In this blog, Ali Hall, Development Officer for Young People in Transition, responds to the second part of the Care Quality Commission's (CQC) review of children and young people. She thinks the findings are sobering but welcome, and call for the sort of approach that Shared Lives is well-placed to provide.
Last week the Care Quality Commission (CQC) published ‘Are we listening?’, the phase two report of their review of children and young people’s mental health services. CQC were asked to conduct this review by the prime minister in January 2017. The phase one report summarises what is currently known about these services. The phase two report draws on evidence gathered through fieldwork in ten areas across England and conversations with around 1,400 people.
In December I reflected on how important it is for young people to access the right support at the right time. This has become even clearer through the second part of this review. It finds that “too many children and young people are only able to access care at a point of crisis”. If this is the case for young people in general, we know that young people with additional support needs or those without a strong network in place will struggle even more.
While there were examples of good practice, the report says that services “did not always work together effectively to provide timely and high-quality care” and makes a number of recommendations for national, regional and local action, one of which states: “National bodies including the Department of Health and Social Care, Health Education England, NHS England and NHS Improvement must recognise and build on the examples of good, person-centred care that exist, and to support people working locally so they can develop innovative approaches to high-quality care based on local need.”
The notion of person-centred care emerges as a key theme in this report and, as care professionals, we all know that we need to look at each person and their own particular needs. We even know it outside of our professional lives. After all, we’re adaptive creatures and we do this instinctively with family, friends and colleagues; one size never really fits all.
Yet this is so often the approach taken when it comes to social care. And it’s one of the reasons why we sometimes fall short. In an area as important and personally unique as the mental health and wellbeing of young people, we need to get it right for each person and to do this we need to listen to them. We especially need to listen to them when we don’t get it right - so that we can make it better.
In Shared Lives, listening to a person’s needs and preferences is paramount to providing a secure, nurturing and empowering environment. Shared Lives is a model of care where adults and young people aged 16+ who need support and/or accommodation move in with or regularly visit an approved Shared Lives carer, once they have been matched for compatibility. Together, they share family and community life. This provides people with unique, tailored and flexible support for those with mental ill health as well as those with other support needs. It is a natural, holistic environment for someone recovering from mental ill health, but it also serves as a way of providing the tools young people need to avoid reaching that crisis point in the first place.
Although this report highlights that things aren’t good enough, it also brings clarity as part of its diagnosis. Therefore, it offers us the opportunity to make things better. What’s really reassuring, though, is to hear policymakers and political leaders saying the same thing as their experts on the ground - young people.
The report also says that local organisations must work together to deliver a clear ‘local offer’ of the care and support available to children and young people. Michael, an Ambassador of Shared Lives Plus, who lived in a Shared Lives arrangement in his early 20s agrees that this is crucial:
“It’s important to have one person that you can be comfortable with. My Shared Lives carer, Richard, would help me contact other professionals. Other forms of care have sent me to all kinds of people and it all got too much, I felt like I was chasing around for staff so I got fed up and just left it. It’s harder for people who don’t have a typical family structure because you don’t have anyone to help, so its lonely. Living in Shared Lives is good because you know the person really well and you can plan with them, so it helps with stress and anxiety”
At Shared Lives, we are working with young people in transition who have a wide spectrum of support needs, and often work with disabled children’s teams to find young people the best form of support for them. As complex as life is for teenagers, this can be even more challenging for disabled young people. Kira, 16, is the Chair of a youth board for national disabled children’s charity Whizz-Kidz and is a committed activist and campaigner for issues around youth mental health. She says:
“There are many people that struggle to get help. Some are even reluctant to because of stigma. I think some disabled people struggle to accept that they not only face physical difficulties, but mental ones too. Family and friends play a large role in helping people with mental ill health. Just knowing that they are there can be a comfort and they can put you in touch with somebody who can offer professional help or support, even pastoral care at school or college. A young person might be mad at you for a short while for suggesting they get help, but in the end, they’ll be safe and thank you for making them take that extra step”
Listening to young people like Kira and Michael talk about their experiences and what they want and need to make their lives healthy and happy doesn’t sound radical. In fact, it actually sounds very ordinary. Indeed, it’s the same things I want. We all want to be somewhere safe, with people that love us and care, we want to be valued, have autonomy and we want to be listened to.
We also want someone to step in now and then to say, “Let me give you a hand with this”. And we’re very grateful for those precious people in our lives who are close enough and trusted enough to do this. Sometimes they take the form of a parent, a mate, a partner and sometimes they take the form of a Shared Lives carer. They’re our people who see us heading for the iceberg and help us to steer and they’re the ones who help us when we occasionally run aground. And the truth is that no matter how strong and sorted we are, we all need one of these people from time to time.