Community%20Learning%20Disability%20Teams

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Community Learning Disability Teams

• Debra Moore
• Managing Director
• Debra Moore Associates
• www.debramooreassociates.com
• 01723 371446
• 07950 333884
• debra_at_debramooreassociates.com

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Mission impossible?
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Background to the research

• Development programme for Community Learning
  Disability Teams based around the 6Cs Model
• Revealed information about current state of
  play and raised questions about future role and
  modernising the workforce

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Background to the research what people were
saying.

• Need to reduce health inequalities and supporting
  the delivery of VP objectives e.g. HAPs etc
• Need to support mainstream NHS including mental
  health
• Reducing out of area placements
• Personalisation
• Safeguarding
• Changes in demography
• Boundaries between teams e.g. children older
  people
• Supporting criminal justice system
• Workforce issues
• Financial pressures
• Some concerns about choice and quality of
  provision

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Pressure to rescue

• In some localities the community based team are
  increasingly rescuing situations created by
  specialist social care providers (often
  importers)
• Also recovering problems created by changes in
  other parts of the system e.g. day services -
  the buck stops here position
• Safeguarding

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Being painted into a corner
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Background to the research old chestnuts

• Issues raised about time spent on health related
  activities and social work activities as opposed
  to care management
• Questions about the content of the work of
  individual CTLD members blurring of roles
  within the team
• Concern about capacity for face to face contact
  and time spent on admin/IT and in meetings
• Concern to make sure that the CTLD is part of a
  wider care pathway

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Methodology

• A brief electronic survey
• A number of key questions generated by emergent
  themes from work with CTLDs
• Self selecting participants
• Survey link posted on various professional
  websites and out via networking groups etc
• 500 responses

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What percentage of your working week is spent
across the following 4 areas?

• Care Management
• Admin IT
• Face to face contact with service users
• Review meetings

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What percentage of your working week is spent on
care management?
0-25 25-50 50-75 75-100
Nurse 75 15 8 2
Social Worker 34 48 13 5
AHP 91 7 2 0
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What percentage of your working week is spent on
face to face contact with service users?
0-25 25-50 50-75 75-100
Nurse 38 43 17 2
Social Worker 80 14 5 1
AHP 27 49 21 3
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What percentage of your working week is spent on
administration and IT?
0-25 25-50 50-75 75-100
Nurse 38 47 14 1
Social Worker 12 34 45 9
AHP 44 48 8 0
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What percentage of your working week is spent in
review meetings?
0-25 25-50 50-75 75-100
Nurse 81 17 1.5 0.5
Social Worker 74 23 3 0
AHP 92 8 0 0
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Health professionals what percentage of your
working week spent on health action planning
health facilitation?
Less than 10 10-25 25-50 50-75 75-100
Nurse 29 32 25 12 2
AHP 56 30 9 4.5 1.5
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Health professionals what percentage of your
working week spent on training and supporting
mainstream health professionals?
Less than 10 10-25 25-50 50-75 75-100
Nurse 49.5 36 11 3 0.5
AHP 57 28 15 0 0
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Regional variations face to face contact -
nurses
Less than 10 10-25 25-50 50-75 75-100
North East 0 0 75 25 0
YH 0 39 44 14 3
North West 10 35 40 15 0
East Mids 3 24 41 29 3
West Mids 0 47 35 12 6
Eastern 22 33 45 0 0
South West 32 42 16 10 0
London 5 50 35 10 0
South East 3 19 56 22 0
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Integrated teams what difference does it make?

• No discernable difference across care management,
  face to face contact and reviews however the
  amount of time spent on administration and IT was
  higher for those who were in an integrated team

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Probably raised as many questions as answers

• Why are there such big variations between regions
  and how does this effect outcomes?
• What does admin IT consist of?
• If health professionals reduce care management
  activity what will be the implications?

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Next steps

• More detailed analysis of survey
• Drilling down on emergent themes
• Examine patterns of provision e.g. AT, Out of
  Area placements etc
• Consider how we map against outcomes such as
  health checks, numbers of HAPs etc

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Lessons for nurses

• Health related activity as a first priority
• Outcomes
• Person experience
• Universal and mainstream services
• Look after one another
• Dont give up
• Use an appreciative eye what do you want more
  of?

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Dont get the Dibleys!

• Strong leadership
• Earn your place at the table
• Ensure people who use services and their families
  are at the table
• No piccalilli and tuna sandwiches!

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FinallyKeeping the message simple - ensuring the
me and mine test is passed

• http//www.youtube.com/watch?vLYPIxHzXAJY