Community-based day activities and supports for people with learning disabilities
Messages from 'Having a good day' - Cultural change in services
Strategic managers need to make a mental shift to think first about ordinary community lives and then about what support and services people need to live them. There is a danger that 'day centre culture' may persist into community settings. Change has been greatest in the employment sector, where there is more of an obvious move towards a business culture. It should be expected that some people will react against change, at least initially.
- Local strategies are emphasising person-centred approaches and an 'ordinary life', and training in person-centred approaches is helping people to think about ordinary opportunities and lifestyles. It's helping to change the culture.
- New community day services are mostly operating from a base, many shared by other community groups or public services. Few have concrete strategies about how they will achieve integrated opportunities and community connections.
- Thinking like a business is helping when partnerships are being sought with community bodies.
- The route into work is becoming more diverse, with increased development of social firms, social enterprises and self-employment - but in many areas the role that community day services will play in relation to employment is not clear.
- There are a small number of services targeted specifically at people from black and ethnic minority groups, and use of person-centred planning and individual funding initiatives are helping to achieve ethnically sensitive provision for some individuals. But, in general, new community services - including employment support - are not reaching people across all communities.
- There is a focus on outcomes and a culture of evaluation in supported employment services, but it is not mirrored in new community day services. Some new services and projects are being showcased with little supporting evidence about any positive impact they have had on people's lives. It's good to be proud and to celebrate achievements, but we need to know that people's lives have changed for the better.
Do as many things as possible - information, debates, quality action groups, training, conferences, for example - which encourage everyone to reflect on the quality of people's daily lives and what needs to be done locally to achieve ordinary lifestyles.
Actively encourage and support learning. Evaluation is part of this. Make sure that new community day arrangements in your area are evaluated and that there is evidence about the changes that have resulted for people. Try to use an evaluation team that includes people with learning disabilities as paid members. Most important of all, reflect on and use the findings to plan your next steps.
Keep talking about ordinary lives, and challenge accepted ways of doing things. Ask why people are doing things in specially designated buildings or in segregated groups. If the answer is about lack of resources for support or about lack of accessible community facilities then tackle those issues. Don't just accept the status quo!
Make sure that training in person-centred approaches is part of the induction programme for all staff in new community services, including managers. And don't forget individual budgets, direct payments and independent living funding (ILF). Make sure that everyone knows about these routes to increased personal control. Spread the word.
Work with your staff teams to develop clear and deliberate strategies about how you will help people integrate and build up their connections and friendships (see Key task 6: Achieving inclusion in community life).
Make sure that you know the make-up - the diversity - of your local population, and find out if that diversity is reflected in the people accessing community day supports. If not, then identify why not and develop a plan to address it.
Initiate a local discussion about the role of staff in community day services in relation to employment. What specific responsibilities should they take? Mapping the routes to employment and how they are currently offered and supported may help to identify gaps that community day services can fill.
Think very carefully about what people locally may accept as wisdom, especially about what opportunities and supports are right for people with higher support needs. Micheline Mason's poem, for example, challenges us to think carefully about multi-sensory 'snoezelen' rooms.
Beware the Baubles
They stole away our lives Condemned us to a bean-bag existence Alone together with our fellow prisoners Left staring at mobiles, slowly moving round and Just out of reach
Over-controlled teaching In a hush of false protection They pared down our experiences To their diet of force-fed crumbs Of learning
Not broken-down, but shattered Stripped of all meaning and context By their one-step-at-a-time Special Curriculum Practising for the life They would never let begin
Now they are trying to sell our lives back Through their glittering, flashing, bubbling rooms Mechanical, artificial, expensive, Another capitalist cone Feeding off our starvation
Beware the baubles, the disco dream The light of the sun will do, thanks, The brush of the wind, the wet of the rain, The sound of children's laughter In an ordinary, busy classroom The touch of a friend's hand Welcoming us back Into the world
Life is a multi-sensory experience Full of lights, tastes, smells Colours, sounds, textures abounding Emotions, all our birthright Denied to us by misunderstanding And fear
Put away your cheque books Bring us in close to the beating pulse Of shared messy, risky, noisy days Where we all have complex needs We will learn then all that matters And so will you© Micheline Mason
A group of self-advocates and family carers in Leicestershire have been reviewing the outcomes of day service modernisation. They have focused on 'inclusion outcomes', particularly friendship and involvement, and have used a traffic light approach. The group has been supported by the National Development Team and further information can be found by contacting Steve Easter: firstname.lastname@example.org.
The local authority day services in Essex have a clear role in relation to employment. They directly provide information to people through Job Clubs, helping them to think about the world of work. They then refer people through to the county's supported employment and social enterprise services to pursue actual jobs.
The Wellington Community Enablement Project in Somerset is a national pilot project that has been investigating a new role of community enabler. Focusing on developing support within a local community, two separate cafés have evolved organically and become local community-based facilities. A range of people have used the cafés, including older people, people with learning disabilities, physical disabilities or mental health issues. As a result of word of mouth other members of the public have also joined sessions and enjoyed sharing skills or time with people there. You can read about it in David Waddilove's ' Redesigned and redrawn - developing new roles in social care' (TOPSS, 2004)
- 'Keys to citizenship' (2nd edition) Simon Duffy, Paradigm (2006)
- Changing the culture, R. Greig (2003) on the Valuing People website (go to Resources/Change/Change Management):
- Inspiring stories, radical shifts in power, exciting ideas for change, Simon Duffy (Paradigm). For a free copy send a stamped, self-addressed C4 envelope to: 100 Westminster Bridge Road, London SE1 7XA, or tel: 0207 261 4100