Grouping Young People for Supported Living

Why might it be of interest?

Supported living is of interest to many parents.  You may know many other parents of disabled young people who might also be interested.  But how do you go about working out who might live well together?

There are no guarantees but the notes that follow are things that Sue considered and worked out might make a difference in the success of a cohort living together or not.

It doesn’t matter whether you are thinking of a parent commissioned home or asking the LA to make the arrangements.

What does the young person want out of their home life?

This is perhaps the key question and everything else that follows is a variation on the theme!

The LA and possibly care providers will most likely look at needs as one of the key factors in determining whether a group of young people can live well together.  This is not wrong and from a care and funding perspective it probably does make the day to day support of the home easier if all the young people share a similar level of need.

However, mixed ages, abilities, needs, gender can all work together if each young person wants something similar from their home life.

For example, in Sophie’s house all 3 of the young people are severely learning disabled.  One young person is a little more able and has some language, the other 2 have none or nothing really functional.  They have a quiet and calm home with a lot of routine as this is what we parents determined they needed.

An able young person on the autistic spectrum who wanted a very calm home where they could lead an independent life, coming and going as they pleased but not having to interact too much with their housemates might well fit in as there would be very few demands on them and certainly not to be sociable!  A young person who wanted to have a conversation and socialise with their housemates would not fit into this house at all.  Equally, a young person who makes noises or moves around a lot wouldn’t fit with the needs of these young people who need a calm and quiet home.

Some things to consider:

• Does a young person like routine?
• Are they OK doing their own thing regardless of what other people are doing?
  • For example, if they like routine are they able to continue with it regardless of what other people are doing or noise they are making?
  • Or would the noise and busyness send them to their room?
• Do they mind noise? Chatter, TV on, etc
• Are they OK with visitors to the house, perhaps friends of other housemates?
• Lots of comings and goings?
• Do they like being around other people or do they prefer to keep themselves to themselves?
• Do they want a quiet and calm house?
  • Or would that be boring and they want a house where there’s things going on?
• Would they like to join in group activities?
  • Or would that send them running to their room?
• Do they want to be able to have a conversation with their housemates?
• Do they want to do activities, at home or out, with their housemates?
• Would too much noise and activity leave them feeling they can’t leave their room?
• If they don’t have anything to do at home does it affect their mood or their behaviour?
• Does there need to be things going on in the home or things they can help with?
• Will they want to help cook?
• Would they like to eat meals with the rest of the household?
• In their current home (with you and/or college) what makes them happy?
• What is it about their current setting they like?
• What don’t they like?
• Do they want to be friends with their housemates or just on friendly terms?
• How would your young person feel if one of their housemates preferred to spend much of their time in their room and not with the household?
• Will the young people want to eat together? So many scenarios – they might want to eat together most of the time, for one of the daily meals, Sunday lunch

Behaviours

No judgement but it is really important to discuss behaviours and how they affect the young person and for other people to be open about how those behaviours might affect their young person.

How would the staff manage a melt-down, shouting, aggressive behaviours?  Can the effects on other house members be minimised or managed so there’s no detrimental effect on the other young people?  The house is home to the others so they can’t all be removed as they might do in a school.

Include all behaviours – we’re not just talking about aggressive behaviours:

• Rigid behaviours
• Strict routines
• Stimming
• Respecting others’ space
• Respecting others’ things

Random

• Would you envisage friends or family staying at the house?
• If a young person has a boyfriend or girlfriend would you be OK with them staying over at the house?
• What sort of process/notification would you want for friends or family staying over (presuming this was possible)
• Do you expect to be quite hands-on or keeping a distance?
• Will you be visiting regularly? Will other family members be visiting regularly?
• Are you all on the same page with use of iPads, mobiles, time watching TV, online?
  • If you’re not how are you going to manage it?
• Is your young person more sensitive to the words or actions of others around them that they might become upset easily?
  • The larger the household the more chance there is of a personality clash
• How much would your young person participate in household chores?
  • If there was a household rota for domestic tasks would your young person participate?
  • Would it be a problem for your young person if they were expected to take part in a domestic routine but other young people didn’t take part?
• If you are not parent commissioning it’s not so essential that parents are all in tune with each other but I think it will still be helpful if you can have a similar approach to what you expect from the home – or know when you don’t!
• How do you envisage managing any problems that might come up?
  • Between the young people
  • How the care team are working
  • I know that you can ask the local authority to intervene but there may be smaller problems that you would prefer to manage between yourselves
  • For example, we had a medication mistake recently – it was quickly identified and steps taken to resolve the problem. I was quite relaxed about it as it was dealt with quickly and the care team were absolutely transparent, reporting internally, to social care and the CQC – how would you feel about that?   Would you be relaxed or would you want a formal review of processes and additional training?  There’s no right or wrong here but if you all have very different views on how things, especially mistakes, are handled it could lead to some friction

 Degree of disability:

Not as important as you might think.  Having a home with everyone having a similar level of need may seem obvious but homes where there are varying degrees of need can work well.

You might find that more able young people don’t want to live with perceived less able young people in case they are seen as carers!

But worth thinking about – if you have a household where everyone is quite able and just one person who is much less able how well will they fit with the household.  And vice versa, if everyone is less able and there’s just one person who is more able will that young person be getting what they want out of their home life?

Type of need:

Whether this is important is going to vary.  I think where young people have, for example, a high degree of medical need it might make sense if all the young people are similar, especially if they are in need of nursing or specialist care.  It might make it more economically viable and easier to schedule care.

However, if needs vary but are not especially complex I don’t think there’s any problem with having varying types of needs among the young people.

Number of young people:

This can pretty much be any number you think would work!  For economy of scale, 3 or 4 young people living together is better than just 2.  For a homely feel I would think that a max of 5 or 6 would be it.  You can, of course, have more young people if the house can accommodate it but I think you would lose a homely feel.

And it would definitely be more complicated to organise a larger group of young people and ensure that there are no personality clashes.  A larger household might suit more resilient young people rather than more sensitive souls.

More young people living together will mean more staff in the house at any one time and on the rota – ie the staff team is likely to be bigger to ensure that there’s enough staff to cover all the shifts.

Would your young person be happier with a smaller team that they can get to know better?  Or would it not bother them that they don’t see the same member of staff more than once a week?

Age of the group:

Age is more important to some young people than others so the age range of the young people in a potential cohort must be considered.  But as most of our young people don’t really present as their actual age there’s more flexibility here than there might be among a non-disabled group of young people.  But it must be considered and especially where a young person is quite aware of age and sensitive to it.

Gender:

Obviously, young people of any gender or sex can live quite happily together but you do need to consider this for your young person specifically.

If you have a young person who is not aware of or interested in more intimate relationships, eg having a boyfriend or girlfriend, would they and you be happy with them living with a group who are very aware of more intimate relationships and perhaps actively seeking them?

I’m not suggesting that any of our young people are a danger to other young people but where there’s a limited understanding of intimacy in relationships you have to consider how to keep your young person safe and / or teach your young person to act appropriately around their housemates.

This may well be TMI but, for example, if you have a young person who likes a cuddle with friends but is not interested in any further intimacies are you sure that they could withdraw from someone pushing their boundaries?  Would they understand that someone was behaving inappropriately?  Would they know that it’s not OK for someone to behave more intimately than they would like?

On the other hand, if your young person would like a closer relationship do they fully understand about consent and how to know when another person is really in agreement with them or not?

I know you would expect staff to be on this – and I would hope that they would be – but they have to be aware of it to support the young people – what if it happened out of sight of staff, in a bedroom for example?

That’s not to say a mixed house can’t work.  My own daughter is very vulnerable but she lives with 2 young men.  It works because the young men are not sexually inclined – in fact, I don’t think anyone them have any idea what sex is!  Nor are any of them looking for a more intimate relationship.

Relationships

If your young person would like a girlfriend or boyfriend how are you going to mange if these closer relationships spring up in the house?

How will your young person feel if other young people in the house become a couple?

What will you do if the relationship breaks down?

Obviously, you will be managing relationships among the young people and considering the existing friendships and who they like or don’t like in general but you do need to consider what happens when young people develop a closer relationship.

And finally!

Parents supporting parents.  As we have discussed, if you are parent commissioning it is essential that you are all on the same page, have the same vision, expectations, etc.  You are managing this house together so you must be in tune.

If you are asking the LA to make the arrangements or if your young person is joining an existing house you probably don’t need to have quite the same level of vision but it can still be helpful to know each other and the young people.

When everything is working well this might really not seem necessary – and I can’t argue that it is – but if there are problems in the home it can make a difference if parents are in contact with each other and ready to share experiences.  A parent on their own experiencing a difficulty with the home may think it’s just them but it may not be and if parents can support each other they can better manage issues that may come up as a team rather than as individuals.