The final DH response to Winterbourne View (2012) states: ‘All
current placements will be reviewed by 1 June 2013, and everyone
inappropriately in hospital will move to community-based support as quickly as
possible and no later than 1 June 2014’. Fantastic, and was just what organisations like Beyond Limits were hoping for as a great start for 2013. However, from my experience so far on moving people from hospital two of the phrases used in this statement give me concern that these dates will not be hit, people will not be discharged and even if they are people will just move on to live in some other form of mini-institution.
The phrases are ‘inappropriately in hospital’ and ‘community-based support’. I believe
that the first phrase may be used to prevent people being discharged due to the
key decision-makers who have these powers making decisions based on limiting
information about a person due to hospital environments that don’t always look
at the whole person. This also provides problems for Providers once discharged
because information given does not always give the whole story. The second phrase may lead to people being
discharged to yet more mini-institutions instead of real homes of their own
because of misinterpretation of community-based support.
Radical social work presentation
A presentation by Sam Sly to students at Plymouth University on the subject of Radical Social Work.
Sam Sly's Learning Disability Today Column February 2013
Another year over and what a year it was. Austerity is starting to bite, but to what extent is still
unclear, all we know is that things are not going to get better soon. The
future is looking bleak for many of the most vulnerable people in society with Dr
Simon Duffy quoting at the Housing Support Alliance conference 2% of the
population taking 25% of the cuts. These are the very same people we support.
It is in these times that we all need to pull together, form partnerships and pool our resources, wealth of experience, capacity and energy for the fight ahead. Cuts cause rifts and distrust making the chasm widen between those that have and have not as everyone fights for themselves instead of together. It is only through alliances that we can remain strong and keep doing the best for people.
It is in these times that we all need to pull together, form partnerships and pool our resources, wealth of experience, capacity and energy for the fight ahead. Cuts cause rifts and distrust making the chasm widen between those that have and have not as everyone fights for themselves instead of together. It is only through alliances that we can remain strong and keep doing the best for people.
Sam Sly's Learning Disability Today Column December/January 2013
As the Individual Health
Budget Project Beyond Limits is part of in Plymouth enters its second year, I
have started to meet and work with some families who have different views from
those we met in year one. These families don’t want their relative to move out
of the Specialist Hospital setting they are in despite them being hundreds of
miles from home.
This is not to say that these families are not just as passionate about their relatives, nor do they love them any less, and they still only want what they feel is best for them. These families have just been so profoundly affected by the lack of support, failed services and rejection by the systems that were meant to protect and help them and their relative in the past that all trust, hope and optimism for the future has disappeared and they are very scared of any change. It has been truly humbling to listen to the heartache and mental stress these families and their relatives have been through trying to make things work when they lived more locally, and for them to still take part in planning for the future.
This is not to say that these families are not just as passionate about their relatives, nor do they love them any less, and they still only want what they feel is best for them. These families have just been so profoundly affected by the lack of support, failed services and rejection by the systems that were meant to protect and help them and their relative in the past that all trust, hope and optimism for the future has disappeared and they are very scared of any change. It has been truly humbling to listen to the heartache and mental stress these families and their relatives have been through trying to make things work when they lived more locally, and for them to still take part in planning for the future.
Challenging Behaviour presentation
A presentation by Sam Sly from Beyond Limits to the Challenging Behavior Foundation Board.
Sam Sly's Learning Disability Today Column September/October 2013
I have been lucky enough to be involved over the past four years in the creation of a dynamic user-led quality checking service ‘Citizen Checkers’ hosted by Cornwall People First that has now been up and running for a year in Plymouth and is making great strides in improving the services they check.
Citizen Checkers started in my head as a seed of an idea back in 2008 when I was part of the Change Team in Cornwall post the Cornwall Partnership Trust scandal. The Change Team were fortunate at the time to employ the expertise of ‘Quality Checkers’ from Newcastle an established user-led checking service which based its work around the REACH standards ensuring that supported living services were focused on the people they supported and reached good standards.
Citizen Checkers started in my head as a seed of an idea back in 2008 when I was part of the Change Team in Cornwall post the Cornwall Partnership Trust scandal. The Change Team were fortunate at the time to employ the expertise of ‘Quality Checkers’ from Newcastle an established user-led checking service which based its work around the REACH standards ensuring that supported living services were focused on the people they supported and reached good standards.
Current Vacancies: Service Leaders, Team Leader, Support Workers
Beyond Limits supports people with a learning or mental health difficulty; to offer a tailored service with a team of staff who are matched to them.
We are recruiting a team for Diane. Diane is a young energetic, intelligent woman with a zest for life. She is a very sociable person and has been described as an "adrenalin junkie" who needs to keep busy. Diane has mental health needs and her team will have to be flexible but consistent and calm and confident when she is testing their commitment to her. Knowledge of supporting people with personality disorder and/or who self-harm is required.
Please see below the vacancies currently available for Diane's Team:
_______________________________________________________________________
Team Leader Full Time
£18,000 depending on skills and experience
Support Workers Full Time & Part Time
£15,000 pro-rata (depending on experience)
Relief Support Workers
circa £7.50 per hour
All posts involve evening and weekend work as well as sleep overs.
Qualifications: Health and Social Care Diploma Level 2 or willing to work towards
Note: A DBS Check will be requested in the event of an individual being offered a position with Beyond Limits, the cost of which will be to the employee, however, this will be returned after successful completion of probation period (6 months).
These positions have a "genuine occupational requirement" covered under the Sex Discrimination Act 1975 and therefore only applications from females are requested.
________________________________________________________________________________
We are currently working with NHS Plymouth on an exciting ground-breaking project developing and providing tailor made services for people returning to the area to live a life of their choosing after time in Institutional settings across the Country. We are excited to announce the following opportunities (to start between now and August 2013):
Service Leaders X 2 Ref: 04/SS
(Full time) circa £25,000.
Operating at a senior and strategic level you will demonstrate:
- A real commitment to the values of inclusion and person centred working
- Flexibility and commitment
- Passion and Innovation
- A creative approach to Leadership and Service Development
- Self-direction and the ability to take and delegate responsibility effectively
- The ability to influence and represent the Organisation confidently
- Professional and/or relevant experience
If you would like an informal discussion please call Sam Sly (Director) on 07900 424 144
Closing Date for completed applications:
Midday Wednesday 22nd May 2013
Note: A DBS Check will be requested in the event of an individual being offered a position with Beyond Limits, the cost of which will be to the employee, however, this will be returned after successful completion of probation period (6 months).
APPRENTICESHIP - JUNIOR OFFICE ASSISTANT
Beyond Limits are pleased to announce that they have filled their vacancy for an Apprentice Junior Office Assistant.
We are pleased to introduce our new member of the team, our new Junior Office Assistant Alexandra Tilley. Alexandra is doing an Apprenticeship with us at Beyond Limits, and we are very happy to take her on board as one of the team.
Good luck Alexandra.
 |
| Alexandra Tilley Apprentice Junior Office Assistant |
NDTi Leeds conference 2012.06.28
Sam Sly, Director of Beyond Limits is speaking at an NTDi conference on Thursday 28th June. During Sam's presentation she will refer to the two documents listed below.
Below are links to Easy Read tools developed by Sam Sly to use with people with learning disabilities. They are designed to help make decisions about housing options.
They are also useful for staff training when looking at change management and the rights and freedoms that come with a person with support being able to live in their own home.
The documents below are free to download and use.
Download: Registered-Care-Home.pdf
Download: Living-in-your-own-home-with-support.pdf
Below are links to Easy Read tools developed by Sam Sly to use with people with learning disabilities. They are designed to help make decisions about housing options.
They are also useful for staff training when looking at change management and the rights and freedoms that come with a person with support being able to live in their own home.
The documents below are free to download and use.
Download: Registered-Care-Home.pdf
Download: Living-in-your-own-home-with-support.pdf
Beyond Limits: Sam Sly's July/August article for LDT
Beyond Limits: Sam Sly's July/August article for LDT:The piece below was written by Sam Sly from Beyond Limits for Learning Disability Today magazine to be published in July/Aug 2012 L..
Independent
thinking
Getting people with learning disabilities and challenging
behaviour out of the specialist treatment system and back into the community
can be difficult, says Sam Sly
My most frequent saying of the past year has been: “If
you have a learning disability and challenging behaviour you have more chance
of winning the lottery than getting out of a specialist treatment hospital.” This
has been prompted by my increased frustration at the complexity and bureaucracy
of the systems in place, the power of professionals and the lack of expertise
of those charged with helping people to move out of hospitals back to their
communities and families.
Now that Beyond Limits’ project has reached the stage of
discharging people from hospitals, the systems have exasperated me enough to
change that saying to: “If you have a
learning disability and challenging behaviour it is easier to get out of prison
than to get out of a specialist treatment hospital.” These are the reasons:
In the prison system a person has committed a crime, gone
through a structured judicial process with the right to appeal, been given a
sentence, done their time (often less than they were sentenced for) and been
released – end of story. Not a good experience I am sure and plenty of people
we work with have been through this system, but there is an end to it and the
person returns to their community.
In the specialist treatment system a person doesn’t have
to commit a crime to be locked up and have their freedoms taken away, it is the
opinions of other people – usually powerful professionals – that dictate
whether their ‘behaviour’ is unsafe, unmanageable, or anti-social. They don’t
even have to be sectioned under the Mental Health Act. I’ve met a person
recently who has been in hospital as a ‘voluntary’ patient for more than seven
years because of the systems in place.
There is a judicial and appeal process if the person is
detained, but for people who find it hard to speak up for themselves and with
families living hundreds of miles away appealing is a complicated business.
The person then does their ‘time’. This may not be how
therapy, treatment or rehabilitation is seen by professionals for whom it is a ‘programme’
but for those people I have met on programmes they don’t want to be there, feel
incarcerated and want to know when they are leaving.
The treatment programmes I have observed are often
complicated, with many hoops to jump through or levels of social acceptability
to climb to get basic things like time on their own, money to spend or a walk
in the high-fenced garden. People sometimes don’t understand the rules – and
that includes staff – goals shift and release dates stretch on and on.
Not achieving goals for those people – or ‘freedom
fighters’ as would better describe those who challenge the system – have led to
longer ‘sentences’ and higher levels of tariff, restraint and incarceration.
For some people non-compliance has led to transfer to even more secure hospitals
sometimes further away from home.
I’m not saying that treatment programmes are not
effective when short, targeted and time-limited. The sadness is we work with
people whose stays have far exceeded the positive outcomes that could have been
achieved and instead whose time in hospital is now significantly harming their
chances of a good life in the community.
In the specialist treatment system people rarely get
given a firm discharge or release date at the beginning of their programme.
When I’ve asked professionals to give timescales the answer is usually that it
is difficult to say, it is down to the individual and that they don’t like to
say in case it takes longer and this upsets the person. My experience is not
knowing when you are being released upsets the person more.
The release date is also further complicated and made
harder to achieve by an additional influx of professionals (care coordinator,
advocates, psychiatrists from the community, housing staff, social workers,
provider agencies) all involved in the discharge plans.
One of the biggest barriers to release we have found is
that it is understandably hard for professionals charged with taking back
responsibility for a ‘risky’ person in the community to see that a person can
be supported safely with less restrictions when support is flexible and
responsive, the person is doing what they like doing and is supported by people
that genuinely care. Agreement to discharge is made harder by hospital reports
stating a person is unmanageable even in a hospital environment without 2:1
staffing or more, the use of physical restraint and PRN, and locks to keep them
safe.
However, throughout all the frustrations and barriers the
thing that keeps us going is the lives the people we support are living once
they move back into their communities. One woman has just moved into a
permanent flat and has been busy painting and furnishing it with the biggest
smile on her face I have ever seen!
Beyond Limits: Sam Sly's March/April article for LDT: The piece below was written by Sam Sly from Beyond Limits for Learning Disability Today magazine to be published in May/June 2012 L...
Learning
Disability Today Column May/June
This month, I pause to
reflect on the work of Jim Mansell (CBE), sadly no longer with us whose work
inspired us at Beyond Limits and the Health Commissioners at NHS Plymouth to take
accountability for stopping the commissioning of placements for people with
Learning Disabilities out of area and to work together as commissioners and
providers to improve services locally.
I was fortunate to meet
Mansell in 2009 in Plymouth when he was rolling out his revised report ‘Services
for people with learning disabilities and challenging behaviour or mental
health needs’ and he said to me that it would be the last report he would
write on the subject as he was tired of repeating himself and not seeing
anything change. He believed there was only one real solution and that was to
stop commissioning places that took people away from their families and
communities and instead invest money locally.
Commissioning is without
doubt the driver for good quality support, especially for people with more
complex needs. The recent learning disability scandals in Cornwall and Bristol would
have been prevented by good planning, insightful joint commissioning and robust
quality monitoring especially if Commissioners had involved families and people
using the places.
Mansell (2007) believed the
answers to good quality commissioning for people who challenge services lies in:
·
Individualised, local solutions providing
good quality of life not those too large to provide individualised
support, too far from their homes, and providing good quality of life in
the home and as part of the local community.
·
Direct payments and individual budgets always
to be considered and to be more widely available.
·
Closer co-ordination between the
commissioners paying for services, the managers providing services and the
professional specialist advising on the support people need to ensure advice is
both practicable and acted on.
·
Commissioners should allocate a budget to be
used to fund a much wider variety of interventions as an alternative to
placement in a special unit.
To give further weight to changing
Commissioning being the only solution findings from a DH funded NDTi project ‘Incentives for Achieving Change in Private
Sector Learning Disability Hospitals’ (2011) stated that despite the offer
of free development support to achieve change few Private Hospital providers
wished to embark on a reduction of Hospital beds and alternative service
models. Change was made even more difficult by Private Hospitals having a large
number of Commissioners from across the Country purchasing beds meaning they
found it difficult to work together to change practice and with no national
steer or direction the problem was compounded. The major obstacle the NDTi
found was Provider’s primary obligation to achieve financial returns to their
shareholders and demonstrate financial viability to their debt funders (banks
etc.) who in times of economical difficulties need demonstration of short term
profitability rather than taking a longer-term financial view. So in summary we
cannot look to Private Hospitals to change.
This month, the end of the
first year of our project with NHS Plymouth, sees us in a series of workshops
run by Dr Simon Duffy starting to think with our partners in Health and Social
Care about Commissioning for continuity of support to enable the people we are
working with to have a life that makes sense to them in the long-term without
having to jump through unnecessary hoops when they, inevitably, move across
from Continuing Health Care to Social Care funding as their health needs
diminish. This may not be an easy transition when Health and Social Care
currently work very differently, the project is set up to support people very
flexibly and people’s Individual Health Budgets will have to transfer into
Social Care Frameworks that have been set up for a market not so used to
flexibility. We will have to consider how to work together to make sure people
remain in the community long term in a system that sees funding currently yo-yoing
back and forth from Social Services to Health if people’s behaviours that
challenge deteriorate. One wonders about a system where there is no incentive
(other than moral of course) for Social Services to maintain high cost support
packages when if they fail the outcome is a transfer back to full Health funding
in a Hospital placement.
On a different subject I’d
like to leave you with a few questions that are mystifying me recently. We are
told the ‘Long Stay Hospitals’ are all closed now and therefore people no
longer have to live in Institutions for long periods of their lives. So why
then in 2012 have I met people with Learning Disabilities who are still
spending from 3-14 years of their lives in Specialist Learning Disability
Hospitals? Is ‘Recovery’ ‘Treatment’ and ‘Therapy’ not supposed to be a
short-term intervention? And at what point does short-term become Long Stay? Have
we really moved very far from the days of Long Stay Hospitals for some people?
Director of Beyond Limits ran a workshop at the NDTi Conference held In London on Service Designs, Working Policies and Individual Health Budgets in March 2012
Sam Sly ran a workshop on Service Designs,Working Policies and Individual Health Budgets and the outcomes of the NHS Plymouth/Beyond Limits Project so far. Please click on the below link Nd ti presentation-2012-sam-sly where you can run through the presentation that Sam used.
Speakers included: Bill Mumford, Chairman, Voluntary Organisations Disability Group.
Can we confidently say that Supported Living is being delivered effectively? After the scandal at Winterbourne View, can this approach be applied to people with high and complex support needs? With support from the Department of Health, NDTi has been running the Housing and Social Inclusion project for two years working with seven Local Authorities working to change and improve their housing and support services for people with learning disabilities. This project has generated significant learning and a range of resources on many of the key issues.
Please click below link for more information
http://www.centrevents.co.uk/supportedliving.html
Please click here to book
http://www.centrevents.co.uk/book-online.aspx
Speakers included: Bill Mumford, Chairman, Voluntary Organisations Disability Group.
Can we confidently say that Supported Living is being delivered effectively? After the scandal at Winterbourne View, can this approach be applied to people with high and complex support needs? With support from the Department of Health, NDTi has been running the Housing and Social Inclusion project for two years working with seven Local Authorities working to change and improve their housing and support services for people with learning disabilities. This project has generated significant learning and a range of resources on many of the key issues.
Please click below link for more information
http://www.centrevents.co.uk/supportedliving.html
Please click here to book
http://www.centrevents.co.uk/book-online.aspx
Gemma's Artistic Contribution
Gemma would like to share with you some of her beautiful art and craft work. We are lucky enough to house Gemma's pictures on our walls at Beyond Limits. The wonderful dragon is sadly just on loan to us! Isn't he fabulous!
Sam Sly's March/April article for LDT
The piece below was written by Sam Sly from Beyond Limits for Learning Disability Today magazine to be published in March/April 2012
Learning
Disability Today Column
Independent
thinking
Sam Sly reviews the progress made in the first six months
of the NHS Plymouth individual health budgets pilot
Beyond Limits is partnering with NHS Plymouth in its
three- year project to explore and implement individual health budgets for
people with learning disabilities currently in out-of-area specialist hospitals
who want to return to their roots and to a home of their own. The project is
also redesigning NHS Plymouth’s commissioning processes to be more
person-centred.
After completing the first six months of the project these
are some of highs so far and the challenges we still face.
Highs
People: We
have often been told that the person who we are planning with will either be
too complex, challenging or dis-interested to contribute to their planning
meeting. When you reflect what ‘meetings’ have meant to these people in the
past – reviewing and imposing restrictions with a room full of professionals, and
discussion and decision-making they find hard to contribute to – it is
understandable people are disinclined to be involved.
We have found quite the opposite with our meetings because
the service design process is about planning with positives for the future,
including people’s gifts, skills, hopes and dreams. We have found people to be fully
engaged, staying throughout the planning day and contributing positively.
We have been privileged to meet people with such
potential, gifts, skills and zeal for life. These people have hopes and dreams
that are achievable, just like anybody else. It has astonished us all how
quickly a person thrives and grows when they feel safe, happier and in control.
Families: We
have been honoured to meet and work with some amazing families who have shown
such resilience in the face of adversity and have continued to champion and
stand by their loved ones while they have been moved around the country often
to more and more secure accommodation.
Feedback so far from families has been that the processes
we use make them feel included, listened to and valued; something sadly lacking
for many of them for years previously. Even those who have Nearest Relative rights
have often felt excluded from important decision-making meetings, often purely
because they physically or financially have not been able to get to the
meetings, which are sometimes hundreds of miles away from home.
I have sometimes underestimated the importance and
connectivity of family to the people we are working with, whether the
relationships are healthy ones or not. Family is definitely the cornerstone of
relationships and community integration. And family members are your greatest
ally in getting it right for the person they love.
People’s
support teams: Feedback from the teams employed so far is
that they find their new roles tough but very rewarding. Working with one
person means they can concentrate on making it work for them. The planning
process we have used ensures that a person’s team (numbers, attributes and
personalities) is planned with them before they move. Also, the team induction
and training is specifically around the person’s needs. Feedback indicates that
they are therefore gelled and confident in their knowledge of the person and
more connected when supporting them.
Challenges
Life
stories: It has been with heartache and anger that we have
listened to disturbingly similar stories of rejection, segregation, detention and
people moving further and further away from their home and family and into increasingly
secure establishments as they have fought against systems that don’t work for
them. People have had to learn new, usually more extreme and negative ways to
gain the attention they deserve. We have to continually deliberate on how we
stop this happening in the future.
Developing
truly community connected services: We
are still not there yet, although awareness is a good starting point. I watched
someone we support recently who was enjoying being with their team, and had
started to do more out and about, but this presented a paradox: we want the person
to trust and feel safe with their ‘paid’ team, but equally we don’t want
reliance on ‘paid’ relationships we want real reciprocal relationships that
will be the foundation of the person’s new life. We need to ensure this begins
from day one.
Using
assistive technology: I
believe in using assistive technology (AT) wherever and whenever possible to
give independence and quality to a person’s life but I am no expert! A fellow
support provider we work with, New Key (www.newkey.org.uk), is leaps ahead of
us in the use of phone apps, iPads and all sorts of other gizmos. We need to
get better at using AT as a given and not an after-thought.
Beyond Limits launch event
Beyond Limits launch event was held in Plymouth.
Get the flash player here: http://www.adobe.com/flashplayer
Update on Individual Health Budget Project with NHS Plymouth
Beyond Limits are now into the final months of the first year of the three year project. We are excited to have been successful in securing the final two years of the project and having Dr Simon Duffy of the Centre for Welfare Reform http://www.centreforwelfarereform.org/on board to carry out an evaluation. An end of first year report will be published in May/June 2012.
We have now worked with 5 people currently in Institutional Hospitals across the country and their families, to prepare Service Designs and Working Policies for their new lives in their own homes. We are also working with NHS Plymouth to test out new processes and Commissioning Strategies to support this new way of working.
Some highlights so far have been:-
- Great feedback from families who feel involved, listened to and included in decision making.
- Good feedback from Hospital Providers who say this is a positive way of planning with people.
- People being at the centre of the planning process and enjoying being listened to and making decisions about their futures.
- Being "bowled over" by the gifts, skills hopes and dreams of people who can't wait to start their new lives.
- Supporting our first person.
Sharing knowledge
Over the next couple of months, we will be setting up a forum for like-minded providers of support so we can begin to share best practice, form alliances and start to change the face of services in the South West.
Getting going
Beyond Limits is a brand new organisation but it's not starting from scratch. It will work in a similar way to Partners for Inclusion, a leading Scottish organisation. Partners has pioneered individualised services over the last 15 years.
Beyond Limits is now registered with the Care Quality Commission. We have just set up our second Team and are looking forward to supporting people in getting on with their lives.
Beyond Limits is now registered with the Care Quality Commission. We have just set up our second Team and are looking forward to supporting people in getting on with their lives.