Case study -Milton Keynes Community Health & MacIntyre on Making it Real

Making It Real In Milton Keynes

Milton Keynes Joint Learning Disability TeamMacIntyre On Track Forensic Support

Forensic Support

Amanda GriffithsHead of Joint Learning Disability Services

Milton Keynes Council

Commissioning

• Integration

• Pooled budget/Section 75

• Collaboration

• Infrastructure

• Providers

Tracy Lavis Forensic Psychologist

MacIntyre

MacIntyre Background

MacIntyre Background• National charity set up in 1966, providing services for over

1,200 children, young people and adults. 2,100 staff, turnover £47.8m

MacIntyres Mission• To be recommended and respected• Offering best choice, best value• Employing the best people in support of people with learning

disabilities (http://bit.ly/Welcome-to-MacIntyre)What we do• Offer wide range of services that encourage increasing

independence

Investors in People Champion, 2014

Appointed Investors in People Champion, and will now act as an ambassador for the Standard

Winner, CareKnowledge

Workforce Innovation Award, 2013

For MacIntyre’s ‘My Key’ self-assessment tool, aimed at reaching staff for whom traditional approaches to supervision, role modelling and teamwork are not easily arranged.

Awarded Investors in People Gold, 2012

Recognising MacIntyre’s commitment to excellence and innovation in how we recruit, train and develop our staff

 Winner, 2012 Charity

Awards - Disability

For MacIntyre No Limits, an innovative project that provides education and support for young people with learning disabilities or autism

Skills for Care 2010 prestigious ‘Winner of

Winners’

Awarded the ‘Most Innovative Workforce Development’ accolade and prestigious ‘Winner of Winners’ Award from Skills for Care for our Great Interactions work

MacIntyre’s approach has been recognised in recent years:

MacIntyre On Track Forensic Support (OTFS)

Our model/methodology

A specialist service for people with learning disabilities or autism who have offended or are at risk of coming into

contact with the criminal justice system

The On Track Forensic Support model is uncomplicated and was originally established in 2005

OTFS Key Features:

• To support people with complex behaviour move back to community

• Supported to live in own homes to live healthy, fulfilled lives

• Support in person centred ways to learn new skills and live as independently as possible whilst monitoring risk to selves and others

• Staff model and encourage respectful and positive relationships

• People re connected to their community, families/friends• Achieve new skills and contribute to community life

The OTFS Model

Why does our On Track Model matter?

Without shared responsibility and MDT working:

On Track Forensic Support in practice:

• Invested in specialist staff • Close partnerships • Risks scoped and managed through partnerships• Person & project specific MDTs established• Routine and specialist supported living support: MacIntyre staff• Clinical support and leadership: community health & social care

teams• Sharing of assessment and support plans/processes• Change supported and measured : Life Star• Bespoke training of staff

How we apply our methodology to our work :

• MacIntyre prepare the internal ground• Close working• Joint assessments/ transition work • Support plans• MDT approach, sharing challenges• Explore ways forward/available, together. • We work together to provide on going, flexible support

Kevin WilliamsSupported Living Manager

Milton Keynes Joint Learning Disability Services

Multi - Disciplinary Working

• Regular and inclusive communication

• Regular update meetings

• All professionals included– Joint Commissioning– Social Care Representatives– Winterbourne Lead (NHS)– Proposed Support Provider(s)– Proposed Housing Association(s)– Other Key Stakeholders

Housing Solutions

• Team approach to design issues based on individual need

• Work with Housing Provider as a key partner (ongoing)

• Work through issues together (MDT)

• Consider all options, share decision making

Supported Living

• Preferred option for ALL new schemes in Milton Keynes

• Unique challenges / solutions

• Assistive Technology / Who can help with what?

• Family members as key part of ongoing team

First Line Contingency

• Community Support Intervention Team (CSiT)

• Shared and evolving support plans

• Person at centre of each decision

• Use of each person’s name (not case number etc.)

Chris WardTeam Manager, CTALDMilton Keynes Council

Care Coordination

• CPA – Fidelity to process

• Early identification of suitable provider service

• Face-to-face contact – Regular & with all stakeholders

• Active involvement – From referral to transition and beyond

• Collaborative planning – Selecting and utilising the most appropriate tools (MHA/PCP/Living Locally toolkit)

Recruitment & InductionMacIntyre On Track Specialist: Barrie Ellis

Specialist Area Manager, MacIntyre

Recruitment and Induction

• Recruitment

– Open Day– New job roles, specific requirements in addition to usual

characteristics– Recruitment specifically informed by MDT discussions of needs

of people– Positive response rate– Different cohort of applicants – excellent but posed new

challenges

Recruitment continued ..

• Interviews involved On Track specialists and Adult Services managers, a combined approach

• Tailored interviews accordingly; existing profiling approach with additional forensic elements

• Challenges around keeping support roles distinct from more mainstream services, staff need firm understanding of this

Induction

• Tailored, intensive and collaborative approach

• Generalised support aspect, supplemented by specialist forensic elements delivered by On Track Forensic Support

• Bespoke sessions based specifically around each person to be supported, in conjunction with our OT specialists and the forensic support teams for each person (including the Registered Clinician)

• Utilisation of local MacIntyre expertise

Collaboration:

• Wide range of multi-agency partners:

– The commissioning team of course, which brings in the LDT, CSIT and the full range of health and social care support services

– Clinical teams in current settings– Criminal Justice agencies (where/when appropriate)– Housing providers

Transition & collaborative workingMacIntyre specialist: Joyce Hennis

Lead Forensic Practitioner MacIntyre

Transition,

• Living Locally and Getting to Know You, collaborating from the outset

• Preparing someone to be ready for a supported living service, collaborating with them, their families/significant people, current providers

• Enabling the person to gain trust in a new staff team, collaborating with the person, working with others to achieve this

Collaborative working with families

• Working with families

• Families are anxious about people returning to local area

• Being introduced to peoples families by someone they know and trust

• Clear communications

• Families can see transition work as a way of spending more time with their relative and this needs to be managed sensitively

Our keys to a success outcome

• Multi disciplinary approach

• Relationships

• Flexibility

• Respecting others points of view and experience