DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY POLICY AND PROCEDURE SABP/EXECUTIVE BOARD/0032

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1 DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY POLICY AND PROCEDURE SABP/EXECUTIVE BOARD/0032 NAME OF POLICY, PROCEDURE OR GUIDELINE REASON FOR POLICY OR PROCEDURE DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY This Policy will ensure that mental health needs of People with Learning Disabilities are met. WHAT THE POLICY WILL ACHIEVE? This Policy aims to ensure that adults with a dual diagnosis of mental health and learning disability receive the appropriate support and interventions when presenting to services provided by Surrey and Borders Partnership NHS Foundation Trust (SABP). The Policy sets out the framework within which people with a dual diagnosis of mental health and learning disabilities will receive appropriate comprehensive interventions. WHO NEEDS TO KNOW ABOUT IT? All clinical staff in the operational directorates of SABP DATE APPROVED TBA VERSION NUMBER 3.0 APPROVING COMMITTEE Executive Board DATE OF IMPLEMENTATION DATE OF FORMAL REVIEW AUTHOR/REVIEWER: RESPONSIBLE DIRECTORATE DISTRIBUTION An extension for this policy has been granted until 30th July 2016 to enable a full comprehensive review. This policy will be merged into the one person one plan policy. Director of Services for People who have a Learning Disability Learning Disabilities All SABP Staff Page 1 of 20

2 DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY POLICY 1.0 AIM This policy is written to ensure that adults with a dual diagnosis of mental health and learning disability receive the appropriate support and interventions when presenting to services provided by Surrey and Borders Partnership NHS Foundation Trust (SABP). The accompanying Procedure sets out the framework within which people with a dual diagnosis of mental health and learning disabilities will receive appropriate comprehensive interventions. 2.0 PURPOSE This policy applies to all adults with Learning Disabilities who meet the eligibility criteria for services to people with Learning Disability or Mental Health delivered by SABP Trust. It is intended as a good practice guide to all clinical staff in the operational directorates of SABP, based on current research and best practice guidance. 3.0 POLICY STATEMENT 3.1 Eligibility Adults with a diagnosis of learning disability and a presenting mental illness and living within the boundaries of the Trust will be eligible for treatment in accordance with this procedure. The primary reason for their assessment will be their mental illness not their learning disability 3.2 Scope This procedure applies to all Trust Mental Health Services, Older Adult Mental Health Services and Specialist Learning Disability Services. Policy /Procedure Compliance Monitoring Table This is to be added to each policy/ Procedure to clearly show how the effectiveness of the policy/procedure will be monitored. What will be monitored Access to appropriate services by people with a dual diagnosis of Mental Health and Learning Disability How/Method Frequency Lead Reporting to (what committee) Completion of KPI for Exec Board Review of issues discussed at Clinical Network Group (Task Group to ensure implementation of Policy and adherence to its principles). Quarterly Service Directors Executive Board (Quarterly) Learning Disability QAG to review work of Clinical Network Group (at least 3x p.a.) Learning Disability Partnership Board (Quarterly) Deficiencies / gaps recommendations and actions Page 2 of 20

3 DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY PROCEDURE SABP/EXECUTIVE BOARD/0032 NAME OF POLICY, PROCEDURE OR GUIDELINE REASON FOR POLICY OR PROCEDURE A DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY This procedure will ensure that mental health needs of People with Learning Disabilities are met. WHAT THE PROCEDURE WILL ACHIEVE? This procedure aims to ensure that adults with a dual diagnosis of mental health and learning disability receive the appropriate support and interventions when presenting to services provided by Surrey and Borders Partnership NHS Foundation Trust (SABP). The Procedure sets out the framework within which people with a dual diagnosis of mental health and learning disabilities will receive appropriate comprehensive interventions. WHO NEEDS TO KNOW ABOUT IT? All clinical staff in the operational directorates of SABP DATE APPROVED TBA VERSION NUMBER 3.0 APPROVING COMMITTEE Executive Board DATE OF IMPLEMENTATION DATE OF FORMAL REVIEW AUTHOR/REVIEWER: RESPONSIBLE DIRECTORATE DISTRIBUTION An extension for this policy has been granted until 30th July 2016 to enable a full comprehensive review. This policy will be merged into the one person one plan policy. Director of Services for People who have a Learning Disability Learning Disabilities All SABP Staff Page 3 of 20

4 DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY PROCEDURE 1.0 INTRODUCTION This procedure is specific to those people who have a dual diagnosis of Mental Health and Learning Disability and not people who have a dual diagnosis of Mental Health and Substance Misuse. Most psychiatric disorders are more common amongst people with learning disabilities than in the general population. Most recent research (cited in Hardy et al, RCN 2010 p: 13) into the epidemiology of mental health problems in people with learning disabilities puts prevalence rates between 20.1% to 22.41% (excludes challenging behaviour) in adults with learning disabilities (Taylor et al, 2004, Cooper et al, 2007), compared to 16% in the wider population (DH, 2003). As with their other health needs, people with learning disabilities must be enabled to access general psychiatric services whenever possible. This is in adherence to National Guidance as set out in the Mental Health National Service Framework, Valuing People, NICE guidance and standards set out in the Green Light Tool Kit. This procedure will ensure that mental health needs of People with Learning Disabilities are met through: Collaborative working between mental health services (this includes our Older Peoples and Working Age Adult Services and Substance Misuse Services,) and specialist learning disability services (community based services and inpatient.) For further information see glossary. Access to mental health services wherever possible The provision of small specialist inpatient services for those whose needs cannot be met by acute provision Consistent application of CPA ensuring all needs of people with learning disability and mental health are addressed The provision of Easy Read information on conditions associated with Mental ill health Access to provision of training to staff within mental health services on the needs of people with learning disabilities Within England current policy on how the needs of people with learning disabilities should be met is asserted within Valuing People Now (2009) that: people with learning disabilities are equal citizens, who have the same rights as any other person empowering people to make their own choices and take control of their lives the right to be offered the same opportunities as other citizens the right to be independent social inclusion becomes a reality for people with learning disabilities. The policy (Valuing People Now 2009) provides guidance on how mental health organisations are required to meet the mental health needs of people with learning disabilities by: promoting collaborative working between general mental health services (primary and secondary care) and specialist learning disability services helping people with learning disabilities to access general mental health services wherever possible Page 4 of 20

5 providing small, specialist inpatient services for those whose needs can not be met by mainstream services 2.0 DUTIES/RESPONSIBILITIES Overall responsibility sits with the Service Directors and Associate Directors. All front line managers and care co-ordinators have a duty to implement this policy as necessary. 3.0 REFERRALS TO COMMUNITY SERVICES (CMHRS, OP CMHT S, CTPLD S, HTT S) Upon receipt of a referral or enquiry which meets the eligibility criteria for the Trust s Mental Health or Learning Disability services the receiving team will assume ownership of the referral. If the referral is deemed appropriate and meets the criteria for a service from the team they will process the referral as outlined in their Operational Policy. If there are concerns with regard to the referral in relation to the person s learning disability/mental health then the referral must be discussed with relevant practitioners in the relevant teams. Service responses will not be based on Learning Disability diagnosis or historical links to Learning Disability psychiatry. Equally service responses will not be based on historical links to Mental Health Services. As appropriate a joint assessment will be undertaken by the Mental Health and Learning Disability Practitioners. A decision will then be made as to which team takes the lead for the individual s treatment and support. With support from the other team as deemed necessary. If agreement cannot be reached as to which team should provide the treatment and support to the individual then this should be escalated to the relevant line managers and above if required. The responsibility of responding to the referral remains with the team who first received the referral until resolution of most appropriate team is achieved. Irrespective of the decision as to who will take the lead role, it is expected that the other team(s) remain engaged and joint work the case to meet the needs of the individual. 4.0 ADMISSIONS People with a learning disability who have a mental illness which requires admission for treatment should be able to access services and be treated to the same standard as anyone else. The rationale for admission will relate primarily to their mental illness not their learning disability. This may require the service to make reasonable adjustments to ensure that their services and treatment are accessible to people with a learning disability. 4.1 A minority of adults with a learning disability have severe complex needs or a level of vulnerability that will require alternative inpatient assessment and treatment services. The purpose of such learning disability inpatient facilities is also to provide intensive assessment and treatment on a short-term basis. The goal will be for these individuals to return to live in their communities, with support packages that adequately meet the persons need (DH SPECIALISED SERVICES NATIONAL DEFINITIONS SET (2nd Edition) Specialised Learning Disability Services - Definition No The Trust operates a range of specialist inpatient services for people with learning disabilities - assessment and treatment units and Active Treatment and Support Page 5 of 20

6 Services. Referrals to units must be supported by a Consultant Psychiatrist referral /recommendation (in the form of a letter/fax). In accordance with the services Operational Policy the team will undertake the eligibility assessment which includes an assessment of needs/threshold using the Clinical Threshold Guide. This will take account of: Level of learning disability Level of vulnerability Initial Presentation Requirement for specialist assessment or intervention Recommendation by referring Consultant Psychiatrist Communication Preference of the individual Once these are completed then the person will be offered an assessment using the NAaRT16 (Nursing Assessment and Rating Tool 16 point Assessment). The person making the referral will be informed of the timescale for the assessment which are as follows: Tier 1 Urgent Tier 2 - within 24 hours Tier 2 within 48 hours Tier 4 The person should be signposted to the services that would be most appropriate to meet their needs. This may include receiving treatment in one of the mental health services assessment and treatment units or support in a community setting Planned admissions are organised to meet the needs of the individual and also to ensure that access to the relevant professionals and other services is possible. Routine admissions are Psychiatry led during working hours / when there is consultant cover. Admission is nurse led out of hours (when prearranged) When a person encounters a crisis (that is not identified in a persons relapse plan) outside of normal working hours (Monday to Friday) the person should access emergency services (e.g. A&E, Crisis Team, Home Treatment Team/Adult Mental Health Services) and immediate referral should be made to the Assessment and Treatment Team (PLD) on to arrange assessment. 5.0 PRESENTATIONS AT A & E DEPARTMENTS If a person with a Learning Disability presents at A&E with a suspected mental health issue they should be referred for assessment by the Home Treatment Team. (HTT take referral from A&E only between 8pm to 8am and weekend) Between 8am and 8pm Mon to Fri all A&E referrals should go to the liaison nurse/team or on-call psychiatrist. An on-call learning disability psychiatrist can provide additional advice if necessary. If admission is deemed not necessary then the Home Treatment Team should provide support and treatment as required by the individual in order to support them and keep them safe. (If admission is not deemed appropriate or necessary then HTT or the assessor should signpost the client accordingly, i.e. community services or GP). The psychiatric liaison team within A&E staff should alert the relevant CMHRS/CTPLD of the individuals presentation so they can be followed up appropriately. If required reasonable adjustments will be made to safely accommodate, treat and support the individual. The following working day, should there be concerns with the appropriateness of the admission, then a referral for assessment will be made to the RMO for the Specialist Assessment and Treatment Service for people with a learning disability. Page 6 of 20

7 The assessment for eligibility transfer should be undertaken in accordance with If appropriate arrangements will be made to transfer the individual to the Specialist Assessment and Treatment Service for people with learning disabilities. If referral to an Active Treatment and Support services is required then further liaison with the funding organisation will be facilitated by the Matron/Service Manager, as spot/specific funding for the placement will need to be agreed prior to any admission 6.0 CRISIS HELPLINE / CRISIS HOUSE People with a dual diagnosis of Mental Health and Learning Disability will have equality of access to the Crisis Helpline and Crisis House. Crisis helpline is available in out of hours. The caller will be advised of whether there is a need for a psychiatric assessment for hospital admission, if so, then a referral to HTT will be made. HTT staff will identify an appropriate place where the assessment can take place. If HTT staff does not feel that the patient needs a psychiatric assessment then he/she will be advised accordingly and signpost to the relevant services, i.e. CTPLD, GP. If Crisis helpline operator feels that the caller needs urgent medical attention, i.e. overdose, then the caller will call an ambulance or advised to go to A&E. 7.0 ACCESS OF TRAINING IN SUPPORTING PEOPLE WITH LEARNING DISABILITIES AND MENTAL HEALTH NEEDS Specific training and support can be provided to mental health teams access through the local CTPLD. Alternatively specific training and support can be provided to CTPLDs from mental health teams accessed through the local CHMRS 8.0 Compliance Monitoring This is to be added to each policy/ Procedure to clearly show how the effectiveness of the policy/procedure will be monitored. What will be monitored Access to appropriate services by people with a dual diagnosis of Mental Health and Learning Disability How/Method Frequency Lead Reporting to (what committee) Completion of KPI for Exec Board Review of issues discussed at Clinical Network Group (Task Group to ensure implementation of Policy and adherence to its principles). Quarterly Service Directors Executive Board (Quarterly) Learning Disability QAG to review work of Clinical Network Group (at least 3x p.a.) Learning Disability Partnership Board (Quarterly) Deficiencies / gaps recommendations and actions Page 7 of 20

8 References and useful information sources: Royal College of Nursing (2010) Mental Health Nursing of People with Learning Disabilities ( data/assets/pdf_file/0006/78765/ pdf) Department of Health (2009) Valuing People Now a 3 year strategy for people with learning disabilities ( H_093377) Department of Health (2007) Services for people with learning disability and challenging behaviour or mental health needs Resources for supporting people with a learning disability Glossary of Abbreviations: A&E: Accident and Emergence A&T: Assessment and Treatment CAMHRS: Child and Adolescent Mental Health Recovery Service CMHRS: Community Mental Health Recovery Service CTPLD: Community Team for People with Learning Disabilities CPA: Care Programme Approach DAT: Drug and Alcohol Team EIPS: Early Intervention and Psychosis Service GP: General Practitioner HTT: Home Treatment Team NICE: National Institute for Clinical Excellence OPCMHRS: Older Peoples Community Mental Health Recovery Service PLD: People with Learning Disabilities Useful organizations: UK Mental Health in Learning Disabilities Network A free to join network for anyone interested in the mental health needs of people with learning disabilities Page 8 of 20

9 QUALITY ASSURANCE CHECKLIST Name of Policy/Procedure/Guideline SUPPORTING ADULTS WITH A DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY Policy/Procedure/Guideline N/A Replaced by it (if any) Lead Person/Review Group Andy Erskine Director presenting Date of presentation 11.07,12 Has the policy/procedure/guideline been benchmarked against 3 similar organisations? No Have issues relating to Human Rights been taken into account? Yes Is a summary included? Has an Impact Assessment been completed? Yes Yes Has this policy/procedure/guideline been cross-referenced with Health Care Standards? Yes List the Standards that it will support the Trust s practice To ensure equality of access to services for people with a dual diagnosis of learning disability and mental health List people who have been asked for their views on this draft (inside and outside the Trust) Have you Impact Assessed this final draft of the policy, procedure or guideline? This draft has been developed in consultation using a small working group that has included a range of clinicians and managers from learning disability and working age adult services. It has been circulated through a number of teams for final revision and also discussed at the learning disability healthcare group (external to SABP). Yes Page 9 of 20

10 What actions are you taking or have you taken as a result? Amended title of Procedure to reflect that it applies only to adults What guidance or statutory procedure does this policy, procedure or guideline comply with? How are you going to implement this change in practice? What are the costs of implementing this change in practice? How will you know that the policy, procedure or guideline is working? National Guidance as set out in the Mental Health National Service Framework, Valuing People, NICE guidance and standards set out in the Green Light Tool Kit. The procedure will reinforce current practice, raise awareness and lead to improved outcomes The consultation process and re-issue of this procedure will lead to the formation of a focus group that will ensure the policy is embedded into practice by front-line teams and continue to meet the Trust s reporting requirements to show that people who have a learning disability are treated appropriately and that health inequalities are reduced through joint working. Implementing the policy should not be a substantial cost as it is a revision of an existing policy. It is arguable that not implementing it would have a greater cost as this may lead to more instances that require escalation to resolve issues of joint working (see below). Historically, these issues have not formed a substantive theme for complaints/si s. However, on occasions there are instances where teams across the Trust don t appear to have joint working as a fundamental principle. Issues are escalated to senior clinicians/ad s to discuss and resolve. This policy should reduce that practice if it is working. Patient experience trackers/ satisfaction surveys (including accessible versions) may show evidence of joint working. Review Only List any key differences between this and the previous policy/procedure The Trust currently has a Management of people with a Dual Diagnosis of Mental Health and Learning Disability Policy but this version is substantially revised and expanded to cover all community and 24/7 Mental Health and Learning Disability Teams. Page 10 of 20

11 START FORM Date Name Is this a review of a current policy, procedure or guideline or a new subject? Why does the policy, procedure or guideline need to be developed or changed? Reason for the policy, procedure or guideline? What will the policy, procedure or guideline achieve? SUPPORTING ADULTS WITH A DUAL DIAGNOSIS OF MENTAL HEALTH AND LEARNING DISABILITY NEW. To ensure that adults with a dual diagnosis of mental health and learning disability receive the appropriate support and interventions It is intended as a good practice guide to all clinical staff in the operational directorates of SABP, based on current research and best practice guidance. People with a dual diagnosis of mental health and learning disabilities will receive appropriate comprehensive interventions. Good practice guide to all clinical staff. Ensure collaborative working between general mental health services (primary and secondary care) and specialist learning disability services Use what you have learned from your Impact Assessment to answer the next set of questions. Proposed author or group which will develop policy, procedure or guideline Responsible Directorate Who needs to be asked to comment on the draft policy, procedure or guideline? Target date for draft policy, procedure or guideline to be sent to Policy Assurance Group? Which Governance Committee will be asked to approve the policy, procedure or guideline? And by when? Andy Erskine; Associate Director for Learning Disabilities Learning Disabilities Directorate All clinical staff in the Operational Directorates of SABP Placed on Trust Web LD QAG then Exec Board Form completed by Title Mark Shakespeare.. Professional Lead for Arts Therapies Page 11 of 20

12 Agreed by Director s Title Andy Erskine Director of Services for People who have learning disabilities For Completion by the Policy Assurance Group: Policy/Procedure/Guideline Approved If no, reasons why Date YES/NO. Page 12 of 20

13 Equality Analysis (EA s) (Formally known as Equality Impact Assessments) Introduction The equality duty now makes it clear that public authorities are expected to consider the need to remove or minimise disadvantage or to meet particular needs, such as through providing services for particular groups. Public authorities are also required to think about how to encourage participation in public life. The good relations duty now applies across all of the protected characteristics. In particular, public authorities must have due regard to the need to tackle prejudice and promote understanding between people who share a protected characteristic and those who do not. Equality Analysis starts prior to policy/function development or at the early stages of a review. It is not a one-off exercise, it is ongoing and cyclical and it enables equality considerations to be taken into account before a decision is made. Equality Analysis of proposed policies will involve considering their likely or possible effects in advance of implementation. It will also involve monitoring what actually happens in practice. Waiting for information on the actual effects will risk leaving it too late for your Equality Analysis to be able to inform decision-making. Be wary of general conclusions it is not acceptable to simply conclude that a policy will universally benefit all and therefore the protected groups will automatically benefit, without having evidence to support that conclusion. When you decide that a policy is not relevant to equality, you will need to document this, along with the reasons and the information that you used to make this decision. A simple statement of no relevance to equality without any supporting information is not likely to be sufficient, nor is a statement that no information is available. This is particularly important where you are not familiar with methods of equality analysis or with equality concerns, as you could inadvertently overlook issues that could indicate relevance to equality. This could leave you vulnerable to legal challenge. This is a summary of the general duty and how they apply to each protected characteristic: General equality duty Protected Characteristic To eliminate unlawful discrimination, harassment and victimisation To advance equality of opportunity between different groups To foster good relations between different groups Age Disability Page 13 of 20

14 Sex Race Religion Sexual orientation Gender reassignment Marriage / civil partnership X X Pregnancy / maternity Please refer to Equality analysis and the Equality Duty: A guide for public authorities for more information. Who should be present at the Screening of an Equality Analysis? A diverse group of people must be in attendance of the Screening; this must involve the policy author, Staff, people who use services, Carers and other users of the Trust services if they are affected by the policy. For example, if the policy has a potential affect on just the staff, some staff must be invited to provide their views on the possible impact. A Screening should be carried out BEFORE the policy is placed out for consultation. At this stage a Full Equality Analysis could be identified. If a Full Equality Analysis is required, the outcomes should be carried over into the Action Plan. After the consultation deadline, all the data must be summarised and attached to the Screening and/or with Full Equality Analysis as a form of evidence. Equality Analysis (EA s) Screening Tool To be completed for all new proposals or reviews of existing policies, procedures, plans, services or functions. This screening should be undertaken at as an early a stage as possible, in order to address any equality issues which are identified before consultation/approval. ame of Initiative: Supporting People with a Dual Diagnosis of Mental Health and Learning Disability nit/department: ate: Time: From: To: Briefly describe the purpose of the Policy/Function: This procedure produced to ensure that adults with a dual diagnosis of mental health and learning disability receive the appropriate support and interventions when presenting to services provided by Surrey and Borders Partnership Page 14 of 20

15 NHS Foundation Trust (SABP). The Procedure sets out the framework within which people with a dual diagnosis of mental health and learning disabilities will receive appropriate comprehensive interventions. ho is it intended to benefit from this Policy/Function? dults with a diagnosis of learning disability and a presenting mental illness and living within the boundaries of the Trust ill be eligible for treatment in accordance with this procedure hat results are intended? This procedure will ensure that mental health needs of People with Learning Disabilities are met through: Collaborative working between mental health services (community based services and inpatient (CAMHRS, EIPS, DAT, Eating Disorder Services and AMH) and specialist learning disability services (CTPLD, ATS and A&T) Access to mental health services wherever possible The provision of small specialist inpatient services for those whose needs cannot be met by acute provision Consistent application of CPA ensuring all needs of people with learning disability and mental health are addressed The provision of Easy Read information on conditions associated with Mental ill health Access to provision of training to staff within mental health services on the needs of people with learning disabilities hy is it needed? It is intended as a good practice guide to all clinical staff in the operational directorates of SABP, based on current research and best practice guidance. Page 15 of 20

16 onsidered all Consultation feedback if this Equality Analysis is carried out after the consultation. hat was the length of the Consultation Period: (From: To: ) hat was the consultation feedback and actions taken: A s group: Identify a lead. Involve and consult stakeholders and people with expertise in the different quality areas get a balance of skills and experience including people who use services and community embers. lex Martin sley Wilson aul Drury ark Shakespeare Name Title Interim Associate Director of Diversity & Inclusion. Professional Lead for SALT & CTPLD Manager Speech and LanguageTherapist Professional Lead for Arts Therapies Please ensure all parties present are aware that this document will be published on the Trust website and is accessible to members of public. Consider the Analysis of the effects on equality is intended to focus more attention on the potential effects on quality of the analysis and how it is used in decision-making, and less on the protected production of a document. You need to analyse the effect on equality for all of the characteristics protected characteristics, and all aims of the general equality duty as set out below. (PC s). Equality Act 2010 General Duty. Age Eliminate unlawful discrimination, Harassment and Victimisation Policy applies to adults only Title changed to reflect this. Children s services are better integrated and group felt that this policy does not need to apply to children. Advance equality of opportunity between people who share a PC and those who do not. Policy applies to adults only Title changed to reflect this. Children s services are better integrated and group felt that this policy does not need to apply to children. Foster good relations between people who share a PC and those who do not. The group considered that there would be no tensions between different age groups as it applies equally to all adults Page 16 of 20

17 Disability Sex Race Religion and Belief Sexual Orientation Pregnancy and maternity Gender Reassignment Marriage/ Civil Partnership Any other type of disability will not discriminate or harass. The policy will enhance the service to people with communication problems as it will encourage joint working between colleagues from the different services Policy applies equally to men and women The policy will take into consideration peoples background and communication needs The needs of the individual will be met and religion and belief of the person will be taken into consideration through assessment process The policy won t lead to discrimination due to the individuals sexual orientation. The same process will be followed. The procedure wont discriminate with anyone with this PC and positively enhance the needs of this group The procedure wont discriminate with anyone with this PC This policy will positively enhance the needs of PLD and AMH Policy applies equally to men and women The policy will take into consideration peoples background and communication needs The needs of the individual will be met and religion and belief of the person will be taken into consideration through assessment process The policy won t lead to discrimination due to the individuals sexual orientation. The same process will be followed. The procedure wont discriminate with anyone with this PC and positively enhance the needs of this group N/A The group considered that there would be no tensions between disabled and non disabled people as it applies specifically to certain types of disability Policy applies equally to men and women No tensions between people from different backgrounds as it applies equally Specialist assessment will ensure there are no tensions between groups Specialist assessment will ensure there are no tensions between groups Specialist assessment will ensure there are no tensions between groups Specialist assessment will ensure there are no tensions between groups N/A Page 17 of 20

18 Carers Human Rights implications if relevant Other equality issues please state The procedure wont discriminate with anyone with this PC and positively enhance the needs of this group by joint working This procedure may result in actions being taken in a person s best interests under the Mental Capacity Act. None The procedure wont discriminate with anyone with this PC and positively enhance the needs of this group by joint working This procedure may result in actions being taken in a person s best interests under the Mental Capacity Act There may be tensions between carers and staff if carers fail to recognize diagnosis however specialist assessment will address this This procedure may result in actions being taken in a person s best interests under the Mental Capacity Act HR and workforce issues/implications if relevant None Evidence used in the decisionmaking. Hardy et al, RCN 2010 p: 13 Taylor et al, 2004, Cooper et al, 2007 Mental Health National Service Framework, Valuing People, NICE guidance and standards set out in the Green Light Tool Kit. If the responses affect any of the protected characteristics then please complete the Action Plan to avoid or mitigate the potential adverse effects on equality. Decision to proceed (please circle yes or no): Yes: We have decided to proceed to a full EA Action plan No : We have decided that it is not necessary to carryout a full EA Action plan If no, briefly summarise reasons and the evidence for this decision: Page 18 of 20

19 Signed by responsible Director or Associate Director: Name: Andy Erskine Directorate: Learning Disability Services Please send a copy of all completed screening and full EA s/action Plan to: Alexandra.Martin@sabp.nhs.uk Diversity & Inclusion Dept, Ramsay House, West Park, Epsom, Surrey KT19 8PB. If you require any assistance, please call Equality Analysis (EA s) Action plan The action plan should provide a focused set of priorities for improvement. It should only include the key activities that are likely to have the greatest impact. Issue/change sought Evidence found in the screening of any issues that may have an effect on Equality for different PC S The policy wasn t clear that it applies only to adults. Action (SMART targets) E.g. Risk register/ policy Change/ training opportunities/ service plans Amended title of Procedure to reflect that it applies only to adults Expected Outcome Milestones and key deliverables. How these will be addressed? By who /Lead/Directorate Who is responsible for taking forward the outcomes Target dates Remove reference to research on children on page 1 Reference removed Page 19 of 20

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