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Similaire à Learning Disabilities: Share and Learn Webinar Thursday 27 October 2016
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Learning Disabilities: Share and Learn Webinar Thursday 27 October 2016
- 1. www.england.nhs.uk Learning Disabilities: Share and Learn Webinar 27 October 2016 Topic One: What makes a successful Care and Treatment Review? Anne Webster, Gavin Harding and Maggie Graham, Improving Health & Quality Team, NHS England Topic Two: Guidance for TCPs in relation to Children and Young People Phil Brayshaw, Service Model Lead (Children and Young People), Learning Disabilities Programme, NHS England #improvingLD @NHSEnglandSI
- 3. www.england.nhs.uk/learningdisabilities Thankyou for inviting us today • Anne Webster • Gavin Harding MBE • Maggie Graham Improving Health and Quality Team
- 4. www.england.nhs.uk/learningdisabilities In the Learning Disability Programme • Work stream delivery - • Learning disability advisers: 1. Gavin Harding MBE 2. Carl Shaw 3. David Gill 4. And looking to appoint a family carer adviser to start in the New Year • Engagement team - • Learning disability network managers: 1. Aaron Wood 2. Katie Matthews Employing people with lived experience Gavin Carl David Aaron Katie Gavin
- 5. www.england.nhs.uk/learningdisabilities • We have had feedback from over 200 people about the CTR policy • We are analysing the feedback and meeting with our advisory group soon to agree what it means for the policy • The feedback will make the policy even stronger • We aim to publish a revised policy by the end of January 2017 • At the same time we are working with Inclusion East to develop ‘Gold Standards’ for Care and Treatment Reviews eg • What makes a good CTR chair? • What makes a good expert by experience? • What makes a good clinical expert? • What makes a good CTR? The Care and Treatment Review Policy Review Maggie
- 6. www.england.nhs.uk/learningdisabilities What makes a good… CTR Chair Maggie
- 7. www.england.nhs.uk/learningdisabilities Is the commissioning lead with current knowledge of processes. Independent – never worked in or for that provider and should declare any interests. Brings out the skills and knowledge of the people involved – supporting panel members to be equally involved. Qualities and credentials Is assertive and critical of poor practice when they see it. Maggie
- 8. www.england.nhs.uk/learningdisabilities Knowledge about Transforming Care and empathy for the person – “hospital is not home”. Has understanding of person centred approaches and tools. Supportive of other panel members when they identify issues. Knows about the contract with the setting. Qualities and credentials Gavin
- 9. www.england.nhs.uk/learningdisabilities Knows about innovative alternatives to hospital. This could be through visits or finding out about examples of good practice where people live in the community. Is prepared to ask and encourage very basic questions. Qualities and credentials Reflects with others to develop their skills as the chair Gavin
- 10. www.england.nhs.uk/learningdisabilities • Has the skills to make sure that everyone is working together to improve the person’s care and plans • Takes a shared approach to problem-solving • Enables difficult topics to be discussed in a constructive way Qualities and credentials Anne
- 11. www.england.nhs.uk/learningdisabilities Asks for the information needed for the Care and Treatment Review from the hospital setting. Sets the agenda and establishes what each panel member should do according to skills and knowledge. Requests panel members to say if there may be a conflict of interest. Visits the ward even when not meeting the person. Takes Action Anne
- 12. www.england.nhs.uk/learningdisabilities Arranges to report back to panel members about urgent actions. Makes sure that the next review will use the same expert by experience to maintain consistency – unless there is a reason why it should be somebody else. Pick up on any challenges for panel members that might need further discussion. Takes Action Gavin
- 13. www.england.nhs.uk/learningdisabilities • Some points to add…. • Gives the person time to take part in the review in the way they feel most comfortable • Makes sure that people use words that everyone can understand • Makes sure the report is written in words that everyone can understand • Makes sure that someone is following up on the actions • Makes sure that any problems with carrying out actions are dealt with quickly • Any more points to add? Takes Action Gavin
- 15. www.england.nhs.uk/learningdisabilities Transforming Care Partnerships (TCPs) • 48 Transforming Care Partnerships • 48 sets of Plans to transform local services for local people and families • 48 sets of Milestones that will enable us to tell the story of change
- 16. www.england.nhs.uk/learningdisabilities Building the Right Support and the National Service Model
- 17. www.england.nhs.uk/learningdisabilities • Every Transforming Care Partnership should have a lead for Children and Young People • Clear links between Transforming Care Planning, work around the Special Educational Needs and/ or Disability (SEND) Reforms and CAMHS transformation programme • Local areas should understand legislative framework • Service Model should be implemented from the point of view of Children and Young People (and their commissioning needs) Supplement to the Service Model for Children, Young People and their Families
- 18. www.england.nhs.uk/learningdisabilities Child, Young Person and Family/ Parent Carers I have an enjoyable and interesting life My care and support is well planned I have choice and control about my care and support My family and paid staff get the help they need to support me to live in the community I have a choice about where I live and who I live with I get good care and support from mainstream health services I get expert health and social care support in the community if I need it I get help to stay out of trouble with the law if I need it If I need to stay in hospital because of my mental health or behaviour it is good quality The 9 Principles of the Service Model
- 19. www.england.nhs.uk/learningdisabilities I have an Enjoyable and Interesting Life My Care and Support is Well Planned I have Choice and Control about my Care and Support • Supported by people with high aspirations (social model training) • Join in everyday local activities - playgroups, leisure etc. • Attend their local school with the right support • Have friends and positive relationships • Local Offer/ Timely Access to Information • Integrated Personalised Commissioning • Personal Budgets Should be Offered • Independent Advocacy • Understand the local population and their changing needs – dynamic register • Person Centred Approaches • Single Assessment and Planning • Keyworking for families
- 20. www.england.nhs.uk/learningdisabilities My Family and Paid Staff get the Help they Need to Support me to Live in the Community I Have a Choice about Where I Live and Who I Live With I Get Good Care and Support from Mainstream Health Services • Early support and intervention • Healthy Child Programme • Evidence based Parenting programmes • Family support – information, emotional support, and practical support • Specialist short Breaks • Timely diagnosis with concurrent support • Hospital passports and liaison • Paediatric assessment and access to health checks age 14+ • Early access to flexible specialist support • Comfortable, well-adapted home • Accessible information on housing • Timely planning and support (transition planning) • Provision for children living away from home
- 21. www.england.nhs.uk/learningdisabilities I Get Expert Health and Social Care Support in the community if I need it I Get Help to Stay out of Trouble with the Law if I Need it If I Need to Stay in Hospital because of my Mental Health or Behaviour it is Good Quality • Integrated, community based, specialist support • Specialist staff support early intervention • Positive Behaviour Support and other specialist intervention (IAPT, SALT etc.) • Flexible support and services • Multi-agency, preventative approach to support and intervention (Family Support) • Access to the same early intervention and prevention services (YJS) • Recognise and signpost learning disability and/ or autism • Consultancy, supervision and training • Liaison and Diversion Schemes • Community/ pre-admission Care and Treatment Review (CTR) • Relationships with friends and family • Clear rationale for any specialist admission/ inpatient stay • Independent advocacy • Governance of out of area placements
- 23. www.england.nhs.uk Date Topic Guest speaker 24 Nov 2016 Enhanced Care Service and Strategic resettlement, personalisation at scale and pace Caroline Kirby and Angie Simmons, Adult Services and Health Commissioning Unit, Worcestershire Pól Turner, Head of Improvement, NHS England 26 Jan 2017 To be confirmed To be confirmed 23 Feb 2017 To be confirmed To be confirmed 30 Mar 2017 To be confirmed To be confirmed Learning Disabilities: Share & Learn webinar programme
Notes de l'éditeur
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- Commissioning processes eg. understanding contract arrangements so can hold provider to account for delivering what they say they will Human rights, legal framework, discharge standards an
- Pace and amount of achievement in short pace of time
- In developing the model we have engaged with: People with a learning disability Their families Support providers Clinicians, Commissioners Academics Organisations Supported thro by a Core Reference Group There is some great stuff going on to support people now – but – it is not universal Service model built on previous Good Practice Documents e.g. Mansell & Valuing People Now Enhanced through Stakeholder Engagement, already mentioned It is based around 9 Key Principles – that promote Choice, Inclusion, rights & Independent living Its about putting people first and building the support around them – flexible & across the life span Its about Choice & Control – inc Personal Budgets Advocacy to strengthen People’s Voice Its about inclusion within the local community inc Employment & using support that is already out there Its about Supporting the Supporters Its about understanding a person, their needs, strengths & ambitions - & - designing the support to enable them to have a great life in their community No “ One size fits all” I want to Focus on a Few partiular features: This is an all age model – as we’ve mentioned often can identify children who will need support & can build resilience in the family as well as create a positive journey through Service Land Person at centre – Good assessment leading to One Plan & a Coordinator, from local community who remains consistently involved – identified point of contact for person & supporters – Has authority & responsibility to make sure the plan is delivered Coordinator works in partnership with the person ( family & supporters) to draw down the support needed personalising the support offer- & - can step up or down that support as required Liaison – In addition to the pre-emptive Reasonable adjustments that all NHS services must make – the Liaison Role bringing the skills from those specifically trained to support this population to those with the skills offered to population as a whole – Particular Key areas are :- GP practices; Acute Hospitals & Mental Health services – inc Court L&D – Addressing the Physical & Mental health Needs of this population is Essential – This Collaborative Care Model will help that Intensive Support – on occasion, individuals or those who support, will require additional support at times of difficulty ( & crisis prevention) – this will be provided through Intensive Support teams who have the appropriate values, skills & capacity to provide the intensity of support required – enhanced assessment & planning skills – developing proactive & reactive strategies – training, coaching & supporting the Supporters – Admission Avoidance – accessible 24/7 Reducing the Reliance on LD specific Inpatient beds : - in strengthening the Community we know we can reduce the number of specific beds we currently have - There may be times when treatment in a hospital is appropriate but it needs to be after Community Options have been considered; Outcome Focused; in right environment; for the shortest time; least restrictive; maintaining links to community; & Discharge Starts on Admission! – We have a programme of Beds closures planned for achieving over next 5 years This is an exciting Time & a great opportunity for all of us to revisit & dramatically improve how we support people with a learning disability to Have Great Lives in their communities