Developing Community Care

This is the first course of its kind run by the European Social Network (ESN) in cooperation with the Tizard Centre at the University of Kent. It is about the principles, values and skills necessary to develop modern community-based services and to support the closure of institutional care services. It will provide participants with the very best expertise in strategic planning and operational service management from across Europe to enable them to analyse their own services and develop effective programmes that meet their local circumstances.

The course will run throughout 2012 and each of the sessions will include taught modules, discussions and group work as well as study visits to local services. ESN held the first of its three two-day training sessions in Brighton on developing community-based care services in the Visegrád countries on the 30 November.

Julie-Beadle Brown, Lecturer on Learning Disabilities at the Tizard Centre at the University of Kent, highlighted that it was important to change not just the size, but the quality of care: “Maybe the buildings which house these institutions look better, but this doesn’t change the fact that conditions in terms of having a quality of life and being lonely are still very much present.” She used the example of people living in large institutions becoming segregated from society, which can lead to the loss of their social skills in the institutional setting (institutional neurosis).

David Towell, Director for the Centre for Inclusive Futures, talked passionately about the important values behind community-care, including quality of life, respect, dignity and belonging. He also cautioned that the word deinstitutionalisation “tells us where we’re coming from, but doesn’t say where we’re going”. As a result it is even more important that personal values are considered and protected along the way.

Jan Pfeiffer, the Chair for the European Expert Group on Transition from Institutional to Community Care, talked about European structural funds as a powerful tool, which could speed up the transition in the Visegrád countries, however a condition of accessing these funds is a national strategy on deinstitutionalization.

After visits to local services provided by the Southdown Housing Association, participants sat down with its director, the local authority commissioner and a user of the services. Andrew Walker, who has been using Southdown services for the past few years, said: “People with learning disabilities are not different. We are like everyone else. We can learn new skills.” Diana Bernhardt, Lead Commissioner for Learning Disabilities from Brighton & Hove County Council, warned participants that unnecessary institutionalisation can have a negative impact on people’s well-being, rendering their disability more profound. She argued that the first step in developing community care is to “close the front door” to institutions and stop hiding vulnerable people.

ESN had also invited experts from Italy and Slovenia to speak about their country’s experiences of the transition to community care. Lorenzo Rampazzo, Director of the Mental Health Protection Services for the Veneto region in Italy, argued that removing the stigma and shifting human and financial resources from hospitals to community care were the biggest challenges. He admitted that whilst the closure of large psychiatric hospitals is complete, large institutions for people with disabilities are still in operation. Davor Dominkuš, Director General at the Ministry for Labour, Family and Social Affairs in Slovenia, described the process of gradually dismantling two psychiatric institutions, both occupying baroque castles (Hrastovec and Trate). He emphasised the need for a network of support services in the community, including user support and coordination services, health as well as rehabilitation services.

ESN is committed to raising awareness of the benefits of transition to community care and to support its members to change the lives of the most vulnerable through the delivery of quality social services. Working closely with the European Expert Group, ESN advocates for a more targeted use of structural funds to facilitate deinstitutionalisation processes across Europe.