Community-based day activities and supports for people with learning disabilities
10 key tasks - Key task 10: Ensuring quality
- Give people a clear direction by having statements that show the outcomes people need to be working towards, and examples of what they look like in practice. It also helps to show people what it wouldn’tlook like. The NDT inclusion traffic lights can be a useful tool. Have a look at the Key Ingredients sections on Leadership and Smart commissioning.
- Make expectations clear by giving providers targets and then regularly monitoring against them. But simply making demands is unlikely to work. Develop a partnership with providers, both internal and external, that commits each partner to shared objectives and agreement to a plan about what the provider will do to achieve them. Nurture and support providers to deliver.
- Make sure that each day service, employment or support provider has an effective system for monitoring and ensuring the quality of support taking place in community settings, and that they have contingency plans to ensure reliability and consistency of service
- Commission people with learning disabilities to check the quality of services. There are several examples throughout this guide. Make sure that actions result from the findings.
- Give family carers a role in monitoring quality. Make sure they know how they can feed back on day-to-day issues that they pick up on.
- Develop a culture that is quality-conscious, where people are open to challenge, and welcome it as a step towards getting it right for people. Empower people to report poor practice. This may mean working to change the existing mindset of some staff, so have a look at Cultural change in services and Workforce planning sections in Key Ingredients.
- Make sure that people with learning disabilities and their families get help to direct the work of assistants they employ through direct payments and independent living funding (ILF). Encourage them, or directly help them to set clear expectations, and to work out how the community-based support will be monitored.
- Work with a person and their family to compile a list of 'essential dos and don’ts’ for supporting the person in community settings - the non-negotiables - so that support staff have clear guidance and can get it right for the person.
- Act on any signs of dissatisfaction or complaints you receive, whether formal or not. Show the person, their family and the provider that you take the quality of service and support seriously.
- Have contingency plans in place so that people can still do their planned activity if you are ill, and make sure relevant people know what they are.
- Make sure that you assess risks individually, in a person-centred way. Everyone is different and reacts differently to situations that arise in community settings. You need to have a plan that minimises any potential risks, agreed with the person, their family, and your manager.
- Read Key task 6: Achieving inclusion in community life. It’s fundamental to the concept of quality.
- Actively seek out supervision and training. Don’t wait for it be to offered: ask!
- Help colleagues to develop their practice. If you see what you believe to be poor practice, find a way of challenging it. Don’t let poor practice become the norm.
The Community Day Services Team in Waltham Forest, East London, has built regular practice monitoring, including spot checks, into its structure. One day service officer and a manager are 'on duty’ each day. Being 'on duty’ includes monitoring visits to people while they are being supported out and around the borough. The checks and findings are recorded centrally on a database which is accessible to all managers. Actions are taken to address any concerns. It’s a systematic approach.
In the West Midlands, Birmingham People First undertook paid work for the Valuing People Support Team acting as 'mystery shoppers’ to find out about the direct payments schemes run by local councils. At the end they gave a presentation to managers from the local authorities to influence the development of the schemes.
- 'My Life: a person-centred approach to checking outcomes for people with learning difficulties', M. Cattermole and R. Blunden. BILD Publications (2002)
- 'Using my life: a guide to conducting a Quality Network review', M. Cattermole, C. McGowan, K. Brunning and R. Blunden. BILD Publications (2002)
- Quick guide to evaluation, C. Chilvers, M. Clarke, R. Purdy and I. Steele.