Personalised support on a local level
Partners in Support is a small, local supported living provider, set up in Hertfordshire in 2007. It supports people with learning disabilities who have behaviours that challenge. Many of its initial clients came from hospitals or assessment and treatment units.
The organisation was set up in partnership with Hertfordshire County Council and Hertfordshire Partnership NHS Foundation Trust, who supported Martin Nicholas, Partners in Support’s Director, with seed money of £70,000 over two years.
Martin explained how the organisation was established: ‘I was fortunate to visit excellent local services such as Partners for Inclusion and Inclusion Glasgow in Scotland. Having worked for a big charity for 14 years, which had increased its provision significantly over that time, I came to the conclusion that, to be able to give consistent high-quality support to people, there had to be a new way of looking at the development of new services. I decided I wanted to be part of something that was new and innovative in its approach and really focused on the needs of the people at the heart of the organisation.
‘Coincidentally, Hertfordshire County Council was struggling to commission local services for people who required more bespoke support. Over an informal discussion with the service manager of learning disability services, we established a common vision of responsive person-centred support which led to Partners in Support.’
Bucking a trend
Partners in Support’s ethos is ‘To enable people with learning disabilities to determine the life they live and strengthen their community of family and friends’. The organisation supports individuals to lead the lives they choose as independently as possible within their own homes and chosen communities.
Martin explained why he set up Partners in Support as a highly-personalised, local, small-scale organisation. ‘The company was set up in response to a number of trends in learning disability services. These included:
- The drive to consolidation, which I felt was detrimental to providing truly consistent, person-centred services.
- The fact that people with complex needs were still in assessment and treatment units or services that didn’t support them to be part of their local community.
- A growth in companies delivering low quality outcomes and paying support staff low salaries.
- An increased use of agency staff and its impact on consistency of support.’
This was in 2007. Current policy is still driving the need for bespoke, community-based, local support. The Government’s recent Transforming Care programme for learning disability services plans to reduce the number of inpatient beds by up to 50% nationally. Central to the progress over the next three years will be new, high-quality, community-based services. Local areas will be able to design bespoke services with those who use them. However, this needs forward-thinking commissioners.
Valuing People Now: a new three-year strategy for people with learning disabilities ‘Making it happen for everyone’ highlighted the innovative commissioning involved in setting up Partners in Support. ‘In Hertfordshire, the local authority and Hertfordshire Partnership NHS Foundation Trust sponsored the development of a new not-for-profit organisation to work in the county. With seed funding from an innovation grant over two years, Partners in Support was created…Working specifically with individuals who were seen to challenge services, Partners in Support has been developing individualised support solutions based on individuals’ person-centred plans, working closely with individuals and their families. As a result, people have been supported to move near to their families into accommodation of their choosing. Each person has their own team employed to work with them, matching staff with similar interests and fully involving the individual and/or their family in the recruitment process.’
Is small beautiful?
Partners in Support fits with the needs of the time, however, as with any successful model, there can be expectations to expand and replicate.
Partners in Support has no such plans. Martin Nicholas explained, ‘Despite many organisations having great mission statements and values, I believe the larger an organisation gets and the wider geography it covers, the harder it is for that organisation to continue to offer the same consistent, high-quality support.
‘Decision-makers, no matter how skilled, become isolated and further away from the realities on the ground. Positive support is fundamentally about the interaction between the person receiving support and their staff; this requires full and dedicated staff teams, awareness of subtle changes in peoples’ lives and regular interaction with people receiving support and their families. All of which is more challenging the larger you get, as responsibilities become delegated down through many management layers to less experienced managers.
‘We have turned down the opportunity to work with other local authorities because, whilst we would love to support more people to improve their lives, we know this would be at the detriment of the people we currently support. From day one, we have stated it is “Hertfordshire only” and that will never change.’
To add to the service’s achievements, it achieved Hertfordshire’s first ‘Outstanding’ rating by the Care Quality Commission. The inspectorate highlighted the time spent developing ways to accommodate the changing needs of the people who used the service and the innovative and flexible ways it supports people to progress. The report states, ‘The registered provider was seen to constantly adapt and strive to ensure people who used the service were able to achieve their full potential…and their support plans and environment adapted and developed to promote their independence.’