Community Lives Consortium

The Background to Targeted Support

Our interest in Targeting Support, began with an exploration of Telecare and an increasing frustration that our model of service is too inflexible to meet people's changing needs and too expensive to be purchased for all of the people who need it.

We have been exploring Telecare and Assistive Technology since 2002

We are interested for 3 main reasons:

• Research shows that too much support for people with high support needs reduces their levels control over their own life.
• Our service model too expensive & too inflexible to be made available to the whole range of people who need it.
• We believe making Telecare part of the everyday world of Social Care will create more technical components to the work of our staff thus creating better more interesting employment.

The Neath Port Talbot Commissioning Strategy for Services for People who have a learning disability.

The Neath Port Talbot Commissioning Strategy offers a view of the future where support is not tied to supported housing projects but can be used flexibly whether people live in their own home, still in the family home, or in any other community living setting.

Neath Port Talbot want to explore opportunities where technology can assist in developing independence as opposed to creating a reliance on staff. To achieve this it got £78,000 of funding from the Welsh Assembly to develop and pilot Assistive Technology in partnership with the Consortium.

It wants to stimulate and increase the domiciliary care provider market and ensure that it is able to respond to people’s needs effectively while helping them to remain as independent as they can be.

Lessons from Research

Research suggests that ‘drop in’ assistance can be more empowering than support that is always available.

Services with higher levels of staffing are not necessarily more empowering, services should be able to target support to when people need it.

Research conducted in Australia by Stancliffe & Keane (1999) showed that a group of people with a learning disability who were supported semi-independently were more independent and had more successful lives than a group of people with similar levels of need who were supported by staff who stayed with them on a 24 hour basis.

This research has been replicated in the UK by the Welsh Centre for Learning Disabilities and the University of Lancaster (Welcome Trust Report 2006).

What have we done so far – A strategy for technology?

We have developed a strategy for Assistive Technology that is broken into two aspects.

• Telecare - A range of shared and individual alarms and supports that will call for assistance if a range of events occur.
• Environmental Control - An individually tailored package of controls that enable people to better control their home environment.

What have we done so far – A new approach to assistance?

With these opporuntities we wanted to then develop a new model for Assistance.

We are exploring splitting the role of Support Worker into two.

• Support Coordinator’s - Experienced Staff, directing activities on a day to day basis, they have close relationships with individual tenants. They have high level's of expertise in Active Support, and Inclusive Communication.
• Support Workers - A mobile team of staff responding to the specific needs of service users. They may be called to deliver support at a variety of locations during one shift. They may arrive in one location to support a service user with preparations for their tea and then move onto another location to provide support for a service user to go swimming. They are part of the on-call response team. Responding in an emergency or when extra help is needed day or night, called by Coordinators or prompted by telecare.

What have we done so far – New ICT approaches?

Computers are now available to most tenants, this helps staff and managers make more effective communication possible.

• Talking e-mails and People and Places, will hopefully help tenants to have more effective more interesting forms of communication.
• For more information about the People and Places software follow the link to http://www.cdsm.co.uk/products/pandp/index.htm
• Mobile computing and tele-rostering will help us to manage this more dispersed workforce more effectively. We have invested in Home Care Roster 3 provided by Staff Plan. 
• For more information about Home Care Roster 3 follow the link to http://www.staffplan.co.uk/

What is Targeted Support?

Targeted Support brings together;

• Assistive Technology
• More flexible models of staff support.
• Better use of Computers and the internet

In a specific geographical area.

We are piloting this new approach the Neath area between July 2006 and March 2007.

This pilot will involve 20 tenants living at 11 addresses.

These tenants are supported by approximately 50 staff who provide 1500 hours of support per week.

What Assistive Technology will we use?

We are installating Intruder Management Systems in tenants homes with their agreement. These are Lifeline 4000++’s so will also be the centre of any telecare packages. For each tenant who wants and needs it there is an individually tailored selection of alarms and sensors including;

• Bed & Chair sensors
• Epilepsy & Enuresis monitors
• Medication dispensers
• X10 lighting systems
• Inactivity sensors

We will then Remodel Assistance

Neath Port Talbot have reviewed tenant's support needs in the light of the availability of telecare and the new model of support. This has been carefully discussed with families and tenants.

What do we think will happen?

Our Projections suggest that the average level of assistance will drop significantly per tenant & thus average package cost. 18% reductions in support appear to be possible leading to a 12 - 14% reduction in overall cost, although we will not be sure about this for some months into the pilot. 59% of our frontline workforce will experience a 15% increase in their rate of pay, for the rest their rate will not change. Our tenants should receive more empowering assistance.

How will we evaluate this change?

This pilot will be evaluated by the Welsh Centre for Learning Disabilities, we will be judging it’s success by looking at:

• The level of independence and safety and social relationships of involved tenants within their own home and their neighbourhoods.
• The conditions of employment of the involved staff.
• The overall package costs of the services provided to involved tenants.
• The capacity of the existing network hours and resources to meet the needs of additional people.
• The satisfaction and confidence of involved tenants and their supporters in this new way of delivering the service.

What do we think that we might learn?

• The increasing limitations of shared supported housing.
• The potential for flexible support for people in a range of different housing situations.
• The effectiveness of Assistive Technology in making staff assistance more efficient and empowering.
• The separation of staff some whose skills relate to people who have a learning disability and those who have more generic social care skills.
• The potential for wider services for vulnerable adults.
• And a lot of things about the Management of Change!

For more information about how we are implementing targeted support please contact either Rick Wilson or Peter Russell by clicking on their names below.

Rick Wilson

Peter Russell