Home For Good – Care Quality Commission

Care Quality Commission’s new report Home For Good highlights how community support, as opposed to secure hospital admissions, can be successful and greatly beneficial for individuals with a learning disability, autism and mental health need. Community support can be a complicated and lengthy process, especially if the individual has additional mental health needs. Success is dependent on a collaborative effort by multiple agencies working with the service users and their families.

In CQC’s report, the provider organisations Avenues, Certitude, Choice Support and Future Directions contributed community support success stories about eight individuals, all of whom had previously been placed in secure hospital settings, often called assessment and treatment units. You can read the stories here. After varying years in hospital settings, all of these individuals now have a much higher-quality of life due to the community support they’ve received. This success cannot be explained by just a single care and support model and although each story is different, they share similarities. Each individual’s community support journey includes characteristics which need to be utilised in community support services so they can reach their full potential:

• Services must be bespoke and truly person-centred. This ensures that the individual is understood and the actions are in accordance with their wants and needs.
• Agencies should work collaboratively. Providers should work closely with clinical and health experts, as well as community teams that include occupational, speech and language therapists. This must occur both during service planning and once the service support starts.
• Suitable housing and environments are essential. Properties may need to be specially built to meet the wants and needs of the service users, whilst other properties may need to be significantly adapted.  
• When individuals are labelled as having ‘challenging behaviour’ – including self-harm and physical or verbal aggression – this should be understood as communication of distress or need. This understanding often comes through a formal adoption of the Positive Behaviour Support approach.
• Family involvement in all aspects of service planning and delivery increases the chance of a successful outcome. This usually involves the support being close to the individual’s family home.

The most important thing is that the person being supported is always at the centre of the support. They will be heard, and their challenging behaviour, which may or may not continue, will be recognised as a form of distress communication. It is the provider’s responsibility to ensure that the communication is understood and responded to appropriately. 

There is no quick fix provided by any support service. It takes a lot of time, planning, and resources to create the right community support, and it must be constantly adapted and maintained as people change and adapt. If the care and support package is person-centred from the start and time and effort has been put into planning and implementing it, it is more likely to be successful and suitable for the individual, resulting in a more enjoyable and fulfilling life.