1. Understand factors affecting the capacity of individuals to develop and/or maintain relationships 1.1 Analyse reasons why individuals may find it difficult to establish or maintain relationships There are several factors that come into play here. There may be an issue with the individuals communication needs, it can be difficult to establish a relationship and maintain it if your communication needs cannot be met. I have worked in a setting where a blind Service User has cohabited with a mute Service User with Down’s syndrome. They would not be able to maintain a relationship without the support of staff to act as an intermediary. There can also be further issues with a disability, a Service User with an autism spectrum disorder may not see the necessity to establish a relationship and see no requirements to maintain one. However with care in the community and the requirement of a lot of disabled people to cohabit with others, social bonds need to be forged and maintained to keep the peace.
1.2 Describe types of legal restriction or requirement that may affect individuals’ relationships This is dependent on the form of relationship. There are a variety of differently kinds of relationships that can be formed by a Service User and a great deal of them are allowed and encouraged without restriction. However, as support staff we have to look out for abusive relationships. We also have to be aware that Service Users may form sexual relationships. Abusive relationships can take the form of bullying (physical, psychological and sexual) and can happen to disabled and non-disabled people alike. As support staff we are there to offer guidance and remain vigilant that these forms of abusive relationships do not take hold. We have a duty of care to the Service User, to make sure they are safe and well cared for. Services Users can form sexual relationships without any hindrance or interference from support staff.
To prevent them forming a sexual relationship or any relationship without good cause would go against “Deprivation of Liberty Safeguards (DoLS)” and the Disability and the Equality Act 2010. However if we feel that there are certain issues with consent in the regard of a sexual relationship, and a certain comprehension of risk we can intervene. The Mental Capacity Act 2005, (DoLS being a part of this act) offers safeguards where a advocates can assess mental capacity and intervene in situations where a person is deemed lacking the ability to safely form certain kinds of relationships. 1.3 Explain how an individual’s capacity to establish or maintain relationships may be affected by the way support is provided Not all support staff are created equal. As support worker we endeavour to work for the Service User to give them a high standard of living and enable them to live independent lives.
Unfortunately I have first hand experience of working with support workers who bring to work their own prejudice and narrow-minded views and have used these to hold back Service Users. If a Service User has the capacity to form sexual relationships, or even go to the pub and drink freely and the desire to do so, without VERY good cause we should not stand in their way. I have worked with support workers who have told Service Users that “you can’t drink your only little” (to an individual with Down’s syndrome). To support workers who have very specific religious beliefs who frown upon premarital sex, preventing Service Users seeing their partners. There are more mundane issues with support that may affect the Service User forming relationships such as communal housing. I work in a setting where three adult Service Users live together, however there aren’t always enough staff or enough staff who can drive to enable everyone to go out and see friends. Also, in this setting the cohabiting Service Users do not always get on in the best of ways so bringing back friends and family can be a contentious issue.
1.4 Explain the importance of ensuring privacy and confidentiality when providing support for relationships We are all entitled to a personal life. Service Users are no different in this regard, I am paid to support independent living, and I am not paid to be ‘Big Brother’. I encourage the Service Users I support to maintain relationships and I am there in case they have any specific needs. In the current setting where I work, there are three adult male Service Users. Each a different age and disability, and each one maintains a different set of relationships to each other, friends and family. Even though they live together in the same house, they are all entitled to their own private lives and space. It would be monstrously unfair to speak to Mr A about the relationships of Mr B or Mr C. They are entitled to a private life away from each other. Also not everyone is understanding of disabled people forming relationships, it is important to ensure privacy and confidentiality so that no one feels different to an extent.
2. Be able to support individuals to identify beneficial relationships 3.1. Support an individual to understand the likely benefits of positive relationships Working in a setting with three Service Users living together I spend a great part of every shift helping the Service Users maintain a happy friendship with each other. This is not always easy, since there are numerous issues with jealousy, anger, fear and other emotions. Each Service User is a different age and has a different disability but have the same level of comprehension and similar communication needs. Some days one Service User is jealous of another because they can go out. Some days there can be anger because of a perceived issue of a Service User getting something extra when they are not. Fear sometimes plays a part, even though the three individual’s have cohabited for more than ten years there are still issues of trust to overcome.
I support the Service Users to interact and try and convey the fact that if they communicate and get on better, they house would be more of a home and everyone would be more relaxed. Most days the task of the support worker is to create diversions. Issues usually stem from a sense of boredom of the environment so we encourage trips out everyday. We do try our best to explain the positives of living together, all pulling together to purchase home items and sharing tasks such as cooking. Unfortunately due to a number of issues it doesn’t always work. 3.2. Support the individual to recognise when a relationship may be detrimental or harmful I support Service Users who access the local Social Services Activity Centre. Many relationships are formed there away from the support workers that work day-to-day with the Service Users. We do our best however to listen to the Service Users when the come home and hear about their day.
Every once in a while we hear stories that are worrying. Mr A has a friend in the Social Activity Centre who likes to punch people to say hello, we tell Mr A that this is how this one person says hello and not everyone appreciates being punched in the arm. Whenever we hear stories like this we liaise with the centre staff and work things out for the benefit of both parties. We have to listen carefully to what the Service User is really trying to say sometimes to get the real meaning. Mr A came home from the centre without having lunch, but he was ok with this because he was given a new hat. After a few more conversations Mr A told us that his new friend swapped his hat for his packed lunch. We explained that this was ok, but in future it’s better to eat than have more hats. When relationships form in venues outside the scope or support staff, we do our best to offer guidance and support whilst maintaining their independence.
3.3. Work with the individual to identify specific relationships that are likely to be beneficial to them A specific relationship we are trying to maintain for Mr B is with family. Mr B has lost both parents and has no siblings, but does have three cousins. We support Mr B to keep in contact with his cousins by telephone, email and letter as often as we can. Sometimes Mr B doesn’t really understand the need to speak to family but he is always happy after speaking to his cousins. We try and maintain this family link as it’s beneficial to maintain this relationship as he has difficulty making friends and is often at odds with other housemates. We have sat down with Mr B and his cousins and have worked out times when he can and cannot get in contact, and this has brought them all closer together.
3. Be able to support individuals to develop new relationships 4.4. Describe types of support and information an individual may need in order to extend their social network I have supported many Service Users in the last two years who have utilised new technologies to make friends and maintain existing relationships. A greater number of disabled people are using mobile phones, the Internet and specifically Facebook. I have helped two Service Users set up profiles on Facebook so they can interact with friends, family and support workers. I have had to explain the issues with forming friendships online and have come to an agreement with one Service User that it is best that they login with a support worker so they can compose and check new messages. The Internet can be a dangerous place to form friendships, and I have also explained that “stranger danger” can happen online. To be wary about strangers asking too many personal questions, asking too many questions too quickly and be carefully of anyone asking to meet.
4.5. Establish with an individual the type and level of support needed to develop a new relationship The Service Users that we support have been previously assessed by Social Services for their mental capacity and we know from there what levels of independence are expected. We can build from that a variety of risk-assessments and used personal centred planning to develop strategies to support Service Users create new relationships. When forming new relationships it can be a difficulty and stressful process. I discussed with one Service User what they wanted to get out of friendship, to see what goals they had in mind. Knowing this I went away and worked out a series of venues, activities, club and other places where they can make friends. There is a great assumption that disabled people need disabled friends. This is a fallacy; I have helped Service Users in the past make non-disabled friends. I guess the trick would be to find out what goals they have in a friendship (i.e. someone to play Xbox with) and work from there.
4.6. Provide agreed support and information to develop the relationship With an individual I supported with ASD, it was agreed that I had to support them to see his friends in the pub. However I had to sit in the corner by the pool table and not talk to them. So in effect I was a passive chaperone. I have supported a different individual in the past to meet up with their friend in the exact same place at the exact same time every week for exactly one hour, but I was responsible for maintaining their conversation. In both these cases I sat down with the Service Users and asked them “what would you like me to do when you meet your friends?”
4.7. Encourage continued participation in actions and activities to develop the relationship With some friendships it’s enough to meet at the same place at the same time every week. Other time I am there to offer ideas and alternatives. I would like to see all the Service Users that I support have active friendships where they take the lead and participate in social activities, but this is not always easy. I have set up in the past meetings in snooker halls, bowling alleys, cinema trips, Art centre activity events and day trips to neighbouring towns. It is good to have variety so that the Service User has a good time, and that the relationship doesn’t just become a required activity. 4. Be able to support individuals to maintain existing relationships
5.8. Describe types of support an individual may need in order to maintain an existing relationship with family or friends There are levels of practical support I provide right now for a Service User to maintain their relationships. For a few of the Service Users I support they live quite a distance away from friends and family so I have to arrange transport and coordinate activities to allow this. With one Service User that I support they require physical assistance to use a telephone and computer, so I will have to type dictated messages to send threw Facebook on their behalf. Sometimes I am called on to give emotional support to a Service User due to unforeseen changes in a personal relationship. With one Service User their parents passed away so there was a need to address this loss and support them through this rough time, but also get them into contact with close relatives at the same time.
5.9. Establish with an individual the type and level of support needed to maintain the relationship After making a relationship, the Service User will have an idea and an expectation of what the want to get out of this relationship. The Service User will fit me in around their needs, I will support where required. I don’t expect on my part to sustain a relationship for them, merely facilitate the Service User to maintain a relationship. With one Service User I am often required to assist in the writing of emails, personal messages on Facebook and dial the telephone. With another Service User I will just arrange transport so that they can get to the pub to meet their friend. With each Service User there will be a different need, with most I often act as a chaperone to make sure that everything goes ok and act as support just in case it is needed.
5.10. Provide agreed support to maintain the relationship I shouldn’t and wouldn’t overstep my mark when supporting an individual. It is their relationship, I can help them look and form new relationships. Maintain and rediscover old ones and make sure that they can sustain links to friends and family. I am not to be their friend, or form close relationships with their friends and family beyond the professional level. There can be an issue with a conflict of interest. This has to be understood with the Service User; sometimes they can bring support staff into their inner circle. Boundaries have to be maintained in this regard. I will agree to support their relationship in a manner that benefits the Service User. Providing support that they request and agree to. 5. Be able to work with individuals to review the support provided for relationships
6.11. Establish with the individual the criteria for evaluating how effective support for a relationship has been The biggest criteria are whether they are getting anything out of their relationships. If so, what are they getting? Do they feel positive and happy after seeing friends and family? Are they content with the way they are supported? I would establish what goals and requirements they have first with their relationships. How has the support they received from me affected their relationships (if at all)? If they haven’t seen a friend for ages and keeping asking how they are, maybe I have been ineffective in supporting them to go and see their friend.
6.12. Collate information about the relationship and the support provided We keep personal diaries in all the supported living environments of our company. By recording when the Service User has been out to see friends and family and who supported them we can build a picture and spot any trends. They should be supported by staff they feel comfortable with. Then again the same people shouldn’t support them all the time. Working with the Service Users we can understand how often they feel comfortable seeing friends and family. With clear communication we can work out their preferences.
6.13. Work with the individual and others to review and revise the support provided The team manager will deploy staff evenly and across the rota in such away that they have rolling shifts and aren’t always asked to provide the same level of support every week. We all take equal share in the house activities with all three Service Users. Unfortunately we aren’t all drivers so there can be days when things are done either by taxi or not at all. The team manager listens to the needs of the Service User and tries their best to make sure that support is provided to enable them to maintain relationships.
6.14. Report and record in line with agreed ways of working Company policy varies from each house, in the house I am currently based we report and record activities in personal daily diaries for each of the Service Users. We do not maintain a special document or form that records personal relationships. However, we do have a form to record any challenging behaviour that may arise from friction in the relationships of the three Service Users in the house.