought a yurt as a safe personal space. There was a consensus that these well planned budgets have given local disabled people real choice and control over their care and finances, as well as a greater sense of dignity.

David Williams, project manager on the Individual Budgets National Pilot Team, says: “It’s been a wonderful experience to see the real choice and control personal budgets deliver and the huge improvement they make to people’s quality of life. As one of our service users said: ‘Before I had a personal budget I just existed. Now I’m working again.I’ve got my life back and its wonderful’.”

CHILDREN AND FAMILIES
Calcot Services for Children

Calcot Services for Children is a set of four therapeutic communities working to provide care for traumatised and damaged young people in Reading. When the group noticed that they were receiving a substantial increase in referrals with a higher age range (14 years plus), they decided that their services needed to be adapted to put more emphasis on independence.

They created a new position, the independence co-ordinator, who was charged with overseeing independence plans and putting them into practice. The young people themselves were asked to take on more tasks that had previously been done by care workers, such as cleaning their rooms, ironing and washing.

The cultural shift that had to take place within the service was challenging, both for staff and the young people. Care workers found it hard to break old habits, while young people were often preoccupied with concerns about their adolescence, past histories and future worries. The team has learned that the path to independence is not a  straight or easy one; young people must be allowed to fail at times, and staff must be available to help pick them up and put them on their way again.

The team’s reformation was helped by the fact that one of the therapeutic communities within the centre was originally set up as a semi-independence unit. They were able  to share information about pathway plans, the Leaving Care Act and the successes and failures of independence promotion policies with the other branches of the service.

WHAT THE JUDGES SAID

Gary FitzGerald, chief executive, Action on Elder Abuse: “The Bell View Brokerage Project represented what I thought was the best in lateral thinking; how to take two problems and resolve them together. Solving the huge challenge of making direct payments safely available to older people is a major issue, and to find the solution by engaging with under-used childminders and parents/carers showed a level of thinking and creativity that deserved recognition. It gives older people access to a CRB-checked workforce with transferable skills, and it provides work for an experienced and capable group of people. Excellent idea!”

Chris Hanvey, director of operations, Barnardo’s: “The engagement of young people in Calcot’s therapeutic care shows that residential provision is possible in a way that values their choice.”

The other judges were Sue Bott, strategic director of the National Centre for Independent Living, Kathryn Stone, chief executive of Voice UK for people with learning disabilities and Andrew McCulloch,  chief executive of the Mental Health Foundation