►
From YouTube: CQC Connect: Home for good
Description
In this episode of CQC Connect, the podcast from the Care Quality Commission, Lizzy Dobres, Engagement and Communications Manager at CQC, speaks to Alexis Quinn, Restraint Reduction Manager of the Restraint Reduction Network, and Debbie Ivanova, CQC's Deputy Chief Inspector for people with a learning disability and autistic people about our new report, 'Home for Good'.
The report celebrates successful community support for people with a learning disability, a mental health need and autistic people.
Read the report: https://www.cqc.org.uk/publications/themed-work/home-good-successful-community-support-people-learning-disability-mental
Listen to more podcasts from the CQC: https://soundcloud.com/carequalitycommission
Find out more information about the CQC and how it regulates health and social care in England: https://www.cqc.org.uk/
A
Welcome
to
this
podcast
by
the
care
quality
commission
in
this
episode
we're
going
to
explore
our
latest
report
home
for
good.
It's
a
series
of
case
studies
of
community
support
for
people
with
a
learning
disability,
a
mental
health
need
and
autistic
people.
Many
of
these
people
were
previously
in
long
stay
in
mental
health
hospitals.
We
were
really
delighted
to
work
alongside
choice,
support
on
the
project
and
we're
going
to
tell
you
a
bit
about
it.
So
my
name
is
lizzy,
I'm
lizzie
dabris
and
I'm
the
communications
and
engagement
manager.
A
Here
at
cqc,
I've
been
involved
in
the
journey
of
this
report
and
I'll
be
hosting
today's
podcast.
Today,
I'm
really
pleased
to
be
joined
by
alexis
quinn,
she's
restraint
reduction,
network
manager
for
the
restraint
reduction
network,
and
many
of
you
who
are
involved
in
the
sector
may
know
her
already
and
debbie
van
over
our
very
own
deputy
chief
inspector
for
people
with
a
learning
disability
and
autistic
people
here
at
cqc.
So
welcome
both
and
thank
you
for
joining
us
today.
A
B
Thanks
so
much
lizzy,
I'm
alexis,
I'm
autistic
and
I've
been
in
those
hospitals
for
a
number
of
years,
and
I
now
work
for
the
restraint
reduction
network
and
you
know
just
with
my
own
experience
and
just
seeing
on
a
daily
basis.
You
know
that
what
is
possible
for
people
you
know
when
we
have
a
bit
of
ambition
for
people,
it's
you
know
it's
perfectly
plausible
and
it
should
be
normal
that
people
are
being
supported
to
live
in
communities.
B
C
Thank
you,
lizzy,
I'm
debbie
vinova
and
my
role
is
all
about
improving
services
for
people
with
a
learning
disability
and
autistic
people,
both
through
regulation
and
also
working
with
the
system
to
deliver
that
change.
That's
needed,
I
think,
for
me.
People
have
often
said
it's
just
too
difficult
to
do
this,
it's
too
difficult
to
support
people
well
in
the
community
when
they
have
lots
of
different
needs,
and
especially
when
they've
been
in
hospital
for
long
periods
of
time.
C
A
Both
that
was
really
great
to
hear
okay,
so
now
I'm
just
going
to
move
on
to
a
couple
of
questions.
So
this
first
question
is
for
debbie.
The
report
really
shows
that
people
who
need
a
lot
of
support
can
live
really
well
in
the
community.
Just
like
you
said
in
your
opening
answer,
could
you
tell
our
listeners
a
bit
more
about
the
report
and
what
it
covers.
C
Yes,
this
report
really
celebrates
successful
community
support.
It
includes
eight
stories
of
people
who've
previously
been
placed
in
hospital
settings,
often
called
assessment
and
treatment
units.
These
stories
describe
how
people's
lives
have
changed
when
they're,
given
the
opportunity
to
live
in
their
own
home
with
a
supportive
staff
team
and
can
exercise
their
choice,
independence
and
control
alongside
real
participation
in
the
community.
C
Each
of
the
stories
is
different,
but
it
might
help
a
bit
to
give
you
a
flavor
of
one
of
them.
So
let
me
tell
you
a
bit
about
richard.
Richard
is
autistic,
he's
36
years
old
and
he
had
lived
in
six
different
places
before
he
was
20
from
a
special
school
to
a
residential
service
for
young
people
and
a
special
unit,
and
all
of
those
placements
had
broken
down
at
his
last
placement.
C
C
C
Richard
clearly
saw
restraint
as
punishment,
and
it
made
him
resist
further,
so
the
provider
who
was
working
with
him
decided
to
stop
stop
using
that
restraint,
even
when
it
perhaps
seemed
risky
to
do
so.
Instead,
if
richard's
distress
started
to
escalate,
staff
would
intervene
by
using
different
approaches.
Techniques
like
reading
aloud
from
his
favorite
book,
sometimes
in
another
room.
If
they
sensed
he
needed
that
space
within
a
year
of
moving
in
richard
was
no
longer
restrained
needed
only
two
to
one
support
and
his
annual
support
costs
fell
by
a
hundred
thousand
a
year.
C
British
has
moved
twice
since
then
on
both
occasions.
At
his
own
instigation,
he
now
lives
quite
close
to
his
family,
who
he
sees
regularly
and
is
still
supported
by
the
same
provider
that
helped
get
him
outside
of
the
hospital
setting.
His
whole
life
has
changed,
he's
a
regular
at
his
local
swimming
pool
sports
center.
He
gets
to
the
cinema.
He
enjoys
cooking
he's
actually
developed
his
love
of
music
into
learning
to
play
the
piano.
C
A
A
I
think
we
saw
a
very
similar
theme
there
in
that,
if
there's
a
staff
team
that
can
believe
that
someone
can
have
a
much
better
quality
of
life
and
and
can
kind
of
visualize
that
with
them
and
really
work
towards
it,
people's
lives
can
change,
and
it
just
takes
that
kind
of
dedicated
group
to
believe
that
there
is
another
possibility
that
isn't
this
perpetual
cycle
of
restraint
and
things
like
that.
So
the
next
question
is
for
you
again
debbie.
A
C
Now
this
might
mean
building
a
property,
particularly
for
that
person
or
considerable
adaptation
of
an
existing
property.
What's
really
key
is
that
this
becomes
the
person's
home
people
shouldn't
be
kept
in
large
campus
style
accommodation.
They
should
live
their
life
in
homes
that
fit
the
lifestyle
that
they
want
to
have
for
a
long
period
of
time.
This
is
true
even
when
they
have
been
in
hospital
for
a
long
period
of
time,
and
perhaps
in
fact,
even
more
so
because
being
around
other
distressed
people
can
make
people's
trauma
worse.
How
do
you
do
this?
C
Well,
it
means
agencies
must
work
in
real
partnership.
In
particular,
providers
need
to
collaborate
with
clinical
and
health
professionals.
Community
teams,
including
occupational
speech
language
therapists,
both
in
planning
to
make
sure
that
they've
got
it
right
and
to
get
the
right
support
once
a
person
is
living
in
their
home.
I
think
another
common
feature
is
when
families
are
involved,
as
appropriate,
of
course,
but
in
all
aspects
of
service
planning
and
delivery.
This
increases
the
chance
of
a
good
outcome.
C
This
usually
involves
also
creating
support
close
to
a
person's
family
home.
There's,
perhaps
one
more
thing,
I'd
want
to
add
about
common
features,
and
I
think
we've
got
to
address
this
issue
and
I'm
sure
alexis
is
going
to
talk
about
this
a
bit
more
in
a
minute,
but
labeling
people
as
having
challenging
behavior
can
get
in
the
way
of
this.
How
people
behave
should
be
understood
as
communication
of
their
distress
or
indicating
an
unmet
need
that
should
be
responded
to
where
we
see
people
recognize
this.
Then
there
is
a
successful
reduction
of
restrictive
practices.
A
Thanks
debian
yeah,
I
think
we
wanna
we're
gonna
talk
a
bit
more
about
the
use
of
challenging
behavior
as
a
term
in
a
minute,
but
alexis
it'll
be
really
good.
Does
does
what
debbie
said
resonate
with
you
as
someone
who's
obviously
been
in
lots
of
different
units
throughout
the
system
in
hospital,
and
now
you
know
living
a
really
independent
life.
Is
there
anything
you'd,
add
or
share
from
your
own
experiences.
B
Well,
I
think
it's
interesting,
isn't
it
that
debbie
said
there's
no
magic
formula,
it's
just
that
it's
individual
and
I
think
that
is
the
magic
formula
that
sort
of
thing
isn't
it
that
people
kind
of
overlook.
I
I
think
what
happens
when
you
go
into
a
hospital.
Is
you
become
part
of
a
system
and
you
become
a
label?
You
know
someone
with
a
learning
disability
or
an
autistic
person
and
that
label
kind
of
limits.
You
know
what
people
think
you
can
and
can't
do,
and
you
get
stuck.
B
Don't
you
in
this
this
kind
of
cycle,
as
debbie
said,
you
know,
of
incident
restraint,
instant
restraint,
but,
what's
not
realized
is
what
causes
that
you
know.
What
precipitates
that
is
the
environment,
being
wrong
is
being
disconnected
from
communities
is
being
disconnected
from
families
and
that's
actually
what
causes
that
cycle
so,
like
debbie,
said
it's
about
sort
of
finding
a
way
you
know
having
that
ambition
to
break
that
cycle,
so
that
people
can
you
know
live,
live
valuable
lives.
B
You
know
that
they've
got
reason
to
value
in
the
community,
and-
and
just
you
know
my
own
experience
experiences.
You
know
people
didn't
have
that
ambition
for
me,
and
people
said
that
I
would
always
live
in
a
congregate
setting
you
know
and
be
and
be
cared
for,
but
actually
I'm
cared
for
in
my
own
home
with
my
family,
and
I
have
my
own
family
as
well,
which
you
know
I
couldn't
have
imagined
for
myself,
because
you
know
that
imagination
was
was
kind
of
dictated
to
me.
B
Well,
for
me,
I
think
it
was
one
member
of
staff
said
to
me:
you're,
not
sick,
alexis,
you're
autistic,
and
I
think
we
can
say
that
for
learning
disabilities,
we
can
even
say
that
you
know
for
people
that
are
very
distressed
and
suffering.
You
know
with
some
some
mental
health
issues,
and
that
gave
me
belief
in
myself,
and
I
think
what's
lacking
is
is
hope
and,
as
I
say,
that
ambition
for
people.
So
I
think
when
we
have
that
it
opens
up
so
many
doors
and
gateways
it.
It
sounds
such
a
small
thing.
A
B
I
think
what
it
does
lizzie
as
well.
Is
it
it
it's
empowering
for
staff,
because
I
think
if
just
one
member
of
staff
listens
to
this
and
actually
goes
to
work
and
says
you
know
jack
I've
got
you
know,
I
believe
in
you.
You
know
you
know,
let's,
let's
do
this
with
you
today
or,
let's
you
know,
would
you
like
to
do
this
and
just
giving
people
a
bit
more
choice,
a
bit
more
agency.
You
know
a
bit
more
freedom.
I
think
it's
actually
quite
an
empowering
concept
as
well.
Things
can
change.
A
B
Was
just
thinking
what
does
that
mean?
What
does
a
rights-based
approach
look
like
and
it's
actually
quite
difficult
to
articulate
because
we
don't
really
see
it
that
much
and
I
think
when
providers
get
it
right,
like
those
people
that
are
in
your
report?
Clearly,
you
know
that's
gone
well,
that's
gone
right
and
in
my
case
it's
gone
right.
That's
what
a
rights-based
approach
looks
like
and
it
looks
like
one
that
values
the
person
and
gives
them
that
opportunities
for
freedom
and
agency.
No.
A
Definitely,
we've
obviously
talked
a
lot
about
what
makes
community
support
so
great
and
and
how
it
can
make
such
an
impact
people.
What
do
you
both
feel
are
the
barriers
and
make
it
sometimes
quite
difficult
to
arrange
like
you
know
why?
Why
isn't
every
single
person
with
a
learning
disability
right
now
living
in
a
great
person-centered
community
placement?
You
know
in
the
area
of
their
choice,
alexis
do
you
want
to
go
first?
I
think
it's.
B
A
difficult
one,
I
think,
first
of
all,
there's
you
know
if
we're
talking
about
moving
people
from
inpatient
settings
or
or
even
from
schools,
you
know
residential
schools
we're
talking
about
moving
people
from
an
institutionalized
setting.
I
I
think
there's
getting
people
out,
isn't
there,
you
know
often
autistic
people
and
people
with
learning
disabilities
are
detained
for
something
that
isn't
actually
treatable.
Yet
doctors
will
say:
oh
they're,
not
clinically
ready
for
discharge
yet
well
I
mean
what
does
that
mean?
B
You
know
because
there's
nothing
to
treat,
so
I
think
I
think,
there's
that
and
then
I
think,
there's
a
there's
a
housing
issue.
You
know
this
idea
about,
you
know
being
able
to
purchase
a
house
and
actually
make
it
suitable
for
the
person.
I
know.
Certainly
before
I
went
into
hospital
and
I
was
really
struggling
in
the
community.
B
My
house
was
so
like
visually
overwhelming,
just
all
the
stuff
in
it,
and
I
I
couldn't
articulate
that
at
the
time
and
it
took
me,
you
know
going
to
a
house
which
didn't
have
anything
really
in
it
at
all,
and
the
wall
was
actually
being
quite
bare
to
kind
of
realize
that
when
I
came
back,
you
know
that
that
was
an
issue,
and
so
I
think
there's
that
and
about
how
do
we
do
that?
How
do
we
make
you
know,
properties
bespoke
and
then
I
think.
B
Thirdly,
there's
a
problem
with
there's
an
issue
with
workforce,
and
you
know
it's
not
just
the
case
of
recruiting
people
to
work
with
somebody
that
those
people
have
got
to
be
trained
and
one
of
the
things
we
do
at
the
rrn.
Is
we
talk
about
prevention?
We
talk
about.
You
know
sensory
strategies,
communication
strategies,
you
all
those
things
have
to
be
in
place.
A
C
I
think
it's
really
interesting.
Isn't
it
because
those
things
that
alexis
has
just
talked
about
are
really
important,
and
I
think
that
underpinning
those,
though
perhaps
the
biggest
barrier,
is
attitudes
and
expectations,
so
we
so
often
hear
what
can't
be
done.
It's
too
expensive,
it's
too
difficult,
commissioning,
doesn't
work.
People's
needs
are
too
complex,
hate
that
expression,
but
it's
it's
kind
of
what
we
often
hear
and
I
think
we
almost
need
to
start
from
a
different
place.
C
If
we
start
to
look
at
actually
what
we
can
do,
what
does
the
person
want?
Listen,
sometimes
an
added
barrier
is
that
people
don't
really
listen,
listen
and
then
plan.
Well
what
that
means,
then
I
think
is
that
two
things
need
to
happen.
Organizations
need
to
really
really
work
together,
that's
often
the
biggest
barrier.
I
think
that
people
look
in
their
own
little
silos
of
what
they
can
do
rather
than
thinking.
C
How
do
we
join
everyone
together
to
make
sure
that
the
care
is
about
this
person
and
bringing
together
all
the
things
that
people
need
to
support
them,
rather
than
oh,
I'm
going
to
be
responsible
for
this.
I'm
going
to
do
this.
I'm
going
to
do
this
part
because
you'll
never
get
a
truly
person-centered
integrated
service
in.
C
In
that
way,
everybody
needs
to
be
committed
to
making
things
work
and
be
willing
to
really
collaborate,
including
financially
across
health,
social
care
and
housing,
and
it's
so
important
that
housing
get
brought
much
more
into
this
debate,
because
I
kind
of
agree
with
alexis
that
you've
got
to
start
with
the
housing.
You've
got
to
kind
of
design
where
the
person
wants
to
live,
and
then
you
look
at
what
is
the
support?
C
They
need
to
live
there,
because
if
you
start
with
the
support
you
provide
that
in
the
wrong
housing,
it's
still
not
going
to
be
right.
It's
not
going
to
work.
That,
of
course
also
means
partnership,
working
with
agencies,
family
and,
most
importantly,
the
person
is
handing
over
some
of
the
control
handing
over
some
of
the
decision
making
to
the
person
who's
at
the
heart
of
this,
the
one
for
whom
the
whole
service
exists.
I.
A
Think
that's
exactly
right,
debbie
and
at
the
end
of
the
day,
it's
just
supporting
someone
to
live
the
life
that
they
want
to
live
anyway.
It's
not
a
case
of
kind
of
treating
them
and
knocking
them
away
in
a
place
that
someone
else
picks
for
them.
It's
a
case
of
you
know
how
do
we
just
help
them
live
the
life
that
they
want
to
live?
I
just
wanted
to
move
back
onto
what
we
touched
on
earlier,
this
idea
of
challenging
behavior
and
this
term.
You
know
we.
A
B
Well,
I
think
again,
it's
it's
it's
about
how
we
we
think
about
people.
I
mean
one
thing
that
I
I
often
say
is
you
know
whose
behavior
is
challenging,
who
I
actually
think
we're
we're
the
most
resilient
people.
You
know,
and
I
went
through
a
number
of
years
where
people
tried
to
tell
me
that
I
needed
to
be
more
resilient
and
I
think
damien
milton's
double
empathy
problem
really
comes
into
play
here.
B
I
don't
understand
you,
but
you
also
don't
understand
me
and
it's
about
how
we
can
meet
in
the
middle,
and
is
it
even
fair
if
somebody's
in
a
crisis
or
in
distress
that
we're
asking
them
to
meet
us
halfway?
Maybe
people
that
are
caring
for
us,
maybe
even
need
to
go
a
little
bit
further.
I
mean,
I
think
that
you
know
every
day
you
know
we
get
up.
B
We
have
these,
these
sensory
assaults,
these
communication
barriers
and
and
it's
and
it's
all
the
time,
it's
it's
it's
it's
a
good
couple
of
times
an
hour,
if
not
constant,
if
you're
in
hospital,
so
we're
incredibly
resilient.
So
I
think,
when
we're
talking
about
challenging
behavior,
I
think
we
need
to
reframe
that
and
think
whose
behavior
is
challenging,
who,
because
we're
putting
people
in
situations
that
are
completely
intolerable.
B
Autistic
people
and
people
with
learning
disabilities
are
demonstrating
their
resilience
to
those
environments
and
then,
when
it
just
gets
a
bit
too
much
and
we
we
can't,
you
know,
manage
it
anymore,
we're
labeling
that
as
as
challenging
behavior,
so
I
think
that's
a
a
fairer
way
to
look
at
it.
We
all
have
a
responsibility
to
communicate
effectively
with
one
another.
We
all
have
a
responsibility
to
make
environments
work
for
each
other.
It's
not
just
our
responsibility
to
be
overly
resilient
to
these
things,
which
is
so
difficult.
I.
A
Really
like
that,
whose
behavior
is
challenging
here,
okay,
so
this
last
one
for
both
of
you.
What
do
you
think
we
can
learn
from
this
report?
And
how
can
we
encourage
people
in
the
system
to
understand
that
it
is
possible
to
support
people,
even
people
that
might
have
lots
of
different
needs
to
live
their
best
possible
lives
and
I'll
go
to
you?
First
debbie.
C
And
I
think
what
alexis
has
just
been
talking
about
is
just
so
important
for
people
to
think
through,
because
if
you
focus
on
the
behavior
rather
than
what's
behind
it,
you'll
come
up
with
the
wrong
response
and
when
commissioners,
when
providers,
when
staff
are
thinking
about,
how
do
we
move
forward
for
this
person,
it
is
really
looking
at
what
is
the
trauma?
What
is
the
distress?
That's
behind?
I'm
actually
going
to
borrow
a
phrase
from
from
alexis,
because
I
think
it's
really
helpful
if
we
think
about
it.
C
As
people
needing
fixing
it's
not
going
to
get
us
the
right
place,
what
we
need
to
recognize
is
people,
don't
need,
fixing
but
understand
and
recognize
the
trauma,
the
distress
the
unmet
needs
and
the
environmental
issues
that
are
behind
that
and
then
think
about.
What
is
the
solution
for
this
person
so
that
their
life
can
be
different
and.
B
Well,
what
what
debbie
said,
but
I
just
want
to
add:
okay,
something
really
important
which
I've
taken
away
from
this
report.
So
at
the
end
of
each
of
the
people,
the
case
studies
in
this
report,
cqc
have
put
key
actions
that
made
a
difference
and
they're
not
rocket
science.
Okay,
so
I'm
just
going
to
give
you
an
example:
jax
says
to
build
a
property
to
meet
his
needs.
Staff
were
given
time
to
get
to
know
him
and
the
provider
understood
jack's
history
I
mean:
are
these
just
standard
stuff?
B
Isn't
this
just
standard
stuff
that
we
should
be
doing
anyway,
like
this
isn't
rocket
science?
So
I
think
it's
debbie's
magic
formula.
Isn't
it
it's
that
we
have
to
do
things
for
individuals
and
we
have
to
take
time
to
get
to
know
them
and
listen
to
them
and
then
design
what
it
is
that
that
people
need?
That's,
that's
the
magic
formula
and
if
there's
any,
you
know,
providers
listening
to
this
or
any
staff.
A
Is
a
really
powerful
ending
thanks
alexis?
This
has
been
a
really
really
interesting
discussion,
thanks
debbie
and
alexis
for
joining
us.
I
know
it
is
an
issue
really
really
close
to
our
hearts
and
there
is
a
sense
of
urgency
to
it.
We
know
that
there
are
still
lots
of
people
living
up
and
down
the
country
in
really
unsuitable
environments
that
don't
meet
their
needs,
and
I
think
we
can
all
agree
that
this
report
does
show
that
it
is
possible
to
create
person-centered
support
housing
in
exactly
the
way
that
people
would
need
to
live
their
best.
A
Thanks
again
for
joining
us
and
listening
to
the
podcast,
you
can
find
our
home
for
good
report
on
our
website
at
www.ckc.org.uk
and
there's
also
some
other
information
there
as
well
about
other
work
that
we're
doing
you
can
keep
up
to
date
with
all
the
work
we're
doing,
to
transform
the
way
we
regulate
services
for
people
with
a
learning
disability
and
autistic
people
that
debbie
who's
been
on.
The
podcast
today
has
been
working
really
hard
on.
We've
been
doing
lots
of
blogs.
A
Bulletin
updates
and
there's
been
some
updates
on
our
digital
engagement
platform,
so
the
links
are
going
to
be
in
the
description
of
this
podcast.
If
you
do
want
to
take
a
look
and
get
involved,
that
would
be
great
and
there
are
lots
of
other
cqc
podcasts
coming
up
in
the
future.
So
please
do
join
us
next
time.
Thank
you.