Personal Experiences of Putting People First: South West

Rob has a history of schizophrenia. This case study shares how he uses personalisation money to develop social skills. We also hear from Ahmed, who talks about Rob's supported accomodation.

Rob's story

I am Rob, a 59 year old man living in a supported housing accommodation where I have got my own flat with 24 hour support. My family is very important to me; I have two sons and a daughter, and although divorced, I also maintain a good relationship with my ex-wife.

I am suffering from a long standing history of schizophrenia characterised by auditory hallucinations. As a result, I have been taking medications prescribed by my psychiatrist for a long time. Sometimes I feel very tired because of the medication. The downside about my life is sometimes I feel pressurized by simple events and I can become very anxious, which is detrimental for my health.

Previously I used to be a heavy drinker and smoke 20 cigarettes a day, but now I have completely stopped smoking and reduced my alcohol intake.

Nowadays, not only I am working for three days a week at Working Well (Access) but I am also attending various workshops in the borough on mental health and other subjects. Additionally, I am always involved in the activities provided by the house where I live. About a year ago I used to do IT training at Weavers-up-link, however the project has closed down.

My interests are very diverse. I like doing printing work, music, watching TV, using the internet and visiting London landmarks, such as the London Dungeons or Madam Tussauds. I enjoy going out doing activities with my ex-wife, I also like to go to the cinema and theatre. Radios fascinate me. I have got more than 30 models in my flat. In the morning I enjoy waking up and listening to the radio with a cuppa. Finally, my favourite colour is yellow!

Thanks to the Personalisation money, I have been able to do more activities which have helped me to feel more confident and develop my social skills. This means that I have been feeling less lonely. It has been also very pleasurable as a man and a father to be able to invite out my ex-wife and other family members.

Ahmed's Story: Look Ahead Housing and Care

Look Ahead is an organisation providing housing and care for people of all ages in London and the South East with support needs ranging from homelessness to mental health issues. Look Ahead's mission is to enable those with particular needs to live ordinary lives within the community.

I have been working as a project support Worker for ten years with Look Ahead Housing and Care; in a Supported accommodation Scheme for Mental Health Customers with Medium to High support needs. A lot has changed in the way support has been delivered over the years, with changes in legislation and local procedures.

Very recently the Personalisation scheme, which is a process of promoting customer choice, independence, inclusion and empowerment, has given us the opportunity to pilot the personalisation scheme for the Borough of Tower Hamlets.

I am the key worker for Rob, who has been diagnosed with Schizophrenia. Rob experiences auditory and visual hallucinations which disrupt his thoughts, hence having difficulty concentrating on anything.

Rob was initially referred to our service by his Community Mental Health Team, whilst in hospital (under section three of the mental health act). Rob had a history of non-compliance with medication which was a major trigger for his relapse, accompanied with alcohol abuse and chain smoking. Rob's smoking habit led to a series of physical health issues. He isolated himself a lot due to lack of confidence to socialise or interact with others.

I initially drafted a holistic support plan with Rob, taking into account his needs and ensuring that the plan was person centred. I was constantly prompting, monitoring and supporting, not to mention sign posting to relevant agencies for professional help with his various issues - such as smoking and alcohol abuse.

I am happy to say that Rob was able to pull through all of the above, due to constant support from all the staff team at the Project. He now engages in voluntary work, actively participates in the personalisation scheme, has stopped smoking through various sessions with the NHS smoking groups, and has reduced drinking through engagement with AA agency and he now complies with medication unsupported.

Rob has become one of the role models of personalisation, as he is one of the customer representatives on the panel. Rob is very excited about personalisation which has given him a sense of empowerment and control over his finance and support.

Rob is moving into independent living in the community and I wish him all the best in the future.

Ahmed'sTOP TIP

"The trial has generated a huge amount of learning for all those involved, and as with any such venture, the path has not always been smooth. Indeed, shifting the power balance demands a lot from commissioners, providers and customers, however it is ultimately a challenge worth taking. "

The Coventry Road Pilot: Personalising an accommodation based mental health block contract

The Coventry Road service, in the London Borough of Tower Hamlets, offers high level mental health support for twenty customers. Each individual lives in a self-contained flat owned and managed by Look Ahead and customers are referred into the project by local Community Mental Health Teams; all customers have severe and enduring mental health needs and are subject to the Care Programme Approach (CPA).

Staff are on site 24 hours a day, and the intended maximum stay is two years, although several have been living at Coventry Road for longer. Customers are mixed in gender, age, ethnicity and background. The full staff team complement is ten support workers, one assistant service manager and one service manager. The service is jointly funded by Supporting People and the Primary Care Trust.

The name core and flexi refers to the way that resources are reallocated to maximise customer control. The core comprises those elements of the service required to provide the level of safety and security needed, to implement any statutory duties and provide the capacity to respond to crises, deal with unplanned events and provide routine support. The proportion of total contract value assigned to core is just under three-quarters. Staff shifts for core delivery are planned into the rota as usual to ensure cover, and all staff members are expected to deliver core support in a way that recognises the self-determination of customers.

The flexi element, constituting just over one-quarter of total contract value, is split into one to one individual support time and a cash allocation for each customer which they use to purchase their own support. What constitutes support is interpreted broadly, as long as it is legal, affordable and practical, and it meets the customer's assessed and eligible needs.

The pilot has been testing the Core and Flexi model since July 2009 and it ends in March 2010. Look Ahead Housing and Care is proud to have led on this innovative personalisation trial in partnership with the London Borough of Tower Hamlets. We acknowledge the potential challenges associated with personalisation, but we fully support the underlying principles which provide customers with greater choice and ultimately greater control over their lives and the support they receive

Whilst user involvement has provided customers with opportunities to input and shape the services they receive, the personalisation agenda takes this one step further by actually allowing them to act as active agents within the social care market.

LINK:
http://www.lookahead.org.uk/default.aspx?CATID=6303

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