When I started writing blogs, I did say that I would sometimes cover controversial topics. This is one of those times. There is a vexed issue in England about offices in supported living. CQC’s stated position is that we shouldn’t have offices in supported living services because they are people’s homes. Imagine how surprised I was when I visited a supported living service run by another provider recently, to find not only did they have a large office, but that it had a big sign on the door saying “office”! Apparently CQC have visited and haven’t raised any concerns.
We are a member of Care England, the main representative body for care providers in England and I chair their learning disability group. I have asked them to raise this inconsistency with CQC. I also think we need to be a bit sensible about offices. We certainly shouldn’t have large offices in people’s homes with a big sign on the door. However, supported living services are work environments for staff as well as people’s homes and we do need somewhere to keep records and for managers to carry out supervisions with staff. I think CQC’s guidance should be that it is acceptable to have a small staff area without a sign in supported living, preferably with a separate entrance. Let me know what you think.
On the subject of records, we will shortly be rolling out the Nourish online care planning system which should remove the need to have lots of files in people’s homes and will make record-keeping and monitoring much easier. A huge amount of work has been carried out in preparation for the Nourish roll out making sure that we have consistent documentation across the organisation. I would like to thank the team, led by Carole, our Head of Quality, for the excellent work they have done.
One final point on regulation of supported living. The system in England, where supported living is treated the same as domiciliary care, is completely unfit for purpose. When supported living started around 25 years ago, it tended to cater for more able people who needed a few hours of support a day. At the time, it was reasonable to treat it like domiciliary care. Now people living in supported living have needs that are just as complex as residential care.
What particularly concerns me is that CQC will inspect the registered domiciliary care office and will sample services, but won’t visit all of them. I have known supported living services that haven’t had a CQC inspector walk through the door for 10 years. Given how vulnerable the people we support are and the history of abuse scandals in learning disability services that date back to Ely Hospital in Cardiff and include the dreadful events at Winterbourne View and Wharton Hall, this is simply not acceptable. CQC have known that this is an issue for years and they need to act before another scandal reveals the inadequacy of the current regulatory regime.
On a different subject, I met Bruce Moore, the CEO of Housing 21, when we ended up sitting next to each other at a sector dinner. It turned out that, not only had we both gone to the same university, Exeter, at around the same time, but we had similar views on what makes an effective CEO. We decided to write about what we have learnt having both been CEOs for many years and that resulted in an article called “Top Tips for CEOs of Health, Housing and Care Organisations”. If you get a chance, please have a read and let me know what you think. You can find it on our website, just click on “about us” and then “news”.
One of the things that Bruce and I talk about is visibility and I am continuing to visit services every week. I visited Conway House in Cardiff recently and had a chat with a person we support who agreed that I could share with you one of his hobbies. He is an avid chess player and he attends a local chess club every week, which he said is very friendly and where he has got to know quite a few people. I think this is a great example of social inclusion and I would encourage our staff to support people to get involved with activities in the local community where they can build relationships. Too many people we support live isolated lives where the only people they know are staff and family members. Friends and acquaintances are an important part of what makes life enjoyable and fulfilling.
I am really passionate about helping people we support find paid employment. It doesn’t have to be a full-time job and for some people a few hours a week is enough. Not only does it help people earn money, but in my experience it can transform someone’s self-esteem. I would really encourage our staff to support people to find paid work. I was speaking to one of our excellent home managers for one of our Welsh services recently, who told me that it is difficult helping people who have previous convictions to get employment.
Quite a few people we support do have convictions for various offences in the past. I agree that it can be very difficult for those people to get a paid job and I think a way around it is to support them to set up their own business. It doesn’t have to be anything hugely ambitious; a few years ago I led a programme to help people with learning disabilities set up “micro businesses”. For example, we supported someone who was very artistic to set up a business making and selling T shirts and mugs. Please let me know if anyone you support wants to set up a small business, and I will see what Iris can do to help.