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Right support, right time, right place…. Viv Cooper The Challenging Behaviour Foundation. To cover. Understanding need Working in partnership with families Building support around the person Proactive vs reactive strategies Beginning with: Who are we talking about?

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Right support right time right place

Right support, right time, right place….

Viv Cooper

The Challenging Behaviour Foundation


To cover
To cover..

  • Understanding need

  • Working in partnership with families

  • Building support around the person

  • Proactive vs reactive strategies

    Beginning with:

  • Who are we talking about?

  • What do we want to achieve?


Individuals
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
What do we want to achieve?

  • Good outcomes for the individual

    Through a person centred approach to planning and delivering support & services, which are

  • Local

  • High quality

  • Flexible

    Policy into practice


Understanding the need early days
Understanding the need: Early days…

Diagnosis

Information

Behaviours

School & respite


Locating support what was needed
Locating support – what was needed?

Access to local expertise

Information and training

A holistic approach

Partnership working

Long term planning


Locating support what happened
Locating support – what happened?

52 week school

275 miles from home

High cost

Planning - what next?


Working in partnership with families
Working in partnership with families

Families

“...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
Why work with families?

Commitment, love and support

Long term

Knowledge and expertise and history

Holistic

Shared 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
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
What do families want?

Information

Good support

To be valued as partners


Their experiences
Their experiences…

a lack of local expertise & capability in understanding &responding to challenging behaviour

difficulty accessing services unless in crisis

a lack of support and training

a 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
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
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 do

We know how to do it


Building support around the person
Building support around the person

  • Understand their needs

  • Design 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
What needs to happen?

Early intervention

Planning – across children and adults services

Development of individualised local support & expertise

Monitoring of outcomes


What do we need to know
What do we need to know?

Starting early… we must work together to

Deliver evidence based practice

Identify children at risk of developing behaviour that is challenging

Translate identified need to development of holistic support to meet it

Plan long term to meet the needs of those individuals & deliver good outcomes


We know what doesn t work
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
Pathway options….

Option P

Person centred needs assessment

Input from range of sources

Agreed outcomes

Local support & service designed around person

Monitor & review

Option R

Assessment of suitability for local existing provision

Attempt to fit into existing provision

Exclusion from local provision / service breakdown

Search for out of area place

Monitor & review

Which pathway is more likely?


Daniel s route reactive pathway
Daniel’s route: Reactive pathway

  • Local school & respite “not able to meet his needs”

  • Family getting to breaking point

  • Out of area 52 week residential school

  • 275 miles from home

  • Living with 13 other children

  • High cost – not contributing to local skill development

  • Lack of local planning for return (child/adult/education/social care/health/housing/workforce etc…..)


Changing direction alternatives to institutional care
Changing direction: Alternatives to Institutional care

  • We know what doesn’t work

  • We know what does work

  • We know what we are aiming for

    BUT

    We need to change the “pathway”


Daniel s route proactive pathway

Daniel is happy & leads an interesting life

Local, close to family

Adapted bungalow- HA tenancy

Good staff support

Exploring employment opportunities

Circle of support

Daniel’s route: Proactive Pathway


What works
What works?

A person centred approach

Working in partnership

Staff with knowledge and skill

Good management & planning

A 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 alternatives
Delivering the alternatives

We need:

Leadership

Change management

Commitment

Partnership

Planning – short & long term


What needs to change
What needs to change?

Working together to….

  • Focus on and invest in prevention & local support & service development

  • Commissioning (it is not purchasing!)

  • Registration & Monitoring

  • Effective safeguarding

  • Data collection that is useful

  • Clearer lines of ACCOUNTABILITY

Collective responsibility

What will YOU do about it?


Actions post winterbourne
Actions Post Winterbourne

  • Stop putting people in the wrong types of service

  • Invest in the development of quality local support

  • Sort out the funding

  • Only register appropriate services

  • Strengthen safeguarding


Actions local
Actions - local

  • Evaluate services for people with challenging behaviour against accepted standards (Mansell; Unified Approach)

  • Clear requirements in contracts

  • Ensure there is monitoring of outcomes, and action taken when outcomes are poor

  • Support (and use) the charter


Quality monitoring
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


Contact
Contact 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.”

The Challenging Behaviour Foundation,

C/o The Old Courthouse

New Road Avenue

Chatham

Kent

[email protected]

www.challengingbehaviour.org.uk

01634 838739

[email protected]


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