For staff working in residential settings, aiming for excellence will help them deliver the best quality
services. Excellent care and support is where people using services are in control, can build good relationships
and spend their time in ways that are meaningful and enjoyable. In this film we brought together a panel of
experts, including people who use services, to discuss what excellence means in a supported living setting.
First, let’s meet the panel. Ann Netten is a Professor of Social Welfare who helps define
excellence for the Social Care Institute for Excellence. Julie Beadle-Brown is a Reader in
Intellectual and Development Disability at the University of Kent. Dorothy Runnicles uses social
care services and is a campaigner for older people. And Pat Charlesworth, a self advocate and champion
for people with learning disabilities. Today our panel will watch clips illustrating excellence
at Rutland Gardens, a supported living service for people with a learning disability or mental
health problems. Here the focus is on excellence in encouraging independence and employment.
Darren has been helped into employment with support from Steph at Rutland Gardens.
Jo Mitchell is the manager.
Darren has mental health needs. Darren came to us about three years ago with quite a complex
offending background. So he found it really hard to get a job, be motivated, he had really limited
skills with communication, relationships.
Darren’s background gave him few employment opportunities. So the care management group which
runs Rutland Gardens decided that the best option was to train him and offer him a job themselves.
He wanted to do gardening, so the staff and CMG trained him around gardening. So he now
goes to ten homes. He started off doing an hour a day, now he does two hours a day.
For Darren, his relationship with the staff has been crucial in turning his life around.
The members of staff used to come with me to learn me about catching buses, I had to learn the routes.
They helped me with my financial side. They have been a total wonderful support.
They’ve just saved my life and I would say that they’re all absolute marvellous.
The panel welcome the approach and discuss how it gives Darren control of his life.
They provided him with some skills, they taught him how to do things. And then they gradually
built up, and they’ve got some hope for the future. And also it seemed important to him that he was
being paid for it, that was giving him some choice and control over other things as well
by having some if you like material wellbeing, having a little bit of money coming in.
He actually said himself that it saved his life. I’m sure it probably did. Once you get in the rut,
it’s really hard - it’s easy enough to get in it, but not so easy to get out of it. And you need,
you know you need people that are really committed, you know to work with you and get
you to - to take responsibility for who you are.
They also found a way to address his own interests and so on. So talking to him about what he actually
wanted to do and fitting that into something that was real and that needed to be done. And I thought
that showed an imaginative and very flexible way of approaching the whole providing support to people.
Sharon, who has autism, is attending a day college focused on independent living skills.
She is supported by a key worker, Kate Grice.
The reason she comes to Avondale is one to add structure to her day, so that gives her a reason
to get up in the morning otherwise she’d be more likely to lie in bed all day, and then that has
a bad impact on her day. She comes to this lesson because she loves to cook, she is a very good
cook anyway, but it just gives her a better understanding of healthy eating, her
knife skills, and it usually gives her a meal for that day to take back with her.
Sharon and Kate sit down regularly together to plan her activities and goals for the future.
So how much do you think you might need for your new trousers? How many pairs do you think you need?
- I can’t think. About two maybe. - Two pairs.
- Yeah. - So I’m thinking that’s going to be probably,
- £40 will be enough for that. - Yeah. That’ll be plenty.
In the past she hasn’t had choices, and she was in institutions, and now she has the choice over
her whole life really. She has the choice over what courses she wants to do, she doesn’t like a
course then she’ll identify that to us and we’ll change that, she has a choice over her menus,
what she spends her money on, what she saves for, what holidays she wants,
she has a huge choice over her life styles.
- What do you save for? - Item things.
- Item things. What sort of items do you save for? - [Response is unclear]
- Your jewellery. - Microwave.
Microwave, yeah you’ve got to replace your microwave.
We’ve got a very good relationship, and every year she will be given the choice of if she wants
to change key workers, because some of the guys at Rutland Gardens do. Luckily for me at the
moment she’s identified that she’s happy with me.
The panel discuss the role of good key worker relationships in promoting choice.
The continuity of the key worker was obviously something to which she was
allowed to choose and subscribe.
There was that real sense of power for the person, or empowerment if you like, for the
individual to actually about who was caring - well, supporting them actually,
rather than caring for them, supporting them.
There was a lot of talk about choice and kind of involvement for her. And also about her interests.
And you could see a lot of potential from that short clip in terms of possible next
steps for her, in terms of working in a kitchen for example, or another environment.
Today, Lisa is having her key worker session at Rutland Gardens, with Katherine.
Lisa, who has a mild learning disability and mental health problems, uses the session to
increase her control over her plans for the future.
So what we need to do - we need to put in there about your college courses, don’t we.
Yes, we do.
So the key worker sessions we do, it’s an opportunity for the tenants to meet on a one to one
basis with their key worker to identify goals. It’s all about personalisation and moving towards
the future. You know, we’re here to work for them. It’s about them taking control of their own life,
decision making, choices, and I just think it’s really important for normalisation for them to feel
part of their community, and whatever their dreams and goals are, we’re here to kind of aim to meet
them, or at least close to meet them as possible.
For staff working with Lisa, the challenge was encouraging her to find activities she enjoyed.
When Lisa first moved in, she didn’t really want to socialise with many people. So we got in contact
with Spiral, which do social events. So she started going once a week to a social event.
And then more and more and more we realised they actually had a charity shop. So it took
a lot of encouragement, Lisa likes shopping, she likes working in shops, so again we
helped her identify that that’s actually what she might want to do.
Lisa now volunteers in the shop every week.
- Hi Sophie. How’s it going? - Ok.
For Lisa, her relationships with the staff have been crucial in giving her the
confidence to take control of her future.
They helped me through a lot. Through a lot, through bad stages to good. They are on twenty
four hours a day, so it’s twenty four hours a day slot, so we have night staff, we have day
staff, we have afternoon staff, they’ve been so amazing, I can’t believe I’m doing this,
you know, it’s… Oh what can I say, I’m over the moon with them, you know.
The panel discuss how raising self esteem through meaningful activity
can improve outcomes for individuals.
I think you know, one of the things that’s really nice about that is actually not only was she being
given the opportunities to meet her potential, but she was recognising how much she’d exceeded her
own expectations of what she thought was possible for herself. And I think that must do wonders for
her self esteem and for her ability to kind of cope with life and to think about the future.
Just that little change of attitudes, how much that helps, yeah. As she goes on, I think she
will get more and more excited because she’ll realise how much she’s giving to society.
Something there for her to build on, as it were. So not just the support -
- No. - The amount of support she needs might potentially
Her own feeling of self esteem.
It’s much less likely that things will ever go back to the way they were, because she has been
empowered to be able to make choices and to say what she would like and what’s important to her.
It can’t always be guaranteed, but it’s much less likely, once you show people what it’s
possible to do and what it’s possible to have, it’s very hard to take that off them.
When I first worked with Michelle, and I took her into the community, we were in a cafe and she
threw hot coffee all over me. And we came back and we looked at her risk assessment management plan,
and we realised that, you know, she was still entitled to go out again, so we took more positive
risks. We just kept going out, this time we identified that there was a reason, we were too
close at the table, so in a risk assessment we realised that she had to go to certain places where
there was space, so we sort of planned more, and just kept going like I said. You know, not being
afraid to take those risks, not being frightened of people, and then make changes to do it again and
again and again. And now she can go to tea at the Ritz, she can sit with any cafe, any restaurant.
- How much? - Yeah, that’ll be plenty.
Don’t want too much in there.
Don’t want too much in there because it’ll overflow, won’t it.
It’d flood everywhere. Gravy?
This positive risk taking has increased Michelle’s quality of life and changed
her challenging behaviour, and her parents have noticed a difference.
She’s been living here for four years now, and she really loves it. She’s able to go out and do
a lot more than she did in her previous place.
Since she’s been here, she’s got a better purpose in life because she’s got a goal to aim for each
day and that lot. And she really looks forward to achieving that goal at the end of the day.
What struck me about that was the member of staff was willing to try again in you know when
she got the hot coffee chucked over her. You know it’s important that people realise that people
with disabilities have the right to be in community and play a full part in our community.
In order to give people that control you have to take risks with yourself, with other people
potentially, and with that person, and it’s really hard to do. But when you do do it,
- you realise how rewarding it is. - Yes, because you’re responsible aren’t you.
And we can’t really continue with a very risk averse policy in these areas, which
has grown in recent years, if we want excellence. Because excellence is risk taking,
innovatory, creative, and it means people delivering services in new ways.
For the panel, the clips they’ve seen contain powerful messages.
I think that our search for excellence and our struggle for excellence is incredibly
important for the future of all of us. Some of these examples we’ve seen of highly
motivated people, people who really want to change the status quo, are exciting and hopeful.
It's not about disempowering people, but about sharing and working
collaboratively with people, helping people to do things as much as they can themselves.