CQC inspectors will focus on how support is provided for people with learning disabilities labeled as having complex needs. The document outlines the background and credentials of the lead inspector. It then details the agenda for the day-long workshop, which will examine attributes rather than deficits, what people and families want versus what they usually receive, and using citizenship as a framework for provision and inspection. The workshop will involve a group exercise applying the "keys" of citizenship (purpose, freedom, etc.) to understand good practice.

1. CQC INSPECTORS
Inspecting support for people with learning disabilities who
are labelled as having complex needs that are hard to
manage

2. Who am I?
 HCPC registered Social Worker with a Dip HE in Mental Health
 Worked for NCSC and CSCI for 6 years as an Inspector
 Regulation of Health & Social Care Award
 Masters in the Regulation of Health & Social Care
 Seconded from CSCI as part of Change Team post Budock
Hospital scandal
 Managed the closure of NHS Campus in Bournemouth
 South West Regional Manager for United Response
 Co-owned & registered Manager for Beyond Limits in Plymouth
 Regulation, Health and Social Care Consultant working with
LA’s, CCG’s, NHSE and families facilitating planning for
discharge from ATUs
 Worked with people who have labels of being hard to manage
for over 10 years

3. Agenda for the day
 10.30 am People First – Learning Disability is not
a Medical Model
 Families matter
 Citizenship as a Framework for Provision &
Inspection
 11.30 am Group work on understanding good
practice using Citizenship as a Guide
 12.30 pm Lunch
 1.15 pm Questions and discussion
 2.30 pm Close

4. Attributes not Deficits
 People who challenge are still People First!
 People challenge because things aren’t right!
 A service won’t work if it is built on deficits
 A service won’t work if Providers don’t know the
person really well & learn from mistakes
 Learning disability is not an illness; the medical
model doesn’t work
 A service only works if it is built around each
individual person’s attributes, skills, hopes and
dreams

5. What do people & families want?

6.  To be happy
 To be fulfilled
 To be part of a family & have a family
 To be accepted in their communities
 To have a place to call home
 To love & be loved
 A life that makes sense to them
(Families want the best for their children but
sometimes )

7. What do they usually get?

8. Service Land
 Segregation and congregation from birth - services
bring children together and group them & this
continues into adulthood
 Little choice in all things
 Being grouped on the basis of ‘labels’. ‘Labels’ that
define deficits & not strengths
 Families pushed out & not ‘really’ listened to
 Services that don’t ‘quite’ fit what the person needs
 Little power and autonomy over their lives
 Their needs seen through service ‘goggles’ and
service solutions becoming the only solutions

9. The Foundation for Excellence
(Evidencing Provider Competence)

10. Families Matter
(How a Provider works with a family evidences it’s core
values)
 Families are often presented as having reputations
as big as their loved one!This is rarely the case if
listen to and understood
 Families are a very important part of people’s lives
 Families have also suffered segregation,
congregation and systematic entry into Serviceland
 Families usually want the same things for their
children as any other non-disabled child
 Families are rarely the problem & often have many
of the solutions

11. The #Mother Blame Game
‘Mothers have been blamed for everything from naughty children to
teenage pregnancy. If you have a child with Learning Disabilities
things are tougher still. From the moment your child strays ‘too far’
from the ‘normal’ developmental path, you are under additional
surveillance, as the blame game begins.You are the problem and the
solution.You have caused your child’s delayed development (through
your inept parenting or your dodgy genetic inheritance) but at the
same time you must lead the charge to move your disordered child
as close as possible towards some sort of mythical norm.Therapies
and interventions replace the simple pleasures of playing with your
child.When they start school you are characterised as ‘in denial’ and
‘grieve stricken’.Your grief makes you unreasonable, tetchy, difficult,
while being in denial leads you to make unreasonable demands of
the system which only has limited resources.’
Katherine Runswick-Cole mother of a son with learning disabilities and
academic

12. The Art & Politics of Listening &
Not Listening to Families
‘The thing that happens is that the practioner or
Organisation concerned will decide if you are
somebody who should or needs to be listened to, or
if your opinions can be thrown on the ‘can be
dismissed’ pile. Useful opinions are those that make
no additional demands on services. Providers that
do not have a person or family centred approach
begin to adopt strategies that will allow the
marginalisation of the family.The MCA has become
a particularly useful way of dealing with
problematic families.’
Mark Lamb carer and researcher.

13. ‘Mothering a disabled child differs to
mothering many other children. It involves an
intensity of emotion, of devotion and, often,
advocacy and activism that stretches across a
lifetime’
Sara Ryan (Mother of Connor Sparrowhawk)

14. WHAT IS CITIZENSHIP?

15. ‘Without Citizenship you are
Stateless’
Citizenship is:
 Being an active part of Society
 How we make Society fairer and more inclusive
 A democracy where people participate and
belong
 How we make Society work – together
 How we unite people
 A powerful status
 Its both Rights & Obligations

16. For most it’s automatic - when you
are born you become a Citizen

17. If you have a disability it’s very
different!
 Life with no meaning
 Life with no purpose
 Seen as having no talents, gifts & skills
 Others control your life
 Living in poverty or trapped and dependent
 Living in places you don’t want to be
 No privacy, rights or belonging
 Controlled, segregated, abused and lonely
 A loveless life

18. What are the Keys to
Citizenship?
 Purpose
 Freedom
 Money
 Help
 Home
 Life
 Love

19. A bit like completing a jigsaw...
 It’s not about
achieving just one
Key. You have to
complete the whole
picture

20. SO WHY USE KEYS ?

21. Because Citizenship is what people tell
us they want!

22. They tell us they want……..
 To be happy
 To be in control of their lives
 To be able to speak up
 To be fulfilled
 To be part of a family & have a family
 To be part of their communities
 To have a place to call home
 To love & be loved
 A life that makes sense to them

23. So that is the Job providers
should be doing!

24. Exercise
 7 groups
 1 scribe 1 person feedback
 Each group takes 1 Key
 As an Inspector what would you look for, how
would you go about it & who would speak
with to assess that a provider was achieving a
Key? (30 minutes)
 Each group feedback & discussion about
issues from the perspective of an Inspector
(30 minutes)

25. Key 1 – Purpose
Purpose means citizens having lives that are
meaningful and that have a sense of purpose.
Sometimes we find ourselves living a life
without meaning.

26. Key 2 – Freedom
Citizens are born free, but sometimes that
freedom is lost. People with disabilities,
especially people who don’t communicate
with words, often find that other people take
control of their lives.

27. Key 3 – Money
Citizens need money and at least enough
money to allow us to live with dignity and
security.Too many people, especially
disabled people find themselves living in
poverty.

28. Key 4 – Home
Citizens belong.They have their own place, a
home where they are safe and secure, in a
community that is right for them. Many
disabled people find themselves living with
their families too long, or are stuck in care
homes.

29. Key 5 – Help
Citizens need help. Everyone needs help.
Help is good. But many disabled people are
made to be too dependent on those who help
them.They get help at the price of freedom.
This is bad help.

30. Key 6 – Life
Citizenship is about making a difference. We
do this by getting involved and helping make
our community a better place. Many disabled
people are excluded from community life.

31. Key 7 – Love
The most important thing in the world is love.
Love exists even when citizenship is missing,
but true citizenship strengthens the force of
love in the world. Disabled people can love
and be loved just like everyone else. But
sometimes the world makes it harder.

33. My contact details
Sam Sly
Enough is Enough
Time4Change!
sam.sly@enoughisenough.org.uk
www.enoughisenough.org.uk
07900 424144