Case study summary
In October 2015, NHS England published a national plan for transforming care and services for people with a learning disability, autism spectrum disorder or both. The Transforming Care programme is helping to deliver the aspirations set out in Building the Right Support.
Sharron Hunt and Lorraine Chapman-Linnett-Champion are part of a local team playing a vital role in ensuring the ambitions set out in Building the Right Support are met for some very vulnerable people. They are part of the team at Stanley Grange in Preston, providing supported living, nursing residential and specialist services as part of the Future Directions Community Interest Company (CIC). The team has a high rate of successfully supporting people to move from long-term inpatient, hospital-based care, to a less restrictive environment, which aims to give the maximum level of choice and control possible. To date, the Future Directions team has supported 18 people to move from an inpatient, hospital setting. The Future Directions CIC team has been nominated in 14 categories for this year’s National Learning Disability Awards.
Sharron and Lorraine believe that getting the initial assessment right when people are referred to them and putting in place an individual transition plan is crucial. This will avoid a “revolving door” situation, where people are discharged and then have to be re-admitted because care packages have broken down. They work to champion the right services for individual service users, striving to ensure that people are discharged from hospital with the right care package, tailored to them.
The priority is to create a wrap-around care package which provides holistic care and treatment. When the team is asked to complete an initial assessment, they start from the position that, irrespective of someone’s past history and how challenging their behaviour, there is always a solution that can help them to live more independently and in a less restrictive environment. A key part of their role is coming up with creative solutions to support people to come out of hospital.
Some of the people they are supporting have high levels of mistrust in the health care system because of past experiences. They have been in hospital for most of their adult lives and have never had the same opportunities as other people to live satisfying and valued lives. Others have had care packages from other providers break down in the past, meaning they have had to be re-admitted to hospital.
The people using the service are involved in recruiting the personal assistants who play an important role in supporting them on a day-to-day basis. It’s important that the person appointed is able to build an effective relationship and trust with them.
Where people present challenges, the team starts by trying to understand what they are attempting to communicate. All care packages include back up and contingency plans to ensure that the service users they take on can continue to live as independently as possible. The teams at Future Directions are constantly challenging each other to improve practice, based on core values that are non-negotiable.
The change over a period of time in people who had previously been long-stay inpatients is remarkable. They begin to develop their own identity and are encouraged to take more responsibility. Where initial packages of care are more restrictive, the team aims to reduce this and where possible move the individual on to more of an assisted or supportive living environment.