Taking a whole system approach to learning disabilities Debra Moore Managing Director Debra Moore Associates [email protected]

Taking a whole system Taking a whole system approach to learning approach to learning

disabilitiesdisabilities

Debra MooreDebra MooreManaging DirectorManaging Director

Debra Moore AssociatesDebra Moore Associateswww.debramooreassociates.comwww.debramooreassociates.com

[email protected]@debramooreassociates.com

Learning disability policy and Learning disability policy and guidance – the guidance – the 3 bus scenario3 bus scenario

Including……Including……Valuing People and Valuing People NowValuing People and Valuing People NowCommissioning Specialist LD Health ServicesCommissioning Specialist LD Health ServicesMansell 2 Mansell 2 Green LightGreen LightProfessional guidance e.g BPS/RCPsych Professional guidance e.g BPS/RCPsych SCIE Knowledge ReviewSCIE Knowledge ReviewPrimary Care Service Framework for Learning Disabilities & DESPrimary Care Service Framework for Learning Disabilities & DESHealthcare Commission Specialist Inpatient AuditHealthcare Commission Specialist Inpatient AuditMichaels InquiryMichaels InquiryCommissioning Services Closer to HomeCommissioning Services Closer to HomeNo-one Knows – Prison Reform TrustNo-one Knows – Prison Reform TrustDRC Report – Closing the GapDRC Report – Closing the GapMencap ReportsMencap ReportsParliamentary Report – Human Rights of Adults with Learning DisabilitiesParliamentary Report – Human Rights of Adults with Learning DisabilitiesOur Health Our Care Our SayOur Health Our Care Our SayPutting People FirstPutting People FirstDarziDarziOn the horizon…..2On the horizon…..2ndnd Audit of Inpatient Services and Joint Commissioning Review Audit of Inpatient Services and Joint Commissioning ReviewHealth Action Planning and Health Facilitation GuidanceHealth Action Planning and Health Facilitation GuidanceWorld Class Commissioning re Learning DisabilitiesWorld Class Commissioning re Learning DisabilitiesBradley reviewBradley review

Making all the pieces fitMaking all the pieces fit

The The Confirm and Confirm and Challenge ModelChallenge Model is is concerned with concerned with improvements in improvements in primary, acute and primary, acute and specialist health specialist health servicesservices

Developing the 6 C’s model Developing the 6 C’s model key considerationskey considerations

Need to articulate a clear Need to articulate a clear ‘ask’‘ask’ that aligns with that aligns with mainstreammainstream interests interests

Need to Need to make sensemake sense of the broad range of relevant policy of the broad range of relevant policy and guidanceand guidance

Need to Need to drive up standardsdrive up standards in commissioning and in commissioning and practicepractice

Need to be clear to people who use services and their Need to be clear to people who use services and their families about families about what to expectwhat to expect

Empowering people to get involved in setting and Empowering people to get involved in setting and monitoring standards from the monitoring standards from the bedside to the boardroombedside to the boardroom

A key principle in the A key principle in the development of the 6C’s Modeldevelopment of the 6C’s Model

““Don't let what you cannot do Don't let what you cannot do interfere with what you can do”interfere with what you can do”

John WoodenJohn Wooden

6 core outcomes to achieve for 6 core outcomes to achieve for mainstream and specialist healthmainstream 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

CTLD versionCTLD version

Led by Anne HutchinsonLed by Anne Hutchinson

Responds to requests for support and Responds to requests for support and clarityclarity

Supports commissioners and providersSupports commissioners and providers

Uses core framework but adapts examples Uses core framework but adapts examples of evidence to reflect particular role of the of evidence to reflect particular role of the teamteam

Will be ‘live’ on the website in SeptemberWill be ‘live’ on the website in September

1.Centredness1.CentrednessPutting the person and their family at the centre – Putting the person and their family at the centre – personalised services that are dignified and respectful of personalised services that are dignified and respectful of individual needsindividual needs

Person centred approaches underpin practice and service deliveryPerson centred approaches underpin practice and service delivery

Partnerships are built that promote and support the needs of individuals and their familiesPartnerships 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 A range of communication tools and approaches are available and employed to meet individual needindividual need

People who use services and their families are involved in service planning and evaluation People who use services and their families are involved in service planning and evaluation at both strategic and individual levelat both strategic and individual level

The service can demonstrate that service developments are based on the needs and wishes The service can demonstrate that service developments are based on the needs and wishes of the local populationof the local population

CentrednessCentrednessCommunityCommunityCitizenshipCitizenshipCommissioningCommissioningCompetenceCompetenceCheckingChecking

2. Community2. CommunityPromoting health and wellbeing, focusing on prevention and Promoting health and wellbeing, focusing on prevention and early intervention and delivering services close to homeearly intervention and delivering services close to homePeople are able to access individualised support, close to home and in the least restrictive People are able to access individualised support, close to home and in the least restrictive settingsetting

Skilled specialist support is available to ensure the availability of early intervention, assertive Skilled specialist support is available to ensure the availability of early intervention, assertive outreach and crisis interventionoutreach and crisis intervention

People should be supported in accommodation that meets their individual needs and promotes People should be supported in accommodation that meets their individual needs and promotes health and wellbeinghealth and wellbeing

Specialist health professionals work in partnership with local authority colleagues to include 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 people with complex needs in opportunities to increase choice and control e.g self directed supportsupport

Partnership working promotes, maintains and facilitates key relationships and the use of Partnership working promotes, maintains and facilitates key relationships and the use of mainstream services within the communitymainstream services within the community


3. Citizenship3. Citizenship

Increasing choice and control, promoting Increasing choice and control, promoting inclusion and a ‘rights based approach’inclusion and a ‘rights based approach’

Services are provided that maximise individual choice and controlServices are provided that maximise individual choice and control

People are supported to develop a social network and utilise natural People are supported to develop a social network and utilise natural and universal supportsand universal supports

There is clear understanding, and promotion, of legal and civil rightsThere is clear understanding, and promotion, of legal and civil rights

Inequalities are identified and challengedInequalities are identified and challenged


4. Commissioning4. Commissioning

Working in partnership to deliver improved outcomes Working in partnership to deliver improved outcomes and reduce inequalitiesand reduce inequalities

Commissioners and health and social care providers work together to promote Commissioners and health and social care providers work together to promote health and wellbeing and reduce inequalities – ensuring benefit from intiatives such health and wellbeing and reduce inequalities – ensuring benefit from intiatives such as world class commissioningas world class commissioning

Specialist learning disability services are commissioned to provide support and Specialist learning disability services are commissioned to provide support and advice to mainstream health services and social care as well as directly serving advice to mainstream health services and social care as well as directly serving those with the most complex needsthose with the most complex needs

There is access to a range of community based specialist learning disability servicesThere is access to a range of community based specialist learning disability services CentrednessCentrednessCommunityCommunityCitizenshipCitizenshipCommissioningCommissioningCompetenceCompetenceCheckingChecking

5. Competence5. Competence

Developing skills and knowledge within services and within Developing skills and knowledge within services and within people who use services, their family carers and supporterspeople who use services, their family carers and supporters

Local workforce development strategies are comprehensive and account for the need to 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 develop capacity and capability in the community and in mainstream health and social carecare

Workforce development strategies demonstrate the requirement to develop specialist Workforce development strategies demonstrate the requirement to develop specialist skills and knowledge in both specialist community and in patient settingsskills and knowledge in both specialist community and in patient settings

Use of person centred approaches underpin all activity relating to personal and Use of person centred approaches underpin all activity relating to personal and organisational development and service deliveryorganisational development and service delivery


6. Checking6. CheckingEnsuring services are high quality, clinically effective Ensuring services are high quality, clinically effective and safeand safe

Robust performance systems are in placed that are able to translate policy and Robust performance systems are in placed that are able to translate policy and best practice into useful metrics and monitor progress and deliverybest practice into useful metrics and monitor progress and delivery

People and family carers are at the centre of, and participate in, standard setting, People and family carers are at the centre of, and participate in, standard setting, performance monitoring and service evaluationperformance monitoring and service evaluation

Quality is ‘everyone’s business’ and all staff are encouraged to look at the way Quality is ‘everyone’s 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 they ‘measure what matters’ in their work and make best use of person centred plans and health action plans to assess outcomesplans and health action plans to assess outcomes

Strategies are in place to protect vulnerable adultsStrategies are in place to protect vulnerable adults


Don’t get the ‘Dibleys’Don’t get the ‘Dibleys’

To concludeTo concludeThe 6C’s Confirm and Challenge Model offers a way for The 6C’s Confirm and Challenge Model offers a way for all all servicesservices to ensure that they are serving to ensure that they are serving all all their population their population wellwell

Not confined to learning disabilities – the 6 principles are Not confined to learning disabilities – the 6 principles are transferrabletransferrable to other groups e.g. older people and other to other groups e.g. older people and other settings e.g. mental health servicessettings e.g. mental health services

A way of A way of organisingorganising effort and resources effort and resources

Offers a way of Offers a way of rememberingremembering what’s important to people what’s important to people and families and ensuring delivery reflects this from the and families and ensuring delivery reflects this from the bedside to the boardroombedside to the boardroom

A QUOTE…………..A QUOTE…………..

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

Vonnegut – The Sirens of the TitanVonnegut – The Sirens of the Titan

Practical supportPractical supportWebsite Website www.debramooreassociates.comwww.debramooreassociates.com

Self assessment tool Self assessment tool

Web based forumsWeb based forums

Workshops & bespoke packages of support for Workshops & bespoke packages of support for commissioners and provider organisationscommissioners and provider organisations

Started with specialist LD health services with Started with specialist LD health services with different versions now in development – different versions now in development – community teams, acute hospitals, primary care, community teams, acute hospitals, primary care, mental health etcmental health etc

Documents

Taking a whole system approach to learning disabilities Debra Moore Managing Director Debra Moore Associates [email protected]