Right support, right time, right place…. Viv Cooper The Challenging Behaviour Foundation.
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Transcript of Right support, right time, right place…. Viv Cooper The Challenging Behaviour Foundation.
Right support, right time, right place….
Viv Cooper The Challenging Behaviour Foundation
To cover..Understanding needWorking in partnership with familiesBuilding support around the personProactive vs reactive strategies
Beginning with:Who are we talking about?What do we want to achieve?
Individuals“People whose behaviour challenges have the same needs as everyone else, in addition to special needs for help to overcome the problems their behaviour presents. They do not surrender their needs for personal relationships, for growth and development or for anything else because their behaviour presents a challenge to services. They have the same human rights as everyone else.” Mansell 2, 2007
What do we want to achieve?Good outcomes for the individualThrough a person centred approach to
planning and delivering support & services, which are
LocalHigh qualityFlexible
Policy into practice
Understanding the need: Early days…DiagnosisInformationBehavioursSchool & respite
Locating support – what was needed?
Access to local expertiseInformation and trainingA holistic approachPartnership workingLong term planning
Locating support – what happened?52 week school
275 miles from home
High cost
Planning - what next?
Working in partnership with familiesFamilies
“...are usually the main source of love, care and support for children and adults with learning disabilities…… Even when people leave home they do not leave the family. Families continue to offer a lifetime of involvement, support and advocacy…”
Valuing People Now (2009):P45
Why work with families?Commitment, love and supportLong termKnowledge and expertise and historyHolisticShared aims & goals“I will always be a part of my son’s life – I know I
am important to him even though he can’t tell me that in words. I know that come what may, I can rely on my family to always be there for me – and it’s even more important for him to have that too.”
Parent
Remember…“People whose behaviour challenges have the
same needs as everyone else, in addition to special needs for help to overcome the problems their behaviour presents. They do not surrender their needs for personal relationships, for growth and development or for anything else because their behaviour presents a challenge to services. They have the same human rights as everyone else.” Mansell 2, 2007
What do families want?Information
Good support
To be valued as partners
Their experiences…a lack of local expertise & capability in
understanding &responding to challenging behaviour
difficulty accessing services unless in crisisa lack of support and traininga lack of information to plan realistically, and
hopefully, for the future;not being included as essential partners Scoping report: McGill Cooper & Honeyman (2010)
Parents tell us…. “It feels as though I have been thrown off a
cliff into deep water and I don’t know how to swim. And all around me there are people who can help me, or teach me to swim. But I can’t get to them and they don’t help me, and I know that eventually I will go under”
“Living with a child with challenging behaviour is a profoundly hard and isolating experience.”
What would it be like if we got it right?Individuals and their families would have
the right support, at the right time and in the right place.
We know what works We know what to doWe know how to do it
Building support around the person
Understand their needsDesign a “capable environment” which includes:- Skilled staff support- Adapted physical environment- Learning new skills- Reviewing outcomes“.. A successful service looks like an ordinary home
or occupation, when…it is a carefully designed & organised service dependent on a great deal of skill & management.”
Mansell (2007)
What needs to happen?Early interventionPlanning – across children and adults services
Development of individualised local support & expertise
Monitoring of outcomes
What do we need to know?Starting early… we must work together to
Deliver evidence based practiceIdentify children at risk of developing
behaviour that is challengingTranslate identified need to development
of holistic support to meet itPlan long term to meet the needs of those
individuals & deliver good outcomes
We know what doesn’t work“I know how I would feel if suddenly I was taken
away from all that was familiar to me and had to live with people I didn’t know who were in crisis and behaving in ways that were challenging…”
“It was so traumatic when he was taken away to Winterbourne View, and then it just got worse, absolutely horrendous, and I can’t yet see the light at the end of the tunnel.”
Pathway options….Option PPerson centred needs
assessmentInput from range of
sourcesAgreed outcomesLocal support &
service designed around person
Monitor & review
Option RAssessment of suitability for
local existing provisionAttempt to fit into existing
provisionExclusion from local
provision / service breakdown
Search for out of area place Monitor & review
Which pathway is more likely?
Daniel’s route: Reactive pathway Local school & respite “not able to meet his
needs”Family getting to breaking pointOut of area 52 week residential school275 miles from homeLiving with 13 other children High cost – not contributing to local skill
developmentLack of local planning for return
(child/adult/education/social care/health/housing/workforce etc…..)
Changing direction: Alternatives to Institutional care
We know what doesn’t workWe know what does workWe know what we are aiming for
BUTWe need to change the “pathway”
Daniel’s route: Proactive Pathway Daniel is happy &
leads an interesting life
Local, close to familyAdapted bungalow-
HA tenancyGood staff supportExploring employment
opportunitiesCircle of support
What works?
A person centred approachWorking in partnershipStaff with knowledge and skillGood management & planningA focus on outcomes for the individual
“.. A successful service looks like an ordinary home or occupation, when…it is a carefully designed & organised service dependent on a great deal of skill & management.”
Mansell (2007)
Delivering the alternativesWe need:
LeadershipChange managementCommitmentPartnershipPlanning – short & long term
What needs to change?Working together to….
Focus on and invest in prevention & local support & service development
Commissioning (it is not purchasing!)
Registration & MonitoringEffective safeguardingData collection that is usefulClearer lines of
ACCOUNTABILITY
Collective responsibility
What will YOU do about it?
Actions Post WinterbourneStop putting people in the wrong
types of serviceInvest in the development of quality
local supportSort out the fundingOnly register appropriate servicesStrengthen safeguarding
Actions - localEvaluate services for people with
challenging behaviour against accepted standards (Mansell; Unified Approach)
Clear requirements in contractsEnsure there is monitoring of
outcomes, and action taken when outcomes are poor
Support (and use) the charter
Quality monitoring…..“I want support providers to ask
themselves: ‘would you like to live your life like this? Would this be good enough for you? For your son, daughter or relative?’ If the answer is no, then you need to change what you are you are doing.”
Parent
“Don’t keep asking me what my views are, or consulting me about this, that or the other or the latest new idea. All I want for my son is that he has a good quality of life, with good quality support and good quality services.”
Parent
“Quality means doing it right when no-one is looking.” Henry Ford
ContactThe Challenging Behaviour Foundation,
C/o The Old CourthouseNew Road Avenue
ChathamKent
[email protected] www.challengingbehaviour.org.uk
01634 [email protected]