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themungofoundation

Developing a Range of

Effective Responses

Una Munro

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Introduction

Who we are What we do A case study Key lessons New developments Conclusion

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Who we are

Previously the Archdiocese of Glasgow Community Social Services

• 38 Projects/Services

• 5 Service Areas:

themungofoundation 1st April 2004

• Learning Disabilities/Sensory Impairment• Mental Health• Elderly/Dementia• Young People Homelessness & Substance Misuse

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Young People, Homelessness and Substance Misuse

• Red Tower - Residential 12 week providing detoxification, respite and short term rehabilitation (18 years +)

• De Paul House – Supported accommodation for young homeless (16 – 25 years)

• Fairstart – Supported Accommodation for young mothers with children aged 0 – 10 years (16 – 25 years)

• London Road – Rough sleepers projects (12 week) (16 – 25 years)

• A S I S T – Outreach support for vulnerable young people (16 – 25 years)

• Ar Caladh – Residential facility providing medical and social support to vulnerable young people experiencing difficulties with drug and alcohol use

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Red Tower Case Study Stage One (1990-1995) Approx

Context

Chaotic IV Drug MisuseResponse to possible HIV epidemicJointly registered: Nursing Home & Residential Social Care

Client ProfileGender (mixed)IV Heroin useAverage age 25Criminal justice involvement Family support

ProgrammeOutreach24-hour nursing careVisit-contracted GPMedically supervised detoxStructured group work programme Key worker systemBasic assessmentTargeted Outcomes

AbstinenceReturn to the community

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Stage Two(1995-1999)

ContextRecognition of underlying issuesIntroduction of comprehensive assessmentChange in ethos (individualised)Formal referrals by local authorities

Client ProfileAverage age 23 Co-MorbidityPolydrug use Mental health Hep C HomelessnessHIV education No family support

ProgrammeIntroduction of Europ-ASI AssessmentsEnhanced key worker systemIndividualised Detox Structured group work - phased approachOne to one (workbooks)Community linksPartnership working

Targeted OutcomesImproved healthAbstinence or stabilisation (linked with GP)Establish client’s links with communityAftercare/self-help groups/care managerAccommodation

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Stage Three(1999-2005) Approx

Context

Glasgow City Council/Greater Glasgow NHS Board joint review of purchased addiction servicesCapacity building

Client ProfileDrug and alcohol & stimulant misuseMost chaotic & vulnerable lifestylesHomelessness/mental health issuesRecognitise parenting responsibility

ProgrammeSingle shared assessmentIndividualised detoxChild protection in projectsParenting interventions/equality issuesTraining & employment pathwaysBasic living skills in programmeTreatment options for stimulant users

Targeted OutcomesDrug-free or stabilised on prescriptionPositive relationship with partner agenciesUnderstanding of care plan & development issuesImproved relationships with family /understand child issuesNext stage in care plan agreed i.e. rehab aftercare, supported acc

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The Vision that underpins all our services and all that we do

This vision has developed as a result of our own experiences of working with vulnerable socially excluded people for over 20 years within Glasgow Communities

Phased Approach

Client Centred Approach - Working with individual at his/her own pace. - Helping them to identify and work on their own identified issues to allow them to achieve positive steps forward in their lives.

Comprehensive Assessment - A holistic review of where the individual is at, using the SSA, and establishing where they wish to go (assessment of motivational levels)

Medical/HealthPsychiatricEmployment and Training/SupportDrugsAlcoholFamily/SocialPsychologicalHousing/Resettlement Support

Partnership Working - Throughout all phases

EnvironmentThe importance of creating a positive socially inclusive culture, which includes mainstreaming equality as a core ethos of management and all staffStaff training

Key Lessons

More manageable

Outreach

Pre Entry Support

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Young People, Homelessnessand Substance Misuse

Red TowerDrug detoxShort term rehab12 week programme

Long Term Drug Rehab18+ years

A S I S TOutreach support12-25 years

Ar CaladhAssisted withdrawalresidentialcare home16-21 years12 weeks

De Paul HouseHousing supportCare supportHomeless young people16-25 years

FairstartHousing Support16-25 years

London RoadRSI Project12 weeks16-25 years

Supported Flats

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Ar Caladh

Provides • Residential treatment providing specific health related services

• Assisted withdrawal and an enhancement of mental health provision

• Short term rehabilitation

• Capacity to accommodate 8 young people

Intensive Support for Young People

For individuals with intensive support needs including the following:

• Drugs and or alcohol issues

• Mental and/or physical health issues

• Homelessness issues

• Social instability

Importance – Alternative prescribing

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Long Term Drug RehabProvides

• Mixed sex core residential settings for 10 service users

• Gender sensitive, flexible and therapeutic programmes

• Length of stay determined by the individual’s progress between 6 – 9 months

• It will prepare individuals for the most sustainable form of accommodation and into appropriate services.

For individuals with a complexity of issues including:

• Severe drug dependency

• Mental health issues

• Currently homeless

• Risk of serious illness/death

• Unsuitable for more structured services

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12 Supported Flats

Providing a stepping stone to independent living for service users from Red Tower

Provided throughout the Glasgow area

Offering housing support, relapse prevention and access to appropriate services for those individuals who can sustain themselves in the community with the necessary support

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Conclusion

1 Getting the Basics Right

• Effective Assessment Tools

• Safe secure environment

• Flexible detox

• User involvement

• Appropriate interventions

Developing a range of effective responses

depends on 2 key factors

• Non discriminatory ethos

• Flexible tailored programmes

• Well-trained staff

• Gender sensitive groups

• User involvement

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2 But it goes deeper than that. It is about the values and principles that underpin service provision

• The service needs to be client driven

• It is about empowering the clients to take ownership and understanding of their issues and working through them

• The atmosphere is crucial – it must be supportive and non judgemental

• Staff have to work at clients’ own pace – measuring success in tiny steps

• Service users must feel that they have long term goals which they can buy into

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• The key is to develop relationships built on trust and mutual respect.

• Only then will an individual start to re-discover their self esteem and sense of worth, allowing them to start to tackle some of their issues.

FINALLY

If you have the basics and the right Values, Principles and Practices you can develop a whole range of services to meet the complexity of each individual’s needs.