There are lots of on-going discussions about what we all need to do to bring loved ones home from Assessment and Treatment Units far from home and to give these vulnerable individuals the same rights as anyone else to live in their own communities. Here are my own simple suggestions inspired by our brilliant #LBBill. I feel these are practical steps which can be achieved in a relatively short space of time.
1. Introduce a simple framework introducing some basic legal rights for the individual, (and parents/carers), which gives them a right to live in their own community and rights for parents and carers to challenge significant decisions made.
2. Stop using cost as the prime motivator. People with complex needs require an appropriate quantity and quality of support. Anything less is likely to cost more in the long run anyway and cause avoidable distress through poor care, neglect or abuse. Qualified and motivated staff are essential, minimum wage is not appropriate.
3. Once a support package has been agreed ring fence the allocated index-linked funding and identify key people who are responsible for delivering the care. Make them legally responsible whether in the public or private sector. There must be no hiding place for anyone in a position of authority.
4.Allow professionals to work together and share best practice in treating the causes of difficulty rather than the symptoms meaning that for all bar a handful hopefully a chemical cosh will not be the answer. Professionals involved should all be judged upon the difference they make to a person’s quality of life that they are helping to nurture. Evidence being sought in the usual ways.
5. Tell private investors to SOD OFF. We are not sheep or widgets that you can herd about or warehouse for maximum profit we don’t want you anywhere near our vulnerable relatives.
Many of us know that fixing this broken and inhumane system is not difficult. What is difficult is culture change and in-fighting about budgets. I think what we need are small, multi-disciplinary teams working with just one budget and one leader fully accountable for making the above a reality. Unless people work together we will never get anywhere and without appropriate and effective steps like these failures will continue in the community settings.
Above everything else we all need to get behind the #LBBill and help promote appropriate person-centred, quality care in the community for everyone with complex needs.
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Very good blog Ian. Makes perfect sense
Bravo Ian. I hope ‘they’ listen
Very much agree – I think people with very complex needs should have a new system of funding based on a National Annuity scheme that allows people to have real choice and control and professionals to support good practice instead of trying to invent inadequate responses based on inadequate budgets. It should be based on the current personal injury formulae, with budgets reviewed every 10 years unless there is a significant change in need. Good lives with a strong emphasis on human rights should be expected outcomes.
Local Authorities cannot provide this funding – they have no way of raising local finances without an expensive consultation and their budgets have been destroyed. A National Annuity scheme would provide stable budgets for people to plan and have real choice and control to purchase the care and support they need to live full lives.
Who would pay for the insurance? Hospitals who have poor maternity or other relevant safety records would pay more. LA’s with poor public health records would pay more – organisations and businesses that contribute to preventable causes – eg tobacco and alcohol companies etc. Joe Smith the public – as we all need to take care of our communities human rights.
It would encourage a positive approach in children’s services to support people to strive for independence to keep the costs reasonable in adult services. It would stop the post code lottery, the constant reassessments to fit new budgets – needs are assessed according to budget – read McDonald V Kensington and Chelsea. It would put people and families in charge.
Helen
You would think it should be simple…