CQC INSPECTORS

Inspecting support for people with learning disabilities who are labelled as having complex needs that are hard to manage

Who am I?

HCPC registered Social Worker with a Dip HE in Mental Health Worked for NCSC and CSCI for 6 years as an Inspector Regulation of Health & Social Care Award Masters in the Regulation of Health & Social Care Seconded from CSCI as part of Change Team post Budock Hospital

scandal Managed the closure of NHS Campus in Bournemouth South West Regional Manager for United Response Co-owned & registered Manager for Beyond Limits in Plymouth Regulation, Health and Social Care Consultant working with LA’s,

CCG’s, NHSE and families facilitating planning for discharge from ATUs

Worked with people who have labels of being hard to manage for over 10 years

Agenda for the day

10.30 am People First – Learning Disability is not a Medical Model

Families matter Citizenship as a Framework for Provision &

Inspection 11.30 am Group work on understanding

good practice using Citizenship as a Guide 12.30 pm Lunch 1.15 pm Questions and discussion 2.30 pm Close

Attributes not Deficits

People who challenge are still People First! People challenge because things aren’t right! A service won’t work if it is built on deficits A service won’t work if Providers don’t know

the person really well & learn from mistakes Learning disability is not an illness; the

medical model doesn’t work A service only works if it is built around each

individual person’s attributes, skills, hopes and dreams

What do people & families want?

To be happy To be fulfilled To be part of a family & have a family To be accepted in their communities To have a place to call home To love & be loved A life that makes sense to them(Families want the best for their children but sometimes )

What do they usually get?

Service Land

Segregation and congregation from birth - services bring children together and group them & this continues into adulthood

Little choice in all things Being grouped on the basis of ‘labels’. ‘Labels’ that

define deficits & not strengths Families pushed out & not ‘really’ listened to Services that don’t ‘quite’ fit what the person

needs Little power and autonomy over their lives Their needs seen through service ‘goggles’ and

service solutions becoming the only solutions

The Foundation for Excellence(Evidencing Provider Competence)

Families Matter(How a Provider works with a family evidences it’s core values)

Families are often presented as having

reputations as big as their loved one! This is rarely the case if listen to and understood

Families are a very important part of people’s lives

Families have also suffered segregation, congregation and systematic entry into Serviceland

Families usually want the same things for their children as any other non-disabled child

Families are rarely the problem & often have many of the solutions

The #Mother Blame Game

‘Mothers have been blamed for everything from naughty children to teenage pregnancy. If you have a child with Learning Disabilities

things are tougher still. From the moment your child strays ‘too far’ from the ‘normal’ developmental path, you are under additional

surveillance, as the blame game begins. You are the problem and the solution. You have caused your child’s delayed development (through

your inept parenting or your dodgy genetic inheritance) but at the same time you must lead the charge to move your disordered child as close as possible towards some sort of mythical norm. Therapies and interventions replace the simple pleasures of playing with your

child. When they start school you are characterised as ‘in denial’ and ‘grieve stricken’. Your grief makes you unreasonable, tetchy, difficult,

while being in denial leads you to make unreasonable demands of the system which only has limited resources.’

Katherine Runswick-Cole mother of a son with learning disabilities and academic

The Art & Politics of Listening & Not Listening to Families ‘The thing that happens is that the practioner or

Organisation concerned will decide if you are somebody who should or needs to be listened to, or if your opinions can be thrown on the ‘can be dismissed’ pile. Useful opinions are those that

make no additional demands on services. Providers that do not have a person or family

centred approach begin to adopt strategies that will allow the marginalisation of the family. The MCA has become a particularly useful way of

dealing with problematic families.’Mark Lamb carer and researcher.

‘Mothering a disabled child differs to mothering many other children. It involves an intensity of emotion, of devotion and, often, advocacy and activism that stretches across a lifetime’

Sara Ryan (Mother of Connor Sparrowhawk)

WHAT IS CITIZENSHIP?

‘Without Citizenship you are Stateless’

Citizenship is: Being an active part of Society How we make Society fairer and more

inclusive A democracy where people participate and

belong How we make Society work – together How we unite people A powerful status Its both Rights & Obligations

For most it’s automatic - when you are born you become a Citizen

If you have a disability it’s very different!

Life with no meaning Life with no purpose Seen as having no talents, gifts & skills Others control your life Living in poverty or trapped and dependent Living in places you don’t want to be No privacy, rights or belonging Controlled, segregated, abused and lonely A loveless life

What are the Keys to Citizenship?

Purpose Freedom Money Help Home Life Love

A bit like completing a jigsaw...

It’s not about achieving just one Key. You have to complete the whole picture

SO WHY USE KEYS ?

Because Citizenship is what people tell us they want!

They tell us they want……..

To be happy To be in control of their lives To be able to speak up To be fulfilled To be part of a family & have a family To be part of their communities To have a place to call home To love & be loved A life that makes sense to them

So that is the Job providers should be

doing!

Exercise

7 groups 1 scribe 1 person feedback Each group takes 1 Key As an Inspector what would you look for,

how would you go about it & who would speak with to assess that a provider was achieving a Key? (30 minutes)

Each group feedback & discussion about issues from the perspective of an Inspector (30 minutes)

Key 1 – Purpose

Purpose means citizens having lives that are meaningful and that have a sense of purpose. Sometimes we find ourselves living a life without meaning.

Key 2 – Freedom

Citizens are born free, but sometimes that freedom is lost. People with disabilities, especially people who don’t communicate with words, often find that other people take control of their lives.

Key 3 – Money

Citizens need money and at least enough money to allow us to live with dignity and security. Too many people, especially disabled people find themselves living in poverty.

Key 4 – Home

Citizens belong. They have their own place, a home where they are safe and secure, in a community that is right for them. Many disabled people find themselves living with their families too long, or are stuck in care homes.

Key 5 – Help

Citizens need help. Everyone needs help. Help is good. But many disabled people are made to be too dependent on those who help them. They get help at the price of freedom. This is bad help.

Key 6 – Life

Citizenship is about making a difference. We do this by getting involved and helping make our community a better place. Many disabled people are excluded from community life.

Key 7 – Love

The most important thing in the world is love. Love exists even when citizenship is missing, but true citizenship strengthens the force of love in the world. Disabled people can love and be loved just like everyone else. But sometimes the world makes it harder.

My contact details

Sam SlyEnough is Enough

Time4Change!

sam.sly@enoughisenough.org.uk www.enoughisenough.org.uk

07900 424144