Taking a whole system approach to learning disabilities

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Taking a whole system approach to learning
disabilities

• Debra Moore
• Managing Director
• Debra Moore Associates
• www.debramooreassociates.com
• debra_at_debramooreassociates.com

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Learning disability policy and guidance the 3
bus scenario
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Including

• Valuing People and Valuing People Now
• Commissioning Specialist LD Health Services
• Mansell 2
• Green Light
• Professional guidance e.g BPS/RCPsych
• SCIE Knowledge Review
• Primary Care Service Framework for Learning
  Disabilities DES
• Healthcare Commission Specialist Inpatient Audit
• Michaels Inquiry
• Commissioning Services Closer to Home
• No-one Knows Prison Reform Trust
• DRC Report Closing the Gap
• Mencap Reports
• Parliamentary Report Human Rights of Adults
  with Learning Disabilities
• Our Health Our Care Our Say
• Putting People First
• Darzi
• On the horizon..2nd Audit of Inpatient Services
  and Joint Commissioning Review
• Health Action Planning and Health Facilitation
  Guidance

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Making all the pieces fit

• The Confirm and Challenge Model is concerned with
  improvements in primary, acute and specialist
  health services

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Developing the 6 Cs model key considerations

• Need to articulate a clear ask that aligns with
  mainstream interests
• Need to make sense of the broad range of relevant
  policy and guidance
• Need to drive up standards in commissioning and
  practice
• Need to be clear to people who use services and
  their families about what to expect
• Empowering people to get involved in setting and
  monitoring standards from the bedside to the
  boardroom

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A key principle in the development of the 6Cs
Model

• Don't let what you cannot do interfere with what
  you can do
• John Wooden

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6 core outcomes to achieve for mainstream and
specialist health

• Each outcome has a set of key principles to guide
  commissioning and service delivery and examples
  of the types of evidence for each principle

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CTLD version

• Led by Anne Hutchinson
• Responds to requests for support and clarity
• Supports commissioners and providers
• Uses core framework but adapts examples of
  evidence to reflect particular role of the team
• Will be live on the website in September

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1.Centredness

• Putting the person and their family at the centre
  personalised services that are dignified and
  respectful of individual needs
• Person centred approaches underpin practice and
  service delivery
• Partnerships are built that promote and support
  the needs of individuals and their families
• A range of communication tools and approaches are
  available and employed to meet individual need
• People who use services and their families are
  involved in service planning and evaluation at
  both strategic and individual level
• The service can demonstrate that service
  developments are based on the needs and wishes of
  the local population

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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2. Community

• Promoting health and wellbeing, focusing on
  prevention and early intervention and delivering
  services close to home
• People are able to access individualised support,
  close to home and in the least restrictive
  setting
• Skilled specialist support is available to ensure
  the availability of early intervention, assertive
  outreach and crisis intervention
• People should be supported in accommodation that
  meets their individual needs and promotes health
  and wellbeing
• Specialist health professionals work in
  partnership with local authority colleagues to
  include people with complex needs in
  opportunities to increase choice and control e.g
  self directed support
• Partnership working promotes, maintains and
  facilitates key relationships and the use of
  mainstream services within the community

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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3. Citizenship

• Increasing choice and control, promoting
  inclusion and a rights based approach
• Services are provided that maximise individual
  choice and control
• People are supported to develop a social network
  and utilise natural and universal supports
• There is clear understanding, and promotion, of
  legal and civil rights
• Inequalities are identified and challenged

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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4. Commissioning

• Working in partnership to deliver improved
  outcomes and reduce inequalities
• Commissioners and health and social care
  providers work together to promote health and
  wellbeing and reduce inequalities ensuring
  benefit from intiatives such as world class
  commissioning
• Specialist learning disability services are
  commissioned to provide support and advice to
  mainstream health services and social care as
  well as directly serving those with the most
  complex needs
• There is access to a range of community based
  specialist learning disability services

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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5. Competence

• Developing skills and knowledge within services
  and within people who use services, their family
  carers and supporters
• Local workforce development strategies are
  comprehensive and account for the need to develop
  capacity and capability in the community and in
  mainstream health and social care
• Workforce development strategies demonstrate the
  requirement to develop specialist skills and
  knowledge in both specialist community and in
  patient settings
• Use of person centred approaches underpin all
  activity relating to personal and organisational
  development and service delivery

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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6. Checking

• Ensuring services are high quality, clinically
  effective and safe
• Robust performance systems are in placed that are
  able to translate policy and best practice into
  useful metrics and monitor progress and delivery
• People and family carers are at the centre of,
  and participate in, standard setting, performance
  monitoring and service evaluation
• Quality is everyones business and all staff
  are encouraged to look at the way they measure
  what matters in their work and make best use of
  person centred plans and health action plans to
  assess outcomes
• Strategies are in place to protect vulnerable
  adults

• Centredness
• Community
• Citizenship
• Commissioning
• Competence
• Checking

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Dont get the Dibleys
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To conclude

• The 6Cs Confirm and Challenge Model offers a way
  for all services to ensure that they are serving
  all their population well
• Not confined to learning disabilities the 6
  principles are transferrable to other groups e.g.
  older people and other settings e.g. mental
  health services
• A way of organising effort and resources
• Offers a way of remembering whats important to
  people and families and ensuring delivery
  reflects this from the bedside to the boardroom
• A QUOTE..

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• The triumph of anything is a matter of
  organisation. If there are such things as angels,
  I hope they are organised along the lines of the
  Mafia.
• Vonnegut The Sirens of the Titan

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Practical support

• Website www.debramooreassociates.com
• Self assessment tool
• Web based forums
• Workshops bespoke packages of support for
  commissioners and provider organisations
• Started with specialist LD health services with
  different versions now in development community
  teams, acute hospitals, primary care, mental
  health etc