In this guest blog, James Allen, managing director of Consensus, considers how independent learning disability service providers can embrace fast track change and navigate the complex landscape of care, following the publication of the national plan.
The national plan to develop community services and close inpatient facilities for people with a learning disability – ‘Homes not Hospitals’ – acknowledges an important point. There are already thousands of people with a learning disability and/or autism who are supported in the community but would years ago have lived in hospitals.
To follow the examples of the fast track areas will require independent sector providers to step up to the challenge. They will need to evidence the good practice they have initiated to make further progress and change the lives of those who remain in hospital. This is at a time when funding and recruitment challenges can stretch the determination of even the most ambitious of us.
Successful independent sector learning disability providers thrive on change. They also welcome challenge. Post-Winterbourne, the independent sector still faces a monumental challenge to restore public confidence in what it does. Without it, fast track change will not be possible.
Change can be complicated. It will come at a significant financial cost – challenging providers already having to share the financial pressures of austerity. Change is also complex; indeed, there should be real concern about the resilience of some smaller providers. They may be delivering the highest levels of quality, but now face unprecedented financial demands and risks as they seek to engage in the transformation agenda.
The sector, whether commissioning or providing, ignores this reality at its peril and failure to understand these risks from each other’s perspective will create further barriers to progress.
At Consensus therefore, we have moved beyond thinking that building the right support is complicated to considering it as complex. Our view is that change in our sector is no longer linear. Therefore, our efforts are not about simply the relationship between the closing of large institutions in favour of smaller community services. It is not about straightforward recruitment and retention of staff from local areas and it is not about delivering change with little or no interest from the public at large.
Change today requires us to revisit and refocus a complex network of already developed services. We need to create systems within communities that are able to support individuals with some of the most complex needs. We need to build a resilient workforce, equipped with skills and a strong value base. We have to create confidence within communities that we can manage risk safely.
But the complexity we now face comes from a number of further, wider-reaching macro factors that are outside of our control, the impact of which we cannot be certain. Our ability to effect fast track change depends upon how well we respond to these factors.
There have always been financial pressures within the sector but austerity continues to cast a huge shadow. This shadow may widen post-Brexit. Finding funding solutions to support change is now increasingly complex and uncertain. The uncertainty around the future of local housing allowance levels, for example, will impact heavily on our ability to deliver housing solutions – a key element of the national plan. The extent of further increases in the national living wage are still unclear and completely out of providers’ control. These are complex issues for any provider to manage as they try to model and plan new services and investment.
Our workforce is now more transient than ever before. Employers from all sectors are now finding more creative ways to reach out to potential recruits. Good employers invest in learning and development and work hard to deliver new initiatives such as the Care Certificate and career ladders. Frustratingly, others just poach. Equally for many, working in our sector is now often seen as a springboard to other more formal career opportunities such as nursing or social work.
As an organisation with a national remit Consensus has been privileged to be able to be involved in shaping new service solutions. We have been encouraged by commissioning attitudes and cultures in line with our own that respond effectively to complexity by seeing transforming care as something other than a ‘one-size-fits-all’ plan. To deliver fast track change we need to focus on a progressive, person-centred model for individuals, supporting opportunity, choice and success in the most appropriate setting.
Our view at Consensus is that change is possible and we have committed significant resource to support local fast track initiatives across the country. We have provided the solutions required in bespoke residential and supported living services. Underpinned by a strong purpose and goal, supported by a clearly understood set of values and expected approach we are managing the complexities we face.
We look forward with enthusiasm to help deliver further change to support the complex national agenda. Lessons will be learnt along the way. These will challenge us to re-engineer, re-shape and re-focus what we do even further.
Part of the Caring Homes Group, Consensus was established in 2005 to provide specialist support to adults with learning disabilities and complex needs. Consensus is a family-owned service provider supporting more than 530 individuals in over 90 services across England, Wales and Scotland.