Why policies, procedures and best practice learning matter in supported living services

Dementia Care
April 11, 2022

 To mark World Social Work Day, I want to devote this week’s column exclusively to supported living. It is a sector that is so often forgotten about when we talk about social care, and it is also one that that continues to be grossly misunderstood.

Many people – both inside and outside of the social care sector – confuse supported living with residential care. They are not the same. The key difference is that people living in a care home receive both their accommodation and care in one single package. Supported living services, however, are different. Individual are tenants and are given much greater autonomy and independence to live their life in the way they want, while at the same time being able to benefit from a dedicated support bubble, which includes support workers and friends and family too. [i]

HMO is not supported living

There has also been some confusion surrounding supported living services and services provided by Houses in Multiple Occupation landlords (HMO). The two are related but are very different in what they deliver. Often, however, the media place HMO under the same banner as supported living services. With there being very little regulation attached to HMO compared to supported living services, the sector has come under the media spotlight recently.

But I don’t want to use this slot to focus on the weaknesses and flaws in HMO that have been exposed by the media. For me, as serious as they are, they don’t define the supported living sector. What those reports do, however, is unfairly tarnish Supported Living services. By not highlighting the fantastic person-centred support exhibited by support workers every single day, these media reports give the general public a distorted and false picture of the sector.

Supported living services embrace regulation and best practice

The Supported Living sector that I know – and the one that the majority of health and social care professionals know – is very different. Not only are services steeped in regulation and best practice – often meeting the high standards set out by the CQC, and the Real Tenancy Test and REACH standards (if supporting individuals with a learning disability or Autism), the sector is transformative. It is empowering and it changes lives for the better. It is a sector full of possibilities – where individuals are empowered to live the life they choose, with like-minded people, in a setting appropriate to their needs, further strengthened by a circle of support.

Take the experience of 29-year old Bryn, for example, a newly qualified social worker in Supported Living services at Portsmouth City Council. To celebrate World Social Work Day, in just a few sentences he captured the very essence of what it means to work in supported living services.

“One experience will always stay with me,” he wrote. “I supported a young person to get involved in a music studio, as they love rap music and write their own lyrics, I supported the young person to attend the sessions and it was amazing to see them feel inspired and engaged in something they love. I love these type of moments – they really stand out for me and reaffirm why I chose this job.” [ii]

Supported living services’ umbrella is wide and inclusive

The real privilege, however, is to be given a unique opportunity to support people of different ages with diverse and sometimes highly complex needs. The umbrella of supported living services provides hundreds of thousands of people, in the government’s words, with “a safe, stable and supportive place to live”.

But ensuring this is the case is easier said than done. It requires teams to embrace a person-centred culture of best practice learning, which ultimately reflects in the support plans they produce. Quality Compliance Systems, (QCS), the leading provider of content, guidance and standards for the social care sector, and the organisation that I work for, has developed a suite of policies for the supported living sector. In addition to creating its own content, QCS has also gathered together Accessible information tools such as ‘Recite Me’. This enables support staff to convert all of the QCS resources into accessible formats for those with communication needs including a range of language options.

QCS, however, recognises the vast challenges that those working in this highly nuanced sector continue to face and the level of support and care that individuals need to fully embrace independent living. Over the course of the last year, QCS has added to its supported living service policy suite and has recently launched a newly improved product in April. More information can be found here.

Care and support plans

QCS also provides care and support plans, which are at the heart of everything a supported living team does. They should identify each person’s individual support needs, likes, dislikes and preferences. The plans should reflect the life they choose to live and want by building a robust circle of support around them that aims to help them achieve life goals and aspirations. That requires an exceptionally detailed plan that is deeply-rooted in compatibility. What do I mean by this? Well, when writing a support plan or any risk plan, support workers in supported living need to not just focus on an individual’s needs but also factor in how they are likely to fit in with the rest of the group. A support plan must also help them plot a path to seamless integration into the community.

The right to choose

Supporting individuals to choose where, and who they live with, is another inalienable right that anybody accessing supported living services should enjoy. For example, placing a 50-year old man, presenting with substance misuse issues, with three young men, who are autistic, would not be a good idea. So, supported living services have the added challenge of ensuring that the living environment is not only safe and secure, but that a collective harmony prevails in the home for all who live and work there. It is absolutely vital that providers and support workers pay close attention to compatibility, because unlike you and me, those in supported living services cannot suddenly decide to move out of their accommodation if they are not happy with other tenants/service users.

There is a difference between ‘care’ and ‘support’

Person-centred plans should also demonstrate that a Supported Living service understands the difference between what it means to care for a person and what it means to support them with outcome and independence-focused goals. Many in the sector are so fixated in ensuring that those accessing services live independently in the community that they forget that people still have identified support needs. In my opinion, as a sector, we really shouldn’t be afraid of highlighting those needs. They don’t present a barrier to independent living and they never should. Supporting someone to pay a bill for the first time with money they have withdrawn from the bank, for example, is not only the right thing to do, it also makes the role of a supported living worker rewarding in itself.

At the opposite extreme, there is sometimes a danger that the culture in a supported living service becomes too paternalistic. By this I mean, some workers forget the residents they support live largely independent lives and begin to make decisions on their behalf, or influence their decision-making. Professional staff may think that intervening has saved an individual from avoiding a potentially bad situation, but Under Principle three of the Mental Capacity Act, everyone has the right to make unwise decisions. In not giving those they support the autonomy or authority to make such a decision, the supported living service worker is actually depriving the person of a chance to learn from an experience or an activity that we take for granted as part of our own lifestyles. We have all made unwise decisions, but most of the time, we go on to learn from our mistakes. Why shouldn’t those residing in supported living services be given the same opportunity?

Letting go and allowing a person to take risks and learn from their mistakes is as fundamental a part of the supported living service experience as is mentoring a person to find their niche in life. On the week in which we mark World Social Work Day, not only should we celebrate the unheralded achievements of supported living service workers, and those who live and thrive as fully-fledged members of a community support, but also the best practice learning, which, when used correctly, provides a gateway to independence and better outcomes.

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