Rochdale’s ‘Transformation’ of Learning Disability Services
The story so far ….. Rochdale Council published a consultation on proposals to change the housing and support arrangements for people with learning disabilities funded by the Council.
Along with many others, I was concerned that this proposed a step back in time in relation to the approach to housing and support and the way it was taking away people’s rights. I wrote a blog on this for the Guardian – which generated a great deal of interest. The Director of Adult Services at Rochdale took umbrage at what I wrote and subsequently wrote her own blog for the Guardian. The Rochdale Director’s response contained some important information and needs further comment – so here it is. To make sense of this, I recommend you read the previous three items, in order, if you have not already.
First of all, the good news. It appears that the outrage of many people has had an impact with Rochdale Council. Their Director’s blog contained two important concessions (albeit claiming these had been intended all along!):
- It states that ‘independent advocacy is fundamental to how we work’. I infer from this that the Council will ensure that they make available (and fund) independent advocacy for all people for whom a possible change in their living arrangements is being suggested. That advocacy should be knowledgeable about rights and different housing models and support people from the word go. Those affected will be pleased by this as, previously, the consultation stated that care managers would be supporting people in relation to their possible loss of housing rights.
- It explicitly states that there will be 'no compulsion, no forced moves'. This was never stated in the original consultation and again, will be welcomed by the people affected who will know they can refuse to give up their tenancy if they have not been made a better offer. It is, however, important to understand that a decision by someone to give up their tenancy having not been provided with full and independent information and advice about consequences, or indeed having to give it up because their support package has been reduced to a level whereby they cannot sustain their tenancy, could well raise interesting legal questions.
Now the less good news. Sadly the Director’s article largely confirmed my belief that some key people in the Council may be pushing this change without really understanding policy and practice. To list all the reasons here would make this blog too long – so here are just three:
- It describes supported living as ‘one model of care’. Supported living is not ‘one model of care’. It is an approach based on people being supported in the way they want, in the place they want, to live the lives they want (1). It has a set of standards, nationally recognised, against which outcomes can be judged (2) One key element of this is them being accorded housing rights (unless they choose otherwise) to give them security in life. If the Rochdale services have been reduced to ‘one model of care’, then commissioners (and indeed providers) have misunderstood it – indeed the article refers to it as being a ‘group home model’. Most group homes are actually residential care. The Council thus need to amend person centred commissioning practice to rediscover what supported living should be – not respond by removing people’s rights and moving them into predominantly larger-scale residential care settings.
- It describes service failures within Rochdale – people having to move miles away from families and blames this on their supported living ‘model’. Could such things not possibly be a result of a lack of person centred preventative action by the Council? It then describes how people with tenancies are being required to move house or are not having some key choices. This implies that Rochdale may be currently operating a group home, non-registered residential care service under the guise of supported living. Use of the ‘Real Tenancy Test’ would rapidly help the Council understand whether they were operating within the law and best practice. Either way, once again the answer to better outcomes and value for money is to rediscover what supported living really is and not throw it out because it is being inappropriately operated.
- It asks me to provide evidence for my statement that the cost savings through moves to residential care will result in larger group activities. This is a simple matter of maths. Significant savings will only arise from having fewer staff per person supported (unless a major programme of developing natural, community supports is being proposed – but the consultation made no mention of community inclusion initiatives). Two staff supporting three people will be able to do more personalised support and community engagement than two staff supporting six people. Fact.
It seems from the Rochdale Director’s article that her challenge is not with a supported living approach that is not working, but rather a failure to commission and care manage services that really are supported living. My respectful suggestion would be that the Council should, prior to going back to residential care, try out supported living as it is described by those national standards.
For many people and families concerned about the consultation’s proposals, the commitment by Rochdale’s Director in her blog that 'We are not envisaging a wide-scale return to residential care' and that there will be 'no forced moves' will provide some reassurance. The Council’s plan is thus clearly for most people’s service not to change – otherwise how can these promises be made? The test will be whether there is genuine informed decision making by people and families, with access to independent advocacy to help people assert their rights, rather than people handing over those rights because of a lack of information - or cuts in personal support that render current services untenable. I believe the best answer though, as the Rochdale blog shows, is to start doing supported living properly. The elected Members, when they consider the consultation’s outcomes, should have this as their starting point.
(1). NDTi. Supported Living – A New Paradigm. 1993
(2). REACH Standards in Support Living. 2007. Paradigm.