“Building the Right Support”. Peninsular Provider Conference. December 2015

Who is it about? People (including children)who have a learning disability. People (including children) who are autistic. AND They also may have a mental health need. AND/OR They also may have behaviours that challenge.

History of the plan and model  Winterbourne View Abuse inquiry.  Too many people in hospitals for too long.  People away from families and communities.  Often poor outcomes for high cost placements.  Focus on containment rather than treatment.  Dependency on this model had reduced the ability to support individuals who challenge within their own communities.

General aims Spotting problems earlier and getting the right help to a person and their family. Making sure there is more choice and control about what happens. Services are used locally and include universal mental health services.

General aims People should have life long person centred plans. Skilled staff should help with a wide range of skills working in teams to help. Crisis plans should be made with each person and their carers, so everyone knows what to do if there is a problem.

Managing “risky” behaviours Plans based on evidence should be put in place to help. Work with the police to steer people away from the criminal justice system. People have individualised plans that help everyone know how to support people better together.

Risk registers for children and adults People who have risky behaviour are identified earlier and given the help they need. Each area keeps a list of people who need extra support to manage risks. Care is proactive, planned and coordinated.

Planning Each person will have care and housing arranged to support their own needs. Very careful planning needs to take place involving the person (if possible) their advocate and family. Everyone on the list should have a named local care coordinator

Key principles The Mental capacity act should be used. Care should be given in the least restrictive way, in the community. The starting point should be that local mainstream services should be used with reasonable adjustments made for the person if possible.

Choice and control Use of personal health budgets or integrated personal budgets should be used if possible (Linked to EHC Plans). Accessible information should be used to share information. ( New standards). Independent advocacy.

Support from and for carers Evidence based parenting training. Access to short breaks for carers. Alternative short break accommodation for times of crisis. Training for staff around the needs of the person.

Living in the community A choice of housing in line with the persons needs. Housing should aim to comply with Reach standards if possible. (People should have separate accommodation and support so if they change provider they do not lose their home.) People should be offered settled accommodation (they could have a tenancy, or shared ownership.) Local housing plans need to support this work. Housing will need to be part of the new Transforming Care Partnerships.

Living well People will have access to education, employment, social sports and leisure activities. This might mean agreeing plans with the Ministry of justice for some people. What people do should be part of their plan.

Keeping healthy Annual health checks need to happen for each person, now year olds also. Use of “quality checkers” to make sure health services are good. Use of mainstream mental health services. Use of liaison nursing in hospitals and primary care.

Skilled help Use of multi disciplinary teams. Teams working together such as Mental health, learning disability, forensic teams or youth offending teams. 24/7 intensive support if needed.

Helped to stay out of trouble Use of diversion and liaison services- This includes nurses working closely with police to make sure people get help rather than court/prison. Help from forensic services. Help to reduce anti social behaviours early (Drugs& alcohol, sexualised behaviours)

Hospital.. A Blue light call should happen before hospital is considered, for all admissions, Inpatient care should be local if needed. There should be a clear plan about what hospital is there to provide- Assessment/ treatment. “I will have a care and treatment review after two weeks to help plan my discharge.” “I will be there for as short a time as possible.”

Transforming Care Partnerships Individuals and carers NHS Social Care Children’s services Housing Specialist services 49 proposed nationally SW ones being confirmed now

What they have to do Develop a local plan Look at the numbers of specialised hospital beds they have, including CAMHS Tier 4. ( Also 52 weeks a year residential schools and colleges) Develop community services helping people manage behaviour. Make sure that children do not end up in hospital when they grow up, and a close focus on 52 weeks a year residential care.

Key Stakeholders Children and Young people Families Advocates CCGs Local authorities Providers- Of all types. Integrated personal commissioning ADASS/ADCS Local Government Association. Housing, Police and Universal services.

Next Steps A 0-25 year old pathway and model being developed collaboratively by NHSE, LGA and ADASS/ ACDS to support “Building the Right Support”. Local Transforming Care Partnerships will need to use local data and produce draft plans by 8 th February Finalised Plans will be implemented from 11 th April 2016, following scrutiny and evaluation. Nationally there is £30m revenue funding and £15m Capital funding over the next 3 years to support this work.

Any Questions?