Inclusion works - Cedar Foundation

The Cedar Foundation delivers a range of services that enable people with disabilities to get the most out of life and to be fully included in their communities. 25 years ago, a gap was identified in that there was no dedicated service to support clients with acquired brain injury (ABI) with employment. The service developed alongside other community brain injury services.

Average number of service users in the whole organisation: 2,500 supported by the whole organisation employability sector, 200 with Acquired Brain Injury (ABI) within Inclusion Works Geographic area of activity of the organization: Whole Northern Ireland (6 counties)
Target group:  16+. Inclusion Works supports adults with a physical disability, those with a diagnosis of Autistic Spectrum Disorder (ASD) and Acquired Brain Injury
The main aim is to ensure that people with disabilities experiencing exclusion and inactivity have equality of opportunity and choice for inclusion and economic activity. Inclusion Works supports adults with disabilities to build employability skills and experience to be work ready, then move into a paid job, a college course or a volunteering role on leaving. Specialist physical disability, ASD and brain injury support is available and tailored to each individual and their needs. Inclusion Works is person-centred, encouraging and supporting individuals to design their own programmes around their needs and aspirations, building confidence and independence. 
Following initial assessments, participants build an action plan, drawn from a menu of choices to address their personal barriers and agree solutions to meet their employability and inclusion goals. Inclusion Works offer goal-directed intervention to support participants to progress from the service when they have achieved their goals. The Case Officer carries out the goal assessment process by carrying out a structured interview using the Engagement Form, a Rickter baseline interview and a Positive Risk Assessment the Case Officer meets with the participant to agree the Action Plan normally no longer than 4 weeks after the start date. Goals/activities recorded on the Action Plan can be claimed as an outcome on leaving.
Throughout the participant’s programme the Case Officer updates the Action Plan in agreement with the participant as they progress with goals, and as further vocational profiling, review, or risk assessment information is gathered.
Outcomes:
The aim is for at least 70% of participants to achieve their individual goals and make a positive progression. Positive outcomes can include employment, further education and training, voluntary work and/or community inclusion. The aim is for at least 10 % of participants to progress to paid employment.
The Cedar Foundation provides
  • Established referral pathways regionally with Health and Social Care Trust (HSCT) teams and a Jobs and Benefits teams, ensuring that the service operates at full capacity and meets the most priority of need.
  • A review of personal barriers to inclusion, family and social circumstances/issues and vocational and personal skills. 
  • This leads to a unique, user-led Personal Action Plan reflecting personal ambitions, disability and skills thereby securing user engagement from the outset.
  • Activities are drawn from a menu of choices to implement solutions to address individual barriers to employability and address inclusion goals.

The programme features:

  • Progression to and tracking of sustainable outcomes for up to one year after finishing the program.
  • Working in partnership with employers, training providers, Colleges of Further and Higher Education and other community and voluntary sector organisations to ensure the foundation’s participants are fully included.
  • The Foundation’s service is designed to complement, contribute to and collaborate with local initiatives to best meet the needs of participants.  

Informing /  procedure to become a client The Health and Social Care Trusts (HSCTs) are the key partners in delivering Inclusion Works and are the main referral agents. All match funding is commissioned through service level agreements with the 5 HSCTs in Northern Ireland in response to their local commissioning priorities as an integral part of their service delivery pathways. The pathway into the service for people with ABI is normally via the local HSCT’s Community Brain Injury teams. People can also self-refer to the service and other referrals come from jobs and benefits offices, GP’s, charities and workplaces. People can find out about the service via a website, Twitter and Facebook, the service also has leaflets.
Service’s start after the disability is acquired The time at which the service intervenes with the service user can vary. A typical case following an ABI, the service user accesses their clinical rehab pathway in hospital where they may have surgical intervention and is then referred to a community brain injury team and then Inclusion Works becomes involved. Other referrals to the service can include someone who has an ABI and is already in work and is struggling to maintain their employment.
Continuity / integration between services Each person has a Case Officer who links with other services including health care workers. Usually a Case Officer works with 10 participants with ABI.
Staff and Resources Resources vary depending on location, there is a specific premise where service users can meet with Cedar Foundation specialists, all staff have laptops and see people on the premises or in community venues. The organisation provides specific training with ABI training materials and packs and has ICT equipment for participants including iPads.
Duration Client can participate in the service for up to 2 years with contact and support maintained for one year after the programme has ended.
Budget The service is funded by the European Social Fund Programme 2014-2020 and the Department for the Economy Match funded by all 5 Health and Social Care Trusts and the Department of Communities. Funding for the service is guaranteed to 2022. Cedar Foundation is involved in a sectoral campaign to ensure continuity of funding beyond this period. There is no co-payment required from participants.
Partners Partners of the service include employers, training providers, Colleges of Further and Higher Education, Universities and other community and voluntary sector organisations
Other stakeholders Other Stakeholder include Health and Social Care teams, families, carers, community organisations and other Cedar services.
Information campaigns An employment engagement strategy and action plan is in place which guides in developing relationships with employers. Staff actively seek out new employers to work with by making direct contact with them and networking. The organisation has information to provide including factsheets, disability awareness training including ABI specific training.  When working with new employers Cedar Foundation provides this training and now it can be done online.  Advice and guidance is given to employers on individual placements, if setting up a service user with a specific employer, the organisation communicates employer’s needs. The service supports companies to comply with disability regulations. They find that promoting benefits of including people with disabilities, increases staff morale and how they are perceived in the corporate world, they support with trying to dispel misconceptions about employing disabled people. Cedar Foundation sponsored the Best Disability Initiative Award this year as part of the Annual Northern Ireland Equality & Diversity Gala & Awards for Employers.
Repeated service accessibility If people lose their job, they can re-join the programme if this is necessary but in some cases the person may have skills and resources to do it alone. There is no regulation preventing re-engaging in the programme. The organisation can also provide support through other Cedar Foundation’s service such as Workable (NI) to help people retain their jobs.
Monitoring Monitoring is provided 1-year post follow to all participants unless they request not to be contacted. Phone call follow ups are made every six months.
Direct and wider impact Some benefits that service users gain from the service are qualifications. The service monitors soft outcomes using a measurement tool called the Rickter scale. The main focus of the measurement is on employability and inclusion, the tool is used at start, middle and end of the persons’ journey. It is a self-assessment tool. The goal of the service input is that the person is more insightful into what they want to do and how to get there. All staff are accredited practitioners to ensure correct and consistent implementation. This allows The Cedar Foundation to co-produce personally relevant rehabilitation and personal development goals and track progress from the perspective of the individual experiencing the service. During the last 2 years of service delivery 91% have reported progress on targeted skills that build personal capacity and resilience in living with complex disabilities when they were ready to exit the service. 
Success factors Fundamentally the main success factor is use of the person-centred approach which involves completing an individual action plan for each person. Each person has a Case Officer, and the action plan is built around the individual, and involves supporting people at different stages. One success factor is local knowledge and partnership with training organisations colleges and local community. In general, the service taps into opportunities as close to home as possible to the service user. If this is not possible the organisation helps to identify opportunities elsewhere and support the participant to access these. Often, it’s the smaller companies embedded in the local community that become involved in providing employment opportunities. Often the context of the person is very important.
Dialogue with policy makers The service has a strong relationship with policy makers. The service tries to effect change by demonstrating through change, influence strategy and policy that way, develop services and push them through, breaking down barriers. It has been found that in the past things were more segregated, now it’s better with a move towards more integration within the community. Now there are people with more complex disability coming through and the organisation is working with service users with ASD.
Adaptation for other countries It is felt that the model of person centeredness and partnership working is transferable to other counties and that third sector organisations can bridge the gap that statutory health and social care sector cannot fill.

Future development will focus on employer engagement.

Currently with lockdown measures the service is developing remote training. Also, the service is working on skilling people up, and engaging companies with online disability awareness training. We have noticed some older ABI clients have difficulty engaging with the move to IT. And we are developing capacity building support to help overcome this.