A checklist for people and families: What evidence should you look for when choosing a high quality supported living provider?

Finding the right care and support option can be confusing, there are often scores, if not hundreds of support providers, websites and glossy brochures to navigate through in any given local authority area, all promising to provide high quality person centred support. So how do you really distinguish what good looks and get under the surface of the marketing and the spin?

This guide is designed to help people and families in evaluating and selecting a care provider that meets their own high standards. It outlines the seven key elements of good support and describes the types of evidence you should look for to ensure these elements are being delivered effectively. Whether you are seeking care and support for yourself, a family member with physical disabilities, learning disabilities, autism or other needs, this guide and accompanying checklist can help you make more of an informed decision.

Each element is is based upon ‘Personalised Support’ by Julie Fitzpatrick published by Citizen Network. It outlines the seven key elements of good support as observed from the work of Doreen Kelly and Partners for Inclusion who have provided outstanding support to people with learning disabilities for many years https://partnersforinclusion.org/ The full paper is also available here: https://citizen-network.org/library/personalised-support.html

1. Commitment to Citizenship

Description: The foundation of good support is the belief that every individual is a full citizen with inherent rights, potential, and the capacity to lead a fulfilling life. This means recognising and respecting the individual's status in society and ensuring they are seen as equals.

Evidence:

• Active Participation: Care plans should encourage and facilitate the individual's involvement in community activities and decision-making processes. This might include voting, attending community events, or participating in local groups.
• Personal Goals: Each individual's care plan should reflect their personal goals and aspirations. Regular goal-setting and achievement tracking should be documented.
• Empowerment: Feedback from individuals and their families should indicate a sense of empowerment and inclusion. Testimonials or satisfaction surveys can be useful tools for assessing this.
• Rights and Responsibilities: There should be clear documentation showing that individuals are aware of their rights and responsibilities as citizens, and these should be actively supported by the care provider.

Discussion: The concept of citizenship goes beyond merely providing basic needs. It involves fostering a sense of belonging and active participation in society. This means individuals should not be isolated or treated as passive recipients of care but should be encouraged and supported to engage in various societal roles. Care providers should implement strategies that promote social inclusion and ensure that individuals have opportunities to participate in community life. This can include facilitating access to education, employment, and recreational activities, as well as supporting individuals to form and maintain personal relationships.

Care providers should advocate for the rights of the individuals they support, ensuring they have access to the same opportunities and protections as any other citizen. This includes ensuring they are informed about their rights and supported to exercise them. For example, individuals should have access to information about voting rights and be supported to participate in elections if they choose to do so.

2. Individual Service Design

Description: Good support must be tailored to the unique needs, relationships, community contexts, and future plans of each individual. This personalised approach ensures that services are relevant and effective.

Evidence:

• Customised Care Plans: Care plans should be developed through thorough consultations with the individual and their family. These plans must be highly individualised, taking into account the person’s preferences, history, and specific needs.
• Regular Reviews: The care plans should be regularly reviewed and updated based on feedback from the individual and changing circumstances. These reviews should be documented and demonstrate responsiveness to the individual’s evolving needs.
• Innovative Approaches: Examples of innovative and flexible approaches to meeting individual needs should be evident. This might include unique scheduling, specialised equipment, or personalised activities.
• Holistic Assessment: Comprehensive assessments should consider all aspects of the individual’s life, including health, social connections, personal interests, and potential areas for growth.

Discussion: Individual service design is crucial because it recognises that each person is unique. A one-size-fits-all approach often fails to address the specific needs and preferences of individuals. Effective individual service design requires detailed and ongoing assessments to understand the person’s life history, current situation, and future aspirations. This understanding should inform the development of a personalised care plan that outlines specific goals and the steps needed to achieve them.

Regular reviews are essential to ensure that the care plan remains relevant. Changes in health, personal circumstances, or preferences should trigger a review and potential adjustment of the plan. This dynamic process ensures that the support provided evolves with the individual’s needs.

Innovative approaches to support can significantly enhance the quality of life for individuals. This might involve using technology to aid communication, designing bespoke activity programmes, or creating flexible support schedules that align with the person’s lifestyle and preferences.

3. Individualised Policies

Description: Policies and systems should be created and implemented at the individual level to maximise outcomes and manage risks effectively. Standardised policies often fail to address the nuances of individual needs.

Evidence:

• Individualised Policy Documents: Documentation of personalised policies for each individual should be available. These documents should outline specific protocols and guidelines tailored to the person’s unique circumstances.
• Policy Reviews: Regular reviews and adjustments to these policies should be conducted and documented. This ensures that the policies remain relevant and effective as the individual’s situation changes.
• Staff Training: Evidence of staff training on these individualised policies should be provided. Staff should understand and adhere to the specific needs and protocols for each person they support.
• Risk Management Plans: Personalised risk management plans should be in place, detailing how to mitigate and respond to potential risks specific to the individual.

Discussion: Individualised policies are essential for managing the specific needs and risks associated with each person. Standard policies can often be too rigid and fail to accommodate the unique circumstances of individuals. Personalised policies should be developed through a collaborative process involving the individual, their family, and the care provider. These policies should cover various aspects of care, including daily routines, communication preferences, behavioural support, and emergency procedures.

Regular reviews of these policies are necessary to ensure they remain effective and relevant. Changes in the individual’s condition, behaviour, or circumstances should prompt a review and potential update of the policy. This iterative process ensures continuous improvement and adaptation to the individual’s needs.

Staff training on individualised policies is crucial. All staff members should be well-versed in the specific needs and protocols for each person they support. Ongoing training and supervision should be provided to ensure that staff are equipped to deliver personalised care effectively.

4. Individualised Support

Description: Support should be provided by people who are a good fit in terms of values, personality, and interests, not just qualifications. The relationship between the support staff and the individual is crucial to the success of the support.

Evidence:

• Personalised Recruitment: Recruitment processes should involve the individual in selecting their support staff. This ensures a good match in terms of personality and values.
• Staff Retention: High staff retention rates can indicate successful matching between individuals and their support teams. Consistency in support staff is critical for building trust and understanding.
• Feedback and Satisfaction: Positive feedback from individuals about their relationships with support staff should be regularly collected and reviewed.
• Team Cohesion: Evidence of strong team cohesion and effective communication within support teams should be evident. This might include regular team meetings, shared goals, and collaborative problem-solving.

Discussion: The relationship between the individual and their support staff is fundamental to the success of personalised support. Recruitment processes should prioritise finding staff who are a good match for the individual, not just in terms of skills and qualifications, but also in terms of personality, interests, and values. This approach helps to build strong, trusting relationships that are essential for effective support.

Staff retention is a key indicator of successful support relationships. High turnover rates can disrupt the continuity of care and negatively impact the individual. Efforts should be made to retain staff through appropriate remuneration, training, and support.

Feedback from individuals and their families should be regularly collected to assess the quality of relationships with support staff. This feedback should be used to make any necessary adjustments to improve the support provided.

Team cohesion and effective communication within support teams are also critical. Regular team meetings, shared goals, and collaborative problem-solving can help to ensure that all team members are aligned and working together to provide the best possible support.

5. Individualised Funding

Description: To provide truly personalised support, individuals should ideally have control over their own budgets through Direct Payments or Individual Service Funds. This ensures that funds are used flexibly to meet their specific needs and achieve the best possible outcomes.

Evidence:

• Transparent Budget Management: Transparent processes for managing individual budgets should be in place. Individuals and families should have clear information about how funds are allocated and spent.
• Financial Reports: Regular financial reports should demonstrate flexible use of funds tailored to the individual’s needs. These reports should be accessible to the individual and their family.
• Input from Individuals and Families: There should be evidence that individuals and their families have input into budget decisions. This might include documented meetings, surveys, or feedback forms.
• Budget Utilisation: Reports and case studies showing creative and effective use of funds to enhance the individual’s quality of life should be available.

Discussion: Individual control over funding is essential for ensuring that support is truly personalised. Transparent budget management processes help to build trust and accountability. Individuals and their families should be provided with clear information about how their funds are being used. This includes detailed financial reports that show how funds are allocated and spent.

Regular financial reports should demonstrate that funds are being used flexibly to meet the individual’s needs. These reports should be accessible to the individual and their family, allowing them to see exactly where their money is going.

Input from individuals and their families is crucial in budget decisions. This ensures that the funds are used in ways that align with the individual’s preferences and priorities. Documented meetings, surveys, and feedback forms can provide evidence of this involvement.

Case studies and reports showing creative and effective use of funds to enhance the individual's quality of life can serve as powerful evidence of good practice. These examples should highlight innovative solutions that have been implemented to meet the specific needs and goals of individuals.

6. Power with the Person

Description: Individuals should be involved in all critical decisions about their lives. When individuals cannot make decisions independently, their representatives should be involved to ensure decisions reflect their preferences and best interests.

Evidence:

• Decision Logs: Meeting records and decision logs should show that individuals or their representatives are involved in major decisions. This includes documentation of consent and input.
• Satisfaction Surveys: Surveys or feedback mechanisms should indicate that individuals feel heard and respected in decision-making processes.
• Advocacy Support: Where necessary, advocacy support should be provided to help individuals express their preferences. Documentation of advocacy involvement should be present.
• Informed Consent: Clear procedures and records for obtaining informed consent should be in place, demonstrating that individuals understand and agree with decisions affecting their lives.

Discussion: Empowering individuals to have a say in the decisions that affect their lives is a cornerstone of personalised support. This empowerment fosters a sense of control and autonomy, which is vital for well-being. Decision logs and meeting records should detail the involvement of individuals or their representatives in all significant decisions. This transparency ensures that the decision-making process is inclusive and respects the individual's voice.

Satisfaction surveys and other feedback mechanisms are essential tools for gauging whether individuals feel their input is valued. These tools should regularly be used to collect and analyse feedback, which can then inform improvements in how decisions are made.

Advocacy support is critical for individuals who may have difficulty expressing their preferences or who face barriers to participation. Advocates can help ensure that the individual's views are represented and respected in decision-making processes. Documentation of advocacy involvement should be maintained to demonstrate that this support is being provided.

Procedures for obtaining informed consent should be robust and well-documented. Individuals should be provided with clear, accessible information about the decisions being made and should be supported to understand and consent to these decisions wherever possible.

7. Creative Community

Description: A supportive community, both within and outside the care organisation, is essential for fostering creativity, understanding, and meaningful connections. This community helps individuals feel valued and integrated.

Evidence:

• Community Engagement: Documentation of activities and support plans that encourage community engagement and inclusion should be available. This includes participation in local events, clubs, and volunteer opportunities.
• Partnerships: Evidence of collaboration with external community organisations and resources should be present.
• Success Stories: Stories and examples of how community connections have enhanced individuals’ lives should be documented and shared.
• Social Networks: Records showing efforts to build and maintain social networks for individuals should be kept. This might include facilitating friendships, family connections, and peer support groups.

Discussion: Building a creative community around individuals receiving support is crucial for social inclusion and a persons overall well-being. Plans and risk assessments should be designed to encourage participation in a wide range of activities that promote social interaction and integration. These activities can include attending local events, joining clubs, volunteering, and participating in adult education for example.

Efforts to build and maintain social networks should be documented and actively supported. This includes facilitating friendships, reconnecting with family members, and creating peer support groups. Strong social networks can provide emotional support, companionship, and help people form a sense of belonging.

Appendix: Checklist for Families

This checklist can be used by people and families to assess whether a care provider is delivering the key elements of good support.

Commitment to Citizenship

·?????? Are individuals encouraged to participate in community activities?

·?????? Do care plans reflect personal goals and aspirations?

·?????? Is there evidence of empowerment through feedback or testimonials?

·?????? Are rights and responsibilities clearly supported and documented?

Individual Service Design

·?????? Are care plans customised through thorough consultations?

·?????? Are care plans regularly reviewed and updated?

·?????? Are there examples of innovative approaches to meet individual needs?

·?????? Is there a holistic assessment of the individual’s life?

Individualised Policies

·?????? Are there documented individualised policies for each person?

·?????? Are policies regularly reviewed and adjusted?

·?????? Is there evidence of staff training on these individualised policies?

·?????? Are personalised risk management plans in place?

Individualised Support

·?????? Are recruitment processes personalised and involving the individual?

·?????? Are staff retention rates high, indicating good matching?

·?????? Is there positive feedback from individuals about their support staff?

·?????? Is there evidence of strong team cohesion?

Management of Individual Service Funds (where available/applicable)

·?????? Are budget management processes transparent?

·?????? Are regular financial reports demonstrating flexible use of funds?

·?????? Do individuals and families have input into budget decisions?

·?????? Are funds creatively and effectively used to enhance quality of life?

Power with the Person

·?????? Are individuals or their representatives involved in all major decisions?

·?????? Do satisfaction surveys indicate that individuals feel heard?

·?????? Is advocacy support provided when necessary?

·?????? Are procedures for obtaining informed consent clear and documented?

Creative Community

·?????? Are there programmes that encourage community engagement?

·?????? Is there evidence of collaboration with external community organisations?

·?????? Are there documented success stories of community integration?

·?????? Are efforts to build and maintain social networks evident?

Suggested Steps for Families:

1.??? Initial Research:

1. Use the checklist to gather preliminary information about potential care providers.
2. Review the care provider's website, brochures, and any available online reviews or testimonials.

2.??? Request Documentation:

1. Ask potential care providers to provide documentation that supports the key elements outlined in the checklist.
2. Review care plans, policy documents, financial reports, and feedback from other families.

3.??? Interviews and Visits:

1. Schedule interviews with care providers and visit their facilities.
2. Use the checklist to guide your questions and observations during the visits.
3. Talk to staff members and observe their interactions with individuals receiving support.
4. Talk to families of people supported - a good care provider will always be happy to connect you up for a chat.

4.??? Follow-Up:

1. After visits, review the information collected and compare it against the checklist.
2. Follow up with care providers for any additional information or clarification needed.

5.??? Decision-Making:

1. Use the checklist to evaluate and compare different care providers.
2. Consider the evidence provided and your observations to make an informed decision.

6.??? Monitoring:

1. Once a care provider is chosen, continue to use the checklist to monitor the quality of support provided.
2. Schedule regular meetings with the care provider to review progress and address any concerns and if necessary bring social services into conversations.