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bulletin THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT
2014 – NO.1
What’s next for personal budgets
Recipe for Success: From Garden to Grill
Homeshare: Housing for Help
Paramedics – New training
Who Benefits from benefits?
Moving into Care www.sitra.org
The PIP that isn’t on time
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Contents 03 04
A caring future Sitra’s Adam Knight-Markiegi looks at what it means to move from housing support into personal care.
What’s next for personal budgets and self-directed support? Jaimee Lewis of Think Local Act Personal (TLAP) says with Personal Budgets set to become law next year there is still some way to go to make sure they offer truly personalised outcomes.
Recipe for Success: From Garden to Grill Joseph, a client living in a Shared Lives house and Ben Trowell, Supported Accommodation Officer at SAILS introduce how their new project will deliver personalised services to achieve better and sustainable outcomes.
Creating a Dementia Friendly Generation Dani Cohen evaluates the significant impact Intergenerational Schools Dementia Project had in the pilot 22 schools in raising awareness around dementia and fostering positive links between members of the community.
Moving into Care
Homeshare: Housing for Help A simple solution to the problems of unaffordable rents and people who need a little support to remain independent in their homes – Laura Johnson of Crossroads Care CNL explains more.
Paramedics – New training to support vulnerable groups Jo Thomas, Senior Lecturer, Pre-Hospital, Unscheduled and Emergency Care; at the University of Worcester explains how trainee paramedics are receiving specific education in the Care of Vulnerable People.
Who Benefits from benefits? We all do Alex Kennedy, Campaigns Manager at Crisis talks about the new campaign giving a voice to the millions of people who have needed benefits at some time in their lives.
The PIP that isn’t on time Geoffrey Ferres looks at what has happened around the Coalition Government’s “other” new benefit Personal Independence Payment and that is finally attracting media attention.
Sitra Staff Chief Executive Vic Rayner Deputy Chief Executive Lisa Harrison Policy Officers Adam Knight-Markiegi Geoffrey Ferres Sue Baxter Policy and Research Co-ordinators Dani Cohen Burcu Borysik
Business Development Manager Tim Parkin (interim) Contracts Officers Anna Robertson Wendy Green Business Support Lana Lewis Sarah Pink (Maternity leave) Georgina Gorton Head of Finance & Central Services Berihu Mohammed
Finance Officer Ray Naicker Finance Assistant Alison Quinn Office Co-ordinator Gill Cotton Central Support Monica Antolin Interns Roselee Molloy Alice Cheatle Jordan Gerlack
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Grasping at astrological straws… I was interested to read that 2014 is the Year of the Horse bringing a compassionate year with the horse attentive to all our troubles and quick to react in protection of those who cannot fight for themselves. The optimistic nature of 2014 allows us to cope with financial hardships in the belief that good fortune will soon be on the way. mmmm….Well, admittedly we haven’t entered the year of the horse just yet, but things are going to have to take a mighty turn around for many of our members and those that they work with to hear the thunder of hooves in the distance. This Bulletin provides a brief glimpse of the fetlocks, however, with an inspiring article looking at the SAILs project in East Sussex. This project is embodying approaches to personalisation, co production and asset based approaches, by developing the innovative Recipes for Success project. The personalisation theme continues with a look at progress around personal budgets, and an invitation to shape the agenda for TLAP and their critical work programme. Sitra are pleased to be working directly with TLAP on a number of projects – notably the production of Making it Real for Housing, to be launched in the Spring. We also look in more detail at Homeshare, a programme providing live in support for older people that want to keep their independence and at the same time need help and companionship at home. Having heard this approach championed at a recent Cross Party group on Older People and Housing, I am aware how passionately advocates of this service see it as a natural extension of community and supporting intergenerational understanding, alongside the more expected headline news around the potential savings it can afford cash strapped authorities. We also have an insiders view on how paramedics are being educated in the Care of Vulnerable People – recognising the strong and positive links between the University and local providers, and highlighting the critical role that Streetlink can play in supporting productive referrals.
Vic Rayner Chief Executive Email: email@example.com
Whilst in fear of plugging the horse analogy too far – I will give it one more go – as the rest of the edition provides more of a ‘saddle up for a bumpy ride’ flavour! We look in detail at the Who Benefits campaign coordinated by Crisis, and why Sitra is supporting this, and the critical role individual stories play in developing understanding of the lives of those on Benefits. This gives a timely reminder of the unadulterated stories of individuals, hopefully offsetting some of the negative press arising from the C4 screening of fly on the wall documentary Benefit Street. Keeping on the theme of benefits, we provide an update on Personal Independence Payments and the significant departure from the original implementation timetable and what that will mean for the individuals you work with. There is also an article reflecting on how the reduction in funding for housing related support is meaning that some housing providers are actively looking towards the provision of care, and what needs to be in place for that to be a smooth pathway. Finally, some of you will have been involved in our first ever ‘Thunderclap’ at the end of last year. This was focussing on our ‘Dementia 4 Schools’ project, and was designed to highlight the first G8 summit on dementia and our message around ‘Creating a Dementia Friendly Generation’. This project has been hugely inspirational, with a great deal of work from schools and communities to enhance understanding of Dementia. I hope that this year will see a significant engagement from the world of supported housing in this project, and I hope that many of you will join us at our Annual Conference on the 20th March where Angela Rippon, the Joint Chair of the initiative provides us with a call for action.
About Sitra Sitra is a membership organisation championing excellence in housing, support and care. Membership benefits include discounts on all services and events, access to free advice, an annual subscription to the bulletin and regular briefings on key policy developments in the sector. Sitra works with local and central government to ensure that the needs of its members are recognised, understood and met by resource providers. If you would like to join Sitra please contact the Membership Administrator on 020 7793 4710 and ask for an application form, or download one from www.sitra.org Content ©2013 SITR (Services) Ltd except where stated, All right reserved. All images © individual photographers & illustrators. Opinions expressed by individuals writers are not necessarily those of Sitra or the magazine’s Editorial Team. E&OE. Design: Aquatint BSC 020 8947 8571 www.aquatint.co.uk
Keep up to date with our Blog Keep up with developments and add to the debate at Sitra CEO’s blog at www.sitraceo.wordpress.com
THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT
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A caring future With Supporting People contracts drying up and worries over welfare reform, organisations are looking to social care as another source of funding. Sitra’s Adam Knight-Markiegi looks at what it means to move from housing support into personal care. We all know the demographics: we have an ageing population, with more retired people for every worker, people living longer but with more years in ill-health. The number of people aged 85 or more will double by 2026, while those with dementia will double in a generation. This all means that the need for personal care is rising too. Sitra delivered workshops for Riverside ECHG to help them prepare to expand their care services. Mark Nightall, their Director of Business Growth & Strategy, said: “Through our nationwide sheltered housing service … we are alive to demographic changes and increasing numbers of older and frailer tenants.” Although budgets in care are falling, there was still some £7.8 billion spent on day and domiciliary care for adults in 2011-12.1 More and more of this funding is being channelled through personal budgets, so opening up the market to new care agencies.
Users and services To enter social care, housing support providers have two main options: domiciliary care or a care home. Domiciliary care, often called ‘homecare’, may well extend the services you already offer. It is organised similarly to floating support and you may have a potential market among your existing clients. While running a care home is akin to intensive accommodation-based support. On average, each person receives seven hours of homecare a week. Just over half of council-funded visits lasted 30 minutes, while 16% lasted just 15 minutes, according to research2 by trade body UKHCA, although there have been recent calls for the 15 minute visit to be phased out. This shows how short most visits are. These will be shorter than many floating support visits, so a constraint to plan for. Hourly rates are becoming increasingly problematic in housing support services. Even lower levels are punishingly common in domiciliary care. The UKHCA
reckons the average hourly rate paid by councils to independent homecare providers was £13 in 2009. So again a limitation. Sitra also delivered a workshop for a housing association in the North West last year. A year on and things have moved forward. They’re looking at taking on a home that is not up to scratch or has “got into financial difficulties”, says their director of support. They’ve also had a feasibility study carried out by a university business school. But what else do you need to consider when setting up a care service?
Register and regulate The Care Quality Commission (CQC) regulates social care (and health services). You must register a service and manager with them before you start. This will be for a specified ‘regulated activity’ such as ‘personal care’ or ‘accommodation with personal care’. In the aftermath of Winterbourne
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View and the Mid-Staffordshire NHS Trust scandals, CQC is changing how it oversees and inspects services. The details are still to be agreed, but at their core care services will need to be safe, effective, caring, responsive to people’s needs and well-led. Services will also receive one of four ratings, something missing from the current system. Following the workshop for the North West provider, they’ve looked in more detail at CQC’s expectations. They’ve also made contacts locally, to start establishing themselves in the care world. There are many differences between personal care and housing support. Medicines are one area. Although many support services already have to deal with medicines to some extent this is not regulated by the Quality Assessment Framework. It is far more likely that medication management will be required in care. CQC regulations expect a good approach to dealing with, safely administering and disposing of medicines. As care is provided to frail or disabled people and often in their own homes, it is common for support to involve both family members and carers. This may be to pass information between all those providing care and leaving good feedback and handovers, so that the family know their loved one is safe and well cared for. Family often know the client best. And as care users are more likely to lack mental capacity, so another reason to ensure family or advocates are involved.
Qualified carers When planning a new care service there are also a number of of day-today issues to arrange. Staffing and staff training are two. Clients value seeing the same care
worker day in, day out, especially given the intimate nature of personal care. As average turnover is one fifth of staff leaving each year in homecare, how will you hold onto staff? Do you keep bank staff for the times when somebody’s ill or on holiday? Will carers be permanent or employed on zero-hour contracts? The average care worker is female, in her 40s and works part-time3. This may mirror your current staffing, but perhaps not. Nor does this have to be the template for your structure. Managers have struggled in services providing both care and support. Do you employ separate care and support workers or do you combine these roles into one? Separating them helps you recruit people with the right skills for each task and pay them differently. Combined roles offer a holistic service and cut the number of people you have to linemanage. On training, care workers must complete the Common Induction Standards within 12 weeks of starting the job. These cover things like the role of a care worker, communicating well, equalities and safeguarding – all similar to housing support. While formal qualifications aren’t needed legally, it’s common for care staff to have a Level 2 or 3 Diploma in Health and Social Care, which replace the old NVQs. Other training will focus on clientspecific issues like dementia or diabetes care and challenging behaviour, or focus on safeguarding around medication and mental capacity. Mark Nightall from Riverside ECHG said “offering privacy and dignity to customers, as well as matters such as lone working” are important in care. CQC requires managers to be “of good character”, “physically and mentally fit” and with “the necessary qualifications, skills and experience”. They are expected to hold or complete a Level 5 Diploma
in Leadership for Health and Social Care and Children and Young People's Services. This is the same as the old Level 4 NVQ. A manager in the North West provider we helped is completing a Level 5 course after our workshop, so readying himself to become a registered manager. For other staff, they’ll probably take over a care home and TUPE workers. This should ensure the carers already have the needed skills. So moving into care is an alternative to Supporting People funding. It can build on your existing services and staffing, while your clients may offer a ready market to sell care to. But no public funding is secure right now, so there are still risks, and you must fully understand how CQC regulates. Yet care is an option many are considering. UKHCA (Feb 2013) UKHCA summary paper: An overview of the UK domiciliary care sector. 2 UKHCA (Feb 2013). 3 Skills for Care (Sept 2013) The size and structure of the adult social care sector and workforce in England, 2013; Skills for Care (Oct 2013) The state of the adult social care sector and workforce in England, 2012. 1
Sitra Training Sitra runs a number of courses on care, including these: • Palliative care for end of life – 11 February in London bit.ly/1glJzrL • Diabetes – 28 February in London • CQC standards (Care Quality Commission): an introduction – 5 March in Southampton and 26 March in London • Moving between housing support and personal care services – 1 May in London and 7 May in Southampton “Comprehensive overview of CQC regs and outcomes.” Learner on CQC course “Very relevant to role and gave me more motivation to carry on with NVQ Level 5 and registration.” Learner on preparing to move into care course
The average care worker is female, in her 40s and works part-time. THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT
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Whatâ€™s next for personal budgets and self-directed support? Jaimee Lewis of Think Local Act Personal (TLAP) says with Personal Budgets set to become law next year there is still some way to go to make sure they offer truly personalised outcomes. Recent data published by the Towards Excellence in Adult Social Care programme shows that while there has been a reduction in the number of people receiving support and care provided by councils, many more of those who do are receiving their support through self directed support via personal budgets and direct payments. Personal budgets allow people to know how much money is available for their care and support upfront â€“ so that they can control the way this is spent and choose the support most suited to them. They can either take the money as cash, through a direct payment, or have
another organisation hold and manage the fund on their behalf. Personal budgets will be introduced into law with the Care Bill, subject to parliamentary approval, next year. September's Personalisation Summit was hosted by Care Services Minister Norman Lamb and facilitated by TLAP and brought together representatives of key social care sector partners, including people who use services and carers. The Summit confirmed the strong consensus that significant progress has been made towards delivering personalisation. However, while the numbers of people accessing personal budgets
Personal budgets will be introduced into law with the Care Bill, subject to parliamentary approval, next year.
have risen significantly, urgent attention is required to ensure personal budgets and the wider personalisation agenda delivers the best outcomes for people, carers and families. In the post-summit action plan which being coordinated by TLAP and will be fully formed by year end, a number of key themes and actions have already emerged:
1. Culture change. We know this is integral to personalisation â€“ from the leadership needed locally to set the vision and see it through, to the empowerment of frontline staff to support people to do things differently. We must also build confidence amongst people with support needs, carers and family members to challenge the
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system to continually improve. TLAP will continue encouraging organisations to sign up to Making it Real, a voluntary way to check progress against what people who use services and carers expect to see and experience if support services are truly personalised. We will also ask the sector to help us refresh our Partnership Agreement and set the scope of our work for the next three years in the context of the Care Bill.
2. Experience of Service Users Agreement is needed to concentrate on the experience of people accessing personal budgets, which varies hugely. For example, although evidence suggests that people with mental health problems get some of the best outcomes, they are less likely to access a personal budget than other groups. We also know that the process people experience remains bureaucratic and cumbersome, from the point of assessment through to sign off and review. Our National Personal Budgets Survey shows too much variation in delivery across the country. While statutory regulations and guidance will help here, there is clearly more to do. The recent work undertaken by Sitra on behalf of TLAP, which showed how 22 councils from across England are trying to unwind the red tape so people can better access personal budgets, makes an important contribution to reducing the processes that have built up around delivering self-directed support. The rollout of personal health budgets (PHBs) brings huge potential for integrating personal budgets across health and care so that people have a seamless and personalised experience. This will be a key area of development for TLAP, working alongside NHS England. We will also be offering support around
this to the recently announced integration pioneers. But with the increased numbers of people using personal budgets, the need for a truly diverse market that responds to people’s aspirations becomes increasingly apparent. The summit recognised there is still a long way to go to stimulate the care provider market. Impressive numbers can mask a reality where too many people are still accessing services that offer more of the same. Particular concerns were raised that some prevalent commissioning practice is at odds with personalisation, and that commissioning for outcomes remains marginal. The infrastructure needed for people to commission for themselves or pool their personal budgets is also absent in many areas. The summit action plan confirms work led by Association of Directors of Adult Social Services (ADASS) to develop standards of excellence in commissioning and TLAP will be sharing learning about micro-commissioning and budget pooling. Finally, we know that in every part of the country there is good practice, but also areas where personalisation is less advanced. Local areas need to be critically
self aware of the outcomes of personal budgets so as to focus on continuous improvement. A number of councils have already used the Personal Budgets Outcomes Evaluation Tool (POET) to this end. While the summit and the action plan was an opportunity to review progress made, we continue to look at the opportunities and challenges that lie ahead for the sector delivering personalisation at a time of unprecedented financial pressure. TLAP is working to refresh its partnership agreement by asking the sector what it needs to focus on in the future; where we might need to shift the emphasis of the personalisation work programme; whether there are new issues we need to be considering or agendas in other public services we should be joining up with, including health and well-being and housing. This revised partnership agreement will be published in Spring 2014 and we hope that the actions TLAP partners will commit to will help focus our efforts on making the changes needed that will make a real difference in people’s lives.
For more on Sitra & TLAP’s work to reduce bureaucracy in selfdirected support go to the TLAP website: http://bit.ly/1glJzrL Look out for ‘Making it Real for Housing‘ a joint project by Sitra and TLAP which will be launched in the Spring
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Recipe for Success: From Garden to Grill
Joseph, a client living in a Shared Lives house and Ben Trowell, Supported Accommodation Officer at SAILS introduce how their new project will deliver personalised services to achieve better and sustainable outcomes. I am Joseph and I live in a Shared Lives house. It has been said that a society should be judged not on how wealthy it is or how much it leans towards certain political viewpoints and issues, but more on how it treats its most vulnerable citizens. Many of these people will at some point in their life develop certain problems regarding physical or mental health, learning disabilities or difficulties concerning old age,
I believe that the work so far for Recipe for Success has been hugely satisfying. It’s given me a sense of responsibility and purpose and I look forward to working on this project in the future!
and may find it difficult living on their own or with family/friends. The SAILS scheme aims to remedy this by providing accommodation to qualifying members of the public with the ongoing support of a carer to help manage the individual's life. However, there can be difficulties in the lives of the clients which can be difficult to address. The main difficulty is that many of the clients are in the scheme due to certain vulnerabilities which may prohibit them from work, having an active social life and cultivating hobbies for self-improvement. This may take the form of learning difficulties, varied disabilities or perhaps even being of a senior disposition and can impact greatly on a client's self-esteem as well as keeping them in a trap of long-term unemployment. As well as this, the clients may not have the information to cook themselves healthy meals on a budget or perhaps lack the ability to follow complex instructions to cook these meals. This is where “Recipe for Success- from Garden to Grill” comes in. Using a £10,000 grant obtained
from Supporting People, the Project aims to use the input and advice of SAILS clients to produce a budget-friendly cookbook and website which allows the creation of healthy meals that can be followed by users with varying learning capacities. A second goal aims to get willing clients into the hobby of cultivating their own fruits and vegetables in a series of allotments. These aims will address the problems described above by: l increasing personalisation in the lives of the clients by allowing them greater choice through running a bottom-up project which will have a clear end goal. The project aims to increase our self-esteem by offering the opportunity to take responsibility for every part of the project. l producing a cookbook that is considerate of varying learning capacities, more clients will be able to take advantage of healthy available ingredients and produce tasty meals that will improve their physical health. The budget-friendly approach will also lead to less money spent on take-aways and fast food by users who find it hard to manage money on limited funds. It
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should be pointed out that the target audience will be expanded to those also with limited resources, such as the clients of Foodbanks. participating and creating an end product such as a book and a website, the participating clients will have developed skills and experience which can be transferable to other employment opportunities, document able on a CV, hopefully increasing possibilities of jobs available.
Brighton University have also offered the Project use of their Culinary Arts studio, where we aim to have an event as well as do the photography and videos for our Recipe Book. The Project website is up and running, which is a way of advertising to people what we’re doing as well as keeping track of what we’ve done. A Media group consisting of 3 clients is now established, and they will be responsible for the running of the website amongst other things.
I’m Ben. I work for SAILS. Before the Project started our Client Involvement was rather limited, but since getting the Bursary two allotment sites have been established, one at a Resource Centre in Bexhill and some raised beds at Brighton University, one of the Project’s partners. Clients will be taking full responsibility for running the allotments, and we hope to have a full harvest next year!
Two clients have done presentations to the whole staff team and the Provider group about the Project, both of which went very well. Joseph, who wrote the start of this article, has also done a fund application for extra money to run the allotments, which the Project will be applying for in January. Part of the Bursary requirements is about involving groups in the wider
community who may not have access to services, and as Joseph mentioned above, we’d like to do a mini-project with Foodbank, creating recipes for food parcels that are given out, so people can make best use of the ingredients. We have the funding for 2 years, and after that we hope the Project will continue to run, with clients deciding what they want to with it, and I’m excited to see where it goes. Everyone involved in the project, clients, staff and partner organisations will be learning new skills and forging new relationships, and gaining the confidence to be more proactive and independent.
SAILS is based in East Sussex and provides support & accommodation within either a Shared Lives or Supported Accommodation placement for adults with mental health issues, learning difficulties and all vulnerable adults.
A ONE DAY NATIONAL CONFERENCE
Integrating Health and Social Care Conference Wednesday 26th February 2014 Central London Our National Integrating Health and Social Care Conference provides you with a timely opportunity to evaluate how best to share NHS and Local Government resources and maximise the potential of the £3.8 billion Integration Transformation Fund for 2015/2016. Key stakeholders working across health and social care need to join forces to meet the NHS planning framework requirement and agree their five year strategies by May 2014, setting out how they intend to use the Integration Transformation Fund. This conference showcases local joined-up health and care and provides an update on the innovative approaches that ‘Integrated Care Pioneer’ areas are developing. Attend to gain practical and transferrable advice from those leading the way in delivering more effective joined up health and care. l Developing a shared approach to service delivery and priority setting across councils, Clinical Commissioning Groups (CCGs), Health and Wellbeing Boards, NHS, social and community care l Achieving person-centred care and involving people in their own care planning l Delivering innovative integrated care plans for older people to reduce care costs l Collaborative working to improve outcomes for local people l Implementing the new measures of people’s experience
For further details : Website: http://www.capitaconferences.co.uk Please quote booking source code: MKFL Contact: Fran Langham – firstname.lastname@example.org or 020 7960 7751 Follow us on Twitter @capitaconf #capitaconf
A D V E R T I S E M E N T THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT
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A g n i t a e r C y l d n e i r F a Dementi n o i t a r e n e G Sitra’s Dani Cohen evaluates the significant impact Intergenerational Schools Dementia Project had in the pilot 22 schools in raising awareness around dementia and fostering positive links between members of the community.
In 2012 the Dementia Friendly Communities programme was developed as part of the Prime Ministers Dementia Challenge. The project aimed to promote a positive recognition for those people living with dementia in communities and across generations. It soon became clear that a lasting impact can only be achieved by involving young people.
As the Joint Chair Angela Rippon explains “We need to create not just dementia friendly communities, but an entire dementia friendly generation. Young people, who would become so familiar with the condition – that it would hold no fear or anxiety for them whenever and wherever they encountered it. They would recognise it in their grandparents, and know instinctively how to help them live well with dementia. Eventually they would take their understanding into maturity, into family life and the work place.”
One teacher expressed “I thought ‘What’s this got to do with me?’”, while another later acknowledged” “It was a mistake on my part not to The idea of have seen [the relevance] teaching children from the start.” about Dementia was originally met with some reticence by some of the heads and teachers we spoke to. “It is so important to remove the stigma of dementia in society and achieve better community support and engagement for now and in the future, by educating children about the condition.”
Despite the initial hesitation however, we were soon able to establish a pioneer group of 22 primary and secondary schools, much bigger than the originally planned pilot of only 12. Addressing sensitive issues through education is key to ensuring young people Teacher, Christ Church C of E Primary are ready to face the challenges of tomorrow and embrace the future with confidence (PHSE Association). Focusing on dementia was therefore thought to be an appropriate subject upon which to model values including compassion, respect and dignity, and to explore pupils’ capacity for caring and resilience in the face of adversity, loss and marginalisation.
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The schools were given a basic curriculum based on the work established by Dr Karim Saad, the Regional Clinical Lead for dementia in the West Midlands, and then encouraged to develop lessons and activities in ways that inspired them. Each school developed very different models and approaches but the effects this work had, not only in the pupils and teachers involved in the project but also in the entire school and out into the wider community, was clear to see.
Participation and approaches Overall, 19 out of the 22 schools from the Pioneer Group implemented a dementia curriculum, with 13 of those participating in the project evaluation carried out by the Association for Dementia Studies The schools carried out very individual projects using a variety of approaches of differing scale and extent, including: l Relatively short projects over a few lessons within a single subject area; l Peer-to-peer learning between schools; l A whole school project across all subjects. These approaches require different amounts of time and effort to implement, but have all been seen to have a significant impact on pupil knowledge and understanding. They could easily be adopted and adapted by any school wishing to implement their own dementia project in the future. In addition, a wide variety of resources and activities were developed during the dementia projects which could be used by other interested schools. These can now be found as part of the Dementia Resource Suite on our website www.dementia4Schools.org
This work has been evaluated by the Association of Dementia Studies – University of Worcester and clearly shows the benefits of even such short term work.
Key benefits At a high level, some of the key benefits seen by schools participating in the evaluation were: l Increased awareness of dementia; l Reduced stigma and fear; l A recognition of the importance and relevance of learning about dementia in schools; l An appreciation of the caring role and how to support carers; l Increased awareness of how to help people with dementia to live well, and the challenges and negative attitudes they may face.
Impact at different levels From the information gathered during the evaluation it was evident that the impact of the project was far wider than anticipated and the impact was by no means limited to the 2000+ pupils and teachers who were directly involved in the individual school projects. There was improved Dementia Awareness in the other teachers and pupils in the school and into the wider community with parents, friends and neighbours all being drawn into the children’s appetite to learn about dementia. Additionally the feedback from the carers and people living with dementia who become involved in the project shows they also gained from the interaction with the children.
“The benefits of this project have been immeasurable – For my part, as a Carer, it helped me to re-engage with Mum as a person, and not just somebody with a disease that needed looking after. It helped me remember the precious memories that can so easily be lost in the day to day routine of caring. It helped me offer a greater dignity and respect to her for all the richness that there is in her life, and to realise that the person hadn’t disappeared, but was still there.” (Family carer who worked with Northfleet School for Girls)
In addition, after seeing the benefits of undertaking their own dementia projects many “My head’s been buzzing all schools are intending to year how, with the help of repeat them in coming young people [...], we can years and building on take this forward.” them to include new ideas that they have (Co-ordinator for been developing and that Gloucestershire schools) have been suggested by the pupils themselves.
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â€œI would definitely repeat the project again. Our children need to know that if they ever spotted someone in the local community who was lost and suffering from dementia, they can come alongside and reassure them and find help for them.â€? (Headteacher, Curzon C of E Combined School)
â€œI have found this project amazing to work on and really informative. I feel that this has helped people become aware of Dementia and hopefully even more people in the future.â€? (Year 8 pupil, Newent Community School) A Dementia Resource Suite for Schools has been created based on the findings of the Phase 1 evaluation. It is hoped that any school wishing to engage with the project and promote Dementia Awareness can use this as a starting point for their own activities
Sitraâ€™s Sitraâ€™ raâ€™s Annual Conference Conference - Change Makers Thursdayy, 20th March 2014, 10:00am - 3:30pm Amnesty International Building. 25 New Inn Yard, London EC2A 3EA 6LWUDPHPEHUVĂ€UVWSODFH)5((DGGLWLRQDOSODFHVÂ…SHUSHUVRQ 6LWUDPHPEHUVĂ€UVWSODFH)5((DGGLWLRQDOSODFHVÂ…SHUSHUVRQ 1RQPHPEHUVÂ…SHUSHUVRQ 1RQPHPEHUVÂ…SHUSHUVRQ 7KHSDUDGLJPKDVVKLIWHGand it is clear that more of the same is no longer an option. Housing, care and support are facing the same challenges. There has been a lot of talk about change: now is the time to act! 6LWUDÂˇVFRQIHUHQFHbrings together anH[FLWLQJDQGFKDOOHQJLQJUDQJHRIVSHDNHUVwho are making the changes that will shape the future. Drawn from the worlds of KRXVLQJFDUHVXSSRUWDQGKHDOWK- they will show how they are making a diffference. ference ference. :HDUHGHOLJKWHHGWRFRQÂżUPRXUKHDGOLQHVSHDNHUVLQFOXGH$QJHOD5LSSRQ'HPHQWLD)ULHQGO\&RPPXQLWLHV
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Homeshare: Housing for Help A simple solution to the problems of unaffordable rents and people who need a little support to remain independent in their homes – Laura Johnson of Crossroads Care CNL explains more. Most older people live independently without any support from social services. However there comes a time when many feel they need a little support to maintain this independence and that is why Crossroad Care CNL launched their HomeCare service around 3 years ago. It has seen the numbers of people using the service grow as the economic climate puts pressure on both council budgets and the income of individuals. The homeshare programme provides live-in support for older people that want to keep their independence and at the same time need help and companionship at home. The Homeshare programme helps older people reduce the cost of support services by at least 80% as the householder only pays a monthly fee of £130.00. In exchange they
Judy seems just as enthusiastic about the arrangement. “What’s so lovely is that Angie is here for me as a companion,” she says. “She makes sure I don’t fall out of bed at night and that kind of thing. And that is the most important thing. I’ve got someone I can rely on.”
get a committed homesharer that spends at least 10 hours a week with him or her helping with household tasks like cleaning, doing the laundry or shopping, as well as providing friendship and the security that comes with having some else living in the property. In return the homesharer gets affordable rented accommodation in locations which they otherwise could not afford. It is important to highlight that our homesharers are not carers but they are genuine caring and responsible individuals that also benefit from sharing a home. This is a programme that helps people help each other; the journalist Joe Sandler Clarke interviewed two people in our programme and you can read an extract of the interview below.
Case story Judy and Angela As soon as Judy Armstrong saw 31 year-old Angela Wilson step into her apartment she knew she would make a great housemate. The 89 year-old had been looking for someone to share her flat with as her dementia made it tough for her to live alone. With Judy hating the idea of someone she didn't know running around her home looking after her, her family turned to a charity-run scheme Homeshare; where young people looking for affordable housing in the capital are matched up with elderly people looking for companionship and support. Now an average day sees Angela get up and make Judy’s breakfast at
7am, before heading out for her job with St John Ambulance, before returning to make dinner in the evening. This is on top of making sure that Judy has taken her medication and generally keeping her company. It’s a big commitment, even with the support provided by Judy’s family and Crossroads Care, the Kentish Town-based charity which runs the scheme. Despite the 60 year age gap between the unlikely housemates, Judy and Angela have become friends; regularly cooking together and going out for meals. “If it was up to Judy she would eat out every night,” jokes Angela. She says her friends are “fascinated” by the scheme, and her boyfriend Jamie is also very supportive: “Jamie loves Judy. And I wouldn’t have Jamie as my boyfriend if he didn’t.” Judy seems just as enthusiastic about the arrangement. “What’s so lovely is that Angie is here for me as a companion,” she says. “She makes sure I don’t fall out of bed at night and that kind of thing. And that is the most important thing. I’ve got someone I can rely on.” Homeshare is run by Crossroads Care CNL, a charity based in North London. If you’re interested in the scheme and want to find out more, visit the website. Call or email Laura Johnson at 020 7485 7416 or email@example.com
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Paramedics â€“ New training to support vulnerable groups Jo Thomas, Senior Lecturer, Pre-Hospital, Unscheduled and Emergency Care; at the University of Worcester explains how trainee paramedics are receiving specific education in the Care of Vulnerable People.
The education and development of paramedics has changed over recent years. Traditionally paramedics were trained using an apprentice type model by ambulance services. Now the majority of newly registered paramedics have been educated in universities, undertaking clinical placements in ambulance trusts. The University of Worcester develops around 50 new graduate paramedics each year, the majority of whom take up employment in UK NHS Ambulance trusts.
Training Modules Throughout their course, students are equipped with knowledge, skills and attributes that will enable them to become Health & Care Professional Council registered Paramedics. As well as clinical modules, students are required to complete a module which includes the study of relevant law and ethical practice and their second year complete a module entitled â€˜Care of Vulnerable Peopleâ€™. This module aims to create informed empathy and to equip the student with the skills required to function as part of a multi-professional team providing healthcare across gender, age, social
or cultural boundaries. This module also provides an insight and understanding of different vulnerable and at risk populations, where the paramedic may encounter legal, ethical and moral dilemmas. It builds upon experiences students will have gained within the operational field and encourages the exploration of the concept of vulnerability. There are opportunities to relate this understanding to care provision across formal and informal sectors and students are encouraged to develop an appreciation of the skill base underpinning such work. Students learn about safeguarding vulnerable individuals including relevant law and policy. Speakers from across NHS, public and voluntary sectors discuss their work with vulnerable people encouraging students to consider how their own practice could be enhanced. Students are encouraged to learn about the specific challenges that patients face other than those that are only health related, this helps them to develop a broad view so that they can recognise when their patients might be vulnerable. Links are drawn between vulnerability and increased health needs and the overarching theme of safeguarding and the role of the paramedic in keeping people safe permeates the entire module of study. Each student is required to focus on a particular vulnerable group to study in depth, they will research and critically analyse strategies that are in place to support their chosen group and to
then propose a new strategy that could enable paramedics to provide better care and support in the out of hospital setting. Students have used this opportunity to visit different organisations and find out from service users and providers what paramedics could do that would make a difference, when a visit to the Emergency Department is not wanted or required. Many have found that this level of engagement has challenged the pre-conceived ideas and attitudes that they held prior to undertaking the module. The module encourages engagement with local services and one such organisation is St Pauls, a local homeless service provider. Staff from the hostel, current and ex-residents spend time with student paramedics, speaking about services that are available and most powerfully, sharing their experiences of being homeless or rough sleeping. Students frequently evaluate this as one of the most influential sessions of the module, indicating that misconceptions and attitudes are challenged. Students learn about other vulnerable patient groups, such as; those affected by domestic violence, learning disabilities, mental health problems, substance abuse, dementia, terminal illness and bereavement. By no means allinclusive, the module is constantly evolving, much like the role of the paramedic, in order to enable paramedics respond to the needs of the public with understanding and compassion.
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e Service Midlands Ambulanc t es W e th ith w ic med e Lea Griffiths a para out the impact of th ab es rib sc de ) AS M ust (W . NHS Foundation Tr Central Birmingham in s es el m Ho et re St d the training on him an cian in
y ambulance techni r I had been an emergenc ste rce Wo of rly received ty rsi ive Un rough sleepers and regula to Prior to attending the ed end att en oft I over 4 years. when caring for rough Birmingham City Centre for during my day to day work, t tha nd fou I r. use ce servi ute medical need the repeat calls to the same m. Even if they had no ac the er off to le ilab ava a place of safety le choice Emergency Department as t sleepers I often had litt res nea the ing be rs felt helpless. rough sleepe rrying and frustrating, I wo be only point of conveyance for uld co ich wh al, pit nsportation to hos but many would refuse tra ortunity to develop Worcester gave me the opp of ty rsi ive Un the at e dul that I believed ople mo focus my study on a group to The Care of Vulnerable Pe and , ups gro e abl ner health with a different vul st the highest risk of ill ong am a greater understanding of are rs epe sle gh I learnt that rou made me aware how I could have an impact on. epers on regular occasions sle gh rou to ng aki Spe e. ohol or drugs. e rat disproportionally high suicid the number that turn to alc and ms ble pro lth hea l nta with me many have been diagnosed erstand hoping it would help me und m, gha min Bir in er nag ma e rvices for h a homeless centr paramedics to access se for le sib I arranged a meeting wit pos be uld wo ilable and whether it t how pro-active other services that are ava I was pleased to hear jus nt. tme par De y enc erg Em were keen to listen to the t for the homeless, they por patients, as an alternative sup and r lte she ng eri the right ng with off This would not only ensure . ss ce these services are and alo ac of nt poi a as support a proposal ency Department. to my concerns and fully me pressure on the Emerg so e iev rel uld co but r use treatment for the service place for my current system that is in the ts, ien pat all for re services, via a duty of ca to be vulnerable to social e liev As a Paramedic I have a be I one any of al I feel it making a referr certain vulnerable groups to p hel t ien ambulance service involves fic suf ers s. hough this service off details and a home addres GP ing lud inc ls tai de single point of contact. Alt nal so means there very sleepers, as it requires per for a rough sleeper, and ult is not suitable for rough fic dif be en oft n ca s information Unsurprisingly, gathering thi n will ever be contacted. so little chance that the per een local authorities and a partnership scheme betw on ion ent att us foc to rs and is earch solely to aid rough sleepe The module allowed my res ned sig de ly que uni is k tlin e or telephone eetlink. Stree smart phone app, web sit ple the government called Str sim A gh. rou ng epi sle ported by about someone uired. The scheme is sup req is on accessible by concerned ati orm inf nal so referral; minimal per provide the support number is used to make a person, assess them and the ate loc and al err ref hospital, I believe upon a who refuse transport to rs outreach teams who act epe sle gh rou to s end o often att needed. As a paramedic wh . ful tool on a national scale use a that Streetlink could be s so that all frontline WMAS directory of service the in ed lud inc be on so orted to hospital. k may ts who are not being transp I am hoping that Streetlin ien pat for it ss ce ac tly staff. can direc the weekly briefing for all in d staff are aware of it and nde me om rec en be of Streetlink has In the meantime, the use ognise when the elessness enable me to rec hom of cts fe ef lth hea ut the best to take someone t, and when it is not the My improved knowledge abo ien pat a for ce pla te ria are sleeping the approp support for patients who of Emergency Department is ans me te rna alte an tnerships I can offer rd to liaising with other par wa for k loo without injury or illness. Now and tem sys t improve the curren rough. I am determined to ure. and universities in the fut
Charter for Compassion (2012) http://charterforcompassion.org/ University of Worcester (2013) A Compassionate University. http://www.worcester.ac.uk/discover/compassionate-university.html
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Who Benefits from benefits?
We all do Alex Kennedy, Campaigns Manager at Crisis talks about the new campaign giving a voice to the millions of people who have needed benefits at some time in their lives. For those of us working in the housing and homelessness sector stories like this are nothing new, though they never cease to be moving. We know that benefits are a vital lifeline and that the overwhelming majority of people receiving help need this support. Yet all too often the voices of these people are ignored and their stories misrepresented. Who Benefits? is a campaign to give a voice to the millions of people in the UK who have needed support
from benefits at some point in their lives. Brought together by Crisis and four other major charities – The Children’s Society, Gingerbread, Mind and Macmillan Cancer Support- the campaign is now supported by over 90 charities, faith and community groups. The coalition is broad to reflect the huge variety of reasons that people are supported by benefits. We need your help to bring in even more organisations and reach out to more people who have experience of being helped by benefits.
I was homeless with 2 small children, having fled domestic abuse. A refuge was a place of safety and started me on the road to getting the help and support we needed. Without benefits we would not have been able to escape and secure the life we have now – stable, balanced and loving.
The current debate We have already seen how major cuts and changes to benefits are affecting many of those we work with and we know more changes on the way. Yet at a time when fundamental changes are being made to the system, public debate around benefits too often focuses on extreme examples, myths and stereotypes. The future of benefits will be a key factor in the next election and currently, across all the major parties the signs are not good in terms of rhetoric or policy direction. It is no secret that public attitudes to benefits have hardened in recent years. Media portrayals of people that need support from benefits are too often extreme and rely on negative stereotypes. The impact of this is very real – 1 in 4 people who currently claim benefits have hidden this because of what people will think, rising to nearly half (47%) of 16-24 year olds. And more than half
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Without the support that I received from benefits, I have no doubt that I would be dead. Not only did staying at a hostel stop me sleeping on the street and starving to death, I gained Alevels and the crucial self esteem I needed for my mental health recovery. I am now a university graduate working in the charity sector!
of those who have never been supported by benefits said they would feel embarrassed to claim them. The positive side of public opinion is discussed less but it does exist. Despite broad concerns, the vast majority (81%) of people believe benefits are an important safety net for people in need. This belief in the principle of benefits is a strong starting point and we want to build on it with the stories being shared through Who Benefits? They show how the vast majority of people helped by benefits are genuinely in need of this support. We are hopeful that by using real stories we can begin to create a new narrative and challenge negative stereotypes.
Using real stories to change the debate Instead of competing to be the “toughest” on benefits, politicians should focus on tackling the real reasons that people are struggling, like low wages, the cost of living and the housing shortage. The stories that front line organisations
hear day after day are emotive and powerful. The campaign aims to use them to show the reality of who needs help, why they need it and the difference it makes. Who Benefits? is asking people that have been helped by benefits to share their stories through the website (www.whobenefits.org.uk) and social media. So far over 1200 stories have been shared which make plain what we ourselves have seen – that life can be unpredictable and the reasons you might need support from benefits are hugely varied. Almost anyone could be made redundant, have to flee domestic abuse, have mental health issues develop a disability or simply not be paid enough to live on without extra support. The campaign is not about what specific policies should be adopted but aims to change the context in which policy is debated and made. It is about how we should discuss benefits, whose voices get heard and, ultimately, about showing who really does benefit from making support available to those that need it. Our argument is that we all benefit.
Join the campaign! If you want to help change the debate, there are two ways that you can help. The first is by getting the organisation you work for, volunteer for or are a trustee of to become a member of the campaign. It’s free and easy to join and we’ll only achieve our aims by working together. By becoming a member of Who Benefits? you will become part of a network of organisations that share your concerns about the impact the current debate has on policy and on those who need support from benefits. The success of Who Benefits? depends on our ability to mobilise millions of people to share their story and inform the discussion and we need your help to do this.
The second way you can help is by sharing your story and persuading others to do the same. Many of your clients will have experience of benefits so we’d love to hear from them. But we’d be equally keen to hear from you, your friends, family or anyone else you know who has ever needed support from benefits, long term or short term and whatever the reason. For too long, the negative portrayal of people supported by benefits has stigmatised millions of people in real need of support and distorted public attitudes. Who Benefits? is calling for a better, fairer debate. Join us: share your story and help change the debate! For further information and to register your interest in joining Who Benefits? please contact Alex Kennedy, Campaigns Manager at Crisis (020 7426 3863, firstname.lastname@example.org,uk) All names have been changed to protect the anonymity of those that have shared their stories. 2 All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1955 adults. Fieldwork was undertaken between 18th-19th September 2013. The survey was carried out online. The figures have been weighted and are representative of all GB adults (18+). 1
Sitra members work every day with some of the most vulnerable members of our community, offering support and advice to help them to remain living independently in their home. It is critical that the wider community understands the impact of welfare reform, and the levels of anxiety and concern that these changes are causing to individuals and their families. Concerns around sanctions, reforms to DLA and housing benefit reforms impact every day on the lives of those receiving housing related support. For this reason, Sitra supports, Who Benefits – it is vital that the stories of how changes are impacting on the ground are heard – to help ensure that where we can the right information and support is provided to those in the most need. – Vic Rayner CEO Sitra Sitra will keep you updated with all the changes to the welfare system – http://www.sitra.org/policy-goodpractice/welfare-reform/
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The PIP that isn’t on time Sitra’s Geoffrey Ferres looks at what has happened around the Coalition Government’s “other” new benefit Personal Independence Payment that is finally attracting media attention. It’s not only Universal Credit that is well behind its original timetable, it’s Personal Independence Payment too – the benefit that is supposed to replace Disability Living Allowance for claimants aged over 16 but under 65.
The roll out New claims for Personal Independence Payment started: l On time, in April 2013, in North East and North West England l Later than originally planned, in June 2013, in Northern Ireland, Scotland, Wales and the rest of England. But that was just phase one. Even when the timetable first slipped, phase two was supposed to begin in October 2013. Phase two meant Disability Living Allowance recipients would be told their
Disability Living Allowance was stopping and be invited to claim Personal Independence Payment if they: l Had turned 16 since 8th April 2013 l Reported changes of circumstances l Had an award of Disability Living Allowance that was fixed-term and due for renewal. First the Government announced phase two would begin three weeks late – on Monday 28th October instead of Monday 7th October 2013. Then Monday 28th October arrived and the Government announced phase two would only begin in Wales and some parts of England but it did not know when it would start elsewhere.
What went wrong? Personal Independence Payment normally requires a face-to-face assessment and the Government awarded four contracts, dividing the country up into separate patches – see table opposite1. The truth is that Atos is struggling with its contracts and is unable to say when it will be ready to take on the extra work phase two involves. And Capita is not ready in Northern Ireland.
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Wales and central England
Scotland and northern England
The problems with Atos – already criticised by many people for its handling of the Work Capability Assessments carried out for Employment and Support Allowance – apparently relate partly to failure to recruit enough staff but also to failure to set up enough assessment centres. Whereas Atos generally expects claimants to come to one of its premises for their tests, Capita has the opposite approach: it expects to visit 80% of claimants in their own homes.
Where does this leave things? So at the moment people can continue to receive Disability Living Allowance except in Wales and central England even if they: l Have turned 16 since 8th April 20132 l Report a change of circumstances – in fact they may be awarded an increase in benefit! l Have an award of Disability Living Allowance that was fixed-term and is due for renewal – in fact they can receive another, fixedterm award!3 Obviously this is not bad news for most claimants as the replacement of Disability Living Allowance by Personal Independence Payment is one of the main elements in the Government’s programme of cuts in benefits spending: it’s supposed to save £2bn. But it does produce an unfairness in the sense that you are getting treated differently merely
because of the contractor’s patch in which you live. Officially the Government denies there is any risk that phase three will be delayed: that’s the phased switch off of Disability Living Allowance for all remaining recipients that is currently scheduled to begin – two years late – in October 2015.
There are indications that phase one has not gone smoothly: l It appears not a single award was notified until October apart from ones from people who are terminally ill and don’t have to attend a face-to-face test – and even these claims have taken eight to 10 weeks to process, according to Macmillan Cancer Support4 l Personal Independence Payment was meant to be claimed online (like Universal Credit) but there is still no online claim form. Claimants have instead been expected to claim by phone but the Government eventually had to agree to accept paper claims (which you send to an office in Wolverhampton)! Beware of versions of the form that say you cannot be paid the daily living component if you live in a hostel or in sheltered housing: it’s not true5.
You can see which areas are in which patch by looking at the information in either of two forms: • Map: http://bit.ly/1d39UYJ • http://bit.ly/K8q9bJ 2 In Wales and central England people who have turned 16 on or after 7th October 2013 will be told their Disability Living Allowance is stopping and will be invited to claim Personal Independence Payment but for the time being this will not happen to young people who have turned 16 between 8th April and 6th October 2013. 3 In Wales and central England people who are receiving Disability Living Allowance under the special rules for people who are terminally ill will not be asked to claim Personal Independence Payment for the time being and can continue to receive Disability Living Allowance. 4 This claim, made on BBC Radio 4’s Today programme on 2nd November 2013, was disputed by the Department for Work and Pensions. View http://www.bbc.co.uk/news/uk24784691 5 You can access an example of the clerical PIP 1 form here: https://www.gov.uk/government/ uploads/system/uploads/attachment_data/file/256476/pip1-claim-form.pdf. The incorrect information about hostels and sheltered housing appears on page 12. Homeless Link has asked the Government to correct the mistake but it has so far refused. 1
When it’s time to arrange training on Personal Independence Payment, there are two options: • Staff already experienced in dealing with Disability Living Allowance only require a half-day’s training. This is available inhouse, or in London on 18th March 2014 and in Southampton on 9th April 2014 • Staff without much experience of Disability Living Allowance will need a oneday training course. This is available inhouse, or in London on 25th March 2014 and in Southampton on 14th April 2014
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Safeguarding Vulnerable Children
Palliative Care for End on Life
3rd February 2014 in London
11th February in London
The Objectives of this course are: • To increase awareness of the nature, scale and impact of the abuse of children with physical and learning disabilities and of what makes disabled children particularly vulnerable to abuse • To be aware of and identify signs and signals of abuse as they may present in disabled children • To be sensitive to the challenges that caring for and supporting disabled children brings • To understand staff responsibilities to identify and report abuse and to be aware of statutory and organisational policies and procedures • To recognise and challenge the barriers to reporting abuse • To be aware of the good practice in the recording and sharing of information regarding safeguarding issues • To develop safe working practices when caring for or supporting children with learning and physical disabilities and to reflect on current practice
The course is designed for those who are involved in providing care for dying people, whether in a formal, informal or voluntary capacity. By the end of this course, participants will have: • Identified the common fears experienced by people facing the end of their life • Identified some of the key components of good care for dying people • A greater understanding of the needs of dying people and also their relatives / carers • Developed greater confidence in supporting relatives, both before and after the death of their loved one
Making Co-Production Work
Training & Facilitation Skills
18th February in Southampton
20/21st February in London
The aim of the course is to equip delegates with the skills required to set up and deliver a successful co-production project. Participants will get the opportunity to: • Examine how clients are involved in co-production themselves • Describe & discuss the difference between Client Involvement and Co-Production • Explore the barriers and challenges of co-production • Discuss the benefits & opportunities of co-production • Outline how power & decision making impacts on co-production • Explore co-production case studies (including risk management) • Describe how to work in a co-produced way • Be able to design a co-production model • Take away practical skills & top tips for setting up a co-production project 2 3 4
This course enables participants to develop skills in the design and delivery of training events. By the end of this course, participants will be able to: • Describe the training cycle • Design clear training objectives • Consider different learning styles in devising a training event • Describe and practice different training methods using different training aids • Be aware of group processes and techniques to deal with difficult situations • Give and receive feedback appropriately • Be aware of training validation and evaluation techniques
Prices New prices with increased discount for members: Half-day: Sitra members £55/Non-members £89 One-day: Sitra members £89/Non-members £149 For a full list of forthcoming courses please visit our website
follow us @sitratraining
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bulletin No.3 WITH CARE, HEALTH AND SUPPORT THE FOR 2013 HOUSING 20MAGAZINE
Courses suitable for new workers suitable as part of an induction programme Courses suitable for frontline staff, also suitable as refresher courses for managers Courses suitable for new managers or frontline staff moving into management Courses suitable for experienced and senior managers Courses suitable for local authority commissioning and monitoring staff
Published on Mar 26, 2014
The Sitra bulletin is widely recognised as a key source of news for policy development and practice implementation in supported housing sec...