Valuing People Now: Partnership Board annual self assessment report template

Transcription

1 Valuing People Now: Partnership Board annual self assessment report template All figures requested below relate to adults with learning disabilities (aged 18 and above unless otherwise stated) who are known to services (local authorities and/or health services) and their families. (Care should be taken not to double count those people known to both local authorities and health services.) All information to be collated from April 2009 to March 2010 data. We have been told to make this 2008/9 data as 2009/10 data is not yet available. The quantitative data should be drawn from existing data collections (see Appendix D in the full guidance document Good Learning Disability Partnership Boards for a list of sources). Health and social care data from national returns to be taken from the August 2009 figures. 1. Name of local authority and Primary Care Trust(s) London Borough of Croydon and Croydon Primary Care Trust 2. Local picture Please give descriptions using full sentences or bullet points. Please give both amounts AND percentages, in all cases (where appropriate/possible). You may want to use information from your Joint Strategic Needs Assessment (JSNA) or Care Quality Commission Self-assessment return. If your JSNA does not currently include this information, you may want to use the information you collect here to help with future assessments. 2.1 Description of area covered. Please include: geographical spread whether rural or city local authority type, such as shire county, unitary authority, metropolitan district, London borough NHS bodies in the area Prison Partnership Board. Croydon Partnership Board Report 8 April 2010 Final 1

2 Croydon is the largest London borough covering an area of 87 sq. km. It is a diverse and complex place with some areas sharing inner-city characteristics while others offer some of the most expensive housing in outer London. Croydon is an edge settlement, a large town in its own right but also with a crucial economic relationship with the rest of the capital city. It is a place that combines very settled communities with more transient population, driven by inward migration. NHS Croydon (the operating name for Croydon Primary Care Trust) is the local NHS with overall responsibility for improving the health of people of Croydon. Croydon does not have any prisons located in the borough so there is not a Prison Partnership Board. 2.2 Description of general population. Please include: total population of adults aged 18 and above a breakdown of socio-economic status number of young people not in employment, education and training (NEETs). With 339,500 residents from a wide range of ethnic origins and cultures, Croydon has a very young age profile, with the largest population of children and young people (0-19) in London. There are approximately 82,000 young people. Whilst this makes Croydon the youngest borough in south London, our population is also ageing almost 60,000 people are aged 60 or above. The black and minority ethnic groups make up 42% of the population which is similar to the London average. The latest official population of 18 and over in Croydon is 261,534 (2008 ONS mid year estimates). While deprivation levels across Croydon vary considerably and include some of the most and some of the least deprived areas in London, on average, Croydon is slightly less deprived than the national average and considerably less deprived than London as a whole. One in four children lives in poverty. At 15%, the proportion of the population with a disability is slightly below average. There are more than two births for each death in Croydon. At 17%, the proportion of social rented households is below average (London 24%; England 18%). Household overcrowding is above the national, but below the regional, average. At 36%, the proportion of older people living alone is about average. Car ownership is above average for London. The proportion of older people with no central heating is similar to the London average. Almost three quarters of the working age population is in employment. The unemployment rate is above the national, but below the regional, average. Average weekly incomes are above average for London and England. Croydon Partnership Board Report 8 April 2010 Final 2

3 Number of young people not in employment, education and training: As at December 2009, the percentage of year olds who were not in employment, education and training (NEETs) was 6.9%, making it one of the worst Council areas in London for young people without education or employment, 28th out of the 32 London Boroughs. 2.3 Description of population of people with learning disabilities, aged 18 and above, known to services. Please give the total population (number) of adults with learning disabilities known to services. Based on the definition in the national strategy Valuing People, about 2% of the population has a learning disability. The number of adults with learning disabilities in Croydon aged over 18 years is therefore estimated to be 5,226 (at 2% of the population) with 1,306 estimated to need specialist learning disability services based on national statistical guidance (0.5%). The total number of people with learning disabilities known to the Croydon Joint Community Learning Disability Team and in receipt of a service or an assessment during the year at March 2009 was In March 2010 out of the current total of 1205: 80 live in supported living provided through the adult placement scheme 197 live in other supported housing (26 live outside Croydon) 460 are at home with carers in the community or are young people attending residential colleges during term time 450 live in residential or nursing homes including residential colleges (221 live outside Croydon) 18 are in hospital or other active assessment and treatment services These figures do not include all the people placed in Croydon who are funded by another local authority, but do include all the people who are funded by Croydon Council and Croydon Primary Care Trust, who are living outside Croydon. A significant number of clients who have received services from the health team are placed in Croydon by other local authorities. As at March 2010, there are 78 residential registered care homes for people with learning disability in Croydon, with a total number of 620 places. Croydon has 229 clients in these homes. This includes clients in registered residential care homes run by Surrey and Borders NHS Trust, located in Croydon. Croydon Partnership Board Report 8 April 2010 Final 3

4 In addition, there are a number of supported housing services in Croydon which provide homes for 171 Croydon clients and an unknown number of clients placed by other local authorities with care packages purchased by these other authorities, who remain responsible for their social care. For all clients living in Croydon, it is the lead responsibility of the Croydon Joint Community Learning Disability Team to follow up on any safeguarding concerns and provide specialist health input, as needed. 305 clients have a specialist learning disability psychiatrist of whom 180 were referred in the last two years. Clients seeing the psychiatrists have a range of problems with their mental health, approximately 100 have challenging behaviours and 130 have autistic spectrum disorder. The number of clients who have care packages managed by the Croydon Joint Community Learning Disability Team (JCLDT) on behalf of Croydon Council has increased steadily over the last ten years. This is mainly attributable to the increasing number of young people who at 18 years old need support from adult services, which exceeds the number of deaths. At present there are 66 young people aged 18 and 19 years receiving funded services. 2.4 Number of adults with a learning disability who are known to services (as at 2008/9, and percentages of total population) Number % Age 18 to Age Male Female Ethnic breakdown of adults with a learning disability (and percentages) People living in Croydon People with LD known to JCLDT White British 65% White British/Other 74% Black Caribbean 9% Black Caribbean 9% Black African 6% Black African 3% Black other 2% Black other 2% Indian 9% Indian 4% Pakistani 3% Pakistani 1% Croydon Partnership Board Report 8 April 2010 Final 4

5 Bangladeshi <0% Bangladeshi 0.5% Other Asian 4% Other Asian 3% Chinese <0% Chinese 0.5% Other 2% Other 3% The following three categories marked with a * are mutually exclusive - please do not count more than once. People with complex needs* N/A ** People who exhibit behaviour that challenges services* N/A ** People with learning disabilities who also have autism* N/A ** Living with family carers aged Who are parents N/A ** Aged 18 to 25 in part-time education N/A ** Aged 18 to 25 in full-time education N/A ** Aged 18 to 25 in local education N/A ** Aged 18 to 25 in residential education N/A ** Number % * * N/A - Comprehensive data is not routinely collected and collated, and poses difficulty with definitions. However, individual care plans indicate when clients have complex needs, autistic spectrum disorder, challenging behaviour, live with older carers, are parents, and educational arrangements. Clients care plans are established to meet needs and any problems meeting specific needs are flagged to the commissioning team who ensure the development of appropriate services to meet needs How are the specific needs of people with learning disabilities highlighted in your JSNA met? Please give examples. The Joint Strategic Needs Assessment (JSNA) is an ongoing process which looks at current and future health and social care need. The specific needs of people with learning disabilities are highlighted in Croydon's Joint Strategic Needs Assessment and the Croydon Learning Disability Partnership s Strategy for Adults with Learning Disabilities These are met as follows: To enable future planning, the Transitions Transformation Programme has identified 159 young people aged 14 to 18 years and through an initial review has identified those with complex and profound disabilities. 49 young people out of 159 had profound and complex disabilities in the 5 transition Croydon Partnership Board Report 8 April 2010 Final 5

6 cohorts with dates of birth 1991/92 to 1995/96. The Transitions Transformation Work Plan has established a range of initiatives to enhance transitions planning and provide earlier identification of individual needs to facilitate better individual service planning. The joint team has several work groups delivering services and one of these is the challenging behaviour working group which consists of a consultant psychiatrist, a psychologist, a speech and language therapist and 2 community nurses. There is a service specification for this work group and operational policies and it has been successfully meeting the needs of clients with challenging behaviours. Increasing numbers and quality of person centred planning and implementation of self-directed support. The initial test phase of selfdirected support has already resulted in more personalised outcomes, while person centred planning alongside community care assessments and annual reviews continues to result in better identification of individual needs. Self-Directed Support and individualised budgets continue to be developed and implemented in line with a person centred planning approach. The Learning Disabilities Partnership through the joint team employs BME practice development officers and much outreach work has been undertaken with African and Caribbean groups and with Asian and Muslim families. Work in this area includes the development of a cultural competency checklist, the introduction of specialist providers for Muslim families, the establishment of a Muslim Families Group to identify needs and increase awareness in the Muslim community. Addressing safeguarding issues through increased partnership working between all agencies and specific work to improve information sharing between the council and the police. Work with local disability forums and including specific work with BME groups, to encourage individuals to report abuse. Developing the role of GPs and hospital staff in meeting the health needs of people with learning disabilities for e.g. through enhanced health checks, introduction of Health Passport and Health Action Plans. The enhanced service is being introduced throughout Croydon with training for GPs and the development of consistent standards. The multi-disciplinary mental health work group, in the Joint Community Learning Disability Team, works alongside the whole Team to provide care for adults with learning disabilities who also have mental health problems. Increasing opportunities for work, for example through Croydon Employment and Support Service (CESS) to enable more people to access appropriate Croydon Partnership Board Report 8 April 2010 Final 6

7 jobs, volunteering and similar opportunities. CESS has supported 32 individuals with a learning disability to take part in work experience, 8 people with learning disability to gain paid employment and 3 to gain voluntary work since April 2009 to date. To meet the needs for better social inclusion, choice and person centred services, more supported housing and domiciliary services have been developed to meet the diverse needs of adults with learning disabilities. These require well trained staff who can look after the health and well- being of clients with complex needs through the implementation of health action plans, risk management strategies and person centred planning. A tender for an approved list of service providers is underway. Plans are being developed to establish enhanced arrangements for short breaks, which will widen the scope of services, provide increased choice and enable more people with learning disabilities to remain with their families, giving carers the support they need. 2.6 What is being done to improve information that informs planning and commissioning of services for people with learning disabilities? The Learning Disability Spreadsheet collects data on all services provided to clients, with key data to enable analysis of demands and trends. There is integrated data collection within and across different care sectors for transition clients, for example the ICount register for children with disabilities. By further integrating Children s client data and enhancing the range of client data available for collation, using SWIFT, better information for planning purposes is being established. The integration of health and social care records needs further attention in 2010/11. It has been a long term objective to integrate records while meeting different reporting requirements. Plans are being developed to establish a more integrated system. For children with challenging behaviour, mapping has been undertaken to identify gaps in current service provision. 2.7 Please give details of any other progress made, including: people with learning disabilities in the criminal justice system people with learning disabilities detained under the Mental Health Act (local authorities and PCTs have this information) Currently, Croydon do not currently have anyone with learning disabilities in the criminal justice system. Croydon Partnership Board Report 8 April 2010 Final 7

8 Croydon currently has 7 people with learning disabilities detained under the Mental Health Act broken down as follows: Section 2-1 Section 3-5 Section 37/41 1 These 7 people are monitored on a weekly basis within the Mental Health Work Group in the Joint Community Learning Disability Team and there is hospital liaison with the team s consultant psychiatrists to assess the current position and their suitability for discharge back into the community. These clients are subject to the Care Programme Approach (CPA) which ensures ongoing regular monitoring and assessment of mental health. 3 Partnership Board arrangements 3.1 Please give details of your Partnership Board. Frequency of meetings 5 meetings per year lasting 2.5 hours plus 0.5 hour pre-meetings for Learning Disability representatives and their support workers with the Joint Commissioner Learning Disability. There is also an annual development day. Details of sub-groups Croydon Learning Disability Partnership steers local learning disability strategy and takes responsibility for monitoring service development. The following sub-groups help the Partnership deliver the Learning Disability Work Plan: Advocacy and Self-Advocacy Strategy Group Better Understanding Group Learning Disability Health Sub Group Leisure Link Person Centred Planning 'Let's Do It Group' Quality Group Learning Disability Performance Sub Group Black and Minority Ethnic Group Supporting Housing Strategic Group In addition there are Provider Forums and the Learning Disability Forum. Date of last review of Partnership Board arrangement Croydon Partnership Board Report 8 April 2010 Final 8

9 31 October Please give details of the structure and membership of the Partnership Board. Roles and representatives Croydon Learning Disability Partnership comes under the umbrella of the Healthy Croydon Partnership within the local strategic partnership. The Partnership's Terms of Reference set out the purpose, structure, work agenda, membership and conduct of business. The Partnership steers local learning disability strategy and takes responsibility for monitoring service development. It has sub groups which are responsible for planning and implementing change to achieve key aims. The members and statutory bodies represented on the Partnership are jointly responsible for ensuring the appointment of an officer to take responsibility for the inter-agency implementation of the proposals in "Valuing people" and "Valuing People Now". The person appointed to take forward priorities agreed by the Partnership is the Joint Commissioner - Learning Disabilities. The Partnership is jointly chaired by the Director of Support, Younger Adults and the Project Manager (a person with learning disabilities) from Croydon People First. Croydon People First are the main local self-advocacy group run for and by people with learning disability. Croydon has a broad representation on its Partnership. This includes people with learning disabilities, self advocates, carer representatives, voluntary and advocacy groups, private and statutory sectors providers, representatives from Black and Ethnic Minority Groups, senior managers, Communication and Access Officer, Person Centred Planning co-ordinator, a Croydon GP who is a member of PCT Professional Executive Committee, Mayday Hospital, Education, Housing. Appendix 1 gives the breakdown of the membership & roles of representatives. The Partnership had 5 representatives with learning disabilities in The 5 representatives were 2 from First Friday, another self-advocacy group, 2 from Croydon People First and 1 from Croydon Contacts, a local voluntary group for people with learning disability and their families. They are supported by support workers at the pre-meets and Partnership meetings. During 2009, the number of representatives began to reduce (at December it had reduced to 2). This triggered a review. Members of the Advocacy and Self- Advocacy Strategy Group and the Joint Commissioner, Learning Disabilities reviewed the representation of people with learning disabilities and their proposals to restore the number to 5 were agreed by the Partnership. First Friday members on the Partnership will now be supported by Croydon People First at Partnership meetings and two students from CALAT have joined as representatives supported Croydon Partnership Board Report 8 April 2010 Final 9

10 by their tutor. The Partnership is part of the Healthy Croydon Partnership and has strong links, through individual members, with other broader strategy groups (e.g. the Carers Partnership, Safeguarding Adults Board, The Transitions Transformation Group, Supporting People Steering Group) to help the Partnership achieve the key aims of the national strategy for learning disability "Valuing People Now" (January 2009) as well as continuing those of the previous strategy, "Valuing People (March 2001). The Partnership is well connected with strategy and policy development groups for Housing, Parents with Disabilities, Education, Transport, Employment, Transitions, Leisure, Sport, the development of Croydon Vision Croydon, the Total Place pilot. The Partnership has close links with other forums such as Self-Advocacy Groups (e.g. People First, First Friday), the Learning Disability Forum, Leisure Link, and the Providers Forums. Croydon Mencap, Croydon Voluntary Action, Croydon Contacts, Advocacy Partners, Parents in Partnership, First Friday and People First all link into the Partnership and many other individuals and organisations link through the Learning Disability Forum. There is a close relationship between the Partnership and the Learning Disability Partnership Executive (LDPE) meetings. All members of the Learning Disability Partnership Executive are members of the Partnership. The Partnership Executive is part of the integrated management structure agreed between the Council and NHS Croydon for Learning Disabilities. It manages the Joint Commissioner and steers the work of the Joint Community Learning Disability Team. Its membership consists of NHS Croydon and Croydon s Department of Adult Social Services and Housing. Number of people with learning Male 3 Female 2 disabilities Number of family carers Male 2 Female 3 Ethnic breakdown of people with learning disabilities and family carers People with learning disabilities: 3 White British & 2 Caribbean Family carers: 4 White British & 1 Pakistani Members that have complex needs None 1.3 Please describe how your Partnership Board has invested in, and supported, leadership, so that members of the Board and associated task groups who are people with learning disabilities or family carers have become real Croydon Partnership Board Report 8 April 2010 Final 10

11 partners in the planning and decision-making processes alongside professionals. Include examples and evidence Croydon Learning Disability Partnership recognises that leadership of the Partnership is critical to the success of delivering better outcomes for people with learning disabilities. Family carers, people with learning disabilities, together with other partners play an important role to help the Partnership identify needs and steers local disability planning. Further a family carer is leading on the development of person centred reviews for 14 year olds together with the Person Centred Planning Coordinator and Heads of Schools. The Learning Disability Development Fund (LDDF) is used to fund a Communications Officer and administrative support, to support development work and provide a quarterly newsletter called Springboard for carers and other partners and a bimonthly newsletter called Leisure Link for people with learning disabilities. This assists engagement through access to information. LDDF also funds the Person Centred Planning Coordinator and Advocacy to enable more control by and empowerment of people with learning disabilities. To make sure we respond to the needs of Croydon s diverse, multi-cultural population, we are developing local partnership arrangements to include more people representing diverse ethnic backgrounds. Croydon Association of Asian & Muslim Carers and Healing Waters (a Black and Minority Ethnic organisation) are Partnership members. We have taken positive steps to ensure this, by setting up a Black, Asian and Minority Ethnic Practice Development Officer post, a Muslim Families Carers support worker and a BME Reference Group as part of the Learning Disability Partnership. The Partnership meetings are designed to help everyone contribute as much as possible and includes an open slot where there is an opportunity for issues to be raised and brought to the attention of the Partnership. Everyone is encouraged to participate in the discussions and usually the meetings are conducted in Café Style. Representatives of people with learning disabilities are supported at the meetings by their support workers to engage with and represent the views of people with learning disabilities. The Joint Commissioner, Learning Disabilities meets with them before the start of the Partnership meetings to go over any key points or issues that the members wish to raise on the agenda items or in the open slot. Any agreed actions from the Partnership meetings are noted as 'Outstanding Issues' for action by a nominated individual or project group or sub group, who will report back to the Partnership. These are reviewed at future Partnership meetings to ensure Croydon Partnership Board Report 8 April 2010 Final 11

12 they have been implemented. The Learning Disability Communication and Access Officer, is a member of the Partnership. Her role is to ensure clear information is provided, in an appropriate way, to explain services and how to access them. The Communication and Access Officer supports the Better Understanding Group (BUG) of people with learning disabilities to help agencies and organisations provide information in the best way for people with learning disabilities including using websites, producing DVDs, updating information directories, developing more face to face groups and talking to the public, schools etc to increase their understanding of people with learning disabilities. The following are some examples and evidence of how members of the Partnership and associated task groups include people with learning disabilities and family carers, who have become real partners in the planning and decision-making processes alongside professionals. 1. Ideas from the sub groups and Learning Disability Partnership meetings are used to develop the Learning Disability Strategy. The Partnership has put the strategy together from the Learning Disability Development Day, Learning Disability Forum meetings, meetings of First Friday and People First, meetings of the Joint Community Learning Disability Team and of the Croydon Learning Disability Partnership and its working groups. The Strategy shows how we will continue to develop services for people with learning disabilities based on the main priorities set out in Valuing People Now. It looks ahead over the next three years, reviews previous Learning Disability Partnership Work Plans and sets out the updated Work Plan for 2009 to The Strategy has been agreed by the Learning Disability Partnership Executive, which brings together Croydon Adult Services & Housing and Croydon Primary Care Trust. It is endorsed by the Croydon Learning Disability Partnership which represents all the Partnership agencies. 2. Issues identified at the Partnership Review were taken forward by a work group consisting of volunteers from the Partnership and Advocacy & Self Advocacy Strategy Sub Group. This led to the following changes in the way Partnership meetings are held. Meetings are now jointly chaired. Improving the way information is communicated, such as the use of symbols and pictures, improving ways of carers' representation, for example: inviting views through Springboard. All relevant news and updates for example: Valuing People Now guidance and reports are circulated to Partnership members by the Partnership Officer. Croydon Partnership Board Report 8 April 2010 Final 12

13 3. Representatives of people with learning disabilities are encouraged to have their say at Partnership meetings and be part of the Partnership sub groups. A recent presentation about what the Partnership can do to improve support for people with learning disabilities led to proposals for representation as described in Section 3.2 above. 4. Representatives from Croydon People First and First Friday help people say what they think about things that are important to them and they tell the Partnership about the things that are important to the group members. For example problems with the Equipment centre not being fully accessible and staff shifts limiting social activities in the evenings. These issues have been taken up very successfully and are being resolved. 5. The carers' representatives meet regularly with the Director of Support, Younger Adults and Joint Commissioner, Learning Disabilities to discuss specific and current issues and shape the agenda. This for example has resulted in Employment being a key agenda item and the development of a Total Communications Plan with a new worker being appointed to ensure clients with profound and complex needs have full communication with high quality support from workers. They are also actively involved in the Partnership's sub groups, for e.g. Health Sub Group, Person Centred Planning 'Let's Do It Group' and Performance Sub Group. 6. The Partnership have been holding annual development days which focus on current issues, involving carers, people with learning disabilities, stakeholders, providers, voluntary sector, BME groups and professionals. At such events the Big White Light Theatre, Croydon Clock Tower's theatre company, has supported people with learning disabilities to do role plays to get their message. Volunteers from the Partnership with representations from carers, people with learning disability and voluntary sector organisations work with staff from the Joint Community Learning Disability Team to plan the Day. The Development Day in 2009 was co-chaired by a person with learning disability. 4 Overall budget 4.1 What is the overall budget for services for adults with learning disabilities across health and social care? million gross including all grant funding in 2009/ Is it a pooled budget? Croydon Partnership Board Report 8 April 2010 Final 13

14 Yes No 4.3 Is there a Section 75 agreement in place? Yes No 4.4 How is it spent? Please give actual figures and percentages % Residential & Nursing care 27.03m 54.4% Nursing care funded by NHS 900k 1.8% Supported living (including respite, outreach, direct 8.92m 18% payments, transport, domiciliary support and shared lives) Hospital care, including where known: - acute hospital (specialist psychiatric beds) 800k 1.6% - specialist inpatient services (active assessment 2.37m 4.8% and treatment beds) - NHS campuses none none Day services (Council, NHS and Other) 4.85m 9.8% Joint Community Learning Disability Team, (including Care Managers, reviewing officers, Independent Living Officers, psychiatry, all other health professionals) 3.6 m 7% Advocacy arrangements and support 100k 0.2% Other (please specify) Dentistry Commissioning & service development, primary care development, partnership support, social care change programme, brokerage, person centred planning, quality assurance, etc 140k 1 m 0.3% 2% Total - gross of grants etc 49.71m 100% 4.5 Has there been an efficiency savings programme in learning disability services in ? Yes No 4.6 Is there a planned efficiency programme for ? Yes No Croydon Partnership Board Report 8 April 2010 Final 14

15 The efficiencies targets for Learning Disabilities are as follows: 2009 to 2010 the financial efficiency target was 673K 2010 to 2011 the financial efficiency target is 690K 5 The health of people with learning disabilities 5.1 Have you completed the regional health self-assessment and performance framework? Yes No In progress 5.2 If you have answered in progress or no, indicate when you expect this assessment to be completed or started. Started Completed 5.3 If you have answered yes, please complete the following summary table based on the most recent results of that assessment. RAG rating Red Amber Green NHS campus closure Addressing health inequalities Making sure people are safe Continuing to achieve other Valuing People Now health commitments This is based on our initial self assessment. We are providing additional evidence as requested following the Validation Meeting on 1 April If you have answered yes, please give details of the overall headline health needs of people known to services - from regional health self-assessment and performance framework. Health needs of people with learning disabilities are being addressed through Health Action Plans (567 in place currently) and annual health checks with GPs trained to carry out enhanced health checks. Currently there are 48 (75%) practices undertaking enhanced health checks for people with learning disabilities. To ensure good care at Mayday Hospital for clients requiring a hospital admission, Croydon Partnership Board Report 8 April 2010 Final 15

16 the health passport is being introduced and clients receive good support and follow up from the Joint Community Learning Disability Team dietician who advises hospital staff on care needs and liaison issues and meets regularly with the Quality Manager at Mayday to review and improve practice. This work is being strengthened with the appointment of a hospital liaison nurse. 5.5 If you have answered in progress or no, please provide the following information. Otherwise go straight to section 6. Percentage of GP practices in your area that have signed up to provide annual health checks as a Directed Enhanced Service (DES). 48 (75%) practices undertaking enhanced health checks Percentage of adults with learning disabilities known to local authorities who were offered health checks in the year up to 31 March Not yet available Percentage of adults with learning disabilities known to local authorities who received a health check in the year up to 31 March Not yet available Are people with learning disabilities involved in learning disability awareness training to primary healthcare staff as specified in the DES? Yes No How are family carers being involved as partners in improving healthcare for people with learning disabilities? Family carers are involved and encouraged to raise and discuss any concerns at Partnership meetings. Health has been a major focus of the Partnership in 2009, and has been discussed at 3 different meetings, with reports and updates by the lead on Health, PCT colleagues, Joint Community Learning Disability Dietician and a GP. The 2009 Development Day focussed on the health of people with learning disabilities and this has been the key priority throughout the year. It identified measures being taken in Croydon to give equal health care access to people with learning disabilities and looked at the issues that arose from Healthcare for All, as well as general health issues that impact on people with learning disabilities. People involved were carers, people with learning disabilities, a local GP who put forward the Croydon Partnership Board Report 8 April 2010 Final 16

17 GP s perspective and identified difficulties GPs experience in providing equal access for people with learning disabilities, Mayday Hospital managers, PCT and Council managers, care providers and the Joint Community Learning Disability Team. Health staff who were involved on the day were psychiatrists, psychologists, speech and language therapists, community nurse, dietician, hospital managers, GPs. The Health sub-group are taking forward the issues that have been raised at the Development Day and at Partnership meetings, as well as the work plan identified in the Learning Disability Strategy. The membership is made up of Deputy Service Manager - Health, a carer, people with learning disability, Croydon Mencap s 'Older Carers Project' staff, BME officer, Dietician and the Strategic Commissioning Manager. Percentage of people known to services who have health action plans that have been reviewed in the year up to 31 March (567/1207) 47 % What are the arrangements for strategic healthcare facilitation in your area? The lead for strategic healthcare facilitation is the Deputy Service Manager for the Joint Community Learning Disability Team (JCLDT) who is the Strategic Health Facilitator. He chairs the Partnership Health Sub-Group. There is a community nurse in the JCLDT who is responsible for leading on health action planning. She trains and supports care workers to put in place and implement health action plans and carries out health action planning for clients living alone or with a family member who do not have a dedicated care worker. All other staff in the JCLDT also promote health action planning, and health professionals carry out health action plans, as required. Some good work has started on identifying health needs through health checks. Training has been given to GPs and practice staff on enhanced service for people with learning disabilities. The JCLDT with People First implemented training for local primary care teams including GPs and practice staff in May In February 2010 further GP training took place. Community nurses are training dentists. The JCLDT is being asked to conduct training across the primary care field on a regular basis now. NHS Croydon is using the Social Service register for people with learning disability and the GP's list to establish all people with learning disability on GPs' lists. A pilot project involving 16 GPs in Croydon started in December The aim of the project is to develop models of best practice for health checks and health action planning for adults with learning disabilities on GP registers. NHS Croydon has agreed a process with almost all GPs regarding annual health checks and awareness Croydon Partnership Board Report 8 April 2010 Final 17

18 of those with Health Action Plans. In terms of acute hospitals, we have appointed an acute liaison nurse who will be facilitating effective patient journeys from point of admission through to discharge for all people with learning disability. This post will also be leading on establishing a health inequalities work group and will lead on gathering and analysing key data and establishing plans to address health inequalities with key agencies. The work group will be set up by September A Hospital Communication Passport has also been developed across the South West Sector which is now complete and is being implemented with a joint launch with Mayday Hospital Trust in April The Health and Social Care Access Group (HASCAG) meets weekly to discuss new referrals, allocate cases to suitable professional disciplines, and discuss ongoing cases. The group consists of the following professionals: - Physiotherapy - Learning disability nursing - Speech and language therapy - Dietician - Clinical psychology - Care management - JCTLD Health Management - Occupational Therapy (awaiting recruitment) The following areas of referral are addressed by the above professionals: eating and drinking issues, dysphagia, communication difficulties, dietary issues, sexuality, access to acute hospital, physiotherapy (e.g. hydrotherapy, exercise), health action planning/health needs assessment, GP liaison, health promotion, primary care mental health needs (e.g. bereavement, mild depression/anxiety); capacity assessments (where appropriate to be conducted by a member of the HASCAG), cognitive assessments, safeguarding adults. The Challenging Behaviour Workgroup, the Mental Health and Health Access workgroups are the three health focussed workgroups in the Croydon Joint Community Learning Disability Team. All workgroup members take cases from the other two workgroups in addition to their challenging behaviour work, providing a flexible workforce compatible with the modern NHS. Consistent with the theme of flexible working, members of other workgroups also take on cases from the challenging behaviour waiting list when needed. The workgroups are continually developing different ways of working to meet changing demands and maintain practice consistent with policy, which are all crucial to ensure that a quality service for adults in Croydon with a learning disability and challenging behaviour is available in a timely manner. How many General Hospital (Acute) Trusts are there in your locality? Croydon Partnership Board Report 8 April 2010 Final 18

19 One How many General Hospital (Acute) Trust Learning Disability Liaison/Facilitator (or similar) posts are employed in your area? One, plus excellent work undertaken by the JCLDT Dietician who has a base at Mayday Hospital. Are the needs of people with learning disabilities and the health inequalities faced by them highlighted within each Trust's Disability Equality Strategies/policies (PCTs and provider Trusts)? Yes No Has your Partnership Board taken the opportunity to comment on the performance of local Trusts as part of the Care Quality Commission's (CQC's) annual health check? Yes No What progress have you made on the Green Light Toolkit for access to mental health services? What was your rating in the last CQC indicator set? Green Light Toolkit for access to mental health services has recently been subject to internal review and was assessed as green. The performance rating for Croydon PCT for 2008/09 indicates that the overall quality of commissioning is good. Is a local multi-disciplinary service in place to meet the needs of people whose behaviour challenges services, or is one being commissioned? Yes No Are there prisons or young offenders institutions or other secure settings in your area? Yes No If so, have you met with the Prison Partnership Board? Yes No Progress in carrying out the review recommended by the Ombudsmen's report (Six Lives: the provision of public services for people with learning disabilities) and report to Boards due by May Croydon Partnership Board Report 8 April 2010 Final 19

20 The review recommended by the Ombudsman's report has been completed and a report was submitted on 28 July 2009 to Croydon PCT Board. The report highlights the work Croydon is doing to meet the issues and recommendations highlighted by the "Six Lives" report. The report also sets out the progress on other recommendations highlighted in "Healthcare for All". The Learning Disability Partnership, supported by the Learning Disability Partnership Executive, has tested the existing systems in place against the recommendations and is assured that there are effective systems in place to enable Croydon Council and NHS Croydon to understand and plan to meet the full range of needs of people with learning disabilities in Croydon. The review has identified a number of additional measures and actions that will support improved practice and improve the health care for people with learning disabilities in Croydon. 7 key steps outlined in the Action Plan had been taken forward during 2009/10 and the work on this is continuing. 6 Where people live 6.1 Please use the data from your Adult Social Care Combined Activity Return (ASC-CAR) for NI 145 (see Appendix E for blank table), to give the numbers and percentages of individuals known to services (aged 18-64) who are defined as being in settled accommodation against the NI 145 categories. Please give actual figures and percentages Total % Owner occupier / Shared ownership scheme (where tenant purchases percentage of home value from landlord) Tenant - Local Authority / Arms Length Management Organisation / Registered Social Landlord / Housing Association Tenant - Private Landlord Settled mainstream housing with family/ friends (including flat-sharing) Supported accommodation / Supported lodgings /Supported group home (accommodation supported by staff or resident caretaker) Adult Placement Scheme Approved premises for offenders released from prison or under probation supervision (eg Probation Hostel) 0 0 Croydon Partnership Board Report 8 April 2010 Final 20

21 Sheltered Housing / Extra care sheltered housing /Other sheltered housing Mobile accommodation for Gypsy / Roma and 0 0 Traveller community Total % 6.2 Please use the NI 145 data to give a similar breakdown for people (aged 18-64) defined as not being in settled accommodation. Please give actual figures and percentages Total % Rough sleeper / squatting 0 0 Night shelter / emergency hostel / direct access hostel (temporary accommodation accepting 0 0 self-referrals) Refuge 0 0 Placed in temporary accommodation by Local Authority (including Homelessness resettlement) - eg bed and breakfast 0 0 Staying with family/friends as a short-term guest 0 0 Acute / long-stay healthcare residential facility or hospital (eg NHS or Independent general hospitals / clinics, long-stay hospitals, specialist rehabilitation / recovery hospitals)* Registered Care Home* Registered Nursing Home* Prison / Young Offenders Institution 0 0 Detention Centre 0 0 Other temporary accommodation Total % 6.3 Please give additional data to show numbers: In residential settings (see categories marked*) 221 in local authority area In residential settings (see categories marked*) 239 out of area Supported to live independently (NI 136) Provider market 7.1 Does your provider market reflect the needs of your current and future Croydon Partnership Board Report 8 April 2010 Final 21

22 population? Yes No 7.2 If you have answered no, in what ways does it need to change? 7.3 What percentage of your market is: In house Voluntary Public sector % Large % of Day support and respite Small percentage Mostly 7.4 Do you plan to change these percentages? Yes No 8 Employment 8.1 Please use the data from your Adult Social Care Combined Activity Return (ASC-CAR) for NI 146 (see Appendix E for blank table) to show the numbers and percentages of working age learning disabled people known to local authorities who are in paid employment (including being self-employed) at the time of their latest assessment or review, against the NI 146 categories. Please give actual figures and percentages Number Total % Working as a paid employee or self-employed (30 or more hours per week) Working as a paid employee or self-employed (16 to less than 30 hours per week) Working as a paid employee or self-employed (4 to less than 16 hours per week) Working as a paid employee or self-employed (more than 0 to less than 4 hours per week) Working regularly as a paid employee or 0 0 self employed but less than weekly Total 6.74 Working as a paid employee or self-employed and in unpaid voluntary work In unpaid voluntary work only Croydon Partnership Board Report 8 April 2010 Final 22

23 8.2 Please also state the number of people in paid employment who work for: The NHS 2 A local authority How many people known to services are not working? How many people known to services who currently work less than 16 hours a week are known to want to work 16 hours a week or above in the future? none 8.5 Do you have an up-to-date local employment strategy for people with learning disabilities in line with Valuing Employment Now: real jobs for people with learning disabilities? Yes No Croydon s current local employment strategy for people with learning disabilities is in line with Valuing Employment Now: real jobs for people with learning disabilities, but needs refreshing and updating. An employment champion needs to be established. The Croydon Employment Support Service works primarily with people with learning disabilities to support people into employment and plays a key role in the local employment strategy. 9 Advocacy and leadership 9.1 Has your Partnership Board developed a clear plan for working with and supporting all communities of people with learning disabilities and advocacy groups in the ways outlined in the Valuing People Now Delivery Plan? Yes No 9.2 Can your Partnership Board show how it has invested in, and supported, selfadvocacy and peer advocacy leadership so all people with learning disabilities are Croydon Partnership Board Report 8 April 2010 Final 23

24 represented on the Board and have become real partners in local planning and decision-making processes through this representation and via strong links to work programmes? This should include leadership and representation from all ethnic communities and the inclusion of people with more complex needs. The council is investing in professional advocacy from Advocacy Partners and the development of citizen and self advocacy groups, locally. Regular reports monitor take up by BME clients. It is an expectation that providers find ways to offer advocacy support to service users. A health advocacy project will be funded by Croydon PCT and implemented to enhance access to promote good health and access to services. The Advocacy and Self-Advocacy Strategy was reviewed in 2008 and is being implemented. There was increased take up and availability of advocacy, especially for mental capacity. Croydon People First became involved in developing and providing self-advocacy support for residents at three of the Surrey and Borders Partnership NHS Trust homes as they move through the changes in their services. Advocacy Rocks has also been involved in the Social Care Change Programme, including the tender and post transfer follow up and review. In the last year, the work of the Advocacy and Self Advocacy Strategy Sub Group of the Partnership has focused almost exclusively upon improving the involvement of people with learning disabilities as representatives. This group looks at a broad range of issues related to how people with learning disabilities can be better supported to communicate about their lives and be central in the process of transforming social care. This has entailed considering and working out answers to how we can obtain new representatives, whether the sources for these new representatives would provide a well rounded view of the lives of people in Croydon and whether our ideas would be successful in practice. The sub group sought to raise the profile of this subject at the Partnership through agenda items and discussions outside of the Partnership. This work is progressing well and from March 2010 two new representatives with support from Croydon Adult Learning & Training (CALAT) are now members of the Partnership. Another key piece of work of the Sub Group has been the development of a DVD training resource. This DVD will be used for people with learning disabilities to extend understanding of the role and function of the Partnership across wider numbers of people. Croydon Partnership Board Report 8 April 2010 Final 24