An Integrated Decision Making Process for Children with Complex Needs 22/05/2019 Steve Garland s.garland7@ntlworld.com

Background Commissioned by Gwent Childrens Partnership Board March 2017 Aneurin Bevan Health Board and the five Local Authority Childrens Services of Newport, Caerphilly, Monmouthshire,Torfaen and Blaenau Gwent. To develop a new Integrated Policy for decision making for Children with Complex Care Needs 22/05/2019 Steve Garland s.garland7@ntlworld.com

Why? The Gwent Partnership Board had recognized and identified that the decision making process for supporting children and young people with complex needs across the Gwent region has become unclear ,confusing and unnecessarily complicated and therefore is seeking an independent review of its arrangements. There needs to be a clear consistency of approach in terms of decision making but more importantly, the response to the outcomes identified by individual child and/or family are consistent .

Three Critical Factors Joint Working And Multi Agency Assessment Local Complex Needs Panel Decision Making Regional Integrated Panel 22/05/2019 Steve Garland s.garland7@ntlworld.com

Joint Working and Multi Disciplinary Working-Gwent Scheme Single Plan Integrated proportionate assessment incorporating ‘what matters’ conversation Single Plan which reflects key outcomes to be achieved Statutory agencies retain responsibility for completion of other required plans eg ALN, Care & Treatment, Care & Support Care Coordination is critical Single Plan is overarching document Clarity of roles Commitment by organisation 22/05/2019 Steve Garland s.garland7@ntlworld.com

Local Complex Needs Panels Robust Information present by key professionals based on Joint assessments Representation from all organisations is crucial Individuals representation organisation should have authority for decision making Each organisation should have clear understanding and guidance on their duties and responsibilities 22/05/2019 Steve Garland s.garland7@ntlworld.com

Regional Integrated Panel Purpose is to resolve any disagreement and dispute at a Local level and identify potential alternatives to services Representation from all orgainsations should be at a Senior level. Individual cases presented by practitioners for discussion and decision. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Implementation PIlot January to end of March 2019 New Regional Panel created Local Complex Needs panels Terms of Reference rr written Commitment from all organisations to engage and commit to Joint assessment and multi agency working Commitment of resources 22/05/2019 Steve Garland s.garland7@ntlworld.com

Guidance: Commissioning accommodation and support for a good life for people with a learning disability Developing improved and progressive practice -National Commissioning Board 22/05/2019 Steve Garland s.garland7@ntlworld.com

provide guidance and explore options on the commissioning of accommodation and support services for a good life for people with a learning disability. challenge and redefine the accommodation and support model to a more person- centred , flexible set of principles ; offering a ‘support for a good life’ approach. This approach seeks to enable people to consider a wide range of places to live and deliver the support person want and need. build upon the overarching guidance on ‘Commissioning Services for People with Learning Disabilities’ published in November 2017. contribute directly to Welsh Government’s ‘Learning Disability Improving Lives Programme’, which includes a recommendation to increase accommodation options closer to home, through working collaboratively with health boards, local authorities, housing providers and third sector social care providers. ensure effective investment with the resources available by developing up-to-date and appropriate services rather than investing in models of service delivery that are outdated. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Audience It is primarily aimed at people and organisations that have duties and responsibilities to engage with people with a learning disability and unpaid carers to commission accommodation and support. However, it is also aimed at all stakeholders involved in the provision of support across all sectors and most importantly people with a learning disability and unpaid carers at the centre of support. Co produced by over twenty organisations. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Structured using 12 questions Person centred pathway Question 1: What should you be commissioning? Answer- Good live Question 2: Question 2: How are people making this happen? Answer: Using person-centred practices and co- production, which is central to the Social Services & Wellbeing Act 2014. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Question 3: What should your commissioning activities achieve for people with a learning disability? Answer-They should protect rights, promote well-being and support independent living. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Accommodation and support for a good life Question 4 :What type of housing should you commission? Answer: Ordinary housing / apartments in the community Question 5:: What is the best model for accommodation with support for good living? Answer: The best support for living means that a person lives in his or her own home and can choose who provides their care and support Question 6: What accommodation standards should support for living services comply with ? Answer: The long-established REACH standards 22/05/2019 Steve Garland s.garland7@ntlworld.com

Good quality support Question 7: What does good quality support look like? Answer: Its person centred and has several key elements – including PBS. Question 8: How do we develop innovative and progressive procurement processes? Answer :Ensure that co-production and good relationships are central to any process. 22/05/2019 Steve Garland s.garland7@ntlworld.com

Strategic commissioning Question 9: What is strategic commissioning? Answer: Person centred approaches should inform and drive strategic commissioning activities. Question 10: How do you commission effective services for people with a learning disability including those with more intensive needs? Answer :Integrated and collaborative commissioning. Question 11: Question: How do you know you are improving well- being? Answer: By measuring outcomes. Question 12: How can you maintain sustainable support for living services? Answer :Ensure that there is a consistent and robust methodology for costing accommodation and support for people with a learning disability 22/05/2019 Steve Garland s.garland7@ntlworld.com

What happens next? The guidance was officially launched on the 5 March 2019 by Welsh Government. The National Commissioning Board (NCB)would like to seek support of the COP and take the views of the Learning Disability Ministerial Advisory Group (LDMAG) to include and prioritise this guidance through their work programme. The NCB will work with the Welsh Government’s Learning Disability Improving Lives Programme and implementation team to take this work forward and ensure that it is a priority. As part of a 12 month follow up implementation support programme ,Welsh Government will be sending out guidance to Regional Partnership Boards, Integrated Care Fund leads and all relevant stakeholders to measure effectiveness of the guidance. This will involve the NCB and appropriate Welsh Government officials. A detailed implementation action plan will be developed to include mapping of services, cross sector communication and engagement building on current reference groups. 22/05/2019 Steve Garland s.garland7@ntlworld.com