Supported Living In Focus

Martin Cawley, Service Director at Quarriers, gives Care Appointments Scotland an insight into supported living projects for people with learning disabilities from the service provider’s perspective…

When I started working for Quarriers most of our services for people with learning disabilities, children, families and young people were provided in Quarriers Village. Over the past 14 years Quarriers has grown significantly in size and now provides a very wide and diverse range of services across Scotland. Although we very much see ourselves as a Scottish Charity we also now have a couple of services in the South West of England.

I personally have always had an interest in providing support services for people with disabilities and this was initiated in the earlier part of my career when I worked in Lennox Castle Hospital, which is now closed of course.

Until the last couple of decades services for people with learning disabilities in Scotland were traditionally provided in large communal environments with people experiencing very little privacy and individualised care and support. However, this has changed significantly in recent years and new innovative ways to support people have been pioneered with the voluntary sector playing a huge part in this. This has been achieved by setting new standards of care and by adopting personalised approaches to develop flexible and responsive support arrangements which have enabled people to develop their skills, achieve a greater level of self determination and enjoy the benefits of community living like any other citizen.

One of the most effective ways to achieve inclusion and acceptance or to challenge discrimination and ignorance is to be present and active in mainstream community life and to be afforded the rights and privileges we should all expect as citizens. These values and principles have influenced the strategic direction Quarriers has taken over the past ten years and they have been the catalyst for shaping the way we provide our services.

Like some other organisations Quarriers has played a major role in developing community based supported living services for people who had previously lived in long stay hospitals. These services are very individualised in nature and are driven and dictated by the wants, needs and dreams of the person being supported to help them lead the lifestyle of their choosing. There are of course some people who have very complex needs and require high levels of support to lead a full and active life. {mospagebreak}

People should not be allowed or denied opportunities simply because of their level of ability or disability. On the contrary the challenge is to ensure we can offer opportunities to support people appropriately and safely. Occasionally it is more difficult for “professionals” to understand or interpret what people are communicating and sometimes this means we get it wrong with the types of support we offer. The more we can get to know people as individuals, for example their likes and dislikes, what motivates them, what dreams they may have for their lives then the greater the chance we have of constructing services that will respond to their needs appropriately.

Supported Living has over the past few years become described by some as a mainstream service and in some respects a service model. It is much more than this however; it is more of a concept or an approach which ensures that people chose or determine the things in life that are very important to them. This approach can be adopted in relation to how people live, where they live, who they live with and how they are supported.

One of the main objectives of “The Same as You”: A review of services for people with learning disabilities in Scotland, which was published nearly 5 years ago, was to extend the opportunities for people to have increased choice and control over their lives. Supported Living puts this aim into practice in that it starts from the basic assumption that people do not need to be ready or prepared to be offered or given the types of choices that we all take for granted but that these are a basic human right. This does, however, present many different challenges for organisations who provide and purchase such services and for the Care Commission in how they monitor services on a national basis to ensure that everyone concerned fully understands the principles of the service and those standards are applied consistently across the country.

As an organisation Quarriers welcome working in partnership with local authorities, the Care Commission and other regulatory bodies to continue to develop and enhance services by sharing learning and disseminating good practice.

One of the challenges for organisations providing supported living services is retaining a high degree of flexibility and responsiveness within an ever increasing regulatory framework and responding to your responsibilities to your employees at the same time. Often staff can be working on their own with very flexible deployment patterns. Organisations therefore need to ensure that they have robust management structures and systems in place and deliver a range of supports to provide staff with the correct levels of supervision, training and development. Staff support people not only with issues relating to their personal care but also to access community resources in order to promote their participation, acceptance and inclusion. This is very skilled and challenging work. Many of the people we support are vulnerable and have very personal or specialised care requirements. {mospagebreak}

Therefore, we need to ensure that organisational processes facilitate a safe culture yet one that also manages risk appropriately. All partner agencies need to work closely together to ensure that accountability is not diluted and that we are providing safe supports for people.

Quarriers provide services to more than people with disabilities alone. We have a range of other services supporting children, families and carers, young people including homelessness services and services for people with epilepsy. In fact Quarriers have the only residential epilepsy assessment unit in Scotland. This is a very unique service which provides a comprehensive tertiary assessment process for people with the most complex of epilepsies. We work in partnership with our NHS colleagues from the Institute of Neurological sciences at the Southern General Hospital in Glasgow where we receive vital neurology and neurophysiology which enhances the assessment for people. Epilepsy is the most common neurological condition and affects thousands of people in Scotland. We take a very holistic approach incorporating both a health and social care perspective.

Although epilepsy is a health condition, living one’s life with epilepsy is something different altogether. We also have a number of fieldworkers working across the country providing information, advice and support locally to people with epilepsy, their families and other professionals who have an interest. We have huge ambitions to improve on what we presently offer. Our aim over the next couple of years is to build a new National Centre for Epilepsy which will maintain clinical excellence while creating a comfortable environment for people. This is very important not least in terms of diagnostic benefits. The more natural and comfortable the environment the more chance there is to observe “normal patterns of seizures and thus more accurate diagnosis. We will look to raise the profile of this venture over the coming months.

Although it is over 130 years old Quarriers is still learning and developing as an organisation. We have many ambitions yet to fulfil and there is still a huge amount of unmet need in our communities. We do however recognise that working in close cooperation with our colleagues in the statutory sector is very important in order to achieve the best outcomes for people who use services in relation to their own personal development.