NHS Continuing Healthcare Is it different for people with a learning disability?

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NHS Continuing Healthcare Is it different for
people with a learning disability?

• Cath Roff Strategic Director Adults, Health
  Housing, Derby City Council

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Where do people with learning disabilities live?
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Introduction Beyond Winterbourne View

• DH have facilitated and co-ordinated a number of
  work streams leading to their own initial report
  in June 2012. This Final report and
  partnership-wide Concordat due October 2012
• A second Panorama programme recently screened
• Following the incidents highlighted in the
  Panorama programme in 2011, a Serious Case Review
  was initiated (South Gloucestershire). The report
  was published in August 2012, with 43
  recommendations.
• Criminal proceedings have concluded and the 11
  people charged have pleaded guilty.
• CQC undertook 150 inspections of Treatment
  Assessment Units (and similar provision) and
  published a report and analysis in June 2012.
• Internal Management Reviews undertaken by CQC and
  the NHS also highlighted a range of required
  improvements.

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Key Issues / Findings

• Incidents at Winterbourne View have sent a
  powerful message that such abusive behaviour will
  not be tolerated
• Services must be more efficient, effective and
  humane.
• Hospitals for people with learning disabilities
  and autism should not exist, but they do. While
  they exist they should be regarded as high risk
  services.
• Serious Case Review
• Clear provider failure to protect and provide a
  quality service
• Too many people are being admitted to Treatment
  Assessment Units (or similar closed services) and
  they are staying too long
• Alternative, community based models of service
  need to be developed more widely and properly
  commissioned

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Key Issues / Findings (contd)

• Need for improved joint commissioning of these
  services across health and social care, and
  commissioning practice to be improved
• People within these establishments need to be
  more visible and have regular, ongoing contact
  with commissioners, families and friends
• Staff need to be properly trained, supervised and
  supported
• There needs to be improvement and strengthening
  of multi-agency safeguarding referrals and
  responses, ensuring that clear pictures of
  referrals/issues/trends are tracked and
  considered
• CQC inspection approaches need to be reviewed and
  improved to ensure Providers are working to and
  delivering services to a high and safe standard
• Establish Quality Frameworks for Provision and
  Advocacy

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Key issues / Findings (contd)

• The Department of Health are working closely with
  all stakeholders to establish a clear framework
  for performance outcomes linked to the main areas
  for improvement. It is proposed that this will be
  monitored through the National Partnership Board
  for Learning Disabilities, which is jointly
  chaired by someone with a Learning Disability and
  the Minister for Care Services.
• The Concordat (to be published in October) will
  set out a wide range of commitments from all key
  stakeholders saying what they will do to ensure
  these improvements are made. This will also form
  part of the accountability framework.

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Our guiding principles

• People with learning disabilities should
• Have a sense of living valued lives as men and
  women with support needs
• Their services should be characterised by social
  inclusion, respect, dignity and choice
• Local ties to their community and families should
  be sustained
• We should ensure the availability of quality
  choices that draw on local strengths and build
  assets to strengthen community support and care
• A commitment to personalised services should
  under pin this approach