Organisation

Gloucestershire Partnership NHS Trust

Contact name

Mike Neilens

Tel.

01452 891363   

Public Statement

2005 

Our Services

Gloucestershire Partnership NHS Trust provides staff to support the 27 care homes operated by the charitable bodies, MEND and Mayfield.

Homes are located throughout Gloucestershire and accommodate adults with a learning disability, many of whom previously lived in large Victorian hospitals.

Typically, each home cares for 6-8 residents and is an integral part of the local community.  The needs of the residents may vary from relative independence to severe physical and learning disabilities.

The Gloucestershire Partnership NHS Trust also provides other services to people who have a learning disability, through in-patient units and Community Teams. These parts of the service will be the subject of subsequent Quality Network reviews.

THE REVIEW

This review took place between January and June 2004. A review team of 12 people, under the guidance of a BILD Quality Coach, undertook training and applied the BILD Quality Review process to assess the quality of life experienced by 12 service users of MEND and Mayfield homes. The members of the review team were drawn mainly from volunteer staff with an interest in promoting best practice. The team also included an independent advocate.

THE TEAM

FINDINGS

What appeared to be working well were the following:

Service users were treated with respect.

The review team noted that time to communicate and be listened to, privacy and in-depth care plans, contributed to a respectful approach to care.

Residents were safe from bullying and abuse.

Some service users were seen to be vulnerable and potentially at risk of abuse from the other service users and their carers. Due to difficulties with communication, some may be unable to complain if they are unhappy. It was noted that carers felt supported in challenging any behaviour they considered to be inappropriate. Whilst service users spoke positively of relationships with paid carers, few service users had unpaid friends or advocates in whom they could confide if unhappy.

Being helped to stay healthy

All service users had regular health checks, the opportunity to eat healthy food and to exercise. User friendly forms of information about health matters was thought to be lacking and it was noted that few service users had the opportunity to talk about feelings or learn about their body and relationships.

Taking part in activities.

All service users could pursue activities outside of their home if they wished and activities were relevant to the individuals culture. One-to-one time and spontaneous activities with carers was limited due to staffing requirements. It was also noted that service users who could communicate well appeared to access more activities.

Making everyday choices.

Service users were supported in making choices about what to wear, what to eat, how to reasonably spend their time and their money. Carers generally knew service users likes, dislikes and preferences. Choices were sometimes noticed to be limited by staffing availability and were often learning disability specific. Some service users did not have friends, other than paid carers, with whom to share activities.

What appeared to be in need of change were the following:

Friendships and relationships

There appeared to be a need to create, support and maintain opportunities for people to have friends and relationships other than with paid carers.

Everyday activities

Whilst service users had opportunities for activities that were independent of their homes, it was noted that more activities should be integrated into the general community and should be less learning disability specific. This applied particularly to activities such as education and leisure. It was observed that weekend activities may be restricted due to staffing considerations.

Opportunities to work

It was noted that few service users have the opportunity to work. Links and support from Job Centres and Employment Agencies need to be developed to ensure that there are meaningful, paid, work opportunities for those who wish to work. Such opportunities should be consistent with employment law and employees rights. (e.g. minimum wage and disability discrimination legislation applies) Many people currently access Adult Opportunity Centres, colleges and learning disability specific services.

Making important decisions

Some service users are not ‘meaningfully’ involved in making decisions that potentially affect their lives. The decision-making processes for service users who have difficulty in communicating their needs are somewhat limited. Though evidence indicated that service users with good verbal skills had their needs met, it was felt that the use of advocates and better communication methods would assist service users who have difficulty with communication.

Communication

A general theme that emerged was the importance of communication in all aspects of service users lives. Whilst it was recognised that methods of communication have improved in recent years, there is room for progress to ensure that all service users have the support and resources necessary to enable them to effectively communicate with their carers. Time to listen to peoples desires and wants is available to those who can communicate, this is more difficult where the service users communication skills are limited.

ACTION PLAN

The review team, having considered and collated the evidence gathered as a result of the in-depth study of 12 individual service users lives, formulated an Action Plan. Members of the team undertook to implement the Action Plan, which centred around three key themes.  These were:

1. To help service users to create, support and maintain friendships and relationships with people who are not paid to be with them.

Actions Required:

• Find out about services that help people to meet/provide befrienders.

• Find out who wants this type of service or who might benefit from it.

• Arrange a Twyver reunion.

• Improve communication and joint activities between homes.

• Ensure Care Plans include maintaining and supporting friendships and relationships.

• Consider the possibility of creating  a MEND & Mayfield ‘befriender’ scheme. (Dating Agency model)

2. To help service users to get involved in activities outside of the home with other people in the community. Including opportunities to work. (Paid and unpaid)

Actions Required:

• Ensure that each person has a Person Centred Plan/Care Plan that contains activities which are inclusive.

• Identify day services, employment agencies and Volunteer Bureaus Compile a list of agencies and people who can assist in the local community.

• Make contact with people in the local community who can help. E.g. Employers, WI, Clubs, Volunteers, etc.

3. To increase service users involvement in the important decisions made about them and, in particular, pay attention to how people with no verbal skills can do this.

Actions Required:

• Feedback at management level the information collected here and passed on to home managers.

• Include the 3 ‘key themes’ within the Annual Appraisal Objectives for all staff.

• All staff should receive Total Communication training.

• All homes should participate in Total Communication and work to the same standards.

• Explore the creation of a new post of ‘Communication Co-ordinator’.

• Give staff more identified time to work on total communication.

• Include total communication within Job Descriptions, Interviews and Supervision procedures.

• Develop an agreed format to ensure that the principles of Person Centred Planning are applies consistently throughout the organisation.

For further information about this review contact:

Mr Mike Neilens

Residential Services Manager

Heathfield

30 Denmark Road

Gloucester GL1 3HZ

Tel 01452 891363

24^th January 2005