Our first guest blog! Small Supports are part of the Building Right Support national plan in making real changes to move people from inpatient settings back to the community. , listening to those with lived experience and taking action to develop wider choice for people with a learning disability and/or autism to promote a strong, sustainable and diverse marketplace.
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Background
The Transforming Care agenda was set up as a national response to the Winterbourne View scandal. Setting out a programme of action to transform services for people with learning disabilities or autism and mental health conditions or behaviours that challenge.
The Transforming Care agenda aims to improve health and care services so that more people can live in the community, with the right support, close to home. This is achieved by breaking the cycle of placement breakdowns that lead to hospital admissions, and the delay in hospital discharge due to limited choices of appropriate placements.
Despite this drive for change there has continued to be a focus on large existing providers who are not able to provide more person-centred individual support. There are also some small providers that give concern to structure and security.
The families whose relatives were at Winterbourne View Hospital have written a report Tea, smiles and empty promises and highlight the areas for improvement as; proactive rather than reactive support. Having access to the right support at the right time, including support for individuals and their families for trauma and access to appropriate funding to ensure that people can move back to their local community.
What are we doing?
Hertfordshire County Council are committed to developing services for people with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition. We are part of the Building Right Support national plan in making real changes to move people from inpatient settings back to the community. Small Supports is a part of that national drive, listening to those with lived experience and taking action to develop wider choice for people with a learning disability and/or autism to promote a strong, sustainable and diverse marketplace.
Small Supports partnership is between Beyond Limits, C-Change, National Development Team for Inclusion, Positive Support for You and Local Government Association and is supported by NHSE. Who are working with local areas to help them create new and encourage existing small supports to flourish. Hertfordshire is one of the areas who have signed up to this national initiative.
What are Small Supports?
Small Supports are described as organisations that follow common principles that are based on choice and control and community lives. They are described as having 9 characteristics that sets them apart from existing providers.
- Control – The starting point is the individual and their and families involvement which is central to success.
- Person Centred – The focus is on the persons aspirations and needs and they choose where and how they want to live.
- Staffing – A key element to great support is staffing, recruiting staff around the person, by the person.
- Choice – Choosing where the individual wants to live and who they want to live with, having ownership over their own home.
- Funding – Having access to individual budgets that take account of transitions, fluctuations and contingency.
- Adaptability – To be flexible and be able to change support to meet fluctuating needs. To work in partnership to overcome challenges.
- Community Focused – To be rooted in the local community, and build links around the individual including in recruitment and actions.
- Staying small – To not grow by more than 3-5 people per year and for staff of all levels to know and understand the needs of the individual.
- Remaining focused to the practices, not taking some practices as goals within a larger organisation. Practices must be about the individual not applied to all individuals.
Hertfordshire County Council are working with NDTi to procure emerging small organisations based on these principles to allow people to take back control over their lives.
How are Small Supports different?
Small Supports focus on remaining small so that the person is at the centre of care planning, they ensure that they have choice and control over where they live, who they live with and how they are supported. They are risk positive understanding that we all take risks to reach our goals and are flexible because of the way they are funded meaning they can grow with the individual.
Small Supports are funded through Individual Service Funds, that allow for flexibility and control over how personal budgets are used to maximise enablement opportunities, enhancing independence, wellbeing and community engagement to meet agreed outcomes.
Hertfordshire County Council have chosen to fund Small Supports using Individual Service Funds as we feel this would be the most sustainable way to fund small organisations. We already have an existing framework for larger established providers but understand that this system is very prescribed and makes it difficult for smaller organisations to be considered.
Individual Service Funds are another form of commissioning support, which means that we can do our quality assurance checks to ensure we are providing high quality services to the public whilst also promoting flexibility, choice and control to the individual around their service design.
What next?
Hertfordshire County Council are looking for new or existing small organisations that want to work with us to become Small Supports. We will use the 9 characteristics as our benchmark, along with what we know about what “great” support looks like to develop organisations that have the passion, values and ethos to provide truly individual and person-centred support to help us achieve our aim of supporting those with complex needs to live meaningful lives in their local communities.
Small supports are existing or emerging small organisations that;
- are passionate about providing creative and risk positive care and support.
- work with individuals and their families or carers, with complex and fluctuating needs as identified through the Transforming Care Agenda.
- create person centred care and support to allow individuals to live independently in their own community.
- will not support more than 3-5 people per year to enable them to remain small and retain their person-centred approach.
The benefits of being a Small Support organisation
- Person centred approach that allows for individual choice and control
- Achievable, enablement driven outcomes where funding allows for creativity and flexibility
- Freedom and autonomy over how care and support is delivered through individual service design
- A real and sustained demand as we know that there are over 2000 people across the country still in secure settings with a national drive to support these people to move back to their communities
- Creating positive impacts for people and being part of the drive for change
- Investing in and contributing to the local community
- Flexibility over funding allowing for better planning and sustainable support
- Being leaders of what “great” support looks like by having the freedom to build support around the individual, created by the individual and their representatives
We think that those that will be interested in becoming a Small Support organisation will be people who have experience in commissioning or providing care. That might be family members, commissioners, social care workers and people that are already working for larger organisations but may be fed up with the way care is being delivered and want to support people in a different way.
We understand that setting up a new small support organisation, or perhaps changing the direction of an existing small organisation is challenging so we are keen to do what we can to help.
This help might include:
- Providing support and signposting to develop your organisation to enable you to deliver high quality care and support
- Connecting you to existing small support organisations who can offer guidance and advice
- Support around Individual Service Design to ensure that you have the tools available to be a sustainable provider
Get in touch
We need help to reach those people that would be interested in becoming a Small Support organisation. So if you think that could be you or someone you know then please get in touch with the Small Supports Project Manager ADS.Supportedliving@hertfordshire.gov.uk
More about Small Supports
NDTi – Exceptional People Needed
Find out more about support on a smaller scale
You can also find out more about Transforming Care below:
