« Previous | Contents | Next »
Listen
Annex B: Personalised Respite - Examples of good practice
This annex offers guidance on the variety of approaches that can be taken to planning and delivering respite and the different outcomes (although it does not provide a comprehensive list). Respite occurs in a range of contexts and many service users and carers will need access to different types of respite and short-term breaks to meet different purposes and needs, possibly in combination with other community care services. It is important to stress the value of involving the carer and care recipient in determining their goals and outcomes for the short break. Evidence suggests that respite 'fails' when carers and care recipients have little control or influence.
Note: While this annex includes examples of good practice in a number of respite models, consultees are invited to suggest similar examples for other types of respite.
Breaks in a care home
Although there is evidence of many people being uncomfortable with taking up a respite place in a care home, some will be happier to try this type of break if they can visit beforehand to see the facilities and meet the staff and make any special arrangements for the individual such as arrangements to host daily visitors during a week's stay. For some, however, the change of routine and environment may be too much, resulting in anxiety and confusion. Other forms of break may be more suitable.
Flexible booking of care home respite
Giving more control to those needing respite can improve choice and make better use of resources. For example, one local authority has booked a respite bed for people with dementia for the year in an independent care home. Families are allotted a number of nights of respite, up to four weeks, and enabled to book time as they wish with the home manager. People now have more control over their respite arrangements and can negotiate changes directly with the manager, rather than going through busy social workers. In the first year of this arrangement, the respite bed was used every night, a big improvement on previous years.
Community-based activities for adults with a learning disability[and others?]
Community-based activities for adults with a learning disability can promote independence while providing an effective alternative to traditional, building-based respite. Successful services offer a variety of regular activities such as sport and leisure activities and educational courses and seek to match staff to clients with similar interests.
Breaks for young carers
Respite can be vital in preventing young carers becoming excluded by allowing them time with friends or peers to participate in social and leisure activities, or time for themselves. These opportunities are essential to promoting young carers' health and wellbeing.
Young carers can benefit greatly from carefully planned breaks. These should be person-centred and as flexible as possible offering a range of options to ensure that the young person is able to have a positive break from their caring responsibilities. Young carers are likely to be unfamiliar with the term respite and therefore some practical examples should be given to aid their understanding and allay any anxieties they may have about the service.
Young carer respite should aim to improve health and well-being; reduce social exclusion; provide choices and empower young carers, leading to the following measurable outcomes:
- The young carer had a choice in determining the way respite was delivered.
- The young carer had the opportunity to participate in mainstream groups or activities.
- The young carer is able to attend a dedicated young carers service, residential trips or activity breaks.
Breaks in the home of another individual or family
These breaks are sometimes referred to as 'Shared Care', where children and young people are concerned, or 'Adult Placements', where clients are adults. The service is essentially the same involving specially recruited and trained individuals who are able to offer breaks in their own home. The 'homely' environment is an attractive feature of this form of break, plus the opportunity to build longer term relationships between host families, the carer and the care recipient.
- National Association of Adult Placement Services
- Shared Care Network
- The Fostering Network Scotland
Breaks at home
Regular, weekly short breaks at home are the preferred respite option for many people. 'In Home' breaks can be provided through sitter services or by personal assistants taking over caring responsibilities for a short period. The familiar surroundings can reduce feelings of anxiety and confusion and offer opportunities to tailor activities to the individual preferences of the care recipient. Services are particularly effective when they can be flexible, allowing those receiving the service to negotiate with the providing agency to adjust times to suit particular circumstances. Carers and service users also benefit from consistency, allowing them to get to know people over a long period. Befriending services can enable care recipients to leave the home and take part in social and leisure activities, promoting self esteem and confidence. However, breaks at home might not suit the carer where the purpose of the break is to provide them with time at home, free from any caring responsibilities, to rest and recover or spend time with other family members.
- Crossroads Caring Scotland
- Befriending Scotland
Providing equipment or adaptations to facilitate respite 25
Providing minor equipment can be invaluable to help facilitate a short break in the home of family or friends. For example, providing bed blocks, a raised chair and toilet seat could make an older person with mobility problems much more comfortable about staying with someone if they knew they would be able to get in and out of chairs and bed easily and visit the toilet unaided.
Equally, for carers and cared for people living together, equipment such as an emergency alarm can make it safer for the person to remain at home alone for short periods. This can also be invaluable in enabling the carer to re-join regular activities outwith the home.
A further example would be changes such as ramps or door widening to accommodate a wheelchair in the home of a foster carer, to help enable respite care for a disabled child.
Involving service users and carers in respite planning
It is clearly good practice for those likely to use services to be involved in planning. For example, a group of service users, carers, health and social work reviewed what respite would be needed to respond to the closure of a particular NHS respite facility. In this case, more short holiday breaks were identified as the priority. A local provider of residential respite was keen to develop this service in the form of a caravan at a nearby holiday park. Because this was what carers and service users wanted, the facility has proved popular and is well used.
Respite in Supported housing
Residential respite in a single tenancy can provide a successful respite model where people, often with very complex physical needs, can be supported by individualised support staff to enjoy community facilities or just a rest.
Day care
Day-care covers planned services provided outside the home of the care recipient, not involving overnight stays. The extent to which traditional day-care services provide 'personalised respite breaks' has been the subject of much discussion. Many carers view day-care as a basic entitlement and that short breaks and respite services should be provided over and above this level of provision. However, there is no reason why day-care should not be considered as respite when the service is carefully designed to deliver this outcome, and meets the agreed needs of both the carer and care recipient. The duration, timing and accessibility of the service are important factors in this regard, alongside the opportunity for activities which provide for personal and social development.
Self-directed support for respite
Self-directed support (through direct payments) is a proven way for people to have a range of respite and short break experiences both within their own homes and at holiday destinations of their choice (see Holiday breaks).
Holiday breaks
The holiday break gives access to mainstream holiday provision through the availability of additional support, specialist providers or access to adapted holiday accommodation. Holiday breaks can provide social stimulation, new activities and being with different company in new environments.
The carer and cared for person can take a holiday break together or apart, depending on the purpose of the break. Breaks together offer an opportunity to escape the daily routine and to enjoy 'normal' experiences together, perhaps as a family. A personal assistant or companion might accompany them to provide additional support and to relieve the carer of some of the caring responsibilities.
« Previous | Contents | Next »