Breaking News Paedophiles Live in Your Community

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Breaking News!! Paedophiles Live in Your
Community!

• Louise Bulmer
• And
• Paula Swift

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Aims

• Role of the Learning Disability Forensic Service
  in TEWV
• History of the development of the Service
• Creating a Rehabilitative Service
• Future Plans for the Service
• Any questions ?

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Role of Learning Disability Forensic Service in
TEWV

• Multi-disciplinary team (MDT) working very
  important
• Provide MDT assessments and treatment plans that
  are designed to meet the holistic needs of the
  individual
• Have strong links with Probation, Social Care
  Departments (CP), Police (including PPU), Generic
  LD services, out of area hospitals, housing
  departments, independent sector providers and
  other mental health services
• Provide training, support, treatment, advice and
  liaison to a range of services, as well as Person
  Centred Plans amongst other things!

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Role of Learning Disability Forensic Service in
TEWV

• Minimise risk of further offending and reduce the
  likelihood of more serious offending behaviour
• Provide a specialist service of assessment and
  treatment
• Provide a focus for rehabilitation and aftercare
  following a period of in-patient treatment
• Work closely with carers and families
• Take on CPA / Care Management responsibility and
  work as liaison alongside the responsible
  authorities
• Supervise and monitor legal orders under the
  Mental Health Act 1983

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History of Service

• Became operational in 1996
• Established to meet the needs of an ever
  increasing group of individuals whose needs could
  not be met within mainstream services
• The Mansell report - recommended that Health
  Authorities provide local comprehensive services
  to meet the varying needs of people with a
  Learning Disability who offend
• The Reed report highlighted that offenders
  with a mental disorder including those with a
  Learning Disability should be treated within
  Health rather than penal settings

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History of Service (Cont..)

• 1996 - 13-bedded mixed sex unit opened and
  community team was established
• 1999 - the inpatient beds increased to 25 and
  6-bedded community based rehabilitation unit was
  established
• 2000 Day Service provision established to meet
  the occupational needs of the in-patient and
  community clientele
• 2001 Community Team established to cover
  identified areas of North Yorkshire

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History of Service (cont)

• 2003 Specialist in-patient treatment unit for
  female offenders established
• 2007 additional 12-bedded unit opened offering
  slow stream rehabiliation
• Due to expansion of service into Wear valleys
  8-bedded unit in this area

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Creating a rehabilitative service in the community

• Due to the increase of in-patient beds there was
  an ever growing pressure to find appropriate
  community provision
• In the early days work was progressing well with
  a local housing provider but this came to an
  abrupt end following the opposition of a
  prominent local councillor, who in no certain
  terms stated that they would not be willing to
  work with the service to re-house offenders.
• Due to lack of provision within the Teesside
  area, most community rehabilitation was provided
  out of area despite Government guidance
  stipulating that people should have the
  opportunity to live locally

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We hit the headlines!

• Out of area placements were managed well but were
  resource intensive due to the risk management
  issues of forensic individuals plus the
  geographical and time constraints of immediate
  response to crises
• Then..
• Scandal of child sex perverts, Fiends watch
  kids seaside fun and Scandal of sickos on
  prowl

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Following on from headlines

• Once the public read the papers, the home became
  a target with leaflets strategically placed
  throughout the local community encouraging
  people to target the home.
• 5 service users were moved for their own and
  other residents safety throughout North Yorkshire
  or into hospital beds
• It became clear that the service was unable to
  move service users back to their homes, causing
  much distress and disruption.
• Increased evidence on how fragile and sensitive
  the whole nature of the work we undertook was.

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Lack of resources

• This highlighted the need for more readily
  available services that service users from the
  LDFS could access
• The service then approached, or was approached by
  providers of services to develop services
• This did not go as smoothly as was hoped with at
  least one provider cherry picking potential
  residents and changing prospective contracts to
  suit themselves.
• One provider was consistent in expressing an
  interest in wanting to work with the forensic
  service and had previously demonstrated an
  ability to work well with offenders

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Next step

• A number of meetings took place with this
  provider to discuss the vision of the LDFS
• It was agreed that a move on resource from
  hospital was needed to provide rehabilitation
  with 4 service users identified
• A home, already owned by the service provider was
  identified.
• A business plan was developed. A Service level
  agreement was negotiated between social care and
  the provider. This took a number of months,
  various meetings were held and costings etc were
  put to the TMT and necessary council bodies

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Vision for the rehabilitation unit

• Would provide 24-hour residential support for
  4-service users with a respite bed available
• The admission would be for approximately 18
  months.
• The support plan would be intensive and focus on
  promoting social and domestic skills alongside
  relapse prevention work
• The staff from the service would be involved with
  all aspect of the CPA approach and be guided by
  individuals care plans and risk management plans
• A high level of effective community integration
  would be offered to facilitate Social Inclusion.
  
• To be offered person centred plans in accordance
  with individual need.

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Outcome

• It was agreed at planning level to open the
  service. Due to the geographical area covered
  the service became operational on an at risk
  basis
• The LDFS were involved in developing job
  descriptions, discussions took place around how
  the jobs would be advertised due to the nature of
  what the service was to offer, and also the
  interview process which the team were involved in
• Whilst the recruitment process was taking place,
  the LDFS compiled a training programme for the
  new staff team that included good
  communication, MDT working, risk assessments and
  risk management plans, who the LDFS consisted of,
  sections of the Mental Health Act, community
  legal orders, information on CPAs, on mental
  health symptoms and diagnosis, and pen pictures
  of potential service users

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The real thing

• The service opened in November 2005
• Gradual admissions with each service user
  choosing their own room
• Almost daily contact from the LDFS
• Monthly meetings to review the progress of
  service users and deal with any outstanding
  issues ongoing to date
• Regular review of placements in accordance with
  legislative procedures
• Continued training of residential staff

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Success of service

• Has been a successful service due to the close
  working relationships with partner agencies
• Has encouraged the service provider to look to
  develop supported living tenancies and women only
  services (another identified area of need)
• Service users who have accessed the service
  report positive outcomes and feel it has helped
  them in their treatment plans
• Quotes from service users include.

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Quotes

• I Like it because I get out a lot more than
  what I used to
• The staff are nice to me
• Its better than being in hospital
• Nice not to be locked up and to have a big
  garden
• I get more choice to do more stuff
• I get to see my family more

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Other community services

• LDFS has close working relationships with other
  agencies and has service users placed in approx
  14-different placements owned by several
  different providers across the country. We
  continue to provide training and support on an
  ongoing basis or when the need is identified
• However, not enough is being done! Almost 15
  years on from the Reed and Mansell reports, many
  people are still being housed out of the area and
  away from their famillies.
• There is just not enough local resources to meet
  local need.

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Ongoing Problems..

• Owing to the nature the LDFS team undertake,
  always feel like you have to work behind closed
  doors. The Invisible Service
• Recently had a home targeted by the local
  community, which again resulted in the removal of
  service users. Thankfully, not to the same
  extent as previously.
• Building confidence with the providers, about the
  level of support that teams can provide is key to
  achieving success.

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Positives

• In the last 5 years, despite the adversity,
  the LDFS has successfully placed over 40
  individuals into suitable community
  accommodation, with only 5 of these individuals
  being re-admitted back into hospital, 4 of which
  was owing to a deterioration in their mental
  health, with only one person re-offending.

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Future developments

• Supported living schemes are being developed
  between the LDFS and various providers to support
  service users moving on
• Valuing People, The Green Paper, (Independence
  Choice and Well-being) are now finally
  beginning to champion the cases of Learning
  Disabled offenders.
• This is to be achieved via identifying
  appropriate accommodation and the providers
  accessing funding from housing associations etc
  and developing business plans as well as
  attending sub housing groups and ensuring that
  the needs of service users are represented on all
  Learning Disability key agendas

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And finally

• Primary Care Trusts, Strategic Health
  Authorities, Valuing People Regional leads, Local
  Authorities and care providers all have a
  responsibility to ensure more is done, to work
  more effectively together, become more involved,
  share information and work on improving
  partnerships to support people to access, secure
  and maintain accommodation in their local
  communities.

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Any Questions ?