1. An Integrated Decision Making Process for Children with Complex Needs
22/05/2019
Steve Garland

2. 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

3. 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 .

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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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