My Home, Your Workplace…..

Who is Melba Support Services?

– Medium sized organization

– Mix of accommodation, day service and individualised support models

– Accredited with the Council on Quality and Leadership – Supports 160 people with an intellectual disability within

our core services• Many of the people we support do not use words to communicate

Core Services• Seven Community Residential Units• Two day services• 40 Individualised Support Arrangements (approx.) • 6 Direct Payment Users• Carer Respite service

Hosted Supports• Two Family Governed projects• One Service User Governed project (Nightlife)• One sector resource project (Belonging Matters)

Council on Quality and Leadership

• For more than 40 years the Council on Quality and Leadership (CQL) has been a leader in working with human service organizations and systems to continuously define, measure and improve the quality of life for all people.

• CQL assists communities, systems and organizations to help people discover and define their own quality of life, measure personal quality of life for individuals, organizations and systems and improve the quality of life for people with disabilities, people with mental illness and older adults including the people, organizations and communities that support them.

• In December 1999 Melba’s board decided to adopt CQL as their quality accreditor.

• In 2004 we achieved formal accreditation with the Council on Quality and Leadership and were subsequently re-accredited in 2007 and validated in Responsive Services and Community Life in 2009 and 2011.

Personal Outcome Measures Personal Outcome Measures is one method that CQL use to define the quality of the services we provide to the people we support.

There are 21 Personal Outcome Measures developed which are organised in three factors:

1. My Self: Who I am as a result of my unique heredity, life experiences and decisions.

2. My World: Where I work, live, socialize, belong or connect.

3. My Dreams: How I want my life (self and world) to be.

21 Personal Outcome Measures1. People are connected to natural support networks2. People have intimate relationships3. People are safe4. People have the best possible health5. People exercise rights6. People are treated fairly7. People are free from abuse and neglect8. People experience continuity and security9. People decide when to share personal information10. People choose where and with whom they live11. People choose where they work12. People use their environments13. People live in integrated environments14. People interact with other members of the community15. People perform different social roles16. People choose services17. People choose personal goals18. People realize personal goals19. People participate in the life of the community20. People have friends21. People are respected

• Melba holds personal outcome interviews with each person we support as a way to evaluate the unique characteristics, needs, and desires of each individual.

• This then gives Melba and its staff the direction to take when working with each individual so that we ensure that we are delivering supports that are relevant and necessary for that particular person.

Human Rights Check List• Historically, people with a disability have not been afforded

the same basic human rights as the general population.

• Whilst there is an increasing level of recognition that people with a disability should have the same rights as those expected by the general population, the day to day reality is that this is not yet the case.

• In order to ensure that we are aware of and working in line with the basic human rights of the people we support we have developed a human rights check list to ensure we continually do what we say we do.

This check list includes, amongst other things, measures to ensure we are respecting each person’s right to; • Be treated with dignity and respect and to be valued for who they are. • Feel physically and emotionally safe in all environments and situations.

• To have all information pertaining to them treated in a confidential manner.

• Determine the activities and relationships (sexual or otherwise) that make up their lives.

• Participate in the community in which they live to the degree that they

choose to do so. • Have private space and time as desired.

• Freely express their opinions and concerns, without fear of retribution, and to have those views respected and acted upon as appropriate.

• Access and control their own money.

• Where a restriction of a person’s human rights has been identified, the check list is sent to Melba’s human rights committee where ideas and strategies to rectify the restriction are discussed.

• Recommendations are then given to the individual and their supports regarding the steps they should take to reduce the restriction placed on that person.

Relationships, marriage and family

25People have the right to develop intimate relationships?

Probing questions and examples:

Am I able to develop my personal relationship with another person? Am I supported to have close personal relationships of my choice? Do I have space to speak / communicate with my family/friends in private?

Owning property

26Have I the opportunity to own things/possessions I want/need?Do I own my own bed, TV, radio, hobby equipment etc.? Am I free to use them with consideration to my housemates? e.g. radio/TVAre my belongings covered by insurance?Do I have an assets list of my belongings?

No Questions Y N Comments

Human Rights Checklist (Pg. 7)

MY SELF

Outcomepresent

Supportspresent WHERE IS THE EVIDENCE FOR THIS OUTCOME & SUPPORT & the

RECOMMENDATIONS provided from the conversation and evidence.

1 People are connected to Natural Support Networks – T&F

2 People have intimate relationships

3 People are safe 4 People have best possible health 5 People exercise rights 6 People are treated fairly 7 People are free from abuse and neglect

8 People experience continuity and security

9 People decide when to share personal information

OUTCOME MEASURES INTERVIEWS CHECKLISTPerson: Date: Person being Interviewed: Note: O = opportunity / + = Supports or Outcome is present F/C = further conversation

Outcome Measures Probing Questions Individualized Supports Decision making questions

1. Intimate Relationships

Type & Frequency

Who are you closest to? Is there someone you share your personal thoughts and feelings with?

Who do have to talk to when you need it? Is this enough for you?

How do you learn about the person’s desire for intimacy?

How do you know the person needs support to develop or maintain intimate relationships?

If the person needs support, what has been arranged?

Are there any barriers that affect the outcome for the person?

How do you assist the person to overcome the barriers?

What Melba practices, values and activities support this outcome for the person?

Does the person have intimate relationships? Is the person satisfied with the type and nature of the relationships? If yes to both ,the outcome is presentIf no to both, is this due to personal choice? If yes to personal choice then the outcome is present.

Information Gathering Notes for Personal Outcome Measures 2005

Data from our Personal Outcome Measures

Of the 160 people we support:

• 37 people have supports in place to have intimate relationships

• 12 of the 37 feel that their outcome in this area has been met

• 123 people have no supports or outcomes present at this stage

Limitations we have regarding supporting people with an intellectual disability to have intimate (Inc. sexual) relationships:

• Informed consent• Peoples knowledge and understanding• Limited Communication• Family engagement - Differing views of family members• Staff comfort levels and personal values• Physical ability of the people we support• Risk of confusion in regards to what is ‘appropriate’

Where to from here?

Continue to work with the people we support to increase the supports and outcomes in the area of intimate relationships by:

– Continuing our work on communication– Continue training and information provision for staff – Looking outside our service for generic supports (sex

workers?)– Continue to engage with families and significant others– Develop policy statements– Learn from others organisation who do this better– Keep talking about this topic