In this guest blog, Gary Laville, chief operating officer of MyLife’s Hartlepool support service for people with learning disabilities, reflects on how its progress since welcoming its first service user last September.
Four months ago, MyLife in Hartlepool was ready to go. Everyone who knew about our new approach was excited about the potential – we had specially-trained staff, a vision of what we wanted to achieve and six bungalows designed specifically to meet the needs of people with learning disabilities. But since then, we've had to prove ourselves to the people who use our services, their families, professional colleagues and commissioners.
The people who use our services have complex needs and often when they are referred to us they've been in and out of hospitals, had stints in shared accommodation that didn't work out, and, with the best will in the world, care with their families has been too demanding for all concerned.
In those four months, I believe we've seen how working in teams specially trained to view people holistically can break that cycle as the experiences of one of our team leaders showed.
For instance, a few weeks ago, one MyLife resident, Pete*, whose conditions include autism, began stripping naked, shouting and refusing to eat. He couldn't explain what was upsetting him.
From my years of experience in the sector, I know that, traditionally, his care worker, with no clear idea on how to address Peter’s distress, would likely have referred him to a psychiatrist who may have assumed his behaviour was caused by communication problems deriving from his autism, and would have intervened with new psychiatric treatment.
But thankfully Pete’s carers recognised that this behaviour didn't fit the normal pattern of his distress. Something else was up. And because we have an established relationship with Pete, we came to understand that his stripping off was because he had a painful stomach and felt that feeling fresh air on it eased the pain. So we organised a GP appointment for him and he was treated for bowel problems. His behaviour and health quickly improved, whereas a standard psychiatric approach would have likely focused on Pete’s behaviour while leaving his bowel condition untreated, leaving Pete more unhappy and unwell.
Another MyLife resident, Joe*, had shared a flat – run by another care provider – where he was frequently tormented by his housemates' boisterousness. Joe’s subsequent behaviour had been too challenging for his mother, and she ended up not visiting him for two years.
When he moved in with us we made sure he shared a bungalow with just one other – quiet – housemate. With the support of our team, he's markedly calmer and happier, and his family came to visit, complete with puppy, at Christmas.
But it's not just about the outcomes. Many longer-established providers work with service users in particular ways just because it’s 'just how it's always been done', even when frontline workers can see better, more practical solutions. Our teams have the training and support to be able to use their experience and judgement.
We also knew we needed to convince commissioners that our approach fits the joint social care and health commissioning model. It helps that Hartlepool's always been open to innovative models, but any commissioner wants clear, demonstrable outcomes.
Our initial assessment of every user leads to a set of aims tailored to their needs. These might be about ensuring their safety, their health, developing how they engage with the community, or building stronger family ties. In the case above, Joe’s improved family ties are clear.
So, four months later MyLife’s bungalows are occupied and we're starting to see the outcomes we hoped and worked for.
But we’re not complacent. Like any new service, we're improving how we put theory into practice. This process never stops.
MyLife was conceived as a response to the Winterbourne View scandal, Sir Stephen Bubb’s report Time For A Change, and the government’s Transforming Care programme as a novel way of integrating health and social care, and we think it is progressing in the right direction. I’m glad to say so do those who use our services.
*Names changed to protect confidentiality