Appendix 3
From Individual to strategic
Change; Driving Change with
Person Centred Information:
Using the information gathered from individuals
to inform our operational and strategic
commissioning
Report from the Transition Task Group
April 2010
Compiled by Caitlin Chapman
1
Contents
Chapter
Page
1
Introduction
3
2
National and Local Context
4
3
Methodology
8
4
Leisure and Social relationships
14
1. Work carried out by the senior managers at the
Strategic commissioning day
2. Action plan
3. what has happened since the strategic
commissioning day
32
Education, Employment, Training
and Skills
45
5
1. Work carried out by the senior managers at
the Strategic commissioning day
2. Action plan
3. what has happened since the strategic
commissioning day
6
Support, Respite and Health
1. Work carried out by the senior
managers at the Strategic
commissioning day
2. Action plan – support
3. action plan short break care
4. what has happened since the strategic
commissioning day
2
41
43
53
56
57
58
68
71
73
73
Introduction
Salford learning difficulty service have been developing person centred
approaches with the people we support for a substantial time. Reflection on
the learning from person centred planning; both nationally and locally has
shown that good plans alone are not a panacea for change, and that
individual plans need to work alongside strong leadership and be used to
inform strategic plans.
Pressure is also on those who commission service to make commissioning
processes more transparent and show how they are listening to the people
they support. However traditional forms of consultation are inherently flawed;
as it tends to be the same people who respond to consultation, and often the
consultation process can inadvertently exempt those hard to reach families
and people who are difficult to engage due to difficulties with communication.
(Putting People First ) Therefore consultation often does not give a full
indication of the needs and aspirations of people.
There are other means of giving commissioners information; which include
socio-demographic data; Joint Strategic Needs Assessment and market
intelligence; however although these are important they tend to base
themselves around need; rather than aspirations, therefore; with the drive
towards personalised services; the challenge both nationally and locally is to
develop ways in which to fully involve the people who use services to be part
of the transformation of social care; and to be partners in the development of
new ways to strategic commission.
3
The Putting People First Team, Valuing People Now team and Helen
Sanderson Associates; have been working together to develop a process
where individual information from person centred reviews; can be used to
inform the strategic commissioning in a given locality. Salford’s Learning
Disability Transition Task group have used an adapted version of this model
to begin to develop strategic and operational commissioning based individual
information.
The first part of this report discusses the methodology behind what Salford did
and how it implemented the six stage process and developed by Helen
Sanderson et al The second part of the report discusses the findings from the
information and the work completed by the strategic commissioning team and
the work which was developed after the commissioning day; from the
information gathered from the reviews. The second part of the report is split
into the three main areas which were discussed in the reviews; which were:
 Leisure and Social Relationships
 Education and Employment
 Support and Respite
There is also a chapter on Health as; this was persistently under-discussed in
reviews, as a consequence work has been carried out to but Health further up
the agenda during Transition.
The work carried out in Salford regards Person Centred Reviews and the
subsequent use of the information to inform commissioning and to be
reflected in the work streams of not only the Transition Task Group but also
other Task Groups and agencies; show how Person Centred Reviews can be
used to inform practice and move towards a model of commissioning which is
proactive not reactive and based on the aspirations of the people who are
supported. We must now look at the local and National context.
The National and Local Background
Person Centred Planning denotes a number of planning tools and thinking
skills which enable us to work with individuals and establish what is important
to and for them; now and in the future, how we support them to stay healthy
and safe and to look at what is working/not working in a person’s life and
action for change.
Developed in the early 1980s; person centred planning really took off in
England as a result of the recommendations set out in the Valuing People
White Paper (2001) where it stated that all people should have access to a
person centred plan by 2004.(DoH 2000)
However although the ethos and the planning were agreed to be of high
quality; there were some concerns that information was not always acted
upon and that great plans did not always equate to great lives.
4
In 2006 a teacher, social worker and person centred planner got together to
look at how they could make the Yr 9 Statutory Transition review more person
centred. They developed a process based on Michael Smulls essential
Lifestyle planning; and called the review a ‘Person Centred ‘Important to and
For review’ This review followed a set process1 and aimed to develop a
Transition Action Plan which contained long term and short term goals and
outcomes. What became apparent was that the person centred reviews had
the potential to reach a wide audience and could become an integral part of
reviewing care packages rather than being seen as an ‘add on’. It was also
soon realised that the review contained a large amount of raw data – which
had the potential to be used to influence strategic plans and commissioning as
well as give evidence for operational change.
One of the key issues of person centred planning has always been the need
to have a pot of money attached to the plan; which could be used to
implement the plan. Social Care is going through a transformation; as set out
by Putting People First and other key documentation2. There is a national and
local drive to move forward the personalisation agenda. The personalisation
agenda is very much in line with person centred thinking and hopes to
promote personal choice and autonomy and independent living. In order to
achieve this it aims to make changes to assessment, support planning and
resource allocation; while widening up access to the community and universal
services to ALL citizens. (Salford City Council 2009)
In order to achieve this; there are four area in which local government are
expected to develop and personalise; universal services, early intervention
and prevention services, social capital, self directed support/choice and
Control. (Salford City Council 2009) Helen Sanderson et al have argued that
by using the person centred thinking skills and working with people in a
person centred way – we can use this information to inform commissioning
and ensure that strategic commissioning is influenced by individual
information.
Salford, led by the learning difficulty team have been committed to developing
a person centred culture. This has been systematically developed by the
rolling out program of person centred thinking skills over a five year period,
and the implementation of person centred reviews, of which the program is in
its third year.
The success of the Person Centred Review program has been based on the
strong partnership working across agencies, departments and organisations.
Salford know have two main sites within transition (the local special school
and the local FE foundation provision) where they are working towards all
students having a person centred review, this information, with the consent
1
See appendix 1 for the person centred review process and appendix 2 for the different types
of reviews available to use and when they would be used
2 Our Health, Our Care, Our Say (2006) Local Authority circular ‘Transforming Adult Social
Care’ LAC(DH) (2008) 1(2009) 1 ‘shaping the future of care together Social Care Green
Paper (2009)
5
from students and families it is then passed on to social services who collate
the information and input it into a data base. This offers the potential that as
activities are developed we can go directly to the people who said they
wanted the service or activity. It also gives us evidence when we are looking
at commissioning or when services are up for tender, both to show what is
required but also the demand. Therefore person centred ‘Important to and
for’ review provide a perfect vehicle for the transfer of individual information
into strategic planning. To enable us to achieve this Helen Sanderson et al
have devised a six stage process (see diagram below). In Salford we have
loosely followed this process in order to start to use the information gathered
to strategically commission.
6
Putting People First (2009) Working together for change: using person – centred information for commissioning Department of Heal
7
Salford’s methodology
This methodology is based on the six stage process set out by Helen
Sanderson et al
Step 1 – Gather the Person Centred Information from Person
Centred Reviews
Throughout the academic years of 2007/2008 and 2008/2009 over 60 people
had a person centred ‘important to and for review. These took place across
three pilot sites:
 Chatsworth High School
 Eccles College
 Adult Services
Everyone who had a person centred review was asked if the information from
this could be used to inform the commissioning strategy. Facilitators/ minute
takers were asked to send the minutes to a central place so information could
be analysed.
The Sample
Putting People First (2009) in the guidance document ‘working together for
change’ states that a sample for the six stage process has to be:



People who have had a person centred review
More than 15 people so trends can be seen
Less than 50 – as after this no new trends are found; there is just
continuing evidence of certain trends
In Salford over the last 3 years we have been continuing to roll out ‘person
Centred Important to and for review’ across adults and children’s services, it
was suggested that it would be beneficial for us to look at information across
the different groups, the sample therefore looked like this;
Table showing how the overall sample was made up from each group
Group
Number of People in each Group
School Age
College Students
Adults
Total
17
12
11
40
8
Pie Chart Show ing the
Percentage of each group as a
m ake up of the w hole Sam ple
School Age
28%
42%
College
Students
Adults
30%
The Overall Sample was 40 people. As the Person Centred Reviews are a
relatively new program – no sampling procedures were used. The Information
was gathered form people who had had Person Centred Important to
Reviews; and whose information had been passed on the person centred
planning team. (66.6% of the overall number who had had a review) The
Table Below shows where people were situated. What this shows is that
although the sample number is optimum, according to putting people first, the
numbers from each group are quite low as people are dispersed in quite a
different number of areas.
Table showing where people within the sample were based
School
All School age Children
attended Chatsworth
high School
College
3 people attended
Chatsworth Community
college
6 attended Salford
College; Eccles campus
3 attended out of area
placement
Adults
5 accessed other
services
5 attended day services
The high ratio of young people from Chatsworth High School and Eccles
College; is due to both organisations being a pilot site for Person Centred
Reviews. The out of Borough and Adult services; have not as such had pilot
sites, therefore people with in these group will have been supported to have a
person centred review due to there personal circumstances; or on their
request
The Groups were further separated to show us 3 main categories of people


Those who were on the Autistic Spectrum
Those who had complex health needs
9

Those who more general Learning Disabilities or physical disability who
have the potential to become vulnerable adults.
For those people who had dual diagnoses or multiple difficulties; there
greatest need was documented.
Table showing number of people who have autism, complex health
needs or are, or run the risk of becoming a vulnerable adult
17
7
Complex Health
needs
4
12
11
40
4
1
12
2
0
8
Total
Autism
School Age
College
Students
Adults
Total
Vulnerable
Adults
6
6
10
22
Pie Chart showing percentage of
people in each category within the
sample
autism
29%
complex health
needs
52%
vunerable adults
19%
The pie chart shows that overall 52% of the sample had a learning disability or
physical disability which may mean that they were vulnerable as adults and
48% of the sample had quite complex needs.
Stage 2 – Transfer Information into useable format
The person centred planning team went through all review minutes and
recorded the following information on individual cards:



What was important to the person now and for the future
What was working for the person
What wasn’t working
In order to further break down the information the cards were colour code
Adults
College
10
School age
What’s working?
What’s not working?
Cards were further broken down with coloured dots – people could be
categorised as more than one dot:
Autism
Complex Health Needs
Vulnerable Adults
Step 3 –Cluster information into a useable format
A ‘Theming day’ was organised in which to start to group the raw data into
groups and themes. This event was open to all people who were part of the
Transition Task Group. The event was facilitated by the Person Centred
Planning Team and had representatives from the following agencies and
groups:







New directions Learning Disability Team
Salford Families social work team
Health
Connexions
Eccles College
Chatsworth College
Family carers
The group were asked to sort the raw data into group. This was completed
through ‘card calling’ which had three phases:




Information on the card was called out
Group decided whether this was part of an existing group or a new group
Once all information was sorted into groups – groups where given
names.
the named groups where then sorted in Themes
By the end of the session there were six themes which had occurred these
were:
11






Leisure and social relationships
Employment and education
Support and respite
Health
Housing
Culture
The group were then asked to prioritise which they felt were the most
important areas for senior commissioners to look at. The group voted using a
dot system where by each person were asked to put:


2 dots on their biggest priority
1 dot on their second priority
This gave three priority areas which were:



Leisure and social relationships
Employment and education
Support and respite
Health was flagged up as an area of concern as it was very rarely mentioned.
This may have been caused by the fact that the information was often based
from the individual’s point of view and that information from the ‘Healthy and
Safe’ boards were not analysed. However feedback from those who had took
part in the reviews stated that there was often little on the ‘healthy and safe’
board with more emphasis being on what was important to the person. There
was some concern that we risked not having a balance between what was
important to a person and what was important for a person.
These four areas were the area which were analysed during stage 4, with
health becoming part of the support and respite area.
Stage 4 and 5 – Analysing the information and Action planning
At stage 4 the person centred planning team took the three priority areas and
started to look for trends and patterns in information recorded. An information
pack was produced for each ‘theme’ which contained:




What groups were present within each Theme
Charts showing trends and patterns
Analysis of the trends and patterns
What was working well/ not well with each area
(All this information forms the second part of this report)
12
Setting up a strategic commissioners event
In order to support senior commissioners to analyse and action plan a
morning session was set up for senior commissioners to attend. This was
attended by 12 senior managers from different organisations across the city
from both commissioning and provider organisations.
Areas included:









Health facilitators
Leisure
Day services
Supported employment
Personalisation
Quality
Children’s Services
Personalisation
Commissioners across adults and children’s services
At the event






Key information for each theme was written up on to pin boards
There were copies of each theme booklet
Senior managers where asked to pick the ‘Theme’ they felt they could
contribute most to
They were then asked to think about current practice on a local and
national level and then think about an ideal.
They were then asked what they felt the barriers were and what
information they felt they had to figure out
From this each group devised an action plan of the next steps for each
theme.
Stage 6: Sharing the information



All information had been collected into a report
All information from each theme has been passed on to the relevant
stakeholders and task groups – so that information can used to inform
business plans and local area action plans and agreements.
Operational managers and staff have used the information to start to
make changes to current services and practices
13
Leisure
and
social relationships
14
Diagram A: Leisure and social relationships
Leisure and Social
Relationships
40 people (100%) of Sample
mentioned this area
Out and about
Creative Arts
78%
50%
Sport
Dance
Clubs
Leisure and Social
Activities
40%
Relaxation
47%
Social
relationships
60%
Own space
Friend
Art
Listening to music
Family
Going out/ community
Music
Therapies
Relationships
Exercise
Drama
Dance
Social Life
Leisure and social
activities
Transport
The great outdoors
Let’s get physical
Swimming
15
Leisure and social relationships
This area was by far the most important to people, with every single person
mentioning leisure and social relationships.
More over:

26 people (65% of sample) mentioned leisure and relationships more
than 5 times across the boards important to now and for the future

13 people (33% of sample) mentioned leisure and social relationships
more than 10 times
As diagram A above also shows, this was by far the largest area with the sub
themes having to be divided further. Therefore we shall first look at which
primary area where most important before analysing this information further.
Bar Chart 1 below breaks down the information into the percentage of people
who mentioned each group. What this clearly shows was that the key areas
of importance for people where activities grouped within ‘out and about’ and
social relationships.
Bar Chart ( ) showing percentage of sample who
were interested in each area
80.00%
70.00%
60.00%
50.00%
% 40.00%
out and about
30.00%
creative arts
20.00%
activities
10.00%
0.00%
out and about
relaxation
relentionships
1
78.00%
creative arts
50%
activities
40%
relaxation
47%
relentionships
60%
area
16
The above Bar Chart 1 also shows that for every group 40% of the overall
sample said that it was important now and in the future. As a whole this would
suggest that all groups of leisure and social relationships are significantly
important to people in Salford.
This information was then broken down into the preferences of different age
groups which are illustrated Bar Chart 2 Below
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
total
school
college
ps
ns
hi
re
le
nt
io
re
la
xa
t io
n
ite
s
ac
tiiv
cr
ea
t iv
e
an
d
ou
t
ar
ts
adults
ab
ou
t
percentage
Bar Chart showing percentage of each group who
were interesed in each area of leisure and social
relentionships
area
Bar Chart 2 above shows that the following were the most important to each
group:

School = out and about (89%)

College = Relaxation and social relationships (50%)

Adults = social relationships (72%)
There seemed to be no significant difference between people, who were
categorised as autistic, having complex health needs and those who are or
could potentially be vulnerable adults, except the majority of information
gathered from people with autism was based on activities rather than
relationships
17
As this was such a big area we will now look at each group individually and
see if there are any trends
18
Out and About
Bar Chart 2 above shows that overall the out and about group was the most
important with over 78% of the sample stating it as important now and for the
future.
Table b and Bar Chart 3 below shows that overall the Out and About theme
was particularly important to the school group, with all areas other than lets
get physical and transport representing 20-50% of the sample.
Table b showing what activities were important to people now and in the
future
area
Age group
school
college
total
sport
adults
11
7
3
1
7
6
0
1
going out
16
6
6
4
exercise
8
5
2
1
Transport
4
1
2
3
11
4
3
2
5
2
3
0
18
9
6
3
activity club
the great outdoors
lets get physical
swimming
Bar Chart Showing what was important to
people now and for the furture regards getting
out and about
60%
50%
total
school
30%
college
20%
adults
10%
sp
or
t
ity
cl
ub
go
in
g
ou
t
ex
er
ci
s
th
tra e
e
ns
gr
po
ea
rt
to
ut
le
ts
do
ge
or
s
tp
hy
sic
al
sw
im
m
in
g
0%
ac
tiv
%
40%
activity
19
From this information we can surmise that the top three area within out and
about for each age group; were as documented in Table C below
Table C showing what the top 3 activities for each age group were for
the theme out and about
School
Swimming
College
Swimming
Exercise
Going out in the
community
Sport/ lets get physical
Sport
Adult
Going out in the
community
Swimming
The great out doors
This shows that swimming, out in the community and sports were consistently
reoccurring themes. Although people talked about being out in the community
– not many specified what they meant by this – further exploration would be
required to find out what people mean by ‘community’.
We also looked to see if there were any differences in chosen activities based
on individual need. The group was spilt up into three groups, those with
Autism, complex health needs and those who were or could potential be
vulnerable adults. Some people will be in to groups because of their needs.
Table D and Bar Chart 4 show the dispersion of the sample when divided by
need
Table D Showing number of people who stated each activity was
important to them – now and in the future based on Need
Autism
Complex Health
needs
vulnerable adults
sport
4
0
7
activity club
4
1
3
going out
6
7
8
exercise
2
2
5
Transport
4
0
0
the great outdoors
7
4
3
lets get physical
4
2
1
swimming
9
8
7
20
Bar Chart Showing Number of people who
were interested in each activity within the area
out and about based on individual need
80%
70%
%
60%
50%
Autism
40%
Complex Health needs
30%
vulnerable adults
20%
10%
ac sp
tiv or
ity t
c
go lub
in
g
ex ou
er t
th
c
e
T
gr ra ise
e
n
le at o sp o
ts
ge u td rt
t p oo
hy rs
sw sic
im al
m
in
g
0%
activity
The Data shows that:
Sport
There is a high prevalence of males within this group; however the groups is
pretty evenly dispersed between people with autism and vulnerable adults
(31% / 36% respectively) However it had no representation from people with
complex health needs. We would need to investigate if this was due to lack of
interest or lack of experience/ opportunity.
Activity Clubs
The Bar Chart shows that only 14% of vulnerable adults found activity clubs
important now and for the future compared to 31% of people with autism.
This is interesting as you would expect a high percentage of vulnerable adults
to be interested in joining groups. However it must also be stated that over
41% of the vulnerable adults group are adults (9 people) and that adult had a
low prevalence in the activity club group – which could explain the low
percentage of vulnerable adults. What was found was that many your people
with moderate needs wanted to join clubs or remain in clubs they were
already in people especially enjoyed after school clubs and summer activities.
For people with autism; other than Chatsworth clubs, clubs were issues as
they were often seen as unsuitable for people with Autism, and there was a
growing discussion in reviews of the need for some specialist autism clubs for
people with severe autism who struggled to participate in either mainstream or
discrete activity clubs.
21
Going out in the community
This group overall was important to all groups with all groups scoring over
35% however this was particularly important for people with autism (46% )
and people with complex health needs (58%) However as stated early
people were not clear what they meant by out in the community; with most
information being ‘out in the community’ ‘going out’ ‘getting out and about’.
No one really indicated where they wanted to go; with whom and to do what.
Most information about ‘community’ was found on the ‘important to the future
board’ which indicated that ‘community presence’ was more of an aspiration
rather than currently occurring. This opens up the question of what needs to
happen to enable these groups to access there local communities or
communities of interest.
Exercise
For people at school age exercise was often linked to PE, which was many
young people’s favourite lesson. Therefore although the Bar Chart 4 only
shows 23% of vulnerable adults, most of these people were young people
going through transition. Only 2 people with complex needs and autism
stated exercise was important to them.
Transport
This was only mentioned by people who had autism and complex needs.
However this was more about the pleasure of going for drives or using trains
rather than getting from a to b.
The Great outdoors
This included activities such as going for walks and being outside. This group
was particularly prevalent with people with Autism (54%) especially young
men with autism from 16- 19 years old. Although the graph shows 33% of
complex health needs wanting great outdoor, all of these people had a dual
diagnosis of autism. This may be a reflection of the need to look at alternative
activities and a move from building base activities. Activities that people
stated as important were activities such as walking, cycling and being in wide
open countryside spaces or woods.
Let’s get Physical
This group included activities such as assault courses and grown up
playgrounds as well as activities such as abseiling. This group was
particularly important again to the young men with autism.
This Group and the great outdoors group – highlight an area of growing need
for young people, particularly men, that although they may require a building
22
base, need to have more physically challenging experiences that perhaps
been the case in the past. This is also highlighted with the swimming group.
Swimming
Swimming was consistently mentioned across all groups, and overall was
perhaps the highest mentioned single activity with 18/40 reviews mentioning
swimming (this is not including hydro therapy) It was important across all
groups however a staggering 60% of people with complex health needs and
autism said swimming was important now and in the future. They often also
stated that they struggled to get to go swimming other than with school,
difficulties included, pool availability and changing facilities.
Conclusion
What becomes apparent is that although this group is important to all people,
the need for physically challenging outdoor activities is particularly important
to young men with autism. There interests tend to lie in individual activities
rather than group or team activities such as football. The big question is will
current provision be able to cope with demand.
The other key observation is that other than those with autism; people with
complex health needs rarely mentioned more physical activities. This may be
due to the lack of opportunity of adapted sports, experience or a side effect of
the health issues. We need then to look at what opportunities people with
complex needs are h complex health needs and autism
23
Creative arts
Overall 20% of the sample mentioned that some form of creative arts was
important to them. Table E and Bar Chart 5 show how the sample was
distributed across each area based on age of sample.
Table E showing what creative arts were important to people now and in
the future
area
Age group
school
college
total
adults
7
2
2
3
9
5
2
2
Music
11
6
2
3
Drama
9
6
3
0
Art
Bar Chart showing the percentage of people in
each group who would like to do the activity in the
area of creative
40%
35%
percentage
30%
total
25%
school
20%
college
15%
adult
10%
5%
0%
Dancing
Art
Music
Drama
activity
What Table E and Bar Chart 4 show is that overall music was the most
popular group; followed by drama then art. The popularity of different groups
varied across age groups with the distribution being as follows:



School; Drama and Music (35%)
College: Drama (25%)
Adult: Dance and Music (27%)
24
When information was analysed based on the needs of the participants (see
Table F and Bar Chart 5)
Table F showing what creative art activities people said were important
to them, based on age of participants
Autism
Complex Health
needs
vulnerable adults
Dance
1
3
4
Art
4
4
6
Music
6
5
4
Drama
2
2
6
Bar Chart ( ) Showing number of
people in each area of need who said
creative art activities were important
to them now and in the future
50%
%
40%
30%
Autism
20%
Complex health
needs
10%
0%
a
Dr
am
us
ic
M
Ar
t
Da
nc
in
g
Vulnerable adults
area
What this shows clearly is that for people with autism and complex needs
music is extremely important to them, where as those categorised here as
vulnerable adults found art and drama to be the most popular area.
Art appeared to be evenly distributed across groups, however what was also
interesting was that many people with complex health needs felt dancing was
important now and in the future.
Although this group is not as big as the out and about group – it does show
that there is still a requirement for people to access different forms of creative
arts. This is an area which could be linked to a person local community
Leisure and social activities
Overall 14 people stated that leisure and social activities were important to
them now and for the future this equated to 35% of the overall sample –
however the importance of this differed with different age groups
25
The pie chart below breaks down the 14 people to show the percentage of
each age group who were interested in leisure and social activities.
Pie Chart Showing how the 14 people who stated
lesiure and social activiites as important to them
now and in the future was made up from the
different age groups
21%
school
50%
college
adult
29%
The pie chart show an equal split between school and college and adults.
What is interesting here is that for young adults and adults this has a high
prevalence whereas school age children were not really interested. This may
be as the group is made up of activities such as going to the pub or shopping,
which tend to be more grown up activities. There was also a higher proportion
of women in this group.
Relaxation
Overall there were 17 people who stated that relaxation was important to
them, this equates to 43% of the sample. Table ( ) shows how the group
was dispersed across age groups
As Table F shows relaxation was particularly important to people who had
autism or had complex health needs. This may be due to the fact the group is
made up of activities, such as therapies, massage multi sensory, listening to
music. This also links to information gathered in the health section, which
shows a growing demand for therapy based activities.
26
Table F Showing percentage of people in each need group who said
relaxation was important now and in the future
Autism
Percentage
of people
62%
Complex
health
needs
50%
Vulnerable
adults
27%
Bar Chart Showing what was to important to
people now and in the future regards relalaxation
45%
percentage
40%
35%
30%
25%
20%
15%
total
10%
school
5%
college
0%
adult
ow n space
listening to
music/tv
Threapies
activity
27
relaxation
Social relationships
Over 60% of the sample said social relationships were important to them.
This group was divided into 4 categories:




Friends
Families
Relationships
Socializing
Bar Chart showing percentage of people in each
group who has stated the important of social
relentionships
90%
80%
percentage
70%
60%
total
50%
school
40%
college
adult
30%
20%
10%
0%
friends
family
relentionships
social life
relentionship
The Bar Chart shows that friends were extremely important to all groups;
especially those at college. For adults; family came as most important, which
is in line with national trends where friends are seen as more important in
adolescent with family becoming increasingly important.
The big issues for young people at both school and college were that they
often did not see their friends outside of the educational environment. Young
people wanted more opportunities to spend time with there friends, and they
often felt vulnerable meeting in more mainstream places such as pubs and
cafes.
Relationships were rarely discussed in reviews and work would need to be
done to decipher whether this is due to a lack of interest or a lack of
opportunity to develop relationships,
28
Friendships and relationships are a regional priority for people with learning
disabilities and we need in Salford to start to look at how we can support
people to develop and maintain meaningful relationships. There is a whole
host of natural support which is being under used, For example how can we
increase peer support as well as friendships between disabled and non
disabled people.
Conclusion of information from Reviews
The information above and the information from the working not working
boards (see below) show that although there is a lot of work currently go on in
this area; there is still a lot of difficulty at supporting people to access leisure
and develop and maintain relationships,
Many families were happy with many of the groups within children’s services
which offered a range of leisure activities, however all off these groups were
discrete provision and no one who had a review was accessing mainstream
youth clubs, activity clubs etc. Even the discrete provision clubs often did not
have provision for people with complex Autism and or complex health needs,
meaning many of these groups were doubly excluded.
For the future there is a growing demand for more activities to be based in the
community and for people to have access to mainstream and discrete
provisions activities. There was some concern that when things ended at 18
there was nothing to replace them; or that people would lose all leisure at a
certain age. More and more people were asking for activities that could
continue into adulthood. There also appeared to be a lack of knowledge
about activities which were already up and running.
Some families were concerned that when young people hit adulthood they
would be mixing with people who were a lot older than they were, and that
there would not be age appropriate activities.
However for the young people themselves, it was important that they get to
keep and maintain there friendships as well as developing new ones, yet to
few transition plans reflected the needs of young people to continue to
develop their friendship outside of school or college. It also identifies that
people may need to be involved in each other plans, and also raises the
question of regards friendships and relationships – what role if any should
services play? Especially as families noted it can be difficult for young people
to meet up out of school due to where people live and getting in touch with
families they have never met. Leisure is not always seen as a high priority;
although research shows that an increase in leisure can play a positive
29
contribution to a person’s health and wellbeing and prevention off ill health.
We need to continue to support people and organisations to increase the
access of leisure.
30
What’s working / Not Working
regards leisure and Social
relationships – Information from
Reviews
Working
Not working
Being in open spaces
The great outdoors
Sports/summer club
Extra curricular activities at school i.e.
swimming drama etc
After school club
Not being able to go out
Not enough activity outside of school
Don’t go to clubs
No transport
Swimming facilities unsuitable /
changing rooms/ time
When groups are put on often not
very well subscribed to
Oakwood youth group – is
underused and people who don’t go
to Oakwood often don’t know about
it
No autism specific activities
Not seeing friends outside of school
Not being able to support young
people to see friends
Don’t know who his friends are
Extra curricula clubs
Oakwood youth group
Seeing friends in school / college
PE
Large age ranges in adult activities
Having to access day services to be
able to access leisure
When looking at the future not
enough emphasis on things people
wanted to do with friends
31
Work Carried out by the Senior
Managers at the Strategic
Commissioning Day on Leisure
and Social Relationships
32
Current practice compared to how we would like to see it in an ideal world
Local

Salford is fortunate as it has very good facilities across the
city with the fit cities – with lots to offer

Salford has capacity to do more things

Pools are often used by school during the day – who get
priority this can cause some difficulties

Often people can have support – but no activities – many
don’t know how to access activities and vice versa

Once fit city members become use to see people with
learning difficulties they have become extremely supportive
of them – this has happened quite naturally

Often difficult to engage with people and their families as
they have an expectation that everything should be for free
– we need to look at perhaps phased ways into paying for
things

Currently induction fee is £15 for 1 hour – difficult to get
people to pay for this

Family and carers can often act as a barrier

Where stuff is – transport can cause some difficulties

There is a group from St Georges based in Clarendon –
they are integrating in more however this has taken time

SCL need to understand the differences between groups
and understand that all people with a learning difficulty can
be lumped together

Relationships have started to form from work already
happening
Ideal

There would be an increase in leisure membership

We would be working using a phased approach – where
people were slowly integrated into the gym

There would be a sharing out of responsibility – with clear
guidelines on who does what and what is the responsibility
of mainstream services and what is the responsibility of the
specialist services.

There would be different support systems in place

More people with learning difficulties working at the leisure
centre’s and on work placements there – increasing the
profile of people with learning difficulties within leisure

People would be using own money to decide what they
wanted to do

There would be loads of different activities available –
based on what people have said they would like to do more
off and also giving people tasters of new activities.

There would also be a variety of groups so there would be
segregated and integrated groups depending on need and
wishes – there would also be room for people to move from
one group to another

There would be opportunities for people to have some
support which is slowly phased out

People would be enabled to take risks – effective risk
management and appropriate level of support which is
flexible
33


There would be a menu of products

People would be seen as consumers and seen as
valuable customers

Local churches to become more involved

Set up a walking group – rambling

There would be autism specific leisure

Buddying systems

Local natural support would be happening all the time –
with the increase of people with learning difficulties being
out and about

City wide accessible information

Peoples individual needs are taken into account

Individual service specs completed for different groups/
activities

We would be using the resources in Salford better –
people could use them to meet up

Local services for local people – more work around
supporting people in their own locality
Leisure task group are trying to pull it all together –
however the right people are not always around the table

Often a lot of talk and not a lot of action

Oakwood youth group are doing a lot of work around
leisure and young people with disabilities – not always
something for them to move on to

Work is currently underway regards setting up a friendship
group
34
Barriers / Things to Work out
Not being able to go out
Possible root causes






Over protectiveness of parents / carers / staff and services
Not enough opportunity to facilitate risk taking
Not enough staff in houses to enable people to go out
Transport issues
Not using mobility car as it is suppose to be used
Expectation by parents/ carers that services should support people in everything they do – this takes responsibility of families
to support person
Unrealistic expectations of services to provide everything – not always partnership

Possible solutions
 Start to break the setting up of activities into components where each is seen individually eg the activity, support and who
attends
 Ensure that there are clear roles and responsibilities between families, agencies and the people accessing the activities
 Look at developing the independence skills of young people from an early age – so that transition is not just a paper
exercise (ie increasing the number of young people taking part in travel training from 16)
 Supporting young people to go to local shops from 16
 Services; especially specialist services to see themselves more as facilitators
Not enough activity outside of school

Possible root causes
People don’t know what is available and when things are on
35





No interaction between parents – makes it difficult for parents to arrange things with each other and to co support each other
Parent may not know who there children’s friends are
Provider services do not know what people want
Unclear about the service need
If activities are available support may not be and vice versa
Possible ways forward





Link new activities to what people have been saying are important to them now and in the future – via person centred
information
Personalize marketing – ie from info we have gathered we can code call people who said they would like something when we
have set it up
For those who are able; those who have asked for something can help us set it up
Increase opportunities for parents to link up
Accessible information – to be in accessible places – it needs to be where the people it is aimed at will see – use the Life in
Salford magazine to advertise opportunities
No transport
Possible root causes








Activities are spread out across city
People have been put in specialist organisations – therefore there friends could come from anywhere in the city
People not using mobility cars to full potential
There is transport to particular services
More people need to be supported by mobility officers
How accessible
What support is needed
Risk aversion rather than risk management
36


No experience of using different types of transport
Expectation by people that services should provide transport to and from places
Possible solutions




Clearer about when transport will be provided
Stricter criteria for people using transport services
More people travel trained
Activities taking place in people localities
Inaccessibility of venues
Possible root causes



Where hoists, changing beds are available
Women supporting men – can cause difficulties with changing
Where building are based – accessibility via public transport
Possible solutions

Clearer information about what is available where
No Autism specific leisure
Possible root causes


Many people with autism struggle to access mainstream and specialist provision
There is a greater expectation that people will be supported where they live in their local communities – this has highlighted
there are gaps for people with greater needs
37

Families have often had bad experiences in the past
People needs support to participate
Possible root causes


The perception that anyone who has additional needs need to have ‘additional support’
Specialist services telling people how ‘special’ the people we support are – and that you have to have special skills to support
them
Now understanding the individual needs of each person
No flexibility in how we support people – an all or nothing approach
No creativity in supporting people
The thinking that support means a physical body next to someone – no creativity in what support might look like
Mainstream services thinking that if they get people going to the centre people who have high support needs will come with
no support at all
1;1 is necessary for some but not everyone






Possible solution







Looking at different ways to support people including phased out support
Get people use to a building from a young age – this can be the constant during transition
Activity needs to marry up with expectation
Giving responsibility and some sort of risk taking
Outcome focused planning
Increase the flexibility in support
Expectations built up in school
38
39
Action Plan
Long term Outcome
Increase workforce training of
mainstream services – so that
staff have a better
understanding of some of the
issues and possible solutions
and understand that one size
does not fit all
Look at producing individual
service specifications for
different leisure activities
based on individual need –
which enable differentiation
and progression
Service specification to be
developed based on
information gathered from
individuals and then people
individually targeted
Continue to develop ‘friendship
groups’ whereby people are
supported to set groups up –
but then they also given
opportunity to grow organically
Next step
1) Continue to widen out learning difficulty specific
training to Salford Community leisure staff
including; Autism Training, Total Communication,
Hallo wick, Teach Person centred thinking skills
2) Increase the experience of the general public and
leisure service staff by looking at opportunities for
work experience and volunteering
1) Further analyze information gathered in the
individual to strategic change project to look at
where gaps are and possible solutions
2) Look at possible opportunity for a meet and greet
service – which could link with the work of Salford
community leisure
By Who
Sue Daniels:
Salford
community
Leisure – work
force
development
By when
Ongoing – Sue to
be invited to
Feedback to
Leisure task
group in March
Caitlin Chapman
Feb
Natalie Craig
John Clarke
1) continue to set up pilot and look at creative
tendering
2) evaluate the pilot
40
Lesley Sampson
Ongoing
Through reviews ensure young
people friendships are on the
agenda and opportunities for
them so see friends outside of
school are discussed
Look at a more flexible
approach to support; where
there is clear guidelines on
different organisations roles
and responsibilities – and
innovative ways of supporting
people – with an
understanding that support can
gradually decrease
To increase the usage of
Salford community leisure
facilities by people with
learning difficulties – by an
uptake of a more consumer
model which using information
from reviews – will look at a
more personalized market
approach
3) leisure and friendships to be added as a sub
Caitlin Chapman/
heading on the review
facilitators
4) start to investigate what other people have done
in other areas to support friendships and
relationships
5) Caitlin to send research around ‘…identifying local Caitlin
barriers to access to leisure for people with
learning disabilities and look for possible
solutions’ to Garry Bateman and Natalie Craig
6) Increase the joint training of staff across
7) Discuss where we are up to with Salford
community leisure’s accessible information
Dannielle Mossell February 2010
– Salford
community leisure
Nigel Johnson
8) Using information from the individual to strategic
change project look at a possible project then
personally contact people about the project
9) Contact Sararh from research and information
and ask her to contact Garry Bateman
41
January 2010
Susan wilderman
– head of
marketing
Bernie Enright
10) Relook at the representation on the leisure task
group
11) Gather information from swipe cards and find out
what this is telling us about who is using the
leisure centres
42
Nigel Johnson
SCL - Nataile
What has happened since the Strategic Commissioning day Regards
Leisure and social relationships
 Salford Community leisure (SCL) teams have participated in learning
disability specific training including Total communication and Autism
 From this an SCL dance session know uses communication
schedules within the session
 An autism specific leisure steering group has been set up
comprising of families and professionals from a range of
backgrounds including the equality officer from SCL, physio –
therapy, day services, learning disability nurse, health play worker.
This group has supported a community based Trampolining club to
set up a Trampolining session for people with autism
 A bid is currently being developed for autism for leisure sessions to
be set up for people from16+ who have autism. Within this bid will
be sessions for walking, swimming, cycling, water sports,
Trampolining and dancing
 There is representation form SCL on a number of the learning
disability task groups including the leisure task group and the Autism
Task group.
 Using monies from the Aiming High Project SCL have set up a
number of activities for young people with disabilities,(0-19) this has
included, water sports, swimming, families swimming, Trampolining
school holiday activities
 There has been an increase in young people from Chatsworth
accessing the Oakwood youth group especially playing football
 Oakwood youth group now have a wheelchair football group
 The autism task group are leading on a befriending scheme
 Salford Being Heard – the local self advocacy are doing a big issue
conference on friendships and relationships
 SCL have begun to send information to all people with a disability to
ensure information is getting to people
 Work currently taking place to devise a directory of activities for
people with disabilities
43
Examples of individual outcomes from person centred reviews regards
leisure and social relationships
 Increase in young people accessing leisure activities including,
football, swimming, Trampolining
 Short break care provisions are increasingly ensuring that friends stay
at the same time – both within children’s and adult services
 Leisure is becoming an increasing part in all peoples transition plan
 As activities that may interest young people are coming up – they are
being contacted directly
44
Employment, Education,
Training and Skills
45
Priority Area 2s
The Transition Task group during stage 3 of this process; agreed that employment, education and training was the second highest
priority for Salford to look at. Using the information from the reviews, the group subdivided the information about employment
education and training into 5 areas as shown in Diagram B below
Employment education and Training
Jobs
Job Interests
Computers
46
Skills
Education
47
Number of people who stated employment, education and training were
important; now and in the future
Table H shows the number of people who mentioned employment, education
or training as important now and/or in the future at their person centred
review. This shows that 29 people (73% of sample) felt that this area was
important
Table H Showing Number of people in each age group who said
employment, education or training was important to them; now or in the
future
Age group
school
college
total
Number of
people
29
12
adults
10
Bar Chart 6 builds on this learning by analysing the percentage of each group
who mentioned this in their review. This shows clearly that those at school
and college felt employment education and training were important now and in
the future. This may be due to the educational environment in which reviews
took place however it may also be an indication of the increasing aspirations
of the younger generations.
Bar Chart Showing Percentage of people who had
mentioned Employment, Education Training and Skills
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
total
school
college
group
48
adults
7
When broken down into area of need, Bar Char 7 shows that although 81% of
vulnerable adults discussed this area, it was also very important to the
majority of people who had autism and complex health needs. However when
we break Employment, Education and Training into the different areas there
are significant differences between the different groups. Bar Chart 8 and Bar
Chart 9 show number of people who mentioned each area when compared
through age groups and needs.
Bar Chart 7
%
Bar Chart showing number of people, with different
needs who said employment, education or training
were important
100%
80%
60%
40%
20%
0%
autism
complex
health
needs
vunerable
adults
area of need
Bar Chart 8
Bar Chart Showing what was important to people now and
in the future regards Employment, Education, Training and
Skills
80%
total
60%
school
40%
college
adults
20%
area
49
ed
uc
at
io
n
sk
il ls
co
m
pu
te
rs
jo
b
in
te
re
st
0%
jo
b
percentage
100%
Bar Chart 9
Autism
80%
60%
40%
20%
0%
ed
uc
at
io
n
sk
ills
pu
te
rs
co
m
jo
b
in
te
re
st
complex health
needs
jo
b
%
Bar chart Showing what was important to different need
groups regards employment, education and training
Vulnerable
area
Bar Chart 8 shows that getting a job was important to over 45% of people at
college and adults. At 35% of people at school, this is slightly lower; however
this may be due to the high proportion of people with complex needs and
autism in the school group, or due to the age of the people and whether they
have fully explored the possibility of getting a job.
Education was mentioned in all group, however this was particularly
precedent in the college group where it was deemed as important by over
80% of the college sample. What is interesting is that only 2 people who were
not in education felt that education was important to them now and in the
future.
Skill building was not particularly prevalent in any of the groups; however this
was seen as particularly important by young people at school, with nearly 30%
saying this was important for their future, especially travel training and
independent living skills. This may show a continuing development within
school, based on skill building rather than traditional academia
Bar Chart 9 shows that only 1 person with autism said that getting a job was
important to the future; and no one with complex health needs felt that
employment was important there could be a number of factors which influence
this including:



Those around them deeming employment inappropriate
Low expectations of people
The capabilities of people
However over 40% of the overall group felt that employment was the route
they wished to take, this equates to 65% of those who, within this project are
categorised as vulnerable adults, which may signify a change in aspirations
50
However none of the people within the sample were in paid employment,
therefore there may be a difference between demand for employment and
supply
Education for people with autism and complex health needs was important to
over 40% of the sample – however if these people are working below entry
level, they will struggle to get continuing education after 19
Questions to Answer Issues to Resolve
1) how do we base work on what people are good at/ interested in
2) do educational/ training programs at schools, college and St Georges
reflect the current job market
3) how do we support more people to get jobs
4) how do we increase people skills
51
What’s Working / Not Working Regards Employment, Education and
Training
What’s working
Activities at school computers, drama,
swimming and Pe
What’s Not Working
Classroom based activities are limiting
Being at school
Not close enough links with school and
supported employment
Chatsworth
People going to college and not being
in work when they finish
Coming to school
Not enough pre entry course in Salford
School and routine of it
Not many options for young people
School –RISB
Information about employment – not
always clear how you can get help etc
Inclusion at Wentworth
School
No clear routes
More emphasis need to be put on
employment
Gap between supply and demand
Work placements at school
Work experience does not equate to
jobs
Increase in work experience
opportunities both at college and at
school
Princess parks involvement with the
schools
Work experience is run separate to
Salford supported employment
Work placements at college
52
Work Carried out by the Senior
Managers at the Strategic
Commissioning Day on
Education and Employment
53
Current Practice and possible moves forward – education and employment
National
Local
Ideal
There are limited opportunities for people
with learning difficulties regards education
– especially as there is a growing
expectation that all jobs require some
form of academic qualification – this can
limited peoples access to education – due
to entry criteria but also limit chances
within the job market
Not enough pre entry courses
Schools would have raised aspirations
for young people
There are particular difficulties with the
emphasis on IQ rather than looking at
practical application
National Proficiency test in services with
partnership from Eccles college
Lots of work around work placement not enough
paid employment
People finishing college and then not having
anything to move onto
Pupils would have raised aspirations
Services continue to deliver education
in some way for example on the job
training
Services working with colleges
With employers
These issues effect entrance both to
school and further education
Young people attending Mancat and Lorretto –
who are not working in partnership with Salford
social care although Chatsworth and these
colleges have good links
There are other entry routes such as night
school and FE
Supported employment are not working closely
enough with school and college
Tailored mentoring – peer support
The National personalization program
Aim 50% of people with learning
disabilities in jobs of 16 hours plus
(valuing people now) national average is
about 7%
Work being repeated, continual assessment…
devaluing
We need to increase equality of opportunity
Working on ethos of out of centres ‘on job
training’
54
Move out of the centres into on the job
training
Personalized assessment that goes
with you – move away from lots of
different assessments
People would be working in jobs they
enjoy
Barriers / things to figure out – education
1) Do current educational programs reflect the current job market?
Answer – jobs tend not to become careers, and can be to narrow
2) Classroom based activities are limiting
Answer – as we NPTC move towards more on the job training and learning in real rather than artificial environments
3) not enough pre entry courses in Salford
Answer - nationally funding has been pulled for a lot of pre entry provision, we need to talk to colleges (not just FE) about courses,
translate skills into qualification
Educational programs ie NPTC should include work skills i.e., social office skills, bigger pictures wider views
55
Action Plan
Long term Outcome
There to be good quality,
updated positive records of
achievement which are used
by different agencies and
follow someone
achievement
Negotiate with colleges
regards future courses –
which represent what young
people want but also reflect
the current job markets in
Salford
There should be a quality of
opportunity for employment
and college for all people
with a disability
To increase opportunity for
adults with a learning
disability who are working at
pre entry level to access
college provision
Next step
1) Kim to take to day service managers and
panels including commissioning team
2) John to introduce to SES employment et al
and cascade
By Who
Kim
By when
Feb 2010
John
January 2010
3) Identification of person to do this from aiming
high (for disabled children)
4) Talk to data person
Maggie
January 2010
5) To look at introducing ideas and share
experiences in this area
John
2010
6) Continue to look for further sources of
funding
7) John and Kim to liaise over a possible
funding bid
Kim
Ongoing
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Bid in for January
2010
What has happened since the Strategic Commissioning day Regards
Leisure and social relationships
 NPTC has been implanted within day services in conjunction with
Eccles Colleges
 Supported Tenancies are going to join the NPTC partnership to
support people to increase there independence skills within their own
homes and be accredited for their learning
 A ‘Dragons Den’ event is taking place where there is £500 available
for the best self employment idea – there has been partnership
working to enable 4 young people going through transition to develop
business plans between Salford supported Employment, transition
coordinator and Eccles College and connexions. All education
leavers were given the opportunity to participate.
 A project between Salford Supported Employment, Salford College
and Sainsbury’s has been set up to give people with learning
disabilities the opportunity to increase their reading and writing skills
and gain work experience and possible jobs at Sainsbury
 SES are working more closely with school and colleges to support
people into employment , this includes Salford and Manchester
college
Individual outcomes
 Six people have started independent travel training as a result of their
review
 1 person accessed a mainstream Japanese course and finished the
course top of the class with 95% - this person is going on to GCSE
Japanese course
 1 person is leaving a specialist Autism provision school a year early to
access a mainstream college to do an arts and drama course – due to
the multi agency work across, education, connexions and social
services and direct payments.
 I person left the local specialist school at 16 to access the local six
form college – the norm is to stay until you are 19 – he was extremely
excited and kept saying ‘do you remember when I had my year 9
review I said I wanted to leave, I was scared but I did it! I did it I did it!’
The person centred review acted as a catalyst and the move was
made possible by joint working and an extensive transition plan from
the school, college connexions and social services.
 Currently working on an educational package for a young person
where he will be part of the local FE College but as he will find the
environment hard due to his sensory issues and epilepsy, he will do
the course at one of the day centres. In principle all organisations are
in favour it is whether it is now feasible.
 Increase in number of young people leaving to Chatsworth at 19 and
going to Eccles College
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Support, Respite
and Health
58
Diagram C Support and Respite3
Support and Respite underpin much of the other themes and were reoccurring themes throughout the reviews analysed. When
information was grouped by the Transition Task group there were three key areas that emerged, which are shown in Diagram C
Here we shall look at what the information tells us about support and respite
Support and Respite
Support
3
Respite
Holidays
All though Salford now refer to respite as short break care – in all the reviews respite was referenced – therefore this became the name of the group
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Diagram D Health
Diagram D shows that within the important to and for boards; therapy sessions were extremely important to people now and in the
future.
Health
Communication
Sensory
Hydro
Therapy
Health
Services
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Support and Respite
As shown in Table I and Bar Chart 10; 68% of the sample participants (27
people) said that support and respite were important now and in the future.
More over as Bar chart 10 shows this was evenly distributed over the 3
groups of age ranges
.
However when looking at this information; we need to be alerted to the fact
that support and respite may not be important to the individual; but important
to the family and carers. This is particularly pertinent to those with greatest
needs who, may not have attended their own reviews and information was
gained through the ‘best guess’ and observations of those who know the
person well
Table I Showing number of people in each group who felt support and
respite were important now and in the future
Age group
school
college
total
Number of
people
27
12
adults
7
8
Bar Chart 10
Bar Chart Showing Percentage of People in Each Age Group
who Mentioned Support or Respite in their review
80%
70%
60%
%
50%
40%
30%
20%
10%
0%
Total
school
college
adults
group
Bar Chart 11 shows the percentage of people in each area of need who
stated the support and respite were important now and in the future. This
shows clearly that issues of support and respite are important to all groups; is
61
especially so for those with Autism and Complex Health Needs. Key stats
from this are:
 68% of people has this as important now and in future

95% of people with autism had this as important

89% of people with complex needs
Bar Chart 11
Bar Chart showing Number of people who mentioned support
and respite in their review; based on their needs
100%
90%
80%
70%
60%
Series1
50%
40%
30%
20%
10%
0%
autism
complex health needs
Vulnerable adults
What people thought was important now and in the Future regards
Support and Respite
The Transition Task group found that information regards support and Respite
fell into three main groups:
1. Support
2. Respite
3. Holidays
This information was analysed based on age group and needs of people.
Table J showing number of people in each age group who stated
support and respite was important now and for the future
area
support
respite
Holidays
Age group
school
college
total
adults
10
5
4
1
11
6
4
1
15
6
2
7
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Table J shows that when information is analysed based on age group;
Holidays was the most important area of support and respite, with 15 out of 40
people stating this in their review.
However Bar Chart 12 below shows that the most important areas for each
group were:



School – Respite
College – Respite
Adults – Holidays
Bar Chart 12
Bar Chart Showing number of people in each age group who
had mentioned support and respite
70%
60%
50%
Total
40%
%
school
college
30%
adults
20%
10%
0%
support
respite
Holidays
area
Bar Chart 13 shows that the top priorities for people based on need are as
follows:
 People with Autism – Respite
 People with complex health needs – respite
 Vulnerable adults - holiday
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Bar Chart 13
Bar Chart Showing Number of people in each need group who
had mentioned support and respite
70%
60%
50%
autism
40%
%
complex health needs
Vulnerable adults
30%
20%
10%
0%
support
respite
Holidays
area
Support
Support and respite were particularly important to families and carers of
people who had autism or complex health needs and those as school and
college. This could be a reflection of the imminent change in support
providers and commissioners; which causes families great distress.
For families of those with complex health needs or Autism they were
concerned about getting the right support; but also enough support so the
young people could remain in the family home. There were concerns that
specialist support was not available and that the young people were often
excluded from groups as there was not adequate support. Most were happy
with the support they received from schools; however they were concerned
that there would not be adequate or the right support when they moved into
adult services. Families of young people with Autism were concerned that
day services within adult services were not appropriate for the needs of the
young people; however there were also concerns that direct payments were
difficult as they were potentially:
 difficult to set up
 it could be difficult to find the right personal assistant
 they were worried they wouldn’t get enough money for the persons
needs
 Most people wanted hours which reflected the school hours.
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 Young people with one worker may be vulnerable; there was a fear of
what support the worker would get.
 Even with direct payments there was no real choice in services.
Many families who worked were also concerned about whether they would be
able to continue to work once the young person left school, although all those
who needed work felt this was extremely important to them both financially
and for their health and well being; stating work gave them a break.
Short Break Care
All families who received short break care found this an invaluable service;
although some young people – especially the more able were reluctant to go.
However there was some anxiety about the move over to adult short break
provision. There was also some concern about the lack of choice and
different types of short break care – especially for young people who either
had Autism or Complex Health needs especially those could not be
supported by the current respite provision as this was not appropriate
Holidays
Holidays were mentioned by many of the people who had learning disabilities
or physical disabilities. Most wanted the opportunity to go on more holidays
both with friends and families. Those at Eccles College particularly enjoyed
the annual college trip to Blackpool.
For people with Autism or complex health needs – having the opportunity to
go on holiday both with the family – but also as an alternative to respite
provision was seen as extremely important for the future.
This highlights the importance of evaluating and modernising the different
ways in which support and respite can be delivered to greater meet the needs
of the people who are supported and their families and carers.
Key issues highlighted in the reviews were:



Concern about getting the right support – especially for those with
complex needs or where people require 1:1 or 2:1 support
Some concerns about whether there are appropriate services for
those with autism; both adult and children, especially around respite
and community support
Often people with greatest needs end up with least; as there are no
appropriate service available
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Working not working – support and Respite
Working
Not Working
France with school
Community support – living ambitions
Lack of formalised 1;1 impinges on what he can do
School holidays – lack of service provision
Respite ‘ grange with friends
Respite
Weekly support from Salford families
How we respond to his behavioural challenges
School holidays
It’s scary getting older
Respite – 25 days a year
Going to grange
Going to grange
Short break (RSIB)
Rigidity/ inflexibility – impacts on family life
Mum not always feels safe when out with him
Mum finds it difficult to support him – physically x 2
Short breaks
Respite brought up twice in reviews nothing done about it
School and the support in provides
Not enough respite options for people with autism
College and the support it provides
Need more respite
Knowledge – don’t know enough about future options
If I don’t get enough respite in adult service – he will have to leave
home
Respite at meridian
Not knowing what will happen in future
Moving to adult service
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Working not working - health
Working
Not Working
Health professionals are on site at school
Physio programs are implemented by staff at the school
Input from Diana nurses
Concerns about the transition to adult health services
Not all young people have a Health Action Plan
Not enough information is being put on the Healthy and Safe
board regards Health – this is often as people assume others
would now – as we are using the PCR as a forward planning tool
– this may result in services not be reflective off need
Input from the learning disability nurses
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Work Carried out by the Senior
Managers at the Strategic
Commissioning Day on Support
and Respite
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Practice – Short Breaks (holidays and respite)







National
Very traditional respite care
(like Granville and the
Grange)
Use adult placement for
short breaks
More people paying for own
holidays e.g. Crystalis
Changes happening to bring
short breaks and day services
as part of the same service
More people asking for
more alternatives than respite
i.e. holidays abroad
Being addressed in
legislation – something needs
to be done – in valuing
people now, carers, strategy
and personalisation – there
needs to be alternative
options













Local
Statistically Salford have high level of people having
short breaks
More people are asking for holidays (short break
care)
Partnership board pushed in last 2 years so that
family carers have a separate assessment
Reassessed every individual in Granville – to see if it
is suitable for short break care
There are some alternatives in place – adult
placement, own money for supported holidays (family
holidays)
More respite is offered to adults than children due to
having day services all year around
People with ‘louder voices’ may get more respite
Crossroads – Beasley green – FLAG
Direct payments/ personal assistants, community
support, individual hours allocated for 1-1
Carers grant
Unmet need for people who want to go on holiday
Lack of natural support to access mainstream
holiday
Struggle with the additional costs to accessing
holidays




Ideal
Natural support –
anytime/anyplace/anywhere
Clearer separation from
what person needs and what
family want
People to be able to
discuss what holiday and
requirements a person
needs / wants
Good information / access
to alternatives are available
but not utilised – in an ideal
world they would be and
people would be thinking
creatively and basing short
break care on what the
person wants
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Barriers/ things to figure out – Short Break Care
What short break opportunities are there for people with Autism?
ASGMA – commission 40 places – currently underused
Granville
Adult Placement
Day services
NAS
Supported Tenancy
Doesn’t need to be special provision when accessible in community
People with Greatest need often get least services available to meet their
needs
Granville / adult placement or nothing
Shortage of community services who feel they can support
Lack of skills to support
How do we best respond to people’s challenges (e.g. behaviours)
Give them something more interesting to do
Widen experiences/ places / people
Communication
Person centred plans
Inflexibility of services impacts on family life
Person centred approach – not seeing people in little boxes
More coordination of services working together for the person
Powerful commissioning – if you don’t provide what’s needed we will go
elsewhere
Action Plan – Short Break Care
What
To use information we have got and include
non- learning disability places/ services and
put all of this into the picture business plan
Have a discussion with Kim and Angela of
how to work across services – use staff more
inventively
Complete an older carers report
Who
Nigel Johnson
When
April 2010
Janet Tuohy
January
2010 – JAM
Nigel Johnson
February
2010
Alison
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Current Practice –Support






National
National carers grant
Valuing People Now
Children’s Plan – Aiming
High for Disabled Children
National Activities strategies
Personalisation agenda
Local authority input


Local
Existing services – mixture of local authority and
private, day service and community support
Direct payments- are there enough personal
assistants?







Ideal
Increase networking – have
more access
More effort to coordinate
what we have already got,
circulate that information and
be more inventive
Celebrate successes
Better knowledge and use
of personal assistants
Match people up with
interests wants and needs
Support people to create
natural supports
flexibility
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Barriers/ things to figure out –Support
Getting the Right support – complex needs -1;1 2:1
Person centred approaches/flexibility of use of support
Transport
Availability of appropriate services (to meet need)
Make services reflect person’s needs and wants which are current
Not having clear agreed view of person’s need (e.g. 1;1)
Separate reviews for carers
No Services in School Holidays?
Parents finding it difficult to support son/daughter
Training for carers- empowerment, support them, inclusion
Action Plan – Short Break Care
What
Regular training calendar and
include more carers through reviews
Who
Facilitators and
professionals
Greater joint working with health
professionals (skill building)
Nigel Johnson/
Cath Rotherham
When
Starting now and
continuing
annually
March 2010
What has happened since the Strategic commissioning day
regards Support and Respite
 Innovations and outcome bid based on ‘personalisation in Salford’ and
citizenship has been applied for. This funding is primarily for training –
so that Salford can develop its own workshops for families, young
people and professionals to understand what personalisation means
and how we are moving this forward in Salford.
 Transition planning is going to based on a citizenship model where
young people and families are supported to look at how to support the
person to become a ‘citizen’ – support is based on supporting the
person achieve what they want to achieve
 Within the following year we are working on 20 person pilot of support
planning based on the citizenship model. Here we will have support
planning teams for each person who consists of the person, family,
carers, school/college and professionals. Each team will be supported
to think creatively about how they use there indicative budget to
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







ensure the person needs are met in the most person centred and cost
effective way
The adult short break provision has undergone lots of changes and
training to build its capacity to support people with complex health
needs. This includes the children’s Diana nurses training staff on
individual persons needs
Where appropriate one page profiles are being developed for young
people moving into adult short break care provision
Direct payments can be received instead of people using the Grange
and Granville
Adult services are using the information coming through transition to
look at developing their services to meet the growing and changing
needs of the young people.
Aiming high monies for short break care are being used to provide
different short break opportunities both mainstream and specialist..
they are receiving information from reviews to inform there
commissioning
Increase in school holiday activities
Individual budgets are available for carers to apply for respite
Carers social worker is in post on the adult learning difficulty team
Examples of Individual outcomes
 I person who was unhappy with the respite provision provided has
had the opportunity to have direct payments for respite so a family
member can support
 4 people who were unhappy going to the Grange – have
discussed why they didn’t like going – now the grange try and
ensure they have their visits when there friends are there and
ensure there are plenty of trips out/ activities they enjoy
 1 person is being supported using direct payments – he went to
see his first band – he got in extremely late past 12:00 and was
extremely excited
 looking at opportunities for mixed packages of care where people
can use some of the adult services buildings as bases but have
individual support packages
 4 people have visited the day services at age 15 to see if this
service is appropriate
What we are currently working on regards Health
 a health transition worker is in post from children’s services
 the health transition worker is currently:
1. training staff
2. working with district nurses and doctors
3. leading on the production of health transition
protocol
74
4. ensuring health action plans at year 9 for all
young people with complex needs
5. rolling this out to all young people

Strategic health care facilitator commissioned by Learning
Difficulty services to work with mainstream and generic health service
to ensure equal access to their services by people with learning
disabilities; this includes work with GPs Hospitals, nurses and
ensuring health action plans are completed.

A task and finish group has been set up to look at health
transition – this feeds into the transition task group

Currently looking for funding for a health transition facilitator on
the adults team to work with the health transition facilitator

The ‘Growing up in Salford’ file which was piloted this year to all
year 9 students at the local special school – is being revamped to
include a section on ‘staying healthy and safe’ this is to ensure
information is given to young people and their families about health
and also to get them to think about their role in staying healthy and
safe.

Health professionals attend the allocation meetings for 16 year
olds
Individual Outcomes regards Health
 District nurse and other health professionals attended a young
man who has complex health needs person centred review
 6 young people with complex health needs have a comprehensive
transition health plan
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80
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