Housing & Individual Support

Around the Clock Healthcare Ltd. is all about supporting you to run your day-to-day life and to be as independent as possible at home and in your local community.

The individuals we support have tenancy agreements and the properties are managed by an independent social landlord. This gives the tenants their rights in that they have secure tenure of the property.

We adhere to REACH standards for supported living. Supported Living is about supporting a person to live with the right support and having (often with friends, family) control over that support. We used a person centred and outcomes based approach for people we support.

Firstly, we know that living in small ordinary houses dispersed in the community is anecessary condition for a better quality of life. Research from over half a cen tury has found that larger settings and those clustered together (whether on a campus, in a cul-de-sac, even in an otherwise ordinary street, or a block of flats) do not produce the same outcomes for people with disabilities, especially in terms of social inclusion, social relationships, acceptance by society, etc. There is no evidence that larg er settings can provide as good a quality of life as small, community based settings.

  • a. What do we mean by “small”? Research has shown that people experience more choice and control when living in settings that are for 6 or fewer people an d this increases the smaller the setting. In fact, it is rare for any of us to live in g roups of larger than 4 people. Average household size in 2015 was 2.4 people, with almost 3 million people living with one or more people they were not related to. Shared (not family) accommodation is seen as a valid and valued option in a number of contexts: e.g. professionals starting out in business or in a service position, those who want to live near their work but need to share in order to afford the rent, friends wanting to get a foot on the housing market, those who have low incomes but are not eligible for social housing.
  • b. What do we mean by “ordinary”? In addition to the size, ordinary here refers to the same range of settings that people without disabilities would live in – rural or urban depending on preferences and how much rent they can afford, houses or apartments, on their own or shared with those they choose to live with etc.
  • c. What do we mean by “dispersed in the community”? Whether people chose to liv e in a city, a town, a village or the countryside, they should have the possibility to e asily access regular community facilities, just like anyone else the post office, local shop, pub and/or café, church, leisure facilities, doctors, etc. on foot or easily by public transport. As well as the places, there is also the issue of being able to meet and interact with others in the community in a way that is man ageable and positive for each individual. The further away from the main commun ity people live the more reliant they are on having a car and sufficient staff availabl e to take them and the less likely they will grow in independence and eventually be able to access some facilities independently. As soon as we build even two houses for people with intellectual disabilities together, especially if provided by the same organisation, then we have a “clustered” setting. When we group people with disabilities to gether, especially within smaller communities it makes it harder for people to be accepted and supported by others in the community. We also make it mor e likely that staff will maintain or revert to values and practices more commonl y associated with institutions. So “dispersed” means not grouped together wit h other settings for people with disabilities and “community-based” means with easy access to the same facilities and opportunities available to other people.

Secondly, we know that the severity of disability of the people themselves pre dicts their quality of life , those who are more intellectually and physically able are often more actively involved in their lives, have more opportunities and have more choice and control because they are less reliant on staff support (although sometimes staff be come a barrier to these opportunities and experiences). We know from resear ch and practice that everyone can live in the community1 and have a good life if they receive the right support. However, those with the most severe disabilities generally experience very poor outcomes without skilled support.

Thirdly, following on from the above point, we know that outcomes for people are better when staff provide support that is enabling and empowering (referr ed to as “active support”) rather than support that focuses on doing things for or to people and controlling their lives. Once in the community, this is what makes the difference to people’s lives. People can live in small community base d settings and still have poor lives and experience institutional practices – as such living in ordinary housing dispersed in the community is a necessary but not sufficient condition for better outcomes.

Recent research in the UK found that only one third of people living in a mixture of small group homes and supported living settings were receiving such support. Research is currently exploring the factors that determine whether people receive skilled support that enables and empowers.

Factors with growing evidence include

  1. The importance of the frontline manager being a practice leader,
  2. The culture of the set ting being supportive and
  3.  The right training and ongoing support for staff.

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