Annual Report 2010 - 2011

1. Brackenridge Annual Report2010 - 2011 Partnership Vision Innovation Person Centred

2. CONTENTS About Us 2 Mission Statement 3 Brackenridge Services 4 Chair’s Report 5 General Managers Report Employment and Communication Service High Health Needs Service Adult Residential Service Children and Young Persons Service Respite Service Training and Organisational Development Statement of Accounting Policies Statement of Comprehensive Income Statement of Changes in Equity Statement of Financial Position Statement of Cash Flows Notes to and Forming part of the Financial Statements Statement of Responsibility Auditor’s Report ABOUT US Brackenridge is a subsidiary company of the Canterbury District Health Board that provides services for children, young people and adults with disabilities and their families. Our services include 24-hour support for people living in residential homes throughout the Christchurch Region and respite care for children, young persons and adults in Christchurch. Brackenridge also offers specialised Behavioural and Vocational services for people in Christchurch. As an organisation, we believe in providing people-centred services and options that focus on individual needs. All our services support people to identify their personal goals and aspirations. These are developed into a personalised and achievable ‘Individual’ plan, which enables the people we support to achieve their immediate and lifelong objectives. Brackenridge supports the principles of the New Zealand Disability Strategy and places great emphasis on the worth of the individual, personal growth and the provision of holistic support for people with an intellectual disability.

3. Our Vision At Brackenridge supporting people to live great lives is the cornerstone of all our work. This combined with working hard to firmly establish a culture of continuous improvement is ensuring people we support are receiving a high quality service. The better we function as an organisation, the more able we’ll be to achieve our vision of ‘people with disabilities living great lives.’ We strive to have an Outcomes based focus incorporating an annual review of the quality of what we are doing which is an inherently more personalised approach. We recognise we can only achieve these outcomes successfully by collaborating and working in partnership with family, stakeholders and others operating in the sector. It’s an exciting journey! As we improve as an organisation, so too do we improve our ability to deliver the highest-quality support to people we serve. Brackenridge Services High Health Needs Service A Service for people requiring specialised high health and physical disability support. Adult Residential Service Support Services for adults living in accommodation services. Children and Young Persons Service Support services for young people living in accommodation services offering a range of living options. Respite Service Residential Support for young people, adults and their family who require specialist respite support services Employment and Communication Service Support service for people looking for work and people requiring communication support. Behaviour Support Service A support service designed to support people manage challenging behaviour through positive behaviour support Active Support A service programme empowering people to participate fully in their daily life.

4. The Brackenridge Chairman’s Report The 2010/2011 year was a year of consolidation for Brackenridge, following a period of growth particularly in the development of community houses. The second half of the year was very much a reaction to and response to additional challenges bought by the September 4, 22 February and 13 June earthquakes. The organisation was fortunate that the damages to houses were mostly minor and there was no requirement to vacate any of the properties. The reaction of staff during and following the events and loss of services was also very positive and ensured that as an organisation Brackenridge has emerged largely unscathed from an unprecedented set of natural disasters. The Company’s disaster planning proved sound but will be further refined from the experiences learnt by the Christchurch area as a whole. Despite the challenges outlined, the organisation was able to introduce a new management structure from late in 2010. This involved the establishment of 7 Managers reporting to the General Manager and also the establishment of 3 Daily Operations Supervisors. This restructure was achieved from within the existing budget. From the Board’s perspective, the addition of two new managers from outside the company and the new functional service arrangements have already shown promising results. In addition the new structure and service extensions have placed the organisation in a good position in relation to anticipated policy and funding changes in the Disability Sector currently being piloted by the MOH. These changes will also be affected by the government’s benefit review, particularly as it relates to those clients on the Invalid Benefit. It is anticipated that services Brackenridge offers will increasingly, need to be more targeted, flexible, and subject to greater individual choice and negotiation. In an environment of constrained government funding, and in the face of major natural disasters, the fact that the Company was able to record a modest surplus for this financial year was commendable. The funding forecasts and other national changes do not bode well for real increases in future revenue. In the course of discussions with the CDHB in 2009, Brackenridge’s charitable status as a company was re-affirmed. The Board and the CDHB in April 2011 reviewed progress toward Brackenridge’s possible ultimate independence, and noted that Brackenridge had made further progress. The Brackenridge Board has asked management to produce a timeline and costed plan for the divesting of services Brackenridge currently receives from the CDHB such as payroll, finance and computer support. We are encouraged by the steady progress being made. In February of 2011 Brackenridge lost a long standing staff member Wayne Simons. As Manager of Support Services Wayne had assisted the General Manager and indeed the organisation through a number of pivotal changes in it’s development. His most visible legacy is the annual Christmas in the Forest event.

5. It remains to express thanks to all our staff, who despite three major earthquakes have continued to provide high quality support to the people in our service. The Board is aware many of the staff have been severely impacted by the effect of the earthquakes themselves and it is a true sign of their commitment they have been able to put this aside and continue supporting our people whilst maintaining service quality standards. On behalf of the Board, may I express our gratitude to the General Manager, Peter Campbell for his consistent efforts and to all the staff, and to those who support Brackenridge in other ways, our appreciation for a demanding and satisfying year’s work in the face of very considerable adversity. As to the Board itself, I was sorry to lose the services of Garth Bateup as a longstanding board member at the end of the year due to his increased DHB commitments with his involvement in the West Coast DHB – the board members have appreciated Garth’s sound counsel in the areas of management and finance. I would also like to offer my personal thanks to the whole Board for their ongoing efforts to support and challenge Brackenridge to achieve its potential as a provider of quality care in a demanding sector and in demanding times. Finally Once again, I would like to thank the staff fro their remarkable commitment through what has been for all, a very difficult year and particularly for those who have either had their homes seriously damaged or in some cases worse still. W. David Morrell Chair, Brackenridge Estate Ltd

6. General Manager’s Report General Manager The year has been marked by the large earthquakes in September, February and June which have changed the city of Christchurch forever. Although I am sure Christchurch will arise from this better, more modern and greener dealing with the impact of the earthquakes has affected all areas of our work. From the point of view of our houses we have been extremely lucky with only the three houses in the Parklands area sustaining any significant damage. However even in those houses we have been able to continue occupancy with only minimal disruption. A number of our staff have not been so lucky and have lost homes, had to find temporary accommodation and still continue working. It is a real credit to them they have been able to do this and it has caused little effect on the way in which we have delivered services. Despite the Earthquakes much has been achieved over the past year but there are still a great many opportunities for the continued improvement of Brackenridge services in supporting the people we serve to live really great lives and in building the capacity of our workforce. We see both of these outcomes working hand in hand because without a trained and skilled staff our vision for people of ‘living great lives’ will not happen. Throughout the year we have shown great passion and determination in working to achieve these outcomes and as the knowledge of our workforce has increased it has been noticeable that staff have examined existing methods and processes of their work and more and more we are seeing the lives of people we support expanding and becoming much more meaningful. Our investment in workforce development is bearing fruit and it’s very encouraging to note the large numbers of staff who are engaged in the gaining of NZQA qualifications through the Careerforce programme. At the wider level of the world of disability service provision in New Zealand an evolution has started to occur and pleasingly this change is being driven by the Ministry of Health. They are piloting a new model of support and local area coordination in the Western Bay of Plenty which is likely to be the blueprint for new and enlightened ways of supporting people with disabilities to live great lives. Brackenridge is highly supportive of the new initiatives and believes they will make it easier for families and people with disabilities to be empowered and have more control in how services for the person with a disability are constructed. If we are serious about really making a difference to people’s lives then we need to embrace the upcoming changes and ensure we are prepared and ready to provide a range of support services which will deliver improved outcomes for people. Outcomes Brackenridge is becoming increasingly focussed on the achievement of outcomes some of which are strategic and form part of our strategic plan and others which are focussed on the overriding outcome of ensuring all people we support, ‘live very good lives’.

7. As part of our strategic vision of being a stand alone community based provider of services for people with disabilities in December 2010 we moved our main administrative office from the sheltered village at Maddisons Rd to 29 Birmingham Drive and this has worked very well for us. In line with our moving the administration office we restructured our client service and now have the following service areas Adult Residential Service, High Needs Service, Children and Young Persons Service and Vocational and Employment Service. This move has been very beneficial and managers of the service areas have more manageable workloads and clearer outcomes that they are working towards achieving. During the year we had computers installed in all our houses and have set up a Technology committee to drive the advances in the use of technology throughout the organisation. A longer term goal is to replace all paper based forms and streamline reporting throughout the organisation. The Brackenridge Board and the Canterbury District Health Boards have agreed in principle that Brackenridge might best ultimately stand alone entity – very likely under some form of trust. We are also discussing with the CDHB interim steps by which some of the services currently performed by the CDHB for us might be absorbed within Brackenridge’s own functions so as to strengthen Brackenridge's position and enable the question of it’s final move to stand alone status to be negotiated. During the year we saw solid growth in client numbers and the demand for respite grew beyond our capacity to deliver. We are exploring options with the MOH for further expanding respite services. Our Employment and Vocational Service continues to grow and increasingly is playing a larger role in providing people we support with real options for work or to engage in more meaningful vocational activities. In 2011/12 further expansion is planned and development of our day programme services to highest international standards is an outcome we are working on achieving. Some exciting new initiatives are also in the pipeline for paid work for people we support. Circles of Support are a key outcome and progress is steady but slow and if we are serious about truly empowering people and working in partnerships with families Circles of Support need to be in place for all people in our service. Workforce Brackenridge has invested heavily in Careerforce Training with up to 50 Support Worker staff being engaged in working towards NZQA qualifications through this programme. Active Support remains a key programme that supports people in our service to fully participate in their own lives and our two Active Support trainers continue to refine and develop the programme.

8. With our commitment to ensuring all support staff working at Brackenridge have completed training at the Foundation and Core Competencies levels of the NZQA framework and the introduction of computers in all our houses we do have some challenges particularly with staff who are not yet computer literate in being able to read or access the necessary information to function in a changing work landscape. However we have been thrilled with the way most staff have embraced the new learning and with computer training planned for the New Year we are confident the obstacles will be overcome. Achievement to date 50% of CSW staff are enrolled in or have completed Level Two or Level Three qualifications We have two in-house assessors who guide and develop staff through the programme We have gained a grant for Leadership Development training and all members of the senior team are engaged in a Leadership Development programme We have established bi monthly meetings with the unions and this has helped address a number of issues before they have escalated Our Daily Operations Supervisors have worked hard on the development of a more robust casual pool and this has reduced the cost of bureau staff. Finance and Sustainability The economic downturn that affected the world between 2008 and 2010 followed by the earthquakes in Christchurch has created the highest budget deficit in New Zealand’s history. As our services are government funded this means we are in a particularly challenging time and with the spectre of the national sleepover dispute still hovering over us the likelihood of increased funding to the sector is not likely. As a result we need to be constantly vigilant of the cost of everything we do and consistently look for efficiencies. While being mindful of this we cannot detour from the path of investing in workforce development and innovation to ensure our staff and services are ready for and can adapt to the changes we know are coming in the disability sector. Developments over the past year The creation of Daily Operations supervisory positions in December is leading to better staffing efficiencies and over more time larger reductions in the use of agency staff are expected. The Daily Operations Supervisors are improving the way in which staff are taking leave and this is seeing a decrease in our leave liability. A planned maintenance programme has been put in place for all our motor vehicle fleet which will result in longer term savings. We have made more efficient use of our housing stock particularly at Maddisons Rd but further reviews of housing stock are necessary to ensure housing we use helps us achieve our outcome of ensuring people we support, ‘live very good lives’.

9. Wayne Simons In February 2011 we lost a dear colleague and great servant of Brackenridge when our Manager Support Services Wayne Simons passed away after a long illness which he battled through and only left work a week before his untimely passing. Wayne had a huge dedication to the people we support in our service having had a sister who had been in Templeton Hospital he always strived to ensure we were able to provide the best for our people. While Wayne will be remembered for a lot of things his lasting legacy will be the Christmas BBQ and Concert in the Forest Park. It was Wayne who came up with the idea and over the years and under his leadership it grew into our major event of the year. Conclusion Despite a great many setbacks from the natural disasters during the year the organisation has proved remarkably robust. We continue to achieve targets which are part of our strategic planning cycle and the organisation continues to establish itself as a leading provider of disability services. We ended the year with record numbers of permanent and respite clients while our employment and vocational service grows in strength and reputation. Brackenridge is aware of the huge changes afoot in the disability sector in New Zealand and we are excited about playing a major role in the change. We have started the process of finding other service providers for the provision of payroll, phone and computer technology systems which may ultimately result in us being able to function without any support from the CDHB. The board have asked management to achieve this capability to provide clear proof of ability to one day operate as a stand alone entity Brackenridge from the Board down through management, supervisors, nurse leaders, advanced practitioners and front line staff are fully committed to the ongoing improvement of services and in to finding ways which will ensure the people we serve and their families are fully engaged in living full and great lives. Peter Campbell GM

10. Vocational & Communication Service Manager The Vocational Service has undergone considerable change in the last year with the service being recognised and now incorporating Vocational, Employment and Communication functions. I took on the position of Vocational and Communication Manager in December of last year, this was a welcome challenge and the service is an increasingly busy one with the expansion of the vocational service to include a therapeutic Activity Service and the incorporation of the communication service. With these changes came the addition of one support staff member into the garden contract area. The service had it’s challenges this year with the unforeseen consequences of the September and February earthquakes and the disruption from the snow not many weeks ago. Programmes were quickly in place after the February earthquakes enabling people to participate in a variety of activities' to minimise disruption to peoples lives. 2010 also saw the end of Star deliveries which many people were involved in and enjoyed delivering. An organised thank you evening ( drinks, nibbles and tour) was held at the Wigram Brewery, everyone had a great time and certificates were handed out. This evening recognised the work that people had done and gave closure to the star rounds as the change in delivery came during the period after the February earthquake. As a service we felt it important to give recognition and a sense of closure for all people involved in delivering the star, fortunately new rounds were secured with PMP and people are now enjoying being back out deliveing pamphlets as well as papers. Community and staff support for this type of community role and participation has increased notably over the last year. The Vocational/Employment Garden Service has expanded and a number of contractors now service an increasing number of contracts for the Brackenridge organisation and private homes in the community. Many private contracts choose to become regular customers. This repeat business is the best kind of feedback. This area implemented an extensive Health and Safety programme for contractors to ensure safety comes first at all times. The success of this programme is reflected in the number of injuries and contract work related accidents which number one for the year. Recently the contract area implemented a skill matrix to assist in the matching of garden activities to the person reflecting the strengths of each individual contractor and ensuring people achieve within the area, which at this time of growth aids in the forward planning and productivity of contract activities, we are striving for seamless movement between contract activities. The foundations for a firewood service have been slowly put into place over the last six months and this exciting expansion of the service will enable people with an interest in this area to be a part of the contract service. It is hoped the structure of the contract area will enable it to seamlessly transition with any changes in the funding model and enable people living at home to take up a contract position. Requests for other work and voluntary positions are increasing and people already participating in work or voluntary positions are continuing to maintain them and in some cases increasing their amount of time. These positions are in workplaces or community services. Support for this type of position has increased and will only improve as the service develops and peoples success and achievements are recognised and valued.

11. A non centre based therapeutic activity service is also a new and exciting venture, planning is underway to create a Brackenridge Therapeutic Activity Curriculum which will incorporate learning themes and meaningful activities of choice in which people can be involved with and participate in. The structure of the service will enable the seamless transition of interested people initially from within Brackenridge and in the future from people living externally at home or with other providers. The communication Service has continued to be busy and many people are accessing communication resources to aid in everyday communication. The focus for this service in the coming six months is to develop and implement a lending library of media for people to access at home. Many people have a computer at home and others have indicated that the person they support would like to own one. A Computer resource library would enable people to access activities of interest at home with the support of staff. Computer activities provide enjoyment as well as learning opportunities. The service has also been working with Talklink providing training in communication. The service also supports recreation opportunities through a Monthly Coffee Group, which meets on the last Sunday of the Month at various cafes, a regular swimming evening at Pioneer on Tuesdays, Bead Making classes on a Monday night run by NZ Beading and Active Movement Classes on Wednesdays; Active Movement is a class facilitated by the Christchurch College of Education and Supported by Special Olympics. Active Movement runs for four terms and is a popular activity of choice for people. Other activities are also incorporated into to the service when requested. The service strives to support all recreation and leisure activities as a component of people living full and active lives. All in all a very busy year! I look forward to the vocational team being a part of peoples success in achieving their dreams and aspirations in 2012. Vivienne

12. High Health Service Manager This past year has been a busy and challenging one. The two major earthquakes Christchurch experienced over this period really tested the organization and created unprecedented working situations that challenged everyone at all levels within the organization. Understandably the disruptions created as a consequence of the earthquakes have had an impact on my ability to achieve the outcomes and goals identified for this service area however overall I believe progress has been made. The restructuring process at the end of 2010 resulted in a change of role for me with my appointment to the Manager High Needs Service position. I also have additional responsibilities of the Health Advisory Service and the Daily Operations Supervisors who report to me. High Needs Service Currently I am responsible for overseeing the support services provided to 42 people in total in this service area. 33 people are supported in a residential service in the High Needs Service area with ages that span across the age spectrum from young children to older adults. I am also responsible for respite services provided within this service area. Most of the people supported in this service area have a physical disability or higher health needs as well as a learning disability and require a higher level of support to meet their physical support needs. Approximately 60 fulltime and part time staff work in this service area and include Registered Nurses, Enrolled Nurses and Support Workers. A review of Registered and Enrolled Nurses during this period identified the base number of registered staff required to ensure the health needs of people are met. There has been a steady stream of referrals from people choosing Brackenridge as their provider of choice and it is encouraging that we maintain a positive profile with Lifelinks and the disability sector. There has been a steady demand for both residential and respite services in my service area and meeting demand has been difficult, particularly the demand for respite services. Consideration has been given to setting up a dedicated respite service for people with physical disability and higher health needs as it is acknowledged the current arrangement of providing respite in existing homes is not ideal and demand consistently outweighs availability. For this to work effectively a dedicated respite house for people with higher support needs would have to operate on a roster system similar to the one currently operating in our other respite service, current demand indicates that this would be viable. Five new clients entered Brackenridge’s High Needs Residential Service and one new client entered the High Needs Respite Service during this period. One young person left the service returning to a family based support arrangement.

13. The challenge for people supported in the High Needs Service area is getting others to look past the physical disability, so often it is assumed because a person has a physical disability they are unable to participate in everyday activities both within their home and the community and this low expectation is a major barrier to people living active, inclusive and meaningful lives. There is a wide range of equipment and technology available to support people with a physical disability to participate in everyday activities however if support staff don’t know how to use the equipment or don’t set it up for the person the opportunity is lost. All of the staff teams working in my service area have been trained in Active Support and there have been some great examples of Active Support in practice over this period from clients ordering their own meals at a restaurant using a communication device, operating switches to turn appliances on and off independently for household activities such as vacuuming, cooking, turning TV’s and stereos on and off, going to youth group, spending time with friends and family, having a paid paper round and even to going rock climbing! I strongly believe that the way forward for people with a learning disability to live a good life is to have a combination of paid support and natural or informal support; service providers can only do so much. While there has been increased awareness of what a Circle of Support is it is disappointing that there is not a fully functioning intentional circle of support in place for anyone supported in my service area and this remains a challenge and an area of strong focus for me as we move forward. However many of the people supported in the High Needs Service do have strong family and friend networks and these have the potential to develop into intentional support circles if supported in the right way. I would like to acknowledge the Nurse Leaders and the Support Staff who have worked so hard over this past year to improve the quality of life for the people they are responsible for and I look forward to working alongside them and the people we support as we head into another year. Health Advisory Service It is well documented that people with a learning disability have poorer health outcomes and are more highly medicated than the general population. The aim of the Health Advisory Service at Brackenridge is to raise awareness of health issues for people with a learning disability and identify initiatives to promote better health outcomes for all people supported within the organisation. I was not able to invest as much time as I would have liked into developing this service however the top three priorities for the Health Advisory Service over this period were as below: - Promoting better oral hygiene - Developing an Annual Health Assessment Tool to raise awareness of health issues and promote better health outcomes - Training Support Workers to perform routine non-nursing tasks currently performed only by registered staff and the development of a Support Plan and Decision Framework to better support people who have higher health support needs.

14. Daily Operations The Daily Operations positions were created through the restructuring process undertaken at the end of 2010. Currently there are three Daily Operations Supervisors who have a primary focus on ensuring the smooth day to day operation of the organization with the ultimate aim of providing a quality service to the people we support. Much of the role focuses on staffing however the role also encompasses some auditing responsibilities as well as being the first point of contact for dealing with day-to-day and extraordinary events. A major focus over this period was on reducing agency staff use by building the casual pool and filling vacancies and it has been pleasing to see progress in this area. The Daily Operations role continues to evolve and develop and will continue to play an important role in ensuring Brackenridge provides quality services to the people it supports. As we head into a new financial year the focus for the Daily Operations Service is on building a bigger and stronger casual pool, filling all vacancies, optimal utilization of staffing resources and working in conjunction with others in the senior team to ensure the support provided to clients is in line with Brackenridge’s vision and philosophy. The earthquakes created many challenges for the Daily Operations Supervisors who did a fantastic job coordinating the organizations response to these disasters and went above and beyond the call of duty to ensure people were well supported during these difficult periods. I admire their dedication to Brackenridge and the people we serve. Rachel Price

15. Adult Residential Service Managers The Adult Residential Service is the largest service run by Brackenridge and as a result two service managers are employed to run the service. Lynne Stanworth who works full time and is responsible for eight houses at Maddisons Rd and one in the wider community and Ivor Dee who works part time and is responsible for two houses at Maddisons Rd and three in the wider community. Both managers took up their appointments in December 2010 and there have been a number of significant events that have affected the lives of the people being supported since. A number of residents were affected by the Earthquakes we have endured and this was noticeable with an increase in the number of Incidents and PRN usage around the time of the larger earthquakes and also in the following month or so with ongoing disruptions to their usual routines. Unfortunately the earthquake meant most adults we support were not able to attend activities in the wider community with some of the buildings damaged or destroyed and parklands out of action and like most people affected by the earthquakes this has left people with limited opportunities. However with the city’s rebuild underway and with the advent of spring- the appearance of sunshine and lighter days there is a renewed optimism for both staff and people being supported to re engage in social and recreational activities. The continued swimming and active movement classes have provided people with ongoing opportunities to get out and about. Key Results / Achievements: We have placed increased emphasis in people having greater involvement outside of their home which has seen a number of people accessing activities and/or vocational day services increase. Many people engaged in paid/ unpaid employment have increased their hours and we have seen more people being employed. One family is currently looking at a wider community placement for their son in a home they own this is an exciting opportunity for the young man and it is great to be able to work in partnership with the family as they work towards this goal. Activities people in the Adult Service are involved: Vocational Day placements: attendance at a variety of established services in the Christchurch area. Meals on Wheels: assisting with the delivery of meals during the week in a voluntary role. Swimming is an activity that is thoroughly enjoyed, especially a soak in the spa pool at the end of the evening. Community paper delivery: a weekly activity for people who are paid for their efforts and supported by staff to achieve this. It has been great to see these rounds continue over the winter period with people rugged up and making sure the delivery is completed. These paper runs provide opportunity for people to interact with other members of the community and builds on self esteem for people. An increasing number of people now participate in paid employment via the Brackenridge work crew programme where a range of work opportunities are available including gardening, recycling, lawn mowing and landscape work. Some people have paid work in open employment on a part time basis. All employment and vocational opportunities encourage increased independence and learning of new skills.

16. Staff Performance and Development Recently the management group revised the Staff Appraisal Tool so that it is evidence based and measurable. It is about to be rolled out once the Advanced Practitioners have been orientated to it. A large number of staff are participating in the Career Force Programme and are at various stages of it. This is giving us a better informed workplace and should improve the quality of support to the people. Relationships with Organisations, and other Health Professionals: The managers have developed positive working relationships with a number of Agencies and Health Professionals to ensure the best care and opportunities for people in the Adult Residential Service. They work closely with our Vocational Service Manager and Behavioural Support Team and also have regular contact with are the various Day Services, Therapy Professionals, Hillmorton Hospital, Health Professionals, GP’s, Lifelinks etc. Role of Families It is becoming increasingly more important that families continue to play very important roles in the lives of people we support. Through the Circles of Support initiative we hope to re-empower families to have increased participation in the life of their family member. A number of families are starting to think about alternative housing options for their family member and we hope in the future more people we support will be able to live in their own homes with Brackenridge’s key role being the provision of supports for the person. and our role will then simply be support. Future Development / Key Projects Circles of Support is a key concept that we are striving for with all people in the service having active support circles. Initially we need to identify those key people who have a genuine interest in the person and develop the supports from there. To continue to drive/explore employment options for people and support them in developing appropriate skills that will see them gainfully occupied and receive payment for their endeavours. We support many people with as yet untapped potential and need to provide them with opportunities to grow their skills and personality To implement the new Staff Appraisal system that will see staff systematically appraised over the next year. To work with an occupational therapist through Therapy Professionals to investigate strategies to enhance environments for people with Autism. The adult residential service is a busy area. We both look forward to empowering people and their families to live life as a valued member of their family and the community. Lynne Stanworth Ivor Dee

17. Children and Young Person’s Service Manager I was appointed to the role of Manager for Younger Persons services on 17th January this year. Since then I have spent time getting to know the clients, their families and staff in this service and the policies and procedures of the organisation. I find this role very rewarding particularly the people contact and opportunity to help people have a good life. Since I started in my role we have had two significant earthquakes, these have brought challenges in regards to the effect on individuals and budget requirements due to additional staff required as some work places and schools were closed. I really enjoy working with my colleagues I have found everyone to be extremely supportive and willing to help or advise. Peter is a visionary leader and clearly outlines his expectations for our service. This service has two houses on the Maddison's Road site, number 8 and 11 and seven wider community homes and a service for one young man receiving one to one support for eight hours per day, five days per week. In total I am responsible for case managing 27 clients one of whom is a 13 year old transitioning home to her family and two young people who access respite services with us. One of the services I manage is for five women, another service is for one young man living alone, one service supports two young men and the rest support three people in each home. I believe the lower numbers of people living together in the majority of these homes provides a better lifestyle for them. Families and their involvement, Organisations and other Health Professionals In my service area the families are very involved, it is important that I develop rapport and trust with them, this has been one of my focuses. The staff show respect for the families opinions and do everything they can to ensure they are happy with the service, overall I find that they do this. From my experience so far it seems all families are extremely happy with the provision of service, I have encouraged them to let us know if they have any concerns and to trust that we will follow up with these as required. They are the best judge of the lifestyle their family member is experiencing. Circles of support are something our service will be discussing with families at each client planning meeting, these are a circle of people who voluntarily are part of a persons life. Due to the age of my clients most have people other than paid carers present in their lives and it is up to us to encourage the families and others to be as involved as they can. I have a great deal of contact with other professionals such as GP's, Psychiatrists, PSAID, Lifelinks, Youth Specialty services, Dental department, Schools, work places, School Transition Services, Child Youth and Family social workers. I attend health visits, Family Group conferences, Specialist appointments, planning meetings, IEP meetings at schools, plan meetings at work places, school transition meetings and any other meeting required for all people we support.

18. Active support Active Support is something I believe should be the rule of thumb for working with any person. I believe as this service is for younger people staff are very aware of the growth and development opportunities still ahead for the young people and do focus on encouraging them most of the time. It is discussed at each team meeting and they are expected to complete paperwork to reflect the amount of time each person has been involved in activities. I believe we need to amalgamate Active support with our planning process and simplify the paperwork around it in order that it is user friendly, I also believe outcomes need to be monitored closely as these are what we as an organisation will be measured on in the future. The earthquake and the fact that workplaces and schools were closed have contributed to some of the higher cost for staffing. I have made changes to some homes staffing in order to have a better mix, most of these have occurred when people have left. Other teams have had clear direction on expectations and follow up to ensure they are doing as asked. Staff I recognise staff are a valuable resource and I have started coaching all my staff one to one for one hour sessions. So far this has been accepted favourably with all coming with issues to discuss and clarify. I am expecting to be able to do this two to three monthly with each person. It is very helpful as a Manager to get to know them on a deeper level and have the opportunity to build a good relationship. When I review the performance appraisals completed I will be able to add my knowledge to these more constructively. I am a now a Careerforce verifier, in this role I will be able to assess the actual performance and knowledge of my staff and see that they practice what they have learned. The future The Children and Younger Persons Service is very important to the future of the organisation. If we become known as the preferred provider for younger people they will potentially stay in our service as they grow. There are many changes occurring in the disability area, families will be even more empowered and their expectations will set the standard. That is why it is so important now that we listen to what they say and provide what they are wanting for their young person. It is likely there will be competition and that if people are not happy with the service they get they may change providers. I am striving to ensure each person is living in the situation of their choice, with people they choose to live with and a location they are happy with. My ongoing focus For all people to have a lifestyle of theirs and their families choice, the opportunity to grow, develop and have a variety of experiences; To build relationships with families, professionals and the community To motivate all staff to provide the very best service to all clients To develop the staff to be empowered to carry out their work in a professional manner with the right values and approach This has been a busy start to my year and I look forward to building relationships and creating lifestyles of choice for people within the service Vicki McClurg

19. Respite Services Respite is a very important area of service for Brackenridge and during the year we were able to provide approximately 35 families respite support. We provide respite for families who have children and young people aged less than 21 years with intellectual disabilities most often with some challenging behaviours. This service is provided in a dedicated respite house at Maddisons Rd. We also provide respite for families with children, young people and adults who have High Health Needs and this service is provided in Homes One and Two located at Maddisons Rd and also at Iroquois Place in Hornby. A third stream of respite is for children and young persons with an intellectual disability who are funded by CYF and these children and young persons often have High Health Needs as well as intellectual disability. During the year CYF funded respite clients received respite in Houses One, Iroquois Place and Dunstan Cres also in Hornby. The dedicated respite service for children and young people provides specialist support to 24 families. Cheryl Cottle has overall responsibility for this home while the day to day management is provided by Julie Hampton, a Behaviour Support Coordinator. The children and young people accessing services in this home often have multiple and specific support needs in relation to behavioural issues. Ensuring the appropriate supports are provided to a constantly changing group of young people requires a team approach with the ability to be flexible yet at the same time to provide consistency for each person. Both Behaviour Support Coordinators have a high involvement with these young people and their families, schools and specialists. Families are encouraged to maintain their involvement during their family members stay and for many the short break provides an opportunity for a much needed respite. The demand for respite in this service area is high with a constant waiting list. We have recently engaged in discussions with the MOH regarding possible solutions for this as many families are facing extra stress and anxiety especially following the recent earthquakes. Rachel Price manages the High Needs respite services which provided service to nine children and young people throughout the year. Most of the people supported in this service area have a physical disability or higher health needs as well as a learning disability and require a higher level of support to meet their physical support needs. There has been a steady demand for respite services for people with High Health Needs and meeting demand has been difficult. Consideration has been given to setting up a dedicated respite service for people with physical disability and higher health needs as it is acknowledged the current arrangement of providing respite in existing homes is not ideal and demand consistently outweighs availability. For this to work effectively a dedicated respite house for people with higher support needs would have to operate on a roster system similar to the one currently operating in our other respite service, current demand indicates this would be a viable service area. Our Children and Young Persons service supports two young CYF funded young people for respite at our house in Dunstan Cres. Both these young people enjoy their time in the house and it’s a very successful arrangement.

20. Training & Organisational Development Manager Training and Quality services encompasses responsibility for Quality across the organisation, Health and Safety, staff education, management of the Behaviour Support Services and the Active Support Team as well as the responsibility for managing the dedicated children and young person’s respite service at Maddisons Rd (excluding High Health and wider community based respite services). On reflection this year has certainly provided the organisation with excitement and challenges especially during the latter part of 2010 and early 2011 when the Christchurch earthquakes tested the resilience of the organization's emergency planning and the resources and resilience of staff and clients alike. Whilst our plans served the organisation well there is room for improvement and adjustment to better meet the diverse needs of the growing service and this is currently in progress. Staffs are to be commended for their commitment to their role and their ability to adapt and continue to provide services to people during what were some very unsettled periods, especially those staff that were also facing adversity and challenges of their own. From a quality perspective Brackenridge continues all endeavors to ensure that all people supported in the service have opportunities to achieve goals and that appropriate resources and supports are available for them to live rich and fulfilling lives. We continue to place great emphasis on implementing a Person Centered Approach in meeting the individual needs of each person. Circles of Support for people remains in its infancy and is underway for a number of people however this remains a key area for development in the 2011 – 2012 year. This year saw the implementation of a new management structure along with the organisation having more clearly defined service areas. In conjunction with this change and the growth of service areas administration services were moved to a more central location in Middleton. This move has encompassed Brackenridge services as a whole and has provided the opportunity to be seen as a community based provider of disability services rather than the previous focus placed on services at the Maddisons Rd site. The dedicated respite service for children and young people continues to provide specialist support to 24 families requiring respite support for their family member. This is a very busy house and whilst I have overall responsibility of this home the day to day management is very capably provided by Julie Hampton, one of the Behaviour Support Coordinators and the staff team. The children and young people accessing services in this home are provided with opportunities to be involved in community activities a much as possible as appropriate. The difficulties of supporting a rotating group of people are managed well by staff through knowledge of support plans, routines and consistency. It is a goal for the New Year to be able to increase the capacity to provide respite support for people who are on our waiting list - this will require innovation from us in conjunction with support from the Ministry of Health.

21. This year we achieved Primary Level requirements for the ACC Work Safety Management Practices Programme which was a positive move forward for us with regard to Health and Safety. There has been an improved positive approach to health and safety within the organization this year and this has been aided by the implementation of a robust Health & Safety Monitoring system managed by Property Maintenance and Management Ltd. This has ensured compliance with relevant Standards and Codes and has also supported an increase in staff knowledge around everyday health and safety. The Behaviour Support Team is now well developed and offers assessment and advisory support as well as hands on with staff and people we support where required. Demand for their involvement continues and they provide an accessible service based on sound researched practice principles. The Behaviour Support Team has had a very positive impact within the organisation with regard to improved supports for people through the development of comprehensive functional assessments and individualised behaviour support plans focused on positive support strategies. Of particular note this year the two Behaviour Support Co coordinators had a presentation accepted for the ASSID Support Worker Conference held in Melbourne in November 2010. This was testament to their growing professionalism and confidence in their expertise and also provided an opportunity for Brackenridge to showcase its success in this area. Both Co coordinators also continue the facilitation of a comprehensive staff education programme – Positive Behaviour Support. This programme provides staff with an increased knowledge and skill development in supporting people whose behaviour can challenge. One of the Behaviour Support Co coordinators is also responsible for managing the liaison with Lifelinks which remains a key focus along with managing the referral process for all new people entering the service, and the other Coordinator is also an NVCI (Non Violent Crisis Intervention) Instructor. Brackenridge provides a comprehensive staff education programme and more staff are taking the opportunity to engage in Careerforce the industry based training programme . We encourage all staff to participate in this programme as it builds a more aware and professional staff base and provides staff with extensive and relevant knowledge . Staff members have the option of completing the Foundation Studies (Level 2 NZQA) or Core Competencies (Level 3 NZQA) and the Intellectual Disability Strand (Level3) leading towards the National Certificate of Human Services qualification. Francie Ryder has been a great contributor to staff success in the programme in her role as assessor and this year has been joined by Kay Liversidge. Both Francie and Kay facilitate the programme and provide essential support for the programme’s success. Active Support trainers have worked hard at implementing the programme with staff teams and individual follow up with people we support. In moving forward there are two key goals for the programme in the coming year. One is to simplify documentation and data collection processes to better inform staff and people we support of their successes. The other goal relates to the revision of the current training programme with the inclusion of new and refreshed material and the development of a refresher training programme.

22. Ensuring the best care, welfare, safety and security for the people supported by Brackenridge is a primary focus in service delivery and a number of initiatives are utilised in order to achieve this. A key concept in this is the NVCI (Non Violent Crisis Intervention) programme. This programme has been running successfully since 2000 and is now a well established component of the staff education programme. As an NVCI (Non Violent Crisis Intervention) Instructor and along with the facilitation of the staff Organisational Orientation programme and other staff education sessions I am provided with the opportunity to meet all employees as they join our work teams and on an ongoing basis through refresher training courses. I have continued the role of secretary of the regional Disability Providers Group, now part of the New Zealand Disability Services Network (NZDSN) having held this position for the past 3 years. With the formation of the NZDSN this has broadened the membership of our local group which has been positive and increased networking opportunities. As an organisation Brackenridge is growing and changing with planned direction – it is our continued enthusiasm and drive, our continued working together that will ensure success in achieving a service delivery that has people living rich and fulfilling lives. Having dreams and expectations and challenging ourselves is vital especially if we are to be well positioned for the future as we work towards set goals. I have enjoyed working with my colleagues and more recently with changes to the management structure an extended group of colleagues which has brought added enthusiasm and diversity to the senior team. I am looking forward to a continued positive working relationship with all those I engage with at Brackenridge as we move positively and strongly towards a future of growth and change and ensure Brackenridge is strongly positioned in the disability sector. Cheryl Cottle