When I talk to leaders in adult social care, they openly admit “we can do better for people” with regards to community support and getting a good life.
So how can we do better? One nationwide project is providing some answers about supporting people and commissioning services differently.
Small Supports developed after an informal group of small support organisations in adult social care quietly evolved.
While each of the organisations is unique, they have several overlapping characteristics, one being that they remain small, often supporting no more than 15-30 people. Another is that they are deliberately local, embedded in their communities.
Research into small supports organisations has shown that compromising on control and aspirations starts to make things go wrong.
NHS England and the Local Government Association formed a partnership with the National Development Team for Inclusion (NDTi) to establish the Small Supports project.
How it works
Personalisation and being person centred are at the heart of this approach, with 12 sites in England supporting the growth of small providers.
The aim is to develop small providers that are able to design focused, tailored support with people who have learning disabilities and/or autism. These include those who have experienced difficult or traumatic events and need a different approach to support them to leave secure hospitals or assessment and treatment units, and people for whom professionals in the community have experienced difficulty in providing and sustaining timely, appropriate support.
Small supports are started by passionate, dynamic, entrepreneurial local people who want to make a difference to people’s lives. Fundamentally, their values and focus are on the person, their human rights, citizenship and individuality.
Relationships are at the heart of small supports, which engage clearly and honestly with people and their families, commissioners and professionals from local authorities, health and integrated care systems and communities.
Taking time to get to know individuals, hearing their hopes and dreams for the future and getting involved earlier – long before discharge – are also intentions.
The nine characteristics of Small Supports
- Control by the person and their family
- Life aspirations of the person are key
- Supporters (staff) recruited by and around the individual
- People choose where they live and who, if anyone, they live with
- Sustainable funding designed and used based on the individual
- Do not withdraw support or sell services on
- Rooted in their local communities
- Stay relatively small and financially sustainable
- Develop around these practices – they are not aspirations within large, segregated services
The full version of the nine points is at https://tinyurl.com/y2d6pcxm
Rooted in the neighbourhood
Being local means the small supports’ leaders and supporters are rooted in neighbourhoods. They will build links with the person to their community based on the individual’s strengths and assets.
They understand the importance of supporting people to lead rich lives, contribute to society and belong by building relationships outside their family and paid support.
By focusing on individual aspirations, assets and building networks, they know that anything becomes possible, including friendships, love, getting a job, being a good neighbour and regaining health and happiness.
In Lancashire, we have developed plans in partnership with experts by experience and stakeholders, thinking about the qualities and values we want our small supports providers to hold alongside the nine characteristics the NDTi advocate.
We have been talking to people and organisations who want to become small supports. We have asked our team to develop excellent questions to ask each organisation to help us understand their values. We are working with Self Directed Futures (www.selfdirectedfutures.co.uk) to develop individual service funds and personal health budgets.
Once small supports providers are approved, individuals and their families will get a chance to meet them to see if they would like their support.
The provider will then design the support with the person, helping them to find their own home and the people they employ using a personal budget. Providers will be supported in their development through opportunities including networking, accessing training and mentoring.
The belief is that staying small enables quality, flexibility and quicker decision making when changes to support are needed. Leaders of the organisation can keep in touch with everyone – the people being supported, their families and staff. Building strong trusting relationships with the individuals they support, their families, commissioners and community teams is vital to ensuring quality continuous support.
All small supports sites are actively looking for brave, values-driven people who want to explore how to set up their own dynamic, citizen-focused great small supports organisation. They will need to be strong leaders, tenacious, proactive, flexible, good at problem solving and passionate about making a difference and supporting people to live great lives. They need to be able to go the extra mile and stick with the person.
Those who have successfully established small supports usually have a background in providing or commissioning services, have some form of lived experience of autism and learning disability or are learning disability or mental health nurses or social workers.
Small Supports, Lancashire: https://tinyurl.com/5x5hzj43
Small Supports, NDTi: https://tinyurl.com/ypc9ye46
Amanda Topps is a health, social care and housing consultant committed to equality, justice and citizenship
