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Residential Care for Younger Adults
Different Problems : Different Answers
The Future of Group and Supported Living for Working Age Adults
How should the needs of working age adults (aged 18 to 64) who require group or supported living be met? This was the question faced by the Residential Forum, and this paper summarises the conclusions it reached.
The Big Six
Control
Service users should have control over their own lives, both in small and large issues – making choices about daily living and about the major questions such as where to live.
Service users need to play a significant role not only in deciding about their own lives but also in planning services. Tokenism is not enough, and if service users need help or training to get their points across, time and resources must be allocated.
Control is not the same as choice. At times it is good to have a variety of options from which to choose, but at other times, as long as the service is acceptable, it is not necessary to have choice.
Citizenship
People using social care services have the same rights as anyone else to be treated as citizens, to be responsible for their own lives, to work and to socialise as they choose. Services and benefits should be provided to enable them to fulfil their rights.
Access
Accessible transport, accessible buildings and accessible facilities such as toilets should become virtually universal if service users with disabilities are to be able to play a full role in the community. The improvements which they require also make life easier for everyone else.
Accommodation
Some people requiring social care in this age group live in residential care or other forms of institution such as hospitals and prisons, but a feature of the scene today is that a very wide range of accommodation is now used, including sheltered housing and different sorts of supported living in the community.
Finding the right sort of accommodation is not just a question of selecting the building. Having a social network is important, and some people live in groups, some are supported individually and, for some, residential care offers companionship as well as safety and
24-hour personal care.
Employment
Most people in the age group are in employment and this provides them with social standing, status, a sense of self-worth and, as a consequence, self-confidence, as well as income. It is therefore important to find ways of helping service users to obtain training and employment. A high percentage of people of working age with disabilities have no occupation, and finding jobs has to be a high priority. Those who cannot work still need a range of purposeful activities so that they can live a full life.
Risk
In order to provide residents with security and safety, risks have been avoided to such an extent that we now have a risk-averse culture. It is time to reverse this trend. Service users need to have the opportunity to take risks like everyone else.
Improving Services
Planning Services
The planning of services needs to take account of many factors such as demographic trends, the economy, links with the Health Service, investment and the views of stakeholders. Ways need to be found to overcome the gap between the emphasis on person-centred planning and assurance to service providers that it is safe to invest.
Commissioning Services
Local authorities should commission reliable agencies to deliver services and not always take the lowest tender, since this can put the quality of services at risk.
Finance
All funding provided by different Government departments should be considered as one “pot” from which resources can be drawn to meet individuals’ needs. Administrative savings can be made if the system is simplified.
A simpler system of benefits is needed which separates daily living costs from social care costs. Service users should not have to pay the economic cost of social care, and the current means-testing system means that it is not worthwhile for residents to work.
Means testing should be separated from assessment of need.
Funding should follow service users, and moving house should not present problems.
Regulation
Systems for regulation, inspection and quality assurance are in some instances too cumbersome, wasting time and putting undue pressure on staff. They need to be simplified and directed more at identifying the success in services’ achievement of the desired outcomes for service users.
Workforce
People who work with social care service users should be trained as “life-space workers”
along the lines of the social pedagogue model under consideration for work with children and young people.
Action
There are many blocks to best practice. The Government needs to give a lead to :
- ensure that finance is used effectively to help service users meet their needs,
- overcome differences of view between central and local government departments,
- encourage innovation and find new answers to problems.
An independent inquiry is needed to :
- gather data about the needs of adults of working age requiring social care,
- identify the resources currently available,
- determine how they may be used better,
- assess the level of resourcing required to meet assessed needs.
Needs and Numbers
Needs
Working age adults are aged from 18 to 64. Because of the attention paid to children’s needs and the large numbers of older people needing social care, people of working age are sometimes given a lower priority, but their needs are just as great. Those requiring social care services come from a wide variety of client groups : learning disability, physical disability, sensory disabilities, mental ill health, alcohol abuse, drug abuse and offending. Within these groups, each person is unique with their own personal blend of personal of problems, strengths, concerns and hopes.
Numbers
Mainly as a result of improved health care, many more people are living much longer despite their physical disabilities, illnesses or brain injuries. The number of people in these client groups is therefore continuing to rise, and some of these people require intensive personal and social care for long periods.
The Residential Forum
Established in 1994, the Residential Forum seeks to promote high standards in residential care and to contribute to improving the quality of services and practice. The Forum encompasses all parts of the residential sector - statutory, voluntary, not for profit and private