Exeter YMCA Support Plan Review Pack

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Exeter YMCA Support Plan Review Pack

HOW THIS WORKS…

The aim of this Support Plan is to think about the areas in which you

are doing well and those in which you feel you need some help with.

Your Linkworker is here to help you think about these and

then together with you, construct a plan to work on them.

There are 11 areas to consider in this Plan.

There are

“reflective questions”

under each heading to ask

yourself in order to help you decide on what score to give yourself.

Alongside this Scoring sheet, is a Ladder which can help

you decide on what score to give yourself. If this is the

first time you have done one of these scoring sheets,

it will be helpful to know that at your interview,

we did this as an assessment of you before you were

accepted into the project.

Your Linkworker can share those scores with you.

If you’ve done this before, then consider your previous

score sheet and ask you how you feel you

are doing now in comparison to then.

You might want to think about what you have achieved

since the last time you gave yourself a score and

if there are areas where you think things have slipped?

To follow your progress there are also

a number of

“Achievements”

that log

where major achievements have been made

in tackling any particular issue.

Money: Income, Budgeting, Saving and Debt

This is quite a large section to think about.

If you are working are you getting a fair pay? Are your hours enough to make your work

worthwhile?

Are you on benefits? Are you claiming the right benefits and all benefits that you are

eligible for?

How well do you manage the money that you get? Are you saving any of the money you

have coming in? Are you in debt or owing anyone money? Do you manage your spending

ok?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Money, Budgeting, Saving and Debt

Knows what benefits they are eligible for including if circumstance change

Confident to make benefit claims without support

Achieved a Benefit Course Certificate

Has created a budget plan to work to, including maximising their income

Reviewed and/or tweaked their Budget Plan to make it better

Has maintained their Budget Plan for 3 months

Debt Repayment plan in place and kept to for 3 months

All outstanding debts are being dealt with by a Debt Repayment Plan

Is now Debt Free!

Money: Income, Budgeting, Saving and Debt

+

Actively involved in helping others to manage money and/or benefits

This could be volunteering, taking part in group work as a representative, producing a leaflet, etc

1

Can manage my money fine and don’t need support with it

 Fully understands entitlements, benefits processes and how to maintain a claim

 Able to forward plan and deal with crises

 May still have debts but is repaying them and can manage situation without support

2

Know when I need help to manage my money and how to get it

 Budgets well; no need to prompt to pay bills, understands income and outgoings and isn’t usually vulnerable to exploitation by others or loaning money inappropriately

 Occasional problems, still needs support to get back on track

3

Able to avoid crises if I plan ahead – sometimes I need help with this

 Immediate problems dealt with and payments kept up. Starts planning ahead

 Doing more for them self but experiencing setbacks, for instance if there is a new form to complete, will attempt to do it them self but may need help to finish it off

4

Can see things are better when I sort out my money and debts

 By this point (if not before) preventing further debt building up. Debts may be reduced

 Can see that being responsible with money brings rewards – it is much better to have some money to spend and not to be receiving red bills

 Regular payments made

5

Starting to sort out my benefits and manage what I have got. It’s difficult!

 Takes responsibility for claims and debts at this point, if not before, and has some understanding of entitlements and benefit agencies

 Awareness of budgeting, though often can’t maintain it. May have a written budget plan

 If vulnerable and exploited by others with money, starting to address this

 Rent arrears may be still be owed but non-payment is less frequent

6

Have plans in place but need to do more things myself.

 First signs of taking responsibility for financial situation

 If in debt, there is a sense that they want to understand their situation and address it

 Attends appointments. Gives CAB and others information and permission to contact debtors

7

Will go along with help if my key worker can sort out my money for me

 In receipt of correct benefits at this point, if not before

 Accepts help with sorting out debts and/or open to talk about it

 Cannot manage without fixed payment plans for rent and bill payment plan in place, if in arrears / debt.

8

Don’t want these money problems

 Accepts help with obtaining benefits or keeping a claim running

 Wants to get rid of the pressure on them as a result of money problems but blames others or is very vulnerable to exploitation

9

Money things are a mess but nothing can be done about it

 May feel helpless around money, have no experience of managing money and/or be exploited by others around money

 Unable or unwilling to prioritise or understand the issues

10

10. Don’t know how much I owe or who to – not willing to talk about it

 Rent not paid and may have extensive debt and/or problems with the courts or those loaning money.

 Any money may be spent in one area, for instance drugs

 Not willing to talk about money

Employment, Education, Training and Positive Activity

Are you happy with the direction you are going in your work/education or training?

Do you know what you are aiming to achieve?

Are there skills you want to gain?

How are you managing your work/college/training?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS :

Employment, Education, Training, Positive Activity

Is In Meaningful Occupation

Has been in Education whilst at Exeter YMCA

Has been in Employment whilst at Exeter YMCA

Maintained Employment for over 3 months

Achieved a Qualification through Study

Is in paid work at the end of the service

Has participated in some informal learning

Employment, Education, Training and Positive use of time

+

Actively involved in helping others to make positive use of their time

This could be volunteering, taking part in group work as a representative, producing a leaflet, etc

1

Spending my time positively– I don’t need any extra help

 Can manage activities on their own and access help as required

 Able to organise new activities, training and/or work as and when necessary

2

Spending my time positively – occasionally need support with it

 Has personal and social skills to maintain activity, work or training largely without professional support

 Still needs help occasionally, for instance if circumstances change or a course comes to an end and they need to make new arrangements

3

Getting closer to my goals and how I want to spend my time

 Has some kind of regular activity which works for them, for instance voluntary work or training

 Encounters difficulties but with support can learn from these to improve employability and ability to achieve own goals

 Sometimes loses confidence or runs into problems (for instance conflict with others, poor time-keeping, personal presentation) and needs help – reassurance and constructive feedback

4

Using my time in a more meaningful and satisfying way

 Trying new things out and discovering what works and what doesn’t

 Starting to get a sense of satisfaction from achieving small things

 Addresses blocks to progress, for instance literacy

5

Getting clearer about my goals and taking steps towards achieving them

 Able to set and meet short-term goals and do smaller things themselves if they can regularly call on help to support them (often at short notice).

 More able to sustain interest and activities (be it training, work or involvement in the community), though still needs a lot of support.

6

Know I need to take the initiative and think about what I want to do

 More meaningfully engaged with Support work process

 Wants to talk about the future and the options available

 Able to identify things they want to do and has some sense of the direction they want to go

7

Going along with things that others suggest

 Follows through on actions agreed in Support sessions but fully reliant on support to do so.

 May take part in activities within accommodation but may express dissatisfaction or boredom.

 Knows what they don’t like but not what they want

8

Don’t want to spend my days like this anymore, it’s boring and not satisfying

 Signs of motivation for change but not consistent

 Doesn’t like how things are but doesn’t have a sense of what else is possible

 Agrees to things (for instance seeing specialist worker) but doesn’t follow through

9

Sometimes get bored or fed up but there’s nothing that can be done about it

 Occasionally will discuss this topic but not motivated to change

 Avoids agreeing to meet with specialists or be referred to services

 Lack of understanding about the issue or need to address it.

10

Won’t talk about work, training, study, learning new skills or having hobbies

 Not possible to engage in discussion about how they use their time

 Avoids structured leisure, work or training activities

Social Networks

This section is about all the relationships that you are involved in.

How are your friendships? Are they positive/negative for you?

Do you have supportive and helpful people around you?

How are your relationships with your family members?

Do you have a partner?

How do your relationships affect you?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Social Networks

Has improved or dealt with relationships with Family members

Has joined a group or activity to widen circle of friends

Has become more involved in the life of the project

Has moved away from friends or groups who are not a good influence

Social Networks

+

Actively involved in helping others to increase positive Social Networks

This could be running groups, producing leaflets, Advanced Resident Committee involvement, etc

1

Have the friends, relationships and contacts that I want and need.

 Has good healthy, equal and positive relationships.

 Fully understands when relationships may be negative and avoids them and/or has strategies to deal with them.

2

Have people I can rely on but need help in this area now and then

 Relationships feel more secure

 Greater sense of being able to deal with difficulties, still needs help sometimes but knows how to access it.

 Willing to explore and take risks with new people

3

Enjoying my (new) friends and/or family but sometimes we have difficulties

 New relationships deepen

 Inevitable difficulties arise such as conflict or feeling let down; needs help to deal with them and learn from them

 Building ability to communicate; can say yes and no, and live with differences

 Sometimes misses their old community or isolation which was less demanding

 Begins to establish positive contacts and relationships for themselves .

4

Have some sense of who I can trust and starting to understand family issues

 Has made some new relationships with people who support their more positive life choices

 Recognises the destructive effect of some past relationships

 May be making first steps to re-establish contact with family, if this is appropriate

5

5. Feeling in-between - left old friends behind but don’t have new ones yet

 Moving away from previous peer group but tentative in making new relationships but may be over dependent on support worker or other trusting staff relationships

 Needs support in recognising constructive relationships

 If naturally private, may be able to express desire for privacy in a less hostile manner

6

6. Have found someone I can talk to and trust. I want to address my family issues

 Starts to explore how relationships could be and reinforces dislike of exploitative relationships

 Willing to discuss moving away from negative relationships.

 Starts to attend some groups to widen or build new social networks.

7

7. Talking to new people but don’t really like or trust them

 Engages with people outside peer group but only if accompanied and very warily - testing people out

 Starts to engage in activities in accommodation but only if accompanied.

 Still involved in negative and possibly exploitative relationships

8

8. Don’t like feeling isolated, or, the people around me aren’t good for me

 Recognises relationships aren’t satisfying and supportive and may be exploitative but doesn’t make any positive moves to tackle this.

 Doesn’t know how to find people who will support them in any change

9

9. Sometimes fed up with being alone or with people I can’t trust

 Some awareness that their relationships are not as they would like them to be

 Starting to feel isolated and not wanting to be

 Still only relating to people who support destructive life choices

10

10. That’s how life is – you can’t trust anyone

 Completely isolated or only associating with a street, addiction and/or offending community

 Any relationships may be exploitative, lacking in trust or regard

Personal Identity (Inc. Faith and Culture)

Do you have a faith?

Are there things that you need to consider in relation to your cultural background?

Are you interested in exploring these things?

Everyone has their own way of thinking about life and death, right and wrong, self-identity

and fairness to others – how does your understanding of how things work (worldview)

affect what you believe about yourself and how you live your life?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

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3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Personal Identity

Has participated in a group to develop or improve self

Increased control / choice / involvement / confidence in own life

Personal Identity (Inc. Faith and Culture)

+

Actively involved in helping others to develop their Personal Identity

This could be setting up trips, mentoring, running groups, producing leaflets or information, etc.

1

Am happy and confident in own Personal Identity and in making choices.

 Fully understands issue and its effects and positively avoids or strategically manages it.

 Looks after themselves and makes use of own support network when needed.

 Able to forward plan and deal with crises.

2

Achieving and enjoying life – when I need help I know how to get it

 More comfortable with Personal Identity and self-worth issues. Mainly manages own engagement with faith, social, cultural or support groups.

 Issues may still be present but resident mainly manages this totally themselves unless there is a larger issue, in which case the resident knows where to get help if they need it.

 May find ideas of letting go of support uncomfortable

3

More content with Self Image/Personal Identity still needs help with ‘blips’

 Taking active steps to engage with personally relevant faith, social, cultural or support groups

 Crises are mainly avoided and doing more for themselves but still needs support when personal behaviour relapses or relationships don’t work out as planned

4

Life is better when I understand and value who I am and what is important to me

 Makes positive personal choices with reference to own conscience, faith, worldview or value systems and can see the positive effect this has on how they feel.

 Regularly tackling the issue on their own outside of support sessions.

5

Starting to tackle this area with support. It’s difficult and I need help.

 Taking a new perspective and responsibility around this area and sees that it is something that they need to work at.

 Has more sense of how they want their lives to be.

 Beginning to tackle outside influences, removing themselves from situations and confronting them.

6

Can see why I feel like this – want to manage my life better

 More aware of their own personal background and how this has influenced them.

 Belief that they need to find positives and overcome difficulties

 More active engagement. Will initiate discussion and may question their belief about themselves.

7

Will go along with help if someone can sort this for me.

 Can see there is a benefit to engaging with support/help in this area but not prioritising it.

 Accepts help in sessions but can’t follow up on things themselves.

 Is showing a desire to work at the situation, but fully reliant on support to make it happen.

8

Want to get over the past and value myself more.

 Expresses some interest in their own personal background and how this may have impacted them negatively

 Wants to get rid of the pressure on them that this problem brings.

 Not making positive moves to meaningfully engage with support to tackle the issue.

9

That is just me, there is nothing anyone can do about it

 Will occasionally talk about experiences but not for long and will refuse help

 Still stuck in viewing themselves in a negative manner

 Voices displeasure or resentment about the issue and its negative impact on their lives.

 Lack of understanding about the issue or problem – refuses or avoids help or advice.

10

Don’t see that there is an issue. Don’t want to talk about it.

 Evidence of Personal Identity issues which are denied or unacknowledged

 Not possible to engage in discussion about their personal or cultural background

Looking after Myself

How are you at looking after yourself?

Do you eat well, regularly and healthily?

Do you keep your home space and yourself clean and healthy?

Do you put yourself at risk by any activities?

Do you know where to go to get help if you needed it?

Are you free to make your own choices in life?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Looking after myself

Has kept themselves safe in their accommodation for 3 months

Accessed help or a service in to help deal with any anger or control issues

Avoided causing harm to others for 6 months

Taken steps to improve confidence or assertiveness

Has reduced any self-harming

Has accessed a service to help with any self-harm issue

Looking after myself and Living Skills

+

Actively involved in helping others to increase living skills

This could be running cooking groups, producing leaflets/booklets, working with other agencies.

1

Can look after my place and take care of myself without outside help

 Will notice if they have let something go, never neglects an important area over a long period

 Very capable in their cooking and hygiene skills.

 Looks after them self and their home well without support

2

Look after my place and myself well, just need occasional encouragement

 Good self care but may let it go when things are difficult and needs help to get back on track

3

Have new habits and I’m doing more but sometimes slip back

 Self care good in some areas but there are blind spots in other areas

 Change is difficult so needs support to deal with setbacks

4

See that when I look after myself and my place, I feel better

 Understands importance of self-care, how it influences how they feel and how others react to them

 Feels better and motivation increases as a result of positive choices

 Generally tackles laundry, cleaning and cooking without needing prompting

5

Doing things to look after myself and my place better, learning more what to do

 Does laundry, cleans room, cooks meals, for example, with occasional prompting

 Has reasonable skills for basic cooking and cleaning by this point, if not before

6

Want to be able to do more for myself - look after myself and my place better

 Starts to initiate conversations about self-care

 First signs of seeing cleanliness, diet, sleeping habits etc as being important to them

 Actively wanting to develop skills, if they don’t have them

7

If others can help me look after myself better, I will go along with it

 Self-care standards improve when a lot of support is given, for instance cleans room, eats regular meals, but are dropped as soon as support is withdrawn

8

Don’t like the fact I can’t take care of myself, I need help

 Sometimes agrees to letting worker help address issues, for example accepting some help from the support worker to tidy the room up; prompting to have a shower and putting on fresh clothes

 Compliance with support worker suggestions is patchy

9

Don’t look after myself well but I can’t - that’s just the way I am

 Will discuss self-care and may acknowledge problems but refuses all help

 Some glimmer of dissatisfaction with how things are

10

Don’t have a problem with looking after myself - though others think I do

 Not able to keep themselves fed, safe, clean, for example; if in flat, there may be abandoned rubbish

 Not possible to engage in discussion about self-care

Alcohol and Drugs

How do you view your use of alcohol and of drugs?

Have you ever got into difficulty or trouble because of your use?

Do your friends think that you drink/use drugs too much?

Has the use of drugs or alcohol ever put your home at risk?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Alcohol and Drugs

Accessed a service to help with any substance misuse issue

Has reduced usage of substances

Has kept to a reduction plan for 3 months

Has kept to a reduction plan for over 6 months

Has changed friendship groups in order to support ability to change

Alcohol and Drugs

+

Actively involved in helping others to tackle addiction issues

This could be taking part in group works as a facilitator, work with other agencies, leaflets, etc.

1

No problem with alcohol or drugs and no support needed

 Able to judge if they need help in the future and initiate contact with appropriate services

2

Enjoying lifestyle without drugs or (too much) alcohol but may need support

 Very little or no alcohol misuse and/or drug use

 Doesn’t need much support but appreciates knowing it is there

3

Getting control. I have choices about what I do and mostly choose well

 Feels a greater sense of control – understands they have choices about what they do

 Further reduction in alcohol and/or drug use or longer periods of abstinence

 Finds new ways to cope with feelings and situations that lead to alcohol and/or drug use

4

Understand why I had/have a problem and what I need to do

 Fewer lapses by this point, if not before, and able to learn from lapses

 Explores triggers for alcohol and/or drug use and reflects on causes

 Feels more confident about ability to live without drugs or misuse of alcohol

5

Doing some things myself to address my alcohol and/or drug use

 May reduce level of alcohol and/or drug use or abstain completely for periods

 More regular attendance at appointments (key work and specialist)

 Alcohol and/or drug use still has an impact on their life but not severe

6

See that I need to make changes myself to tackle my alcohol and/or drug use

 Recognises that addressing alcohol and/or drugs will require change on their part

 Less chaotic and more willing to engage in discussions about options to help

 Has agreed to access or is engaging with services or groups to address the issue.

7

Will go along with things my worker and doctor say will help

 Compliance with these measures dependent on enforcement by others

 Accepts referral to alcohol and/or drugs service if needed but is not fully engaged with it

8

Need some help with alcohol and/or drug issues

 Fed up with the negative consequences of the alcohol and/or drugs use

 Wants change but may not believe it is possible, often misses appointments

 Justifies behaviour, blames others, not taking responsibility

9

Sometimes see that it’s a problem but I can’t change it (or don’t want to)

 Some engagement with staff but refuses all help

 Some glimmer of dissatisfaction with how things are

10

Don’t have a problem with alcohol or drugs - though others think I do

 Alcohol and/or drugs causing harm to service user and/or other people

 Life totally organised around alcohol and/or drugs, nothing else matters

Physical and Sexual Health

Are you registered with a Doctor and a Dentist?

When was the last time you had a “check-up”?

Do you know where to go to get help or advice about health including sexual health?

Do you have any medical conditions? Are you managing these ok?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Physical and Sexual Health

Is registered with a Doctor and seen them within the last 3 months

Is registered with a Dentist and has seen them within the last 6 months

Has improved their general Physical Health

Making healthy choices about sex and relationships

Physical and sexual Health

+

Actively involved in helping others to improve health or raise awareness

This could be setting up running or sports group, producing leaflets / posters, etc.

1

Looking after my physical health well

 Independent and responsible approach to own health

 Reasonable level of self-care, diet, exercise, use of condoms and use of contraception

 Knows when they need to access help and how to do so

2

Lifestyle is reasonably healthy. Need occasional support to keep it up

 Feels as good as they have ever felt

 Still needs occasional support or encouragement

3

Changing my lifestyle to make it healthier but find it hard

 Improving lifestyle towards better physical self-care and healthy choices

 May change diet, start exercising or try to stop smoking

 May use condom and contraceptives but still occasionally don’t

 Change is difficult so needs lots of support

 Can make own appointments when needs to.

4

Can see that when I look after my health, I feel better

 Takes more responsibility

 Makes the link between getting treatment, leading a healthier lifestyle and feeling better

 As a result, motivation to care for own health increasing

 May say they are feeling physically healthier, though not necessarily

5

Doing some things to look after my physical health

 Takes some initiative, for instance attends GP appointment on their own

 Take some interest in their own sexual health e.g. Read sexual health leaflet

6

Realise I need to take some responsibility for looking after my health

 First signs of taking responsibility for their health

 Registers with a GP (probably with support to do so)

 Engages in discussions about health rather than just going along with them

7

Will go along with treatment provided for less pressing problems

 Will see doctor regularly, if needed, but only if someone else organises it

 Passive compliance with treatment resulting in some health improvements

8

Will get help when in pain or discomfort

 Acknowledges pain or discomfort and wants to do something about it

 Accepts help with acute problems but ignores less severe or obvious ones

9

Health isn’t great but so what

 Some glimmer of concern about themselves

 Will discuss health but refuses any help offered

10

Not interested in my physical or sexual health - don’t want to talk about it

 Will not discuss health issues

 Doesn’t attend to immediate health issues, for instance skins ulcers, bad cough, rash on sexual organs...

Emotional and Mental Health

Have you suffered from feelings of depression, anxiety or stress before?

How do you manage these now?

Do you have any diagnosed illness? How do you manage your medication and/or

strategies?

Do you see anyone regularly for support and help?

Are you getting support from others and are you making the best use of that support?

10

9

8

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6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Emotional and Mental Health

Is managing any Wellbeing or Mental health issue more independently

Has accessed a service or group to help deal with any emotional issues

Is accessing a CPN or some counselling

Has strategies in place to deal with issues that might affect emotional health

Emotional and Mental Health

+

Actively involved in helping others to manage their Mental and Emotional Health

This could be leading or running groups, producing leaflets, involvement in drama to raise awareness, etc

1

No emotional or mental health issues or can manage without external support

 If diagnosed MH issue, may have symptoms but they are being managed as well as is possible and the service user is able to find support as needed

 Otherwise, reasonably stable and positive emotionally. Not self-harming

2



Enjoying life and mostly feel fine. Just need support now and then

Comfortable with lifestyle and ways of coping

 May find the idea of managing own support frightening

3

More content and getting on with my life. Need help with ‘blips’

 Plans ahead and manages own prescriptions / medication.

 As a result of positive choices, feels better, energy and motivation increasing

 Crises are mainly avoided but change is difficult so needs support with setbacks

4

On a more even keel. Understand how to help myself

 If no underlying MH issue, may be more positive with more good days than bad days

 If MH problem, good insight and understanding of MH, what triggers relapse and what helps them feel better

 Makes better choices and can see the effect this has on how they feel

5

Can see the options and will try out ways to help me feel better

 Tries new things and takes some initiatives, for instance, engages in behaviour to lift mood and avoids behaviour and situations that make them feel worse

 May need lots of support, especially with new things, may slip back after positive risks

6

Can see why I feel like this looking for ways to help me feel better

 More awareness of what is wrong and/or of MH condition and looking ahead

 Believes they can influence their own emotional well-being and/or how much a mental health problem affects their life

 More active engagement. Will initiate discussion and may question medication etc.

7



Going along with treatment and feel OK some of the time

Attends appointments and goes along with support or treatment but only if accompanied

 There is a sense that they are going along with things rather than really engaged

8



Want change - want to get out of this hole and feel better

Say they want help, may make appointments or accept referral but attendance is unreliable

 If on medication, may take it but erratically

9



Don’t like feeling like this but there is nothing anyone can do about it

Severe symptoms having a negative impact, as above

 Will occasionally talk about symptoms but not for long and will refuse help

10

There is nothing wrong with me - though I often feel pretty bad

 Symptoms such as depression, high anxiety, self-harm, panic attacks, post-traumatic stress, or suspected or diagnosed mental health issues cause distress to service user and/or others and have a negative impact on daily living

 Not possible to engage in discussion on emotional or mental health

Managing Disabilities

How does your disability affect your day to day life?

Have you developed ways to manage?

How well do these work?

What aids or adaptations have been made available and how well do you use these to help

you cope?

Do you have any aids that need to be serviced or maintained and is this happening?

Are you getting support from others and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Managing Disabilities

Recognised some strategies are limiting and further aids, adaptations or

support is needed

Has improved independence through use of aids, adaptations or technology

Has strategies in place for overcoming any day-to-day issues

Managing Disabilities

+

Actively involved in helping others to manage their disabilities

This could be working with other agencies, creating leaflets, translating leaflets, group work, etc

1



Can manage my disabilities without external support

Confident in lifestyle that enjoys achievement taking appropriate account of disabilities

 Looks after themselves and makes use of own support network when needed

2



Achieving and enjoying life – when I need help I know how to get it

Comfortable with lifestyle and ways of coping – manages / renews own aids and adaptations

 May find ideas of letting go of support uncomfortable

3

Changing my lifestyle: managing my disabilities and making good choices most of

the time

 Belief they can find the positives and creative ways to achieve

 As a result of positive choices, feels more confident and motivated

 Crises are mainly avoided but still needs support when new choices don’t work out as planned or if confidence drops.

4



Life is better when I understand what I can do to help myself

Makes better choices and can see the effect this has on how they feel

 Understands how using aids and adaptations can give the personal control they want to enjoy

5

Getting clearer about my goals and starting to take action to improve things

 Tries new things and takes initiative if they can call on immediate help.

 Engages with services regularly, usually unaccompanied

 Has more sense of how they want their lives to be

6

Can see why I feel like this – need to be able to manage my life better

 More awareness of personal limitations and strengths – looking ahead

 Belief they need to find positives and overcome difficulties

 More active engagement. Will initiate discussion and may question aids and adaptations

7

Going along with support or treatment and managing OK sometimes

 Regularly attending appointments and goes along with support or treatment but only if accompanied

 There is a sense they are going along with arrangements made by others rather than really engaging

 Still seeing aids and adaptations as a nuisance or being stigmatised

8

Want to change – want to feel I can do things like other people

 Say they want help, may make appointments or accept referral but attendance is unreliable

 If on medication, may take it but erratically

 If possessing aids and adaptations, may use but not consistently

9

Don’t look after myself – that is just me, there is nothing anyone can do about it

 Severe issues having a negative impact (see 10)

 Will occasionally talk about the experience of disabilities but not for long and will refuse help

 Solely negative view about using aids and adaptations

10

Not interested in talking about physical or learning disabilities

 Difficulties at school, bullied for being seen as different, behaviour problems in class, finding some activities difficult, trouble understanding or remembering, other people take advantage, unhelpful friendships

 Not possible to engage in discussion about physical or learning disabilities

 May have low self-worth, lack confidence, suffer consequences from making poor choices

Respecting Others

How well do you manage your anger/frustration?

How do you feel about your ability to control yourself?

If you have got into trouble in this area - are you working with anyone to help you to not

re-offend and is this helping?

Have you had any disputes with neighbours recently and how well do you think you

managed this?

Are you involved in the wider community in any ways? How involved are you in helping

other people?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Respecting others

Kept to and engaged with any statutory agency or order for 3 months

Kept to and engaged with any statutory agency or order for over 6 months

Accessed a group or service to help deal with offending behaviour

Has become more involved in the life of the wider community

Has “given back” in some way to the community or other group or individual

Respecting Others

+

Actively involved in helping others, involvement in the wider community.

This could be being involved in local community work or groups, undertaking voluntary work, etc

1



Community Member

No offending history within 12 month period or ever.

 Fully in control of self and reactions to difficult or challenging situations.

2

Staying on the path

 Has not offended for at least 9 months, no outburst of anger in 12 months

 Can control feelings of anger and frustration by recognising long before boiling point and using a strategy.

3



Managing the source of the issue – with occasional help

Has not offended for at least three months, have not had an outburst of anger in six months

 Still finds some situations difficult, so benefits from occasional support

4

Changing my life to keep within the law and can see the benefits

 Avoids high-risk situations and has strategies to avoid triggers leading to further reduction in criminal behaviour

 Builds skills and makes lifestyle changes to support abstinence from criminal activity

 Change is difficult, so service user needs support to keep going

5

Understand how and why I get in trouble and finding ways to stop

 Will discuss triggers for offending and how to avoid high-risk situations

 Actively considers other lifestyle changes that may support abstinence from criminal activity, for instance social circle, addictive behaviour

 Considers help they might need in managing their behaviour, for instance managing anger

6

Can see why things happen and need to manage things better

 Recognises that they need to make changes to really get out of their difficulties

 Takes some initiative to comply with terms of legal orders

 Starts to realise that some actions they took caused these issues.

 Reduces offending behaviour; this could be linked to tackling addictive patterns

7

Would like help to sort out issues with the police, courts and/or probation

 Willing to acknowledge and discuss offending pattern

 Accepts help with court or legal order but

 Not willing to fully acknowledge or address offending pattern

 May break terms of legal order

8



Wish I didn’t have these problems - want to get them off my back

Unhappy with the negative consequences of their offending or anti-social behaviour

 Still not accepting responsibility for the situation

9

Fed up with these issues, but that’s just the way it is

 Acknowledges current situation (if in contact with police and/or courts) but won’t discuss changes in behaviour

 Not in contact with police and/or courts but hints they might be breaking the law

10

Not willing to talk about behaviour or how it affects others.

 Suspected of offending regularly but won’t discuss it or acknowledge there is a problem

 May be in contact with police or courts; may have an ASBO or injunction

Maintaining Accommodation

How are you managing with your Licence at Exeter YMCA? Have you had any warnings?

What were any warnings for? How could this have been managed better?

How are you managing your rent account?

Do you understand your responsibilities and what you have to pay and when?

How confident do you feel about moving on from the YMCA?

How will you manage living in a shared house, for example?

What things do you think you still need to have a better understanding of?

Who is supporting you and are you making the best use of that support?

10

9

8

7

6

5

4

3

2

1

+1

+2

Comments:

ACHIEVEMENTS : Maintaining Accommodation

Has positively engaged with the support service for 3 months

Has positively engaged with the support service for 6 months

Has positively engaged with the support service for 12 months

Has kept to the rules of the project for 6 months

Has remained in credit on rent account for 3 months

Has achieved a certificate in Move on

Secured a settled place to live (Move on)

Has maintained their accommodation to the point of move on

Has been saving for a deposit / rent in advance for 2 months

Maintaining Accommodation

+

Actively involved in helping others to manage their accommodation

This could be joining in with Move on Courses as a leader / facilitator, creating information for new tenants

1

Can manage my accommodation without external support

 No risk of eviction

 Able to forward plan and deal with crises

 May still have debts but is repaying them and can manage situation without support

2

Managing well - know when I need help and how to get it

 Managing accommodation well, avoiding crises and planning forward but may have occasional problems or particular areas they find difficult and still need support with, for instance an entrenched problem with a neighbour.

 If in flat, may develop positive relationships with neighbours

3

Can avoid crises but need some help with things like planning ahead

 Immediate problems dealt with but need to ensure they don’t arise again so develops skills in budgeting, cleaning, dealing with the housing provider and/or benefits agency etc.

 May be involved in Resident Association (Committee or attending meetings or involved in consultations)

 Doing more for themselves but experiencing setbacks

4



Life is better when I take an active role in managing my accommodation

Difficulties lessen and service user starts to see that being responsible brings rewards – it is much better not to be in conflict with neighbours or getting red bills

5



Starting to do things to keep or get the kind of home I want

Seeks out help with forms, bills etc., for example

 Gets help with behaviour issues, for instance takes an anger management course

6

Want to change behaviour to keep accommodation or get move-on

 First signs of taking responsibility for accommodation situation

 If in debt, there is a sense that they want to understand their situation and address it

 If anti-social behaviour is a problem, then there is now interest in addressing it

7

Will go along with things to keep accommodation and/or get move on.

 Compliance with action plans to address issues (for instance rent payment and debt repayment) but if given a choice (for instance money paid direct to them) then may stray

 If antisocial behaviour is a problem, this may still be present

8

Don’t want to lose my accommodation

 Realises that they are at risk of eviction so decides to ‘play the game’, for instance cooperates with getting claim running or talking about debt repayment and budgeting

 Won’t take action unless forced to

9



Don’t care what happens, nothing can be done. No one can evict me anyway

Will discuss issues but refuses to take action or accept help

 Some awareness that people are talking about eviction but not fully taking it on board

10

Not interested in your rules and regulations – go away!

 At risk of eviction, for instance due to non-payment of rent or anti-social behaviour

 Won’t discuss issues or acknowledge there is a problem

 If in own flat, may refuse access to the property

Further Comments / Notes:

Resident (Signature)

Support Worker (Signature)

A copy of this Support plan should be kept by both the resident and the Linkworker