Getting others to help: developing the community

Good practice examples

Overview

How the community might take a wider role for particular groups

Transport

Housing

Leisure

Education, Lifelong Learning and Libraries

Good practice examples

Nottinghamshire - Sharing resources for leisure services

Nottinghamshire - Transport

Reading - Focus House

Surrey - User Involvement in commissioning

West Berkshire - Transport

Tameside - Learning Disability Quality Scheme

Overview

Recent government initiatives have focused on the role of local government in supporting the community to identify its own priorities and find local solutions within a context of social inclusion. Councils are beginning to use local public service agreements and the sustainable communities agenda to promote the role of universal services in responding to the needs of older people and those with disability or ill health.

The following section gives a few ideas about the innovative ways which some authorities across the country have developed. It looks particularly at partnership opportunities with other local authority departments as well as recognising the role that the business and voluntary sector could take..

Key components in this are

• transport
• housing
• leisure and
• educational/lifelong learning and library facilities

As a general guide do focus on things that matter to older people like:

• safe neighbourhoods
• getting out and about and
• having useful, enjoyable ways of spending their time with others
• having choices and control over their lives and
• being able to offer support to others

Don't:

• Limit Services for older people to a narrow range of intensive services that support the most vulnerable in times of crisis.
• See older people as exclusively an NHS and social care problem, a perception that rests on dependency and deficit, rather than on wellbeing and independence.

Don't accept

• poor physical access,
• poor understanding of the sort of support and equipment available to facilitate employment and use of mainstream facilities;
• poor training for staff on disability and health issues,
• continued prejudice often based on ignorance which promotes fear.

Remember people with learning disability are entitled to;.

• education,
• live in the community,
• access the normal services which everyone else has.

Do

• challenge ignorance in the community about learning disability,
• work with communities where families fear for the safety of their relatives in communities which they may see as hostile,
• challenge attempts to access universal services which have been met with rebuff and intolerance.
• promote the user's voice which is beginning to be heard where they are demanding the right to access youth and leisure services, shops, public transport, pubs, clubs etc. in exactly the same way as everyone else. If you want more ideas about how to communicate with users to help give them a voice See Good Practice: Tameside Learning disability quality scheme

Do promote

• Government programmes about awareness and understanding of mental health and prevention within the NSF for mental health which have attempted to tackle fear based on ignorance, but people with mental health problems continue to face significant prejudice.
• Publicity about developments in treatment mean that for a number of individuals with significant long term conditions it is now possible to sustain a job, family and friends.
• More specialist support services for people with mental illness run by users (see Good Practice: Surrey User involvement) themselves who are modelling for other service users and the community that people with mental illness are capable of running their own lives and being responsible members of the community.

Don't

• Let a few high profile cases of violence inflicted on others by people with significant mental health problems contribute to a continuing fear within your community about associating with people with mental health problems.

Transport

Overview

Is that journey really necessary?

If transport is needed what's the most effective way?

How much should users fund their transportation?

Overview

Traditionally public funding to cover the extra cost of transport for disabled people has come from three sources (Exhibit 10)

Source: Joint Reviews

Social Services have generally focused on getting best value out of their specialist transport services and have not looked at these in conjunction with the wider range of subsidised transport available within the authority.

Frequently transport costs are hidden within a range of different care management and unit budgets with apparent significant discrepancies between costs of providing what appear to be similar services. Patterns of service have often developed piecemeal over time. So a number of authorities have found that by taking an overall look at their transport there is potential to reduce costs.

As day services for users become less building based and more become involved in a combination of employment, education, leisure and day time support services, traditional mini-bus type transport picking up in the morning, taking to the day centre and dropping off again at night becomes less relevant. This presents challenges to all local authorities whether urban or rural.

In looking at their charging policies authorities are also grappling with how or whether to charge for transport costs. For more information on national transport policies see:

www.socialexclusionunit.gov.uk/publications/reports/pdfs/SEU-Transport_Summary.pdf

www.dft.gov.uk/stellent/

www.wales.gov.uk/subitransport/index.htm

The Community Transport Association's website is also helpful:
www.communitytransport.com

Is that journey really necessary?

What services can be developed close to people's homes?

• Can local employers be persuaded to provide work experience placements for those who need them in their communities? Promises of lots of support in the early stages may convince an employer to have a go, any costs of providing this can be balanced against longer term expensive transport costs going further a field
• Is the large day centre model what users really want, smaller community based social support groups may meet the needs of some users. Borrow rooms in schools, health centres, sheltered complexes or even the local pub (they might let you use the function room on a weekday in return for purchasing lunch)
• Work with users and carers to encourage walking to services where this is practical, stress the benefits of exercise for those with weight or possible heart problems, a real issue for a number of learning disabled users. Volunteers may be able to help with practising routes etc and with escorting service users where there are always going to be safety issues. However, you might be able to link your opening times with times when school crossing patrols are in action.
• Involve your local transport planning department in thinking about creating safe routes for pedestrians accessing services they use regularly.

If transport is needed, what is the most effective way of providing it?

• Use public transport where possible, look with your colleagues in transport planning departments at bus routes, accessibility for disabled users, times etc and work together to see how you can maximise the numbers using public transport.
• In Wales, a review of community transport undertaken by the Welsh Transport Forum and presented to the Welsh Assembly Government made 75 recommendations for improving the contribution that community transport already makes to improving accessibility. The recommendations includes closer collaboration between local authority departments to improve the efficient use of resources.
• Maximise the use of public transport by linking your services in with the times when suitable public transport is available
• Where they exist use dial a bus schemes where public buses pick up and drop off at home addresses. Where they don't, talk to transport planners about the possibility of developing them, particularly in isolated rural communities.
• Provide training for users on using public transport, it may take a long time but in the long run will be cost effective and increase the quality of users' lives.
• You might offer this to bus crews too, giving them confidence in understanding the needs of disabled users, and carers more confidence that their relatives will be supported sympathetically.
• Think imaginatively when employing drivers, might joint drivers/carer posts provide better value for money, See Good Practice: Nottinghamshire.
• Subsidised bus pass systems for the elderly and disabled operate in most local authority areas. Where users live close to the authority boundaries there can be an issue if passes do not enable users to access the services that are geographically closest. Talk to neighbouring authorities about reciprocal arrangements.
• Link with transport colleagues in other departments to see if there are any economies that can be achieved. Some authorities have developed coordinated transport departments, which are able to maximise the use of authority owned vehicles across the working day and at weekends. They can also use the power of bigger contracts to reduce the cost and improve the quality of taxi and other hired vehicles when they are needed. West Berkshire Council have identified savings of up to £200,000 on their Community Care transport budget since setting up a corporate Transport team in 2001. See Good Practice: West Berkshire Council; Integrated Transport Service
• In addition to supporting closer working within authorities, the Welsh Assembly Government is also encouraging stronger partnerships between the Community Transport Association (and community transport operators) and local government in Wales.
• Use modern route mapping technology to ensure the most effective routes are used. Whilst it is important to be sensitive to the needs of users when you are using one vehicle to transport users to several different venues, some authorities have found that it is possible to rationalise and reduce journey times for some users.

How much should users fund their transport with the mobility component of Disabled Living Allowance?

• If the family have purchased a car using the motability scheme how much should the vehicle be available to transport the disabled user?
• Should mobility component at the lower rate (£14.90) or the higher rate (£39.30) be put towards the cost of transport to day services, employment, further education etc?

For many families who have been in receipt of mobility component for some time the benefit has come to be seen as part of the overall family income, perhaps to purchase or lease a vehicle large enough to transport a wheelchair, or just to keep a reliable family car on the road. At the same time, the allowance has been made to cover the extra costs of getting around involved in being disabled.

Begin talking to user and carer organisations about how local people use the mobility component of DLA and what contribution towards the cost of transport to day services, education and employment is reasonable:

• Is it reasonable that a vehicle provided through motability is only available to transport the disabled person at weekends?
• Most people fund their transport to work costs themselves
• Most people fund their transport to leisure costs themselves
• Link this with the subsidy already going into public transport
• Explain how income from charging does make a difference to the amount of service you are able to provide

Housing

Supporting People

Tenancies and registered Care Homes

Supporting People

Appropriate and good quality housing is an essential element of well being. Most people want to remain in their own homes and communities and dread the moment when deteriorating health may mean they have to give this up. So minimising the numbers of people who move into expensive residential care is not only cost effective, it generally is what the user wants too .

The new government initiative "Supporting people", focussed on moving the resources for support to tenancies which were formerly funded through housing benefit, into a separate funding scheme. The legislation was fully implemented in England and Wales in April 2003. For further information, in England, see www.spkweb.org.uk and in Wales see http://www.housing.wales.gov.uk/index.asp?task=content&a=k1

The level of grant for supported housing costs was fixed on a formula based on the level of transitional grant in April 2003. Therefore, any future developments will have to be funded out of existing resources. However, users who are eligible for benefits can still claim their living expenses (but not their support costs) through the benefits system. A separate financial assessment and subsidy arrangement is available for those who can not afford to pay support charges.

So transfer of in house residential provision into supported housing may still be a cost effective route, provided that the levels of support needed meet with supported housing criteria. At the same time the partnership working that underpins Supporting People will help maximise resources, ensure shared priorities and a common agenda on accommodation across agencies and departments.

Use supporting people to revisit the range and level of their supported housing provision in your area.

Supported housing does not have to be in sheltered or supported housing complexes, some authorities are using peripatetic support workers to support people in their own homes

Look to use this particularly for:

• people with short term support needs (e.g. reactive depression after a bereavement or separation)
• those where whole complexes of people with similar needs could be unhelpful, ( mental health or substance misuse)
• those who wish to stay in their own homes reducing the numbers of specialist supported housing units that an authority needs to provide

It can also be a useful way of maximising the use of support workers with specialist skills (e.g. substance misuse) (See Good Practice: Reading, Focus House Supporting People initiative) and can extend the types and location of accommodation that service users can access. Hull Council worked with a Housing Association who purchased a house on a private estate for two adults with learning disabilities. See Good Practice: Hull

Tenancies and registered care homes

Use good needs mapping to prioritise housing development

• Try to predict the types of supported housing you will need over the next 5 to 10 years, as many capital developments will take this long to reach fruition.
• Work with planning departments on the likely levels of need and the likely planning implications to ensure your development plans are not destroyed because of community fears about neighbours with special needs
• Where land for development is at a premium, work with your planning department to maximise the use of "planning gain". Many authorities in these areas insist that a percentage of all significant new residential development must be social housing.
• Talk to local private sector landlords about your predicted need. Some authorities have found landlords who are prepared to work in partnership with local authorities in developing new resources. It may be particularly worth considering in areas where the numbers of people buying to rent has flooded the local market for private rentals.

Leisure Facilities

Overview

Health and leisure

• Work with health colleagues on the shared benefits of exercise and the use of leisure facilities
• Some PCTs are offering access to leisure as a prescribed service
• Some leisure services discourage use of leisure facilities by disabled people outside specialist sessions. This is discriminatory and means that families are discouraged from going to sports facilities together.
• Work with the service providers to deal with their anxieties through training, support on communication skills etc

Use leisure resources in their widest sense as an aspect of a full range of day services:

• Use of leisure and community centre facilities is a key part of the development of community based day services. They are often
  • accessible to the disabled,
  • well placed for public transport links,
  • and they often also have community rooms as well as more specialist sports facilities available for use.
• Maximise the use of these buildings as an alternative to long journeys to traditional day centres. Some authorities are seeing leisure and /or community centres as replacement bases for their traditional day services

Don't forget the other providers of leisure services. Some authorities are using staff and volunteers to take users to activities like salsa dancing, go carting, horse riding etc. The costs of these sorts of activities are often the sort of things local charities are willing to underwrite, even if it time limited.

• Sports clubs also have a role to play in offering facilities to disabled users. Identify the interests of your users then go out to clubs like, angling societies, swimming clubs etc. and see how with support and training they might be able to involve more users with special needs.
• Use the same approach for arts and theatre groups
• Organisations that need volunteers like BCTV, local footpath and canal maintenance groups, the National Trust etc are generally willing to provide opportunities for people with disabilities. With proper risk assessment and support a number of users can get real benefits from these opportunities, and the more service users are out in the community you may find you can function with fewer day centre buildings
• Where users are unable to get out to services, can they be brought to them? Get qualified staff from your sports and leisure services to provide exercise and activity sessions for older people, or for those with autism where changes of venue can be a problem. Don't think the only way of doing this is to train your staff to provide, use the skills of education and leisure colleagues to ensure all the community can access the services they offer. Nottinghamshire have developed an arts project linked with day services. If you want to know more about this see Good Practice: Nottinghamshire Sharing resources for leisure services

Leisure as prevention

• Work with your leisure providers and voluntary groups like Age Concern to offer specific sports and leisure activities to younger older people and people with lesser disabilities as a way of maximising mobility for those with early symptoms of conditions like arthritis etc
• Get health colleagues involved so users and leisure staff are confident that adequate training and advice is available on the level and type of activity that will promote good health
• Target high risk groups like those with learning disability (who are vunerable to weight problems linked with heart disease) and those who may not be able to access mainstream services easily because of communication difficulties

Education, Lifelong Learning and Libraries

Use funding available through life long learning to provide activities which include significant learning components, whether they be for staff, users or carers

For more information about what lifelong learning includes, and a lot of linked sites see www.support4learning.org.uk/site_index.htm

Remember lifelong learning has no age limit; include the needs of older users in your discussions with lifelong learning providers

Encourage providers to offer courses that may be of use to carers like, sign languages, lifting and handling etc. (might be an idea for future carer's grants).

Use of educational/library buildings and resources

• Maximise use of school, adult education and further education sites for service users, a number of these are empty during evenings, weekends and school holidays. They may have specialist equipment, sports facilities, teaching kitchens etc.
• Most school sites are generally individually managed by heads and governors and rental income is often a significant source of extra funds to that establishment. So involve school staff, parents, governors and local community leaders early in your development work so any project is part of a shared community agenda.
• Some authorities run day services for younger disabled people from college sites.
• Most colleges provide a range of courses specifically for disabled people, make sure your in house day services are not simply a duplication of this.
• All local library services have to develop a strategy to promote social inclusion.
• Some libraries have rooms available for community use, others are not open full time.
• Talk to colleagues in the library service about the sorts of books they stock, not just large print versions, what about books for people with learning disabilities, and the needs of those whose first language is not English?
• What about useful books for carers, do they stock them, would they be easy to identify?
• Make the library service accessible; some libraries provide stocks of books to day centres, residential units etc. But what about taking users to libraries, getting library staff to run reading clubs etc geared at the needs and interests of a particular group.