I have been helping a friend of mine - Emma - with developing a support plan that takes into account the needs of her whole family, but only costs £20,000 per year.
Emma has two sons with autism - Jon and Max. Max is 15, and beginning his transition from school to adult life. Jon is 17 and attends mainstream secondary school with full time support. Emma is separated from Mike, the boys' father, but he shares the childcare and support with her.
Balancing work and supporting her sons is challenging and exhausting. The way that services are set up adds a significant degree of frustration. As far as Emma is concerned, it makes no sense to solely focus on each son's individual needs without looking at this in the context of the family. Services working together to support the family are the only sensible way forward.
If Emma and Mike were no longer able to support their sons, and they had to be supported in a different way, they would be prime candidates for out of county placements, costing the Local Authority in excess of £200k per year. The additional cost to relationships and quality of life far exceeds this. Surely it makes sense to invest in supporting the family to stay together and stay strong?
I attended Jon's review with Emma, as a friend to offer support. It was not a person-centred review as we know them, and I can see how powerless families must feel when faced with a room of professionals around the table. I found it very uncomfortable.
Emma and I decided to see how we could look at a family support plan, bringing together the direct payment funding that Max receives from children's services, and the budget that Jon would be eligible for from adult services. Stockport's Director of Social Services, Terry Dafter, was interested in exploring this, and so the relevant assessments were set up and then Emma and I got started on the support plan.
The support plan needed to address the seven criteria used in Stockport; reflect the whole family; and be something that other families would be able to replicate. Many years ago, Emma had been on a 'Families Leading Planning' course, and was familiar with one-page profiles and 'working and not working'.
This is what the family support plan looks like:
The first page introduces the family and describes the purpose of the support plan, what people like and admire about each individual in the family, and summarises what is important to the family and how to support the family.
Then came one page profiles for each of the family - Jon, Max, Emma and Mike.
The next section is what needs to change. To do this there is 'what is working and not working' from the perspective of each family member (and the best guesses about Max as he cannot tell us directly). This working and not working from the different perspectives is then summarised into what the family wants the support plan to achieve - their outcomes.
There is a table with each person's outcomes, and how they plan to achieve them.
Jon's outcomes include being supported by people that he chooses, extending what he does outside of the home, and slowly building a social circle. For Max, his outcomes are to get involved in more leisure activities, particularly physical activities like swimming, trampolining and the gym. Mike's outcomes are to be able to continue his voluntary work at the Citizens Advice Bureaus, and to have regular short breaks. For Emma, the changes that she is seeking are to decrease her stress, have regular breaks and improve her health.
The support plan then describes how the budget will be used to achieve this. This means extra support for Jon and Max, particularly to support the activities outside of the home, to enable Mike to continue with his voluntary work, and for both of the parents to have regular short breaks, and a course of mindfulness and regular yoga for Emma.
The total cost per year is £20k.
The support plan ends with how they will stay in control - this means whole family person-centred reviews - another first for Emma and her family.
This is what Emma said to me about the process:
' I always knew that it didn't work to look at Jon and Max in isolation as their needs significantly impact on each other, and on me and Mike as carers. To make matters worse, services often only want to address one area of difficulty of one member of a highly stressed family of four… Consequently, interventions and supports are a lot less helpful than they might be, if the real life context of our family and lives was properly taken into account.
'Direct payments help as they provide a degree of flexibility around meeting the boys social care needs, but with Jon's transfer to adult services looming, it was clear that we were going to lose that small flexibility as now funding and assessments for Jon and Max would be provided by different directorates with very different practices and cultures. We wouldn't be seen as a family at all any more, despite the fact that both Jon and Max are still very dependent on us. When Terry and Helen suggested a family-centred plan and budget, I knew that this was the answer for keeping our family working, and ensuring we all have some quality of life.
' I'm really excited about the possibilities of this new way of working - particularly for the increasing number of families where more than one person has significant health or social care needs.'
