Mental health services join the ISF pilot

Hirila with Michael at Fanon House

Hirila Anaughe is a Supported Living Manager and is overseeing the Individual Service Fund pilot in two residential registered mental health services in Lambeth.

We started this process about six months after the learning disability directorate started theirs, so we are in a position to learn from their approach. We have started by using the Care Fund Calculator (CFC) to help us assess how support is currently being provided to people. It’s important to be accurate in measuring how we spend our time to ensure we can properly identify a person’s “in my control” hours. We defined these hours as one to one hours in which the person being supported could change the purpose of and had maximum choice and control over .

The CFC is a desk top exercise. We made good initial estimates about people’s hours in the first instance but we are still making adjustments. As a final check we are currently accounting for every half hour of our time over a four week period. To be honest it’s been a cumbersome process but worthwhile; I’m confident that this will give us the best possible measurement.

Once we have the CFCs sorted our next step is planning with people and we’re looking at how we can do this in a way which best suits the people we support. We have had informal discussions with people and it’s become clear that they aren’t interested in a group planning approach such as *Planning Live, so we’re going to take a more individualised approach. We’ve identified a couple of excellent facilitators who are having extra training so we hope to be ready to move on this in the New Year.

One of the most obvious benefits of the detailed person-centred approach required for the ISF pilot is how we talk to individuals – both in the questions we ask, and how we ask them. We are shifting the emphasis away from it all being about managing risk and giving people more opportunities to do what they really want to do.

Many staff have really embraced this approach – particularly managers. For some, however, it has been more difficult. Staff inevitably build up close relationships with the people they support and I understand that they want to protect them, but I think we have to let people explore more options. Everyone should have the opportunity to learn from their experiences, both good and bad.

It can be challenging when we are working with people who find it difficult to identify what they want to do. Many of the people we support have spent their lives being told what to do by doctors and social workers. They aren’t used to being asked for their opinion and so they aren’t sure how to express it. Fortunately as a team we have had a lot of person-centred training so we are well equipped with the tools we need to help people find their voice.

Day to day we are already seeing the benefits of being more person-centred. We are working with eight people within the ISF pilot but I have changed my approach in all the services I manage and I am encouraging my staff to do the same. We are changing shift patterns to give people more choice about who supports them and we are doing our best to put them at the centre of decisions which affect their lives.

I have been really pleased to have been involved; I’ve learned a lot and I can see the change we are making. If I were doing it again I would have liked more time for team meetings to get everyone together at the same time. There is a lot of support to be gained from hearing about other people’s experiences – both positive and negative. Implementing something new like this can sometimes feel hard and isolating but when you feel you are all in it together it can make a big difference.

*Planning Live is the process of getting the individuals, families and staff together to gather information and plan. Planning Live balances sharing information and examples with the whole group with working in small teams around each individual.