Transforming Care is about:
- improving the quality of life of children, young people and adults with a learning disability and/or autism who also display behaviour that challenges.
- making sure as many people as possible can live in their local community with the right support.
- fewer people going into specialist Learning Disability and Mental Health hospitals and only stay there for as long as they need treatment.
After BBC Panorama showed the television programme about the abuse of people with learning disabilities at Winterbourne View hospital, the government wanted to change the way that people with behaviours that challenge are supported.
The government said they would move everyone with a learning disability and/or autism out of specialist hospitals who should not be there.
Email us at joint.commissioning@hertfordshire.gov.uk if you have any questions about Transforming Care in Hertfordshire.
Hertfordshire’s Dynamic Support Registers (DSRs) and Care and Treatment Reviews (CTRs) processes for Adults (PDF 168kb)
The national plan - visit the NHS website for more information.
National plan - building the right support (easy read PDF)
NDTi and their partners have spent a lot of time listening to people and exploring support options, they believe that there are a group of support organisations who follow common principles and ways of working that are based on individual choice and control and community lives. Their approach can best be summarised as ‘small supports’.
As a local area Hertfordshire County Council is signed up to the principles of small supports agreed by a number of existing small support organisations. These principles are based on nine key characteristics that set small supports apart:
- Control – The starting point is the individual and their representatives involvement which is central to success.
- Person Centred – The focus is on the persons aspirations and needs in developing enabling outcomes.
- Staffing – A key element to great support is staffing, involving the person in recruiting staff that are aligned to their needs and supportive in achieving outcomes.
- Choice – Choosing where the individual wants to live and who they want to live with, having ownership over their own home.
- Funding – Having access to individual budgets that take account of transitions, fluctuations and contingencies.
- Adaptability –To work in partnership to overcome challenges and adapt support to meet an individual’s fluctuating needs.
- Community Focused – To be rooted in the local community, building links around the individual including in recruitment and actions.
- Staying small – To not grow by more than 3-5 people per year and for staff of all levels to know and understand the needs of the individual.
- Remaining focused to the practices, not taking some practices as goals within a larger organisation. Practices must be about the individual not applied to all individuals.
If you have experience of supporting people who can challenge services and know you could bring something different then you may be interested in finding out more.
Our aim
As part of our commitment to autistic people and people with learning disabilities, Hertfordshire County Council together with its NHS partners is committed to ensuring that every aspect of commissioning achieves the highest quality care and support needed and represents good value for money. Hertfordshire County Council’s Connected Lives service approach focuses on community opportunities, citizenship, personalised outcomes for people, expanding services to promote a strong, sustainable and diverse market place.
We know that there are more than 2000 people across the country that are currently in inpatient settings and that on average these people remain in these settings for five years. These experiences often cause trauma to the individual and their families. Individuals are placed away from home or risk being moved out of their community and in to settings that do not meet their needs. We know that current support may not be right for people with complex and fluctuating needs because of the way services are designed and delivered.
HCC has a good range of services locally and we are not looking to replace our existing frameworks but to expand the market through wider choice and the use of Individual Service Funds to focus on prevention, independence, and the assets and strengths of people and communities.
We have identified that there is a gap in our local provision for small, flexible and person centred, community and homes-based support that focuses on people with complex and fluctuating support needs. We have joined a national initiative to help these small supports to become established and thrive in Hertfordhsire.
What are small supports?
Small supports are existing or emerging small organisations that;
- are passionate about providing creative and risk positive care and support.
- work with individuals and their families or carers, with complex and fluctuating needs as identified through the Transforming Care Agenda.
- create person centred care and support to allow individuals to live independently in their own community.
- will not support more than 3-5 people per year to enable them to remain small and retain their person centred approach.
Small supports are funded through the use of Individual Service Funds that allow for flexibility and control over how personal budgets are used to maximise enablement opportunities, enhancing independence, wellbeing and community engagement to meet agreed outcomes.
For an individual with support needs this means they are involved in choosing who supports them, where and who they live with and how their personal budget is spent to help meet outcomes.
For an organisation this means that you have freedom and autonomy over how care and support is delivered through individual service design. There is a real and sustained demand and that you are involved in creating positive impacts for the people you support. You are investing in and contributing to the local community and have flexibility over funding allowing for better planning.
Who might small supports be for?
We are considering small supports for people who would like to explore an alternative approach to funding their care and support which moves away from prescribed methods that do not allow for flexibility around their fluctuating needs.
In Hertfordshire this will initially be for people that fall under the Transforming Care Agenda, who may be living away from their local community, and lack choice and control over their lives and their care and support. The support will be aligned to our Connected Lives approach and be outcome focused. It will enable those with more complex needs to live independently in their own homes.
Are you interested in becoming a small supports provider?
Small supports providers will:
- have a background in providing or commissioning services, this includes people with lived experience and family members
- want the challenge and opportunities of setting up and leading their own organisation
- be viable and offer security to the people who use them
- are committed to human rights and promote diversity and equality
- remain small not growing by more than 3-5 people per year
- work in a person centred, outcome focused way, where service design is developed by the individual and their representatives, engaging their expertise as a partner in care
- be community focused, supporting people to reside where they choose and be a part of their community. Recruiting locally, where staff do not work across services.
- understand the needs of those using services and the daily challenges faced by them and their families and provide high quality, local support showing a commitment to continuous development
We understand that setting up a new small support organisation, or perhaps changing the direction of an existing small organisation, is challenging so we are keen to do what we can to help.
This help might include:
- Providing support and signposting to develop your organisation to enable you to deliver high quality care and support
- Connect you to existing small support organisations who can offer guidance and advice
- Support around Individual Service Design to ensure that you have the tools available to be a sustainable provider
Find out more about support on a smaller scale:
Beyond Limits
C-Change
Positive Support for You
You can also find out more about Transforming Care below:
NHS England – Homes not hospitals
Transforming care: Louise’s story
Get in touch
If you would like to know more about becoming a small support organisation please email us at ADS.Supportedliving@hertfordshire.gov.uk.