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Policy Briefing
February / March 2018
This is a regular briefing for learning disability commissioners and other associated professionals in the northwest.
You are receiving this briefing because either your organisation subscribes to the North West Training and Development Team; or you subscribed to our policy briefing mailing list on our website. If you no longer wish to receive these briefings then please click on the ‘unsubscribe’ link at the bottom of this email.
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This briefing is compiled by Dr Laurence Clark and Colin Elliott from Pathways Associates CIC.
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A. HEALTH & SOCIAL CARE
A1. Government Response to the Lords Select Committee Report on the Long Term Sustainability of the NHS
On 5 April 2017, the Long-term Sustainability of the NHS Select Committee published its report into the issues relating to the sustainability of the NHS and adult social care.
The Committee itemised a number of conclusions and made 34 recommendations in relation to a wide range of areas including service transformation; funding the NHS and adult social care; innovation, technology and productivity; public health, prevention and patient responsibility; and towards a lasting political consensus.
The government response, published on February 20th responds to those points in order and sets out action planned and being taken to ensure the sustainability of the NHS.
The government’s response and a link to the Lords Select Committee report are available here: http://tiny.cc/jkniry
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A2. Care Act Statutory Guidance Updated
On 12th February the Department of Health and Social Care released further updates to the Care Act Statutory Guidance for local authorities.
Further detail is available here: http://tiny.cc/ilniry
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A3. Latest Guidance for Local Authorities on Social Care and Support Charging
On 30th January the Department of Health and Social Care published the latest guidance for local authorities on charging for social care and support. A summary of key points is provided below, the guidance sets out fuller details:
- The capital limits remain at their current level (i.e. lower capital limit £14,250 and upper capital limit £23,250).
- The Personal Expenses Allowance for local authority-supported care home residents remains at its current level (i.e. £24.90 per week).
- The Minimum Income Guarantee for people receiving local authority-arranged care and support other than in a care home remains at its current levels.
- The savings credit disregards remain at their current level (i.e. up to £5.75 per week for individual supported residents and up to £8.60 per week for couples).
The full guidance is available here: http://tiny.cc/kmniry
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A4. Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England
On 20th February The Kings Fund published an analysis of work underway across the country to develop integrated systems of care. The analysis examines:
- Why is change needed?
- What are integrated care and population health?
- What’s happening with new care models?
- What’s happening in integrated care systems?
- What are ACOs and why are they controversial?
- How are integrated care systems and partnerships developing?
- What has this way of working achieved?
- What do these developments mean for commissioning?
- Are these developments really a way of making cuts?
- Will these developments lead to privatisation?
- Where next?
It provides a useful insight into the benefits and potential difficulties of such large scale system changes. Further detail is available here: http://tiny.cc/3nniry
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A5. Approved mental health professionals: the local picture
On 14th February Community Care published an article following research that revealed continuing pressures on the approved mental health professional workforce nationally, including reducing numbers of warranted AMHPs.
The findings have also highlighted the context for, and implications of, these pressures in local areas. Recruitment and retention are amongst the key issues to be addressed and the article summarises some different approaches to maintaining safe statutory AMPH services.
Further detail is available here: http://tiny.cc/goniry
An accompanying article, including more statistical analysis is available here: http://tiny.cc/upniry
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A6. Survey to assess the impact of the sleep-in pay crisis
Changes to government guidance mean that sleep-in staff who previously earned around £30 per shift must be paid minimum wage, with providers liable for six years’ worth of back pay for such shifts. The unexpected bill comes amid an existing financial crisis in social care, with yearly cuts since 2010 amounting to £6.3bn and planned savings in 2017/18 a further £824m, according to the Association of Directors of Adult Social Services' Budget Survey.
On 19th February Care Management Matters announced that new independent research, launched the same day, will assess the impact of the sleep-in pay crisis, and the estimated £400m bill for back pay on the nation’s care and support sector.
Care providers are being urged to participate in the national survey commissioned by the Solve Sleep-Ins Alliance, a group of organisations that represent providers delivering overnight support shifts. The alliance is formed of the Association for Real Change, Care England, Learning Disability England, Learning Disability Voices and the Voluntary Organisations Disability Group (VODG).
The research, which closes at midnight on March 5th is intended to provide an independent, accurate analysis of the impact of the bill for sleep-in back pay on social care.
Further information is available here: http://tiny.cc/2qniry
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A7. The Use of Surveillance and Monitoring in Care
On 26th February Care Management Matters published an article examining the potential benefits and issues associated with the use of surveillance and monitoring technology in social care.
The article examines some of the drivers for use of CCTV in care environments, safeguarding is one example, it also references ethical and human rights concerns and potential business benefits.
The article can be viewed here: http://tiny.cc/3rniry
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A8. Local Government Association responds to National Audit Office report on emergency hospital admissions
On 2nd March the LGA responded to a report by the NAO on reducing emergency hospital admissions, which cost the NHS £13.7 billion in 2015/16. Key points include:
“Councils are working closely with the NHS to avoid unnecessary admissions to hospital through better self-management of conditions, better community support and better advice and information.”
“However, due to historic underfunding, the adult social care system is under significant pressure and community based services are being reduced, which is impacting on inpatient services. This reduced government funding means councils have had to spend less on key prevention work – £64 million less in the past year.”
“The LGA has consistently argued that there needs to be a focus on preventing hospital admissions in the first place rather than focusing disproportionately on delayed discharges of care.”
The full response can be read here: http://tiny.cc/vtniry
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A9. Adding extra years to life and extra life to those years: local government guide to healthy ageing
On 28th February the LGA published the Local Government Guide to Healthy Ageing. The report sets out why reducing the years people live with ill health is so important, from human and economic perspectives and provides interesting examples of initiatives in place across the country to promote healthier ageing.
The report is available to download here: http://tiny.cc/e4niry
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A10. A matter of justice: Local government’s role in tackling health inequalities
On 28th February the LGA published a report examining the wide range of factors that contribute to health inequalities and the strategic and more practical roles that local and central governments can play in working with their populations to address those inequalities.
The full report can be downloaded here: http://tiny.cc/a5niry
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A11. Government rebuked over poor adult social care workforce planning
The Department of Health and Social Care (DHSC) is not doing enough to support a “sustainable” adult social care workforce and should produce a “robust national workforce strategy”, a review has found.
The report by the National Audit Office (NAO), which scrutinises public spending, criticised the government’s failure to have an up-to-date workforce strategy which took account of major developments in the sector, including the Care Act 2014, and for its lack of oversight of workforce planning in local areas.
More detail is available here: http://tiny.cc/8egjry
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B. RESOURCES
B1. Disabled Children: A Legal Handbook 2nd edition
Disabled children: a legal handbook is an authoritative yet accessible guide to the legal rights of disabled children and their families in England and Wales. The authors navigate the many, often overlapping, sources of law, explaining the difference between what public bodies must do to support disabled children and that which they may do.
Each chapter can be downloaded as a PDF file free of charge here: http://tiny.cc/phpiry
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B2. Writing a best interests assessment report: key tips
Carrying out a best interests assessment is a complex but vital task. Its purpose is to decide whether a deprivation of liberty is happening or may happen, and if it is whether this is in the best interests of the person affected.
In this comprehensive guide for Community Care Inform Adults, Javeda Jafri and Rita Panayides provide a clear account of what a best interests assessment must include, deciding whether a deprivation of liberty is taking place, and how to use the balance sheet approach. Jafri and Panayides are best interests assessors (BIAs), trainers in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and lecturers on the qualifying course for BIAs at the University of Hertfordshire.
The framework can be found here: http://tiny.cc/2qfjry
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B3. MindEd
MindEd is a free resource is aimed at both families and professionals regarding children and young people’s mental health. MindEd is an e-learning tool led by Health Education England and supported by the Department of Health and Education. The resource is quality assured by clinical experts and is suited for use by schools, children’s care homes, health professionals, social care, families, advocates and many more. It offers specific modules around autism, learning disabilities and behaviour that challenges.
For further information please access: http://tiny.cc/m8fjry
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B4. Council for Disabled Children - Annual Review guidance for Education, Health and Social Care plans
The Council for Disabled Children have produced a factsheet and guidance notes which are intended help parents and young people understand the Annual Review process. For further information please access the following link: http://tiny.cc/qagjry
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B5. Supporting people to have meaningful personal relationships: Skills for Care guidance for employers
Everyone has the right to have personal relationships, including people with a learning disability, autism or both. It’s vital that adult social care workers have the right values, skills and knowledge to support people with personal relationships - and training is a vital part of this.
This new guidance helps employers to think about how they can develop their staff through training. It explains what workers need to know and understand about personal relationships, and how they can create a workforce development programme
For further information please access the following link: http://tiny.cc/uogjry
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B6. Co-production Project Planner
This free resource focuses on putting ideas into action. You don’t need to be an expert in co-production prior to planning a project. Work through the guide and see how you get on.
The resource comprises:
- 1.project planning workbook to take you from initial ideas to running co-production workshops
- 2.guide to planning co-production projects
- 3.suite of Iriss facilitation tools
Order a free copy using the form on this page: http://tiny.cc/aahjry
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B7. Six innovations in social care
This paper for TLAP captures the ideas of a group of innovators in social care in a series of one-page profiles of their innovations. This document is useful for anyone who is interested in new models of care and support, and would like to find out about different innovations that are being developed across the UK at the moment.
The paper can be read at http://tiny.cc/puhjry
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B8. Learning disabilities and behaviour that challenges: service design and delivery
This NICE guideline covers services for people with a learning disability and behaviour that challenges, their family members, carers and day to day support. It recommends providing a range of services in the community to minimise the need for inpatient admissions. It also promotes a lifelong approach, emphasising prevention and early intervention.
The paper can be read at http://tiny.cc/s8hjry
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B9. Learning Disabilities Market Position Statement: Good Practice Checklist
Based on a review of published learning disability market position statements by IPC, this good practice checklist assesses whether they are actually helping to shape the market and to explore their implications for people with learning disabilities and their families. It recognises that people with a learning disability can live successfully in different types of housing.
The paper can be read at http://tiny.cc/27hjry
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B10. Commissioning Services for People with a Learning Disability: Good Practice Guidance (Wales)
This good practice guidance was developed for the National Commissioning Board for Wales to help Regional Partnership Boards to develop their own approaches to the integrated commissioning of services for people with a learning disability.
The paper can be read at http://tiny.cc/96hjry
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B11. NICE: improving the experience of care and support for people using adult social care services
This guideline covers the care and support of adults receiving social care in their own homes, residential care and community settings.
It aims to help people understand what care they can expect and to improve their experience by supporting them to make decisions about their care. This guideline includes recommendations on:
- providing information;
- assessing care and support needs and care planning;
- providing care and support;
- staff skills and experience, and;
- involving people who use services in service design and improvement.
The paper can be read at http://tiny.cc/3sojry
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C RESEARCH
C1. Latest NHS Learning Disability Statistics
Data collected at the end of January 2018 show that:
- 2,465 patients were in hospital at the end of the reporting period.
- There were 100 admissions to hospital; of these 20 were readmissions within a year of the previous discharge and 25 were transfers from other specialist hospitals.
- 1,475 had a total length of stay of over 2 years.
There were 150 discharges/transfers from hospital. Of these, 100 discharges were back to the community.
More data can be accessed at http://tiny.cc/l0gjry
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C2. Beyond direct payments
This guidance has been developed to make the case for new approaches to support people should a direct payment not be the preferred option. It challenges the view that support from micro-enterprises can only be purchased using a direct payment. It offers alternative options for consideration:
- Micro-enterprises
- Individual Service Funds
- New models of commissioning
The guidance has been co-authored by Dr Simon Duffy, Director of the Centre for Welfare Reform and Angela Catley, Director of Operations and Communications at Community Catalysts.
More detail can be found here: http://tiny.cc/kwgjry and http://tiny.cc/r6gjry
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C3. Approved mental health professional numbers continue decline
The number of approved mental health professionals, the practitioners authorised to carry out Mental Health Act assessments, continues to shrink, research by Community Care shows.
A Freedom of Information request to local authorities also highlights a continuing failure to make the AMHP workforce more professionally diverse by bringing in more non social workers, one of the main reasons for the creation of the role to replace that of the approved social worker (ASW) in 2008.
More detail can be found here: http://tiny.cc/v3gjry
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C4. Growing innovative models of health, care and support for adults
This briefing is based on research conducted by Nesta, SCIE, Shared Lives Plus and PPL. It plans for the forthcoming care and support green paper.
The paper can be read at http://tiny.cc/ayhjry
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C5. Reimagining Community Services – Making the most of our assets
This Kings Fund report argues that a radical transformation of community services is needed, increasing the share of the NHS budget allocated to these services, and making use of all the assets in each local community wherever these are to be found. The report also highlights the need for collapsing silos between services and reducing fragmentation in service delivery, with renewed focus on improving population health as integrating care.
The paper can be read at http://tiny.cc/8yhjry
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C6. Bringing Us Together reports
Bringing Us Together has worked with a group of parents who have children and young people with autism and or learning disabilities in ATUs.
The papers describing their experiences can be read at http://tiny.cc/9cijry
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C7. Everyday Decisions – Supporting Legal Capacity through Care, Support and Empowerment
The Everyday Decisions project explored how people with learning disabilities make everyday decisions in and about their lives, and how care professionals support them in doing so. The research explored how mental capacity law works in practice to identify areas of good practice and areas where practical changes, shifts in social attitudes or legal reform are needed to secure the rights of disabled people.
The paper can be read at http://tiny.cc/08ojry
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