Excellence Network honoured teams 2009: the Self-directed care category

The Excellence Network recognises achievement in social care. Honoured teams are invited to the presentation at this year’s Community Care LIVE 

The Excellence Network recognises achievement in five key areas. Here, Natasha Salari reports on the teams honoured for exceptional self-directed care

Organisation: The Opportunities Trust

Client group: Learning disability

Location: Cambridgeshire

A network of providers has joined forces to offer people with a personal budget in Cambridgeshire a wide choice of activities and support. The Opportunities Trust has more than 40 members, ranging from care homes to community radio stations. It was set up to prepare for the change in the way people are supported with the move away from day centres towards personal budgets.

People with learning or physical disabilities, mental health problems and older people will be able to use the trust to access information on support available as well as being assured that any activities and support they do purchase are of a high standard.

Carers and service users sit on the trust’s board. Workshops and focus groups involving service users are being held to identify gaps in provision. The trust will be a centrepoint for service users to access leisure activities, education, personal support and help into employment.

Helena Harris, joint chair of the trust, says: “We have some quite rural areas so we wanted to make sure that there were consistent opportunities for people across the county. We are collecting and understanding what people want, which could be anything from horse-riding to one-to-one care. The service users and carers are our checking process, making sure that what we are doing is right.”

A “kite mark” accreditation scheme is also being set up for the trust’s members to maintain high standards of provision and meet national policy guidelines. The “kite mark” will look at every area of service delivery and will be subject to both self- assessment and checks from the trust.

Members have agreed to a set of standards which include encouraging independence and self-worth, valuing people’s differences, providing an atmosphere which encourages self-choice and promoting development and independence through learning, activity and support.

The trust has secured funding from Cambridgeshire Council which has helped pay for a development worker and administrative staff. Neighbouring counties are also being approached to establish new partnerships.

“We want to understand what people want to purchase and we want to provide them with individual and creative opportunities rather than traditional, one-size fits all day care,” Harris says.

Judge’s comments

“This is a highly ambitious project that is succeeding thanks to superb partnerships, planning and management.”

Su Sayer, chief executive, United Response

Organisation: Lincolnshire Partnership NHS Foundation Trust

Project: Louth and Skegness Recovery Teams

Client group: Mental health/substance misuse

Location: Louth and Skegness

Recovery teams helping people with mental health problems take control of the care they receive have reduced hospital admissions in Louth and Skegness.

The health and social care teams, part of the Lincolnshire Partnership NHS Foundation Trust, specialise in working with people with severe and enduring mental health problems.

Many service users are supported by the recovery teams to directly purchase social care using their personal budgets. Staff work with service users to decide on outcomes they would like to work towards, which could be anything from employing a personal assistant to helping them integrate into the community, to buying a computer to help enrol on a college course.

Bob Marshall, the seconded personalisation lead for the trust , says: “What we had prior to this approach was a person being told what they needed and then it was arranged. It was about taking control and being completely risk averse. This is like turning everything on its head. Now, things are led by the service user so it’s much more creative. Clients identify their outcomes and make real choices about what they want.”

The team has improved working relationships with other agencies and organisations such as adult education providers, employment agencies, voluntary groups and the independent sector, to increase the number of purchasing options available to service users.

The teams have already seen a reduction in hospital admissions as a result of moving away from service-led delivery and empowering service users to think creatively about how to spend their personal budgets.

One service user was able to use his budget to join a gym and buy a car. He also bought a new bed to help him sleep better and a shower to replace an old bath in his flat. With support he was able to spend his money on what he needed rather than employ a carer.

“Several people have said the most empowering part of this is being given real choices and control over their support which then leads to them having control over their lives,” Marshall says. “The ultimate aim is to reduce people’s reliance on mental health and social care services and promote independence and well-being.”

The success of the scheme now means that it will be rolled out across Lincolnshire.

Judge’s comments

“It was good to see an effective mainstream implementation of self-directed care in mental health which demonstrated the ability to have overcome a number of practical and philosophical issues.”

Paul Jenkins, chief executive, Rethink

Organisation: Doncaster Council

Project: Community Adult Autism Team

Client group: Disability

Doncaster’s Community Adult Autism Team (Caat) is helping people on the autistic spectrum to be independent by reducing reliance on home care support.

The team was set up as part of Doncaster Council‘s implementation of personal budgets, whereby service users receive funding following an assessment of their needs. Through the Caat, service users are in control of developing their own unique support packages.

By intervening when service users have a low level of need, the Caat hopes to use creative responses to reduce the chances of autistic adults unnecessarily entering mental health services or the criminal justice system.

Kelly Hicks, a senior practitioner for Caat, gives the example of a woman with a nine-year-old child who had always needed the live-in support of another adult. When the support was no longer available, the woman became very anxious that her child would be taken from her.

Through the Caat the woman was able to use her personal budget to reduce anxiety by having aromatherapy and massages. She also employs someone to telephone her in the mornings so that she does not become overwhelmed at the prospect of each day’s activities.

“It’s enabled the woman to be a parent, and a good parent. Before, she would only have been able to go to a day centre, a place where a lot of people didn’t really want to go to,” says Hicks.

A priority area for the Caat is the transition of service users from children’s to adults’ services. All young people receiving children’s services who are likely to need support as adults are identified and person-centred plans are developed for them. The Caat also supports people with Asperger’s syndrome, who are sometimes denied access to services because they can have an above-average IQ.

An analysis of the service is due later this year but the team already has figures that show a reduced access to mental health services and improved access to suitable housing options.

“We are picking up a lot of people with lower level support needs and we are managing to sort out a lot of the problems facing these people before they reach a crisis point,” Hicks says. “There are a lot fewer referrals to the crisis team.”

Judge’s comments

“An innovative service for a traditionally neglected group. I particularly appreciated the emphasis on the transition from the child to the adult.”

Simon Heng, disability writer and activist

Published in Community Care 14 May 2009

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