12 Lessons from the Development and Operation of an Australian Accommodation support system for Deafblind Adults.
These 12 Lessons were written jointly by

Trish Wetton
CEO, Forsight Foundation, and

Mike Steer
Royal Institute for Deaf & Blind Children, and
The University of Newcastle, NSW

An Australian with sensory and multiple disabilities is a full citizen with the rights and responsibilities accorded all adult Australians, and is entitled to dignity and respect. The Forsight Foundation located at North Rocks in suburban Sydney was founded 30 years ago by parents of children who were deafblind to provide quality accommodation support services and facilitate training and employment for adults who were both deaf and blind with additional disabilities; and to enhance and enrich their lives. In 2008, Forsight manages eight independent group homes, with 49 full-time, part-time and casual staff providing support to 32 adults with sensory and additional disabilities, (See photos of the residences, residents, staff and activities).

Forsight Foundation staff firmly believes that each resident is a unique and important individual. The agency’s Board, staff, the residents, their families and advocates do all in their power to foster a service model that is based on mutual respect. Staff are trained by the agency to adopt a person-centred approach to all aspects of its Accommodation Support Program. The agency’s objectives are as follows:

To promote, encourage, foster and develop the care, accommodation, communication and training of adults who are deafblind with additional disabilities.

To assist residents to interact with others in the community, to protect their rights and treat them with dignity and respect as valued members of the community.

To assist residents to lead satisfying lives and as far as possible become self-determining.

To consolidate world knowledge and encourage sponsorship for research.

To become a model of best practice in the provision of services for adults who are deafblind with additional disabilities.

In its 30 years successful experience at developing and managing a reasonably large accommodation and support system for deafblind adults, Forsight Foundation’s management, staff and residents have learned that the following areas are highly important to the success of the agency:

Sound principles
Lesson 1 Services need to be based on sound human service policy principles

Forsight Foundation has developed and implemented policies and procedures including Code of Conduct, Code of Ethics, Meeting Individual Needs and Mutual Respect for Others. The ecology of each group is a high priority for Forsight Foundation. Nurturing relationships between residents and also between staff, families and Advocates and residents is very important by Forsight Foundation management.

Attempts are constantly made to have each Forsight Foundation group home is a welcoming, safe and happy home and workplace. All staff focus on each resident’s needs to provide a person-centred service. The goal is to provide a person-centred service. Communication training in Augmentative and alternative methods of communication include finger-spelling, Makaton and Compic. These are provided to meet individual communication needs.

Assessment
Lesson 2 Residents with sensory and multiple disabilities need to be correctly needs-assessed.

Assessments at Forsight Foundation take into account the centrality of the sensory and multiple disabilities, and include consideration of the whole person. Assessments require input from the resident with a disability or an advocate, and from family members and carers. The importance of identifying the range of impairments, the way they combine and the resultant effect cannot be over-emphasised. Early identification and complete assessment leads to effective program development and enhances the probability of providing positive outcomes.

Practical Assessments are conducted in each resident’s own group home to enable abilities to be identified more accurately. Residents are more confident in surroundings and with people they are familiar with. A range of medical and other Assessments are conducted for the Lifestyle & Environment Review, the Developmental Disability Health Unit Care Plan and the Forsight Foundation Care Plans.

Community presence
Lesson 3 Australians with sensory and multiple disabilities have a right to live and spend their time in the community, and not in facilities that deny their access to fellow citizens.

Towards this goal, Forsight Foundation constantly seeks alternatives to such long-stay programs as nursing homes and institutions. The location of a support service is highly important as this can affect opportunities for involvement in ordinary, everyday community life. Residential support services need to be located within easy reach of such community facilities as shopping centres, post offices, community health centres, recreational facilities etc. Proximity to public transport is also highly important. In planning and delivering accommodation support services, equal weight should be given to day activity provision and access to community services.

Residents are able to access their local shopping centre with one-to-one support for personal shopping and personal care appointments. Additional one-to-one support is available through the Group Home Support Centre at North Rocks.

Forsight Foundation obtains donations each year to provide support and transport for residents to attend Blind Bowls, Blind Cricket, Riding for the Disabled, RAPS and Hand Over Hand recreational activities in the community. The Agency believes that when group homes including gardens are well maintained, residents are accepted by their neighbours and welcomed into the local community. Forsight Foundation welcomes local Service Clubs to participate in special events with residents.

Relationships
Lesson 4 Living in the community is not enough. Relationships in daily life with non-disabled people need as much as possible to be fostered.

Forsight Foundation seeks Advocates to provide support to residents who do not have family members or friends to assist them to make informed decisions and choices about their lives. Links with Corporate partners allow relationships to be formed between volunteers and residents. Working bees, including group home garden and room makeovers involve community donors-in-kind and residents working side by side on a project.

Professional photographers have become mentors to blind residents, training them to take digital photographs to expand their perception of the world using their senses of touch, sound and smell. New opportunities for building new relationships are continually being sought.

Choices
Lesson 5 A person with a sensory and multiple disabilities has rights of citizenship in the service development process to make views known and have account taken of those views.

Residents attend regular meetings where they receive assistance to communicate their views about their group home. They have a representative on the Forsight Foundation Homes’ Committee which gives them access to the Board. Under guidance from the CEO a unique communication link with each resident has been developed to enable all residents to make their views known and be listened to at any time.

Communication
Lesson 6 Opportunities for communication with other people is of primary importance in the development of relationships, since this enables choice and decision-making as well as participation in community life.

Individual Plans include goals for increasing communication skills.
Vision Australia, Deafblind Services NSW, Guide Dogs Association of NSW/ACT and the Deaf Society assist the Forsight Foundation to provide opportunities for residents to communicate with other people in their group home and in the community.

Staff receive training in offering choices to residents, knowing when to hold back to encourage independence is important to ensure that each resident is given the time he or she requires to make choices about being independent and doing things for him or herself. The Agency provides weekly Dance Therapy sessions to residents. Positive outcomes from this project include enhanced communication between residents, enjoyment and documented changes in challenging behaviour.

Families, friends and Advocates play an important role in the lives of deafblind residents. Home visits are anticipated eagerly. These highly important links are nurtured by staff.

Home
Lesson 7 Wherever possible, remaining in the family home with support from the agency should be considered a viable option for a person with a sensory and multiple disabilities.

New enquiries for accommodation support programs are referred to the Department of Ageing, Disability and Home Care Vacancy Management Committee. The Department provides Case Management and Assessment options to identify level of support needs to ensure that all viable options are considered. In-home support services are discussed with stakeholders at Individual Planning meetings.

Forsight Foundation believes that all residents where possible go home to their families during Christmas and Easter breaks. Regular home visits are encouraged throughout the year.


Follow the blog and make comments if you wish. In the following weeks we will be publishing each of the 12 Lessons through the Sensory Learning blog.