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Thursday 20 November 2008

Part 3 - User and Carer Services

3.3 Adults with a Learning Disability

1. Achievements 2001- 2004 and Key Actions for 2004/05

What we have achieved through the Strategic Programme (2001-2004)

Actions to Improve Performance (2004 - 2005)

1. Transition into (and throughout) Adult Life

Good links established in all localities through the Learning Disability Partnership Board (LDPB) with the Education and Employment services. Developing joint definitions and assessment criteria for people with learning disabilities including work on Fair Access to Care (FACS).
Multi-Agency Transition sub-groups have been developed. Learning Disability representatives have been involved in drafting a multi-agency transition protocol. Developing further partnership with Children's services at county and locality levels.

2. More choice and control

Multi-agency Choice and Control sub-groups have been established.

The Service Users Regional Forum (SURF) has been developed and support given to the development of service user 'speaking up' groups.

Continue funding of SURF through Learning Disability Development Fund (LDDF).

Develop more speaking up groups and support them to access funding/support in order to enable true independence.

Advocacy and Communication for Everyone (ACE) network established to link people and groups and to circulate information in an easy to understand way.

£130,000 of the Learning Disability Development Fund (LDDF) has enabled the spending on advocacy to increase to approximately £80 per head.

Continuation of ACE: Increase membership by 50% over the next two years.

All new policies to be produced in an easily understood format.

Increase from 2 to 7, in the number of people in receipt of direct payments.

Further 200% increase in the number of people in receipt of direct payments.

Creative use of direct payments as part of Person Centred Planning approach (PCP) to transform daytime activity.

Multi-agency framework for Person Centred Planning (PCP) produced and implemented. Nearly 500 people (staff, service users and carers) received training in person centred approaches.

Implementation of FACS for all existing service users by April 2004.

Completion of the "Partners in Policymaking" course.

Increase in the number of  'Words And Symbols Persons' (WASPs).

3. Supporting Carers

Recruitment of Carers Development Officer to locate “hidden” carers and support the development of Learning Disability carers fora (increased from 5 to 21.) Inclusion of carers in all Joint Investment Plan groups, LDPB and sub groups.

Development of family based respite scheme in partnership with voluntary sector.

Database being devised to establish a system for the accurate mapping of older carers. Increase in the number of older carers referred for assessment. Mapping carers from minority ethnic groups has commenced.

Carer involvement in recruitment of all new Learning Disability staff.

£6,000 grant to county Learning Disability Carers' Forum.

Better use of new 'Care First' system to identify older carers and carers from minority ethnic groups.

Establish a system to monitor carers' assessments.

Develop and Implement LDPB respite strategy led by carers.

Continue in the identification of hidden carers especially older carers and carers from minority ethnic groups. Work with carers link network to ensure that carers needs are met.

Maintain and develop commitment to involving carers in recruitment and planning.

Fund carers' fora to enable independent operation.

4. Good health

Establishment of Learning Disability Health and Social Care Partnership Board to deliver more person centred services and single point of access. Health Action Plan (HAP) framework completed. Learning Disability Plans and Joint Investment Plan objectives incorporated into NHS Local Delivery Plans.

Creation of Devon-wide steering group to map out strategic framework of preventative health services for people with complex needs.

Reviewing and auditing in-patient units.

Further develop Joint Community Teams to ensure single point of access via single referral. Implementation of 'My life - my plan' (MLMP) as a person centred joint assessment tool and trigger for use of Use of Health Action Plan (HAP). Further investigation into the use of Reed coding in GP surgeries to identify service users and carers.

Create re-investment plan for preventative and inpatient services.

Develop a pathway for people with a learning disability and early onset dementia.

5. Housing

Housing strategy written by multi-agency group in July 2003.

Create a health and social care service plan to deliver the health and social care elements of LDPB housing strategy. Develop system to enable relationship between housing registers and 'CareFirst' to collect accurate numerical information regarding housing provision, choice and need.

Increases in the number of people accessing supported living.   

 

Re-provision of Trust Residential Services and other residential homes to supported living.

Development of Accessible Tenancy Agreement for people with a Learning Disability.

Work with the Supporting People team to ensure the best use of supporting people grant monies.

Complete modernisation of Trust residential Services Homes.

Develop resources (videos, leaflets etc) to give information to people with a learning disability and carers about housing choices.

To improve access to social care and housing and related support services for Black & Minority Ethnic people.

6. Fulfilling lives

Multi-agency “Fulfilling Lives” sub-groups developed working with the Learning and Skills Council.

Formation of sub groups to write strategy for modernisation of day services.

Partnerships established between day centres and local Further Education colleges to gain access to "moving on" opportunities.

Work carried out by service users on behalf of the LDPB to investigate service users experiences of using public transport.

Develop and implement a Health and Social Care Day Services Modernisation Strategy.

Develop strategy in relation to parents with a learning disability.

Develop training programme on friendships and relationships.

Write a transport plan.

Better use of local Citizens Advice Bureau (CAB) for benefits checks.

Increase in benefits take-up through FACS assessments.

7. Moving into Employment

Employment strategy presented to the LDPB in September 2003.

Modernise day services taking into account the priority to enable access to employment.

Employment of 6 people with a learning disability at County Hall, Exeter by Devon County Council.

Implement employment strategy.

Write and implement health and social care service plan based on LDPB strategy.

Increase the number of people with a learning disability employed by health and social care organisations.

8. Quality

Extensive and inclusive service user and carer consultation carried out on quality. Support made available for the development of “speaking up” groups and carers forums.

Best Value principles incorporated into planning requirements.

Use of the feedback from the SSI inspection and Best Value Review to inform planning and strategy. Response made to the Best Value Review in relation to day service modernisation and formation of a LDPB respite sub-group.

Better involvement of service user and carers in adult protection procedures.

Drafting of multi-agency Better Care Higher Standards Charter.  

LDPB Quality Assurance Framework written.

Better evidence of involvement of carers and service users in strategic planning. Identification of carer and service user "champions" for priority areas as identified by the LDPB. Increase in the effective resolution of complaints.

Use feedback from SURF and other fora to inform development and strategy. Development and implementation of an equality strategy for people with a learning disability.

Nominate Health and Social Care Lead for adult protection. Devise and implement strategy.

Agree a revised approach to the Better Care Higher Standards Charter resulting in publication of information on standards in 2004/5. Ensure that the Charter addresses Human Rights and Equalities legislation

9. Workforce and planning

Multi-agency Workforce and Planning sub-group developed for LDPB. Workforce and planning strategy written and submitted to the Department of Health.

Introduced the new national framework for training, competencies, qualifications and skills levels in the learning disability workforce.

Write Health and Social Care Learning Disability Learning and Development Plan to include the achievement of the White Paper targets particularly in relation to Learning Disability Awards Framework (LDAF) registration and National Vocational Qualifications (NVQ.)

Develop a better system for induction of new staff.

Roll out of training to include Person Centred Approaches, Total Communication and the use of 'My Life My Plan'.

Recruitment of learning disability Learning & Development Co-ordinator through workforce confederation monies.

10. Partnership working &lt

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Established Devon’s Learning Disability Partnership Board (LDPB.) Board reviewed after one year of working.

Audit carried out and action taken to make the work of the LDPB and Joint Investment Plans (JIPs) more effective.

Locality based joint commissioning resource panels for all health and social care investment established.  

Agreed arrangements for Health and Social Care Partnership to enable more effective use of Health Act flexibilities.

Continued development of:

  • The partnership board following its review.
  • Joint Investment Plan infrastructure.
  • Integration of the service

2. Medium Term Strategy to 2008

  • Services during the day - modernise whole stock of day services provision according to service vision i.e. three tiers of modernised service - complex care in buildings, community based individual support through direct payments, and investment in community infrastructure. Development of routes into mainstream services for employment, leisure, education, opportunities create sustainable personal networks.
  • Accommodation and support - greater choice, better value, more effective leverage in the market, strategic partnerships with key providers, development of alternatives to residential care including supported living, adult placements. Explore options for shared ownership.
  • Development of comprehensive short breaks service by transforming current overnight respite. Create individual family centred flexible service.
  • Involvement - continue to develop embedded involvement - moving from consultation to assured involvement at every stage. Continue to invest in advocacy and speaking up capacity.
  • Workforce Development strategy that acknowledges employment market, and our new skills requirements.
  • A Learning & Development strategy that meets national requirements and prepares and maintains staff at appropriate levels of competence.
  • Continue to evolve our partnership working both with the health and social care service and with the wider learning disability network.

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