Winterbourne View local update Debbie Endersby –Head of LD commissioning And Sue Culling Strategic Commissioning manager –LD June 18 th 2014

Aims of the program of work To understand the range and context of Restrictive Interventions (RI) that are being used by LD providers in East Sussex To have systems in place to assure stakeholders that where RI are used that they undertaken in a safe and ethical way for example are individualised, based on positive behavioural support and recovery models and are recorded To ensure a focus on reducing the use of all RI To ensure that services and staff are supported To ensure best practice is promoted and shared

Purpose of the focus group June 2 nd to co produce/assist with the development of East Sussex service specifications for people with a learning disability who may challenge services and where RI is in use to assist with a notification process to record where RI is in use particularly for physical restraint to share approaches and good practice around RI

Positive and proactive care (DH 2014) indicates 4 overarching themes Improving care Leadership, assurance and accountability Transparency Monitoring and oversight

What needs to be in place Use of positive behavioural support approaches and individual behavioural support plans Service Providers to have RI Reduction programs in place Service Providers to have Board level accountability for RI Service Providers to have audits of quality of practice including post incident analysis Service Providers to have skilled staff trained by accredited trainers if using physical restraint Good record keeping

Where we are now We shared the draft specification with the focus group We proposed a notification process for providers to inform commissioners that RI is being used Discussion about approaches as to defining what good looks like Discussion around current LD Provider training to support continuous improvement in services and promotion of best practice

Key themes and issues (1) Some providers indicated that they were already doing what the guidance required but that policies and procedures would need updating to reflect the new guidance requirements Some providers had already started to look at the implications of the guidance for their organisation for example Restrictive Intervention reduction programs Main issue was the new language and consistency of use of definitions to describe key elements

Key themes and issues (2) In addition to training -there was a recognition that some of the practical issues were about recruiting the right staff to work with the client group Needed to consider how best to share information and involve service users and carers

Some suggested areas for ongoing work To circulate examples and exemplars of good practice Involvement of people with learning disability and their carers in reviewing process and procedures An East Sussex network to share good practice and ideas

We would like to know … What works in practice ? What needs to be avoided? Are there quality measures that you use that would be useful to share? Please contact me