Working Together For Change WORKING TOGETHER FOR CHANGE TRACK 1 INTRODUCTION

Audio Transcript

This is a report about meetings and workshops with users of Norfolk County Councils In House Day Services for people with learning difficulties. If you have any difficulty understanding this report, please phone Alys Duberley on 01603 481146. Alternatively, you can Email Alys on alys.duberley@norfolk.gov.uk. Alys is spelt A-L-Y-S and Duberly is spelt D-U-BE-R-L-E-Y. This report was completed as part of the Learning Difficulties Day Activities Support Project. The project was set up to look at the future of Norfolk County Councils In House day services. We made sure that the full range of people who use the In House day services were involved in the project and had a chance to give their views. We worked with a random sample group of 150 people, two thirds of which was made up of people with more complex needs. People with complex needs make up the majority of users of our day services and many have found it difficult to speak up for themselves in past consultations. We used a team of person centred review facilitators and independent advocates to find out what you thought of the service provided. What is working? What isnt working? And what is important to you about the future of your day service? TRACK 2 ANSWERING THE QUESTIONS How were people helped to answer the questions? First of all, each of the 150 people had an individual assessment to work out what would be the best way of supporting them. Communication workers were involved in this to help us understand how we could enable people who do not use speech to give their own answers to the questions. Depending on the results of this assessment, our users then took part in either an advocacy group or a circle of support. Advocacy groups were held for people who were able to answer the questions independently. We held a group session for the self advocates in each day centre, supported by a tutor from Adult Education, to give people an opportunity to think about the questions and begin to come up with their own ideas. After the group session, people had the chance to spend some time with the advocate in private to decide what their final answers would be.
KEY: BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

Their ideas were then displayed clearly and sorted into the categories of things that are working, things that are not working, and things that are important for the future. For those that did not have the level of understanding or the communication skills needed to answer the questions for themselves, we set up a circle of support. The circle of support used some of the principles of person centred planning to make sure that these people had the same opportunity to participate as those who can speak for themselves. A facilitator put together a circle of support, made up of friends, family and support staff who know the person well in all areas of their life. This circle was invited to meet with the person and their facilitator, where they helped to answer the questions based on their shared knowledge of that person. One such service user was Michelle, who invited two of her favourite support staff to visit her house, along with a friend, her mum, her sister and her niece. They all had a drink and talked about what Michelles answers to the three questions should be. After answering the questions, they talked about what they could do straight away to make Michelles service better for her. As a result of the meeting, Michelle has already made some changes to her activities and to the days and times she is supported. Michelles mum said that the meeting was very helpful and that it is good for everyone to work together to make Michelles life happier. Michelle really enjoyed having everyone over to her house and her circle are going to carry on meeting regularly. What was the next step? TRACK 3 WORKSHOP DAYS Once all of the 150 responses were collected we had 5 workshop days with people who use the service and family carers, working alongside day service staff and other professionals who had been involved with the project. People at the workshops put the responses into groups to work out what the big messages people had given us were and then came up with suggestions about the root causes of the things people said were not working and how services should look in the future based on the aspirations of people who use them. The rest of this recording brings together the results of the 5 workshops.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change I like gardening with John I like sitting in the snooker area with friends I wish we had internet access Id like to be able to go out in the evenings

Audio Transcript

We put together all of the answers from across the whole county to find out the biggest things that people were saying. You can find out more about what people said in each area of Norfolk by listening to track 6. What did people say was working about their day services? 142 people said that they enjoy a good variety of things to do, both building based and in the community. 84 people said that they like having the chance to see people and to form relationships. 70 people praised the amount off staff that know them and understand their needs. 13 people like to have a routine so that they know what is happening. 24 people said that like to be supported in making choices. 25 people like learning new skills to do things for themselves. 54 people commented that the services provide a safe, familiar base with specialised equipment. 7 people said that they like to be supported to travel in different ways. And what did people say was not working, or needed to change in the future? People came up with a variety of comments about what they would like to see change about their day services. We will shortly be looking at those comments in more detail.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

We asked people who came to the workshops to vote on the statements that they felt were the most important. Next we asked them to come up with answers to three questions, based on the statements with the most votes. What are the root causes of whats not working? What would success look like, and how can we get there? The next part of this report is about the answers people gave us to these questions and the biggest ideas people came up with for the future. TRACK 4 THE BIG IDEAS I dont like the people Im grouped with and I miss old friends who have moved on 48 people agreed with this. They pointed out that day services are traditionally about activities not relationships. People are grouped based on what they want to do and not who they want to spend time with. Staff try to keep people busy all of the time, but just seeing friends is not seen as a good reason for a persons service. I like seeing people friendships and relationships are important to me This was an opinion shared by 25 people, who believe that seeing friends, meeting people and having relationships should be seen as a good reason for a service. There has been lots of work to get people who use the day service out into the community, but this should be a two way process. People from outside the service should be invited in to the day centres more often to give families and community members more chances to mix socially with people who use the service. This would give everyone time to get to know each other and help create networks of support that are bigger than the paid staff team. The building is old and not nice, sometimes it is too noisy and busy 36 people said that day centres were built to provide pseudo employment for more able people and training for work skills in the disability model. The buildings havent been or cant be adapted to their current needs.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

I want a base that suits my needs & wishes, a safe place where I can be myself & have access to a variety of specialist services 40 people shared this view. Some people with complex needs have very specific requirements and need a lot of their support provided all on one site. It would be good to have space for specialist input from other professionals and to share these sites with other organisations and community groups. This would share costs, avoid segregation and create opportunities and a vibrant atmosphere. Joint working with other groups would enable longer opening hours so a service could be provided during evenings and weekends. Partnership opportunities with other organisations, for example Kings Lynn and Parkview, would share costs. It would be good to be able to see your Care Manager, Physiotherapist or Community Nurse at the day service. More community facilities should be accessible as people need suitable places in the community to spend time. There should be better links with local planning to make sure that this is happening. Some people would like to have smaller, welcoming bases closer to home, with private space for people who need time alone. If people are to mix and match between different bases depending on what is on offer, there would need to be a system of accessible transport links to the community. Public transport is not always viable without higher support levels. Lots of building based activities have stopped & I dont always like the things I have to do now 66 People felt that this was a problem. People dont want to be stuck in a building, so there has been more focus on outside activities. These need more staff support, and so the people left in the building end up with less support. As a result there are less building based activities than there used to be. The service usually runs in the daytime during the week. However, most community activities run during evenings and weekends so there isnt a wide range of outside activities for people to access. Many people who use the service have had limited experiences, so dont always come up with their own ideas for new activities. Information about community events and activities isnt produced in an accessible format and can be difficult to find, meaning that people, their families and staff dont know whats available, especially outside of the day centre. In house sessions are not always interesting and the staff that lead them dont always have the right skills for the sessions that they are asked to provide. Some groups are too small to be fun or are not with friends. This can happen if not enough people in the day centre are interested in the same things.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

I would like a better choice of activities so I can have fun, learn skills and try new things 94 people suggested there could be a more flexible range of mix and match opportunities. There needs to be a system where activities provided are based on the plans people have made, rather than peoples plans being based on the activities on offer. We can make better use of third sector, families, home staff and volunteers to increase the activities on offer, with added help from outside Council staff teams. We could be better at using staff talents in specialist areas, for example using a trained artist on the staff team setting up the Art Waves project at Norwich Day Services. There needs to be a better system to match what people want with what we offer and provide staff support where it is needed most. Floating members of staff should be available for 1 to 1 support when and where needed, especially setting up new activities in partnership with volunteers and outside agencies. Theres no work, I miss the money and my friends 19 people said that the lack of work is a negative issue for them. The economy has changed, and opportunities have been reduced. The switch from a manufacturing to a service economy means there are less routine manual jobs available than in the past. We dont have a dedicated department to develop work opportunities & mainstream departments like the job centre dont see it as their job to support people with learning difficulties. We removed the skill building workshops that used to be in the day services and these havent been replaced with anything similar to enable people to feel valued useful. Should the question be about people being given a chance to work or about individuals and communities creating their own opportunities for work? We have disempowered people from creating their own opportunities and sorting things out themselves by making employment into a specialist subject that only an expert can deal with. Individuals and their support networks (including families) need to be the driving force behind finding solutions. I want to work, paid or voluntary, I want to be valued 32 people shared this opinion. We have an employment project running at the moment which is looking at what support we can provide to anyone with a social care need to enter paid employment. We should use the skills of people who use the service to interact on an equal basis with other members of the local community, in order to make friends, have a valued role and a sense of responsibility.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

We should set up community volunteering groups, to help people who use the service and members of the local community to swap skills. This would mean that people with learning difficulties would feel valued and equal. An example would be starting a community gardening club, open to local residents, using some of the on site facilities like greenhouses. Everyone could pay a small fee to provide the start up costs. There would then be an exchange system, where service users volunteer to help out in their local area and ask others from the local area to join the club to provide support and take part in a plant and equipment sharing scheme. I dont get enough support to do the things I like, including evenings and weekends 43 people said that they feel this way. This message is not coming from people who have 1 to 1 support, but rather from people who are supported in groups. Have we concentrated too much on giving full time 1 to 1 support to the lucky few at the expense of the rest of the service users? All of the emphasis on providing peoples support is on paid staff. We dont often use other kinds of support for people, such as peer support, families, friends and volunteers, which means there isnt enough staff support to go around. Appropriate transport for groups isnt always available. It is hard to be flexible when specialist transport is only available for certain time periods during the day. Taxis are expensive and public transport is not always available in rural areas, accessible for people with physical disabilities, or possible because of the higher staffing ratios needed to support people to travel in this way. Not everyone who uses the service wants flexible hours. Many people prefer to be supported between 9 and 3, and so it can be hard to coordinate out of hours working. We dont have a clear picture of who wants what and what should be provided by other services such as residential homes. Many existing staff chose to work in day services because the hours fit around other commitments. Our existing staff are not all able to support evening and weekend activities. Staff and managers are not always confident to introduce new ideas and new ways of working. I want more flexible support to do things I want at times that suit me, including evenings and weekends We need a better way of coordinating services and localities. We could link up people with similar interests and organise a combination of staff, voluntary and family support, to provide more flexible opportunities. We could use funding to respond more to individual needs. Staff, family and service users should be jointly able to choose when and how this is used in their area.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

A system should be used to map out who wants what, who can provide it and who can run it, linking up individual needs and skills to create shared opportunities across the community/ locality. I dont like the way I am supported, I dont have a choice about who supports me and how People who cant use speech and have not been provided with another way of communicating find it difficult to tell us how they want to be supported. This means decisions are being made for them and not with them. One person, who may not know the individual that well, usually writes their support plan. Families, friends and staff from other parts of life are not involved, meaning we get a one sided view of the persons support needs. Support plans are not user friendly, they are complicated and do not tell you the important things you need to know at a glance. Staff cant support people in the right way if they dont get the right information. We dont have plans that are outcome-focused, forward-looking and future sensitive. We dont know what the person who uses the service wants out of their life. This could be as simple as being able to meet friends or as ambitious as holding down a full time job. Some staff may be resistant to new ideas which means people get what theyve always had instead of being asked what they want. There are no overlaps between staff leaving and new staff starting, so there is not enough time to get to know people. I want more skilled support, especially with communication so I can choose what I want 50 people identified this as something that needs to change in the future. The Total Communication team needs to be protected and communication training should be more widely available. Training in alternative communication methods should be mandatory for all staff and part of the induction process. Time must be provided for the creation and updating of communication profiles, together with service users home and family so that everyone is working together. Person-centred day service plans need to be created and enhanced with a my life book for each person as part of a regular person centred day service review. These can be written by a circle of support and overseen by a professional such as the service users Speech and Language Therapist or Care Manager.

KEY:

BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

Key workers & co key workers, provide a clear, obvious point of contact for service users, families and carers, especially when people have time to get to know each other. There should be a clear key worker system and key workers should not be changed without good reason. We need better links between different providers, including residential, supported living and in house providers to rid us of the them and us attitude. This can be achieved by closer joint working, including regular circle of support meetings with each individual I dont like my routine or staff being changed, especially without an explanation 44 people mentioned this problem. Those who shout the loudest, get the most and this is a problem we have not yet been able to tackle. People and families who make a fuss get more regular staff and those who dont complain are sometimes forgotten. Staff dont explain changes enough as often theyre too busy trying to implement those changes. Things are not always explained to people in the right way and people who do not use speech cannot be told what is happening verbally. The added problem here is that staff dont always have the right resources or skills to tell them in other ways. Peoples families or home staff are not always told if things have changed and this means they cannot pass on the details to the service user. The groups felt that this problem will never go away completely but the root cause is communication, and this can be made much better. I need routine & continuity with staff I know and trust to support me, changes should be slow, I need time to adjust 62 people shared this view. We need more shadowing of experienced staff by new starters and more sharing of knowledge between old and new staff. It is important to check regularly about changes that are wanted or needed, but not to make unnecessary changes without asking the person or, if appropriate, their family and home staff. We need to communicate changes to everyone in a way they understand and, where possible, give people time to adjust before making changes. People in my life dont talk to each other, or to me in a way I understand; this means I dont have a way to speak up for myself 26 people think that we concentrate too much on those that can speak for themselves, and must remember that not everyone can do this - especially people with complex needs. Communication is not part of mandatory training as it is not seen as important enough. Not enough staff, families and service users access specialist communication training such as sign along. Suitable communication methods are not being used, lots of people cannot use speech
KEY: BLACK Louise RED TOM BLUE SCOTT

Working Together For Change

Audio Transcript

and we dont provide enough alternative communication methods. Communication books are not always filled in, communication passports and profiles are not high priority and there are not enough chances for in depth communication, especially between families and the service. The Total Communication team has been scaled back - we have three communication development workers for the whole county, and this is not enough. We have lost the informal communication and networking that used to happen during group social gatherings, meaning that staff from different services dont talk to each other enough. People are sometimes territorial about the part of the persons life they are responsible for. I want people in my life to talk to me and each other in a way I understand. I want more circle of support meetings, so I can speak up for myself and plan for the future This was a view shared by 24 people. The biggest message given to us at the workshops is to put the main focus onto person-centred planning. People said that their circle of support meetings were very positive and helpful. Planning does not happen well for people at the moment. Forward planning is currently looked at within an annual review and this is not regular enough. Although this review is ably led by their care manager, there is limited time for future planning and not enough input from their support worker or family. People want support from day services to plan their future, work on choosing and developing activities and improving joint working between all areas of support the individual has in their life. Forward planning can help us become an outcome focused service. I cant always get to where I want to go, in transport that suits my needs 27 people had this opinion. Mobility cars are not always available for people to use at day services if they are also the family car. Some peoples mobility allowance is tied to residential home transport. We have less in-house transport and drivers than we used to have and our fleet transport is only being used for the morning and afternoon run in and out of the day service building. Our minibuses dont have flexible drop off times and this impacts on the service timetable. Public transport is not always accessible. There are no lowering floors on some buses and no space for a wheelchair if a buggy is on board. Some buildings are not on a bus route and bus timetables dont match our service hours. Staffing ratios are not high enough to support people to use public transport.

KEY:

BLACK Louise RED TOM BLUE SCOTT

10

Working Together For Change

Audio Transcript

I want to be able to get where I want to go, in a way that suits me 19 people said that this is something they would like improved in the future. Titan training should be continued so people who are able to are supported to use public transport independently. Good examples of this can be seen in Kings Lynn, Great Yarmouth, Norwich and Dereham. As a council we need to focus on making sure public transport is accessible for those who are able to use it, especially in rural areas where buses are infrequent and unreliable. We need to accept that public transport will never be enough on its own for many of the people who use the service. An alternative system needs to be provided for people with complex physical or behavioural needs. TRACK 5 CONCLUSIONS Following the responses of our 150 service users, the following developments are the things that the Working Together for Change project team will be recommending to the LD DAS project board as important things to consider when writing the options report about the future of day services. We realise that making friends and keeping in touch with them is very important to the people who use our service, as well as mixing with families and community members. We need to help people make networks and friendships by creating integrated, shared activities and spaces. The day service base is also very important. Although people like the facilities in their current centres, these buildings were not designed for what they are used for now. Many people find their environment too large, busy and noisy and are asking for a place that suits them better. A way forward may be to create smaller, more welcoming satellite centres with private space for people who need it. A big consideration must be the very limited amount of accessible changing places in Norfolk and the need to get people out of a wheelchair - supporting mobility and positional change for our more complex service user. We will be putting forward the prospect of a shared environment at our day centres. Some existing buildings could be redeveloped in order to create opportunities for working with other groups of people. A shared environment could give us more chances to share costs and use staff skills across the joint sectors, for example the NHS and NCC. Many people mentioned activities in the workshop. Activities need to be based on what the people who use our service want to do in the future. At the moment activities are being based on what staff and facilities are available to provide on the day. Floating members of staff should be available to provide short term support to set up new activities. This would enable greater inclusion of families,
KEY: BLACK Louise RED TOM BLUE SCOTT

11

Working Together For Change

Audio Transcript

community groups, volunteers and independent organisations. This means we could offer a bigger range of activities and allow more people to access them. Many people mentioned that they are not being notified of changes to the day service. We need to communicate changes to everyone in a way that they can understand, and give people time to adjust before making those changes. Attention also needs to be focused on the issue of employment. We all know that the economy is under pressure, but the question must be asked; are day services staff the right people to set up employment opportunities or should this be done by private industry and the job centre? We need to recognise that, for many, having a purposeful task to do and a valued social role is as important as paid work. Day services should support the creation of voluntary community enterprises. Our workshop revealed that we must address the issue of when and where support is available to our service users. We need to have a more coordinated approach to team working across services and localities, linking users from different services with similar interests and friendships. A combination of staff, voluntary and family support could be used to provide more flexible opportunities. Another issue raised in our workshop was communication. All staff must be trained in methods of communication as part of their induction. Although we have communication coordinators within most day services, supported by the Total Communication team, there is a big lack of communication knowledge as this is a specialist area. Priority should be given to writing communication profiles in partnership with families, residential and supported living providers in order to offer meaningful choices to people who use our services. The responses have shown that a system to help with person-centred planning should be implemented to improve our service. We should create a dedicated team of specialist person centred planning facilitators by using staff who already work in the service. These staff would help with person centred planning in three stages. The first stage would be undertaking the Working Together for Change project with everyone who uses our day services to set up a circle of support and start a person centred plan. Once started, plans can be handed over to the core staff team, treated as business as usual, as part of the key worker role. This will enable the specialist facilitators to do more targeted work to support the staff team.

KEY:

BLACK Louise RED TOM BLUE SCOTT

12

Working Together For Change

Audio Transcript

The third and final stage considers the long term changes to the service. As the service changes we would need to protect these staff and their funding to focus on providing the planning service needed for young people in transition, thus reducing the need of going to a day service in the first place. The final conclusion we have drawn is that we need to provide better transport for our service users. Public transport is not always available in the countryside, accessible for wheelchairs or possible because of the higher staffing ratios needed to support people to travel in this way. Transport will always be a necessary part of the day service if we are to provide outcome focused, person centred, flexible services. However, we need to use fleet transport more economically. TRACK 6 BEHIND THE RESULTS In this section, we will find out what was said by our service users in different areas of Norfolk. These responses were put together to pinpoint the big issues with our service, and draw the conclusions in this report. First, we will look at what people said was working about their day service. The area of East Norfolk includes Great Yarmouth Day Services, Caister Day Services and the East Norfolk Community Support Team. In this area, 38 people said that they like doing lots of activities. 15 people said that they like being able to meet with their friends. 14 people said that they like having enough staff who know them well and understand their needs 7 People like their routine 8 People like making their own choices and another 8 people like doing things for themselves. The area of West Norfolk includes Kings Lynn day services and Park View. In West Norfolk, 11 people said that they have staff who they know and trust to support them. 9 people see the centre as a safe place to be. 22 people were pleased to have the chance to see friends and family and form relationships. 13 people said that there are things they enjoy doing. 3 people like being independent 6 people like routine, so that they know what is happening. 5 people like to help and have a job to do and 11 people said that they like to have choice and flexibility.

KEY:

BLACK Louise RED TOM BLUE SCOTT

13

Working Together For Change

Audio Transcript

Norwich-based services include Norwich Day Services, The Black Horse Centre and Norwich Community Support Team. In Norwich, 34 people said that they like having things to do. 20 people like to meet their friends, boyfriend or girlfriend at the day centre and other places. 11 people said that they feel the centre is a familiar place where they can be free 16 people were pleased with how the staff support them 6 people said that they like working, especially when it is paid work. And 3 people mentioned that it is nice to have a break away from home. The area of South Norfolk includes Dereham Day Services, Attleborough Day Services and South Norfolk Community Support Team. In this area, 19 people said that they like doing different activities. 14 people said that they like going into the community, as it has helped them learn new skills. 12 people said that they like to feel safe and supported by familiar people. 13 people see the day centre as a safe, familiar base. 12 people said that they like being with friends at the day centre. 4 people mentioned that day services save them from boredom. 1 person said that they have the right balance of support with the centre and oneto-one service and one person said that they have accessible transport so can access community facilities. The area of North Norfolk includes Sprowston Day Services, Holt Day Services and North Norfolk Community Support Team. In this area, 20 people said that they like a good variety of activities, both building based and in the community. 21 people said that they have a familiar base where they feel safe, independent and have specialised equipment. 15 people said that seeing staff, friends, drivers and meeting people is important to them. 7 people mentioned that they enjoy their 1 to 1 support 7 people like the staff continuity. They are familiar, know the users needs and make them feel safe. 6 people said that they like being supported to travel in different ways. 5 people said that they like being supported with making choices and 2 people said that they like good quality staff who communicate with them and their home effectively (2 people) Here are some more things that people said was working about day services: The centre is a safe environment; I can spend time out of my wheelchair and move about independently. I have access to the facilities I need. I know where everything is: I can move around by myself and choose what to do and where to go. I cant do this anywhere else.
KEY: BLACK Louise RED TOM BLUE SCOTT

14

Working Together For Change

Audio Transcript

I find being with people hard, but I have built up positive relationships with staff. I get on well with the staff, they know me and make time to talk to me. We will now look at what people said was not working about their day services: In East Norfolk, 17 people said that sometimes the centre is too noisy and busy, and that they don't like all of the people. 23 people said that some activities have stopped, including work, and sometimes they have to do things they dont like. 18 people said that they don't get enough staff support to do things they like. 11 people mentioned that they don't like their routine or their staff being changed without being asked. 5 people said that people involved in their lives often do not talk to each other. 4 people can't always get to where they want to go and 2 people said that some staff are not trained to give the medication they need. In West Norfolk, 20 people have said that there isnt enough they like to do and they get bored. 10 people said that they dont always get a choice of staff, or the amount of staff that they want or like. 7 people mentioned that the transport isnt meeting their needs, saying that they dont get out as much as they'd like. 9 people complained that the building is old and not nice. 10 people said that they miss their friends who have moved on and dont get on with everyone. 9 people have said that not all staff know their communication needs and communication is not always good between people in their life. 10 people said that they dont like their routine being disrupted or their activities being cancelled. In Norwich, 13 people said that they dont get enough support to do the things they like to do. 7 people complained that a wide range of food is no longer available and some of the facilities are not good enough. 14 people said that sometimes its too noisy and they dont like the people they are with. 9 people have said that there isnt enough to do at the time they want to do it 6 people said that their transport isnt always what they want. 12 people complained that sometimes the support they get isnt what they want and 8 people said that they dont have the choice to work anymore and miss the money.

KEY:

BLACK Louise RED TOM BLUE SCOTT

15

Working Together For Change

Audio Transcript

In South Norfolk, 20 people said that they dont like changes in the building when they arent asked or told. 6 people said that they dont like it when people in their life dont communicate with each other. 11 people said that they dont have a choice about how they are supported. 9 people complained that they do not always like the way staff support them. 18 people said that they miss activities that have been stopped and do not like some of the activities they have now. 3 people are worried about the centre closing. 7 people feel that sometimes the centre is too noisy and they have to spend time with people they dont like. 3 people said that they dont always have suitable transport and 4 people complained that there is no work anymore. In North Norfolk, 20 people complained that the lack of good staff has reduced their opportunities. 19 people said that the building is too big, too noisy, needs updating and there aren't enough quiet areas. 7 people said that the minibus journey is too long and too crowded and that there is a lack of transport for spontaneity. 7 people said that they miss working, miss the money and miss their friends. 6 people complained of poor communication between them, the day centre and their home. They also said that there is limited time for circle of friends meetings which help give them a voice. 2 people don't have enough support to get out at evenings and weekends. 5 people think that they have fewer opportunities, including education and hydrotherapy. It was noted by 5 people that some staff lack enthusiasm which effects what they can do, and some staff don't know them well enough (5 people) Here are some more things that people said is not working about day services: I cant always join groups that are going out because I need a wheelchair and there isnt a member of staff free to push me. Some staff dont know how to communicate with me, I dont always get a choice so I get stressed I miss my friends that have moved on to different places I dont like feeling pressured to join in some activities, like games.

KEY:

BLACK Louise RED TOM BLUE SCOTT

16

Working Together For Change

Audio Transcript

Were now going to look at what people said was not working about their day services: In East Norfolk, 24 people would like to choose more activities and learn new things. 12 people would like the support they need to do the things they want to. 11 people would like to have a routine and staff they know and trust. 10 people would like the way they are supported and the things they do to stay the same. 8 people like seeing their friends and family when they want to. 10 people said that they want to have a service that is for them. 6 people want to get a job and 4 people want to have transport they can use when they want to. In West Norfolk, 15 people want to do more, including trying new things 15 people want flexible support at times that suit them 12 people want to keep seeing their friends. 8 people want a safe place that suits their needs and wishes. 3 people need to have suitable transport. 12 people think that changes need to be slow. They need time and support to adjust. 8 people need the right support and communication to choose what they want to do and 10 people want to have staff they know and trust and want to be part of smaller groups. In Norwich, 35 people would like to go out more and try new things. 13 people want more skilled support to help them communicate and make choices. 13 people would like the chance to work and earn money 16 people need flexible support to do what they want, when they want, including evenings and weekends. 2 people would like their own car. 3 people would like to keep things the way they are and 3 people mentioned the importance of having a place where thy can feel safe and relaxed. In South Norfolk, 31 people want to do what they want, when and where they want with who they want. 10 people want a base that suits their needs 7 people want people in their life to listen to them and talk to each other in a way they understand 18 people want support based on their needs. 7 people would like continuity and routine in their life 5 people mentioned that friendships and relationships are important to them and 7 people want paid or voluntary work.

KEY:

BLACK Louise RED TOM BLUE SCOTT

17

Working Together For Change

Audio Transcript

In North Norfolk, 17 people would like the opportunity to experience a variety of activities in the day centre and community. 18 people want a familiar base to see friends and have quiet rooms to chill out in. They would also like specialist input. 11 people want to have one-to-one support to give them more choices, independence and opportunities. 9 people want to be supported by people who know them and who they like. They don't want sudden changes to their routine. 10 people would like to have a choice of transport, especially their own car, to get to community activities and to and from day centres. 7 people want good staff support to have a holistic view of life, including regular circle meetings to help them speak up for themselves and plan things for the future. 4 people would like evening and weekend support so they can have a social life and go on holiday with friends from the day centre and 6 people would like a paid job or charity work. Here are some more things that people said is important in the future: It would be good to have a modern building in the community that is not just for people with learning difficulties. I would like support to develop new interests. I could do things independently once they were set up but I need help to get things started. I want to know what is happening and have a stable routine doing things I enjoy with people I know. TRACK 7 WHAT HAPPENS NEXT? The information in this report will be used for different things.Some of the people who had meetings as part of the project have already made the changes they asked for. Day service staff and managers are using the information to make changes to the way services are run, like starting up new activities. The information has also helped to produce a model for the future of day activity services. The model will be looked at by the Overview and Scrutiny panel on the 19 th of October, who will decide whether to recommend it to Cabinet. If Cabinet agree to adopt the model, we will do a public consultation on its impact. This means you will have a chance to tell us what you think.

KEY:

BLACK Louise RED TOM BLUE SCOTT

18

Working Together For Change TRACK 8 FINAL INFORMATION

Audio Transcript

This report was completed by 150 people who use County Council in-house day services as well as their friends, families and staff, with some help from Alys Duberley and Donna Gibling. If you would like to order a paper copy of this report or the short version, which includes answers to the same questions from family carers and staff members, please contact: Alys Duberley on 01603 481146. A huge thank-you is extended to all who helped with or took part in the project. We hope that you have enjoyed listening to this report.

KEY:

BLACK Louise RED TOM BLUE SCOTT

19