Agenda item

To receive a report on the draft Learning Disability Strategy and consultation proposals from Sarah Dillon, Director: Adult Social Care, Telford & Wrekin Council.

The Committee received a presentation introduced by The Director: Adult Social Care, Telford & Wrekin on the proposals of the draft Learning and Disability Strategy currently in consultation. The committee were asked to note that Adult Social Care have previously developed a strategy around learning disability but have recently worked alongside Telford and Wrekin Integrated Place Partnership which has enabled the strategy to now be seen as the local learning disability Telford and Wrekin place-based approach towards supporting people. The aim of the strategy is to continue to ensure the Council are achieving legislative requirements and includes new elements such as the Transforming Care Programme which supports people with learning disabilities moving back into Telford and Wrekin post hospital stay, developments around Think Local Act Personal and the recent addition of British Association of Social Workers – Professional Capability Framework. The Director: Adult Social Care continued to inform the Committee that the Council had worked carefully worked across Telford and Wrekin Place with Partners and more importantly across the STP/ICS around how as a system the Council supports people with learning disabilities to live a life to their full potential. The strategy consultation will feed into the wider STP/ICS strategy to support people with learning disabilities.

 

The Committee were advised that in Telford and Wrekin last year the Council developed the Learning Disability Partnership Board to feed into the development of the Council’s approach to supporting greater independence of people living in Telford and Wrekin also linking with the Making It Real Board, Carers Partnership Board and Local Telford Voices group. The Learning Disability Partnership Board was started in Autumn 2020 to champion, challenge and support delivery of the strategy. This involved an engagement period which commenced from 30 September to 11 November 2020 to enable the development of the draft strategy between November 2020 and January 2021. The formal consultation period commenced in February 2021 and includes a number of sessions to collate feedback and comment to enable the strategy to be finalised and approved by Cabinet in Summer 2021. The draft Learning Disability Strategy will be in place from 2021-2025 and sets out the most important elements that the Council will focus resources on. The Director: Adult Social Care highlighted to the Committee that for each area asked about in the engagement there is a section in ‘You said…We will do’ that includes:-

 

·         A summary of feedback from people with learning disabilities

·         A summary of feedback from parent, carers and professionals; and

·         Suggested actions to address the feedback.

 

In particular, there are 15 specific questions and the consultation responses will help further shape the draft strategy and the implementation of it. The Committee were provided with examples of the wide range of individuals who have been consulted with including but not limited to people who are expert by their experience, family and carers, professionals and a range of different groups.

 

The Committee were informed of the breakdown of how the Council will be consulting which includes:-

 

·         Virtual sessions for adults with learning disabilities supported by Taking Part;

·         Virtual sessions for family and carers;

·         Virtual sessions for Shared Lives Carers;

·         Virtual sessions for people who work with, or support people with learning disabilities;

·         An Easy Read questionnaire for adults with learning disabilities – available in paper and digital versions and

·         An Online questionnaire – also available in paper if needed.

 

The Director: Adult Social Care updated the Committee on the progress so far which includes 26 online responses received and a number of people involved in staff sessions including people with lived experience and family carers. The Council has received a very good reach out via social media channels with over 45,000 people engaging, 263 clicks and 15 specific comments. The Council have continued to raise the consultation in partnership meetings with Telford Voices, Learning Disability Partnership, Telford & Wrekin Integrated Place Partnership (TWIPP), STP Learning Disability and Autism Board and Carers Partnership. Feedback received so far has been positive on not only Adult Social Care but how as a wider community and place in Telford people can be support in their community to live as independently as possible.

 

Members asked questions and received responses as follows:

 

We know there are 4,100 people with learning disabilities, we are providing support to 493 which is only 12%. Do we know who the other people are and is asking them questions part of supporting them?

 

Can any of the 4,100 ring up for support or are you only referring to people in the 493 who receive significant services?

 

The Director: Adult Social Care responded to the Committee to advise that the Team are consulting widely and the lower number of people are those who have care and support needs under the Care Act whereby formally they are being provided with care support due to complex needs. The Care Act requires the Council to have a preventative approach which involves any person who contacts the Council or partners would be offered information advice and guidance regardless if they meet requirements to be provided with care and support under the Care Act enabling people to stay independent. This support will also tie in with ongoing development of the Independent Living Centre and after initial contact if the person’s needs are more complex to the extent where they require more formal social adult care input then further support would be provided.

 

We are promising people ‘You Say…We Will Do. Are we promising something we won’t be able to deliver?

 

The Director: Adult Social Care confirmed with the Committee that the Council are using a strength and asset based approach which supports people to be as independent as possible and not everyone will need a higher level funded care and support. The Council may be required to explore resources occasionally and use the resources available in the best way possible to support individuals with learning disabilities with more resources directed at those individuals with complex needs. 

 

The Chair opened the meeting to Cllr A Burford, Cabinet Member for Health and Social Care for further comment. Cllr A Burford addressed the Committee to advise that personalisation for adults with learning disabilities has become very important throughout the pandemic due to limited operation of services such as day care centres which has required Adult Social Care to carefully review the needs of every individual cared and supported. Some individuals have been able to find new opportunities and ways to socialise and use strengths and assets in their communities during the pandemic, however some individuals have struggled and have been provide with respite during this period. Cllr A Burford concluded by applauding the work of staff in Adult Social Care towards adjusting to new ways of working and developing new skills to help tailor services towards individual needs and part of the strategy is to ensure we take into account individual needs going forward.

 

What steps are you taking to engage with prospective employers to help people with special needs to be employed and what resources are in place for this?

 

What would the wraparound care be for these potential employees?

 

The Director: Adult Social Care advised the Committee that the approach of Adult Social Care to date has been very much personalised and covers individuals who wish to look into employment opportunities, have recently been discharged from hospital with complex needs or would like to improve socialisation with friends. This individualised approach allows people to gain more independence and part of the consultation for the strategy is to look into the feedback around elements such as employment and the best way the Council can work with partners to offer opportunities. So far, feedback received as shown a clear aspiration for paid employment and the Council will continue to work with partners on how to provide support on an individual basis to meet individual support needs. Support would be made bespoke around the needs of those individuals to enable them to gain the best outcomes for themselves.

 

How will you achieve the reduction in the number of inpatients with learning disabilities and what resources are in place for these individuals coming out of hospital?

 

What care would be given to these individuals and would their families be expected to care for them or would they be provided accommodation at a care home or provided a home of their own?

 

The Director: Adult Social Care advised the Committee that a programme as part of the Transforming Care Group has been in place for over two years to support longer stay hospital patients as part of an integrated offer with NHS partners. An individualised approach is taken with the multidisciplinary team once patients are ready to be discharged to ensure the appropriate care, support and healthcare are available. Some individuals will be supported for a period of time in higher levels of care due to the nature of their care and this is dependent on the individual needs of the person.

 

The integrated transport service has continued to bring people into the area to enjoy exercise and fresh air with one another. When restrictions are lifted how will this be put in place?

 

The Director: Adult Social Care advised the Committee that due to the pandemic, the Council have had to be careful with providing support to individuals to get out and about in the community while adhering to COVID-19 guidance and have found new and different ways to provide support. This has been taken on an individual level and has found that some people may be able to with assistive technology go out more independently with minimal care support whereas others have required significantly more support.

 

Members asked The Director: Adult Social Care to confirm if there is a long term plan in place to ensure there is a provision in place for individuals with learning disabilities to continue to socialise once restrictions are lifted. The Director: Adult Social Care advised the Committee that provisions would be taken into consideration however some people may make different choices going forward.

 

Members were impressed with the overall tone of the report and discussed the objectives of the former East Shropshire Disablement Advisory Committee which focused on employment for individuals with disabilities. Members highlighted and agreed that there may be other professionals in the community who have experience with supporting individuals with disabilities as well as Council Officers and Health Professionals. Members reflected on a statement referred to in the presentation referring to not just caring for but developing the individual and the importance of identifying and nurturing specific skills and taking an interest in the development of the individuals and not just their care needs.

 

Members asked further questions and received responses as follows:

 

Are the people who support individuals in supported living trained to provide adequate care and do we have enough supported places in Telford?

 

The Director: Adult Social Care confirmed to the Committee that staff who provide care to supported living residents are trained and registered with the Care Quality Commission if they are providing personal care and support. Training has been a key factor with the Learning Disability Partnership Board therefore the level of training around learning disability has recently been evaluated. Experts by experience provided feedback on if the level of training around individual conditions was sufficient. Assured about the level of training across partners and will continue to develop on elements such as positive behavioural support.

 

The Director: Adult Social Care also confirmed to the Committee that last year the Council developed a Specialist and Supported Accommodation Strategy which clearly sets out the numbers of accommodation needed over the next five years and the progress made to date so far. The Council has made significant progress and has supported over 60 people over the last two years to either have individual tenancies or more supported living. Some arrangements that have been put in place are shared and some are individual living, however it is dependent on the person’s needs and preference. Currently the Council are working steadily to have sufficient supply of accommodation. An accommodation forum has been set up and helps to identify people who need support. The Council continues to plan ahead with Housing Team on how to meet supported living needs with a particular focus on providing support at transition age.

 

Going forward how are the Council going to address the issue with four tier beds? Are there any plans on getting four tier placements for families?

 

The Director: Adult Social Care advised the Committee that the Council are working closely with NHS Partners and it is a key priority of the STP/ICS programme group to support people with learning disabilities and mental health problems.

 

With the current Local Authority financial position, is the Council still short of resources?

 

The Director: Adult Social Care informed the Committee that the Council are actively ensuring the resources that are available are being used to the best effect with priority and focus based on an individual’s needs and aspirations.

 

Do the Council have any views on the issue around the small number of people living with a learning disability who are not registered with GPs as having a learning disability and therefore annual health checks are relatively low?

 

The Director: Adult Social Care advised the Committee that this has been a key focus across the STP/ICS group for learning disability and autism across Shropshire and Telford and Wrekin. Working with NHS Partners and Primary Care, the Council have been working to improve the current performance across the whole system. In Telford and Wrekin alone the performance has continued to improve with the help of the recent vaccination programme which has highlighted certain individuals to ensure they are getting adequate access to the healthcare they need. The Council are following the Making Every Contact Count approach whereby they ensure when in contact with people with learning disabilities who are receiving care and support that healthy lifestyle and welfare issues are also highlighted. This is an area of continued improvement but has seen significant progress over last 6 months.

 

Are there particular issues with the BAME communities in terms of access language and the way the Council provides services?

The Director: Adult Social Care confirmed to the Committee that there is a need for a greater focus on BAME communities and ensuring that the Council are providing as much support to individuals as possible in the correct format is integral to the draft strategy.

 

Are there particular issues around post COVID-19 and lockdown easing with people with learning disabilities? Is there an intention to re-establish day centres?

 

The Director: Adult Social Care advised that Committee that there is a focus on community access and the Council has made good progress around digital engagement with individuals to support them through COVID-19 restrictions to continue to support them with independence. There has been continued support around day services with over 50 people accessing support in this way and this is an area that the Council has continued to focus on. This has been done through phases working within the COVID-19 guidance gathering smaller groups to start with and will go onto increasing the size of groups safely.

 

How many people do we have out of area that we would like to bring back to the area and what are the things that prevent us from brining people back?

 

The Director: Adult Social Care advised the Committee that the Council had identified a need to support more individuals to come back into the area such as those in residential care outside of the area of Telford and Wrekin. Numbers of individuals have reduced significantly and it is very unusual to place new individuals with learning disabilities into residential care. Telford’s performance has been the highest in the region over the last 12 months and the numbers of people with disabilities being placed in residential care is low outside of the area. The Council are supporting individuals to live as local as possible to their own community in a more supported living environment. The Council are not supporting a high number of individuals in residential care outside of the area.

 

The Chair opened the meeting to Cllr A Burford, Cabinet Member for Health and Social Care for further comment. Cllr A Burford advised the Committee that the Council are in a position of flux following COVID-19 and are currently looking at ways to reassign monies to make sure we are making the best use of resources currently available. Going forward, will not be able to have full capacity at day centres and could look at redirecting those resources to helping individuals in the community to socialise, find employment and find new opportunities to live a fulfilled life.

 

Members asked further questions and received responses as follows:

 

Do you feel that Telford has sufficient weight in relation to the approach the ICS has taken given it covers Shropshire and Telford and Wrekin?

 

The Director: Adult Social Care advised the Committee that it was felt that the Council have maintained good influence towards the wider system approach to support people with learning disabilities due to the early commencement of the strategy and its continuation through the current COVID-19 pandemic. The SDP Group focusing on learning disability and autism has taken in feedback provided by the Council as part of their overall strategy and discussions have featured at the local Telford and Wrekin Integrated Place Partnership, raising issues with partners who not only serve Telford and Wrekin but the wider system. 

 

Only 32 adults with learning disabilities out of 493 has responded to the current consultation taking place, however this is a small proportion. Were these individuals asked to take part and did anyone find it difficult?

 

The Director: Adult Social Care confirmed that 32 people with learning disabilities are being consulted currently. Information regarding the consultation has been pushed out via the Council’s main services as well as digitally through social media messages. The Team are continuing to run a number of consultation sessions and have commissioned the advocacy organisation Taking Part to feedback through their groups and forums. In particular, there is a focus on Telford Voices which comprises of service users who actively use the Council’s daytime services. Easy read questionnaires have been sent to each individual whom the Council are aware of with learning disabilities as well as their carers.

 

As can be seen by the consultation, the top answers for ‘where do you go to see your friends’ is at the day centres and club 2000. It is therefore clear that carers and adults with learning difficulties are concerned about the day centres remaining open.

 

Please could the Social Care Team update the Committee on the current situation with the day centre and if they feel they are important for adults with learning disabilities to meet with friends and peers?

 

The Director: Adult Social Care advised the Committee that the day centre service will continue in the future. It has been highlighted during COVID-19 that people have found different ways to socialise and going forward the Council may not be in a position to have day centres at full capacity under the current restrictions. At present up to five individuals can meet at the day centres under the current restrictions. Through the pandemic and due to other opportunities arising as a result, the Council have been able to take their approach on an individual needs basis and have been able to continue to provide support that best meets the person’s needs.

 

How much influence will adults with learning difficulties have on the policies in the strategy and will they be able to change a policy?

 

The Director: Adult Social Care further advised the Committee that wide measures have been taken to ensure sufficient feedback is received from the consultation from those individuals with a learning disability.

 

During the consultation, what do you believe is the ratio of professionals to those who buy into Council services?

 

The Director: Adult Social Care informed the Committee that the ratio of people with lived experience and their carers versus professional feedback appeared well balanced. More feedback has been received from people with lived experience and their carers, however the Council has ran a number of sessions with family carers and the advocacy organisation Taking Part have also run a number of sessions with lived experience. If required, a breakdown of the data can be provided to the Committee.

 

The Chair welcomed the opportunity to view the breakdown of data and felt it was important to ensure the consultation is conducted correctly and reach out to the relevant individuals for feedback who buy into Council services.

 

What support, guidance and safeguarding is available to help people who are eligible under the Care Act with direct payments?

 

The Director: Adult Social Care advised the Committee that in-house staff are available and have undertaken training to support individuals who have direct payment and make regular contact with those individuals. The Council have worked with the Making It Real Board who have developed a number of videos and support guidance to ensure the pathways that have been put in place are appropriate to support any individual with learning disability to make direct payments. When an individual with care and support needs has a reviews or assessment, the Team continue to work with them when setting up a direct payment to ensure this meets their needs and the right support mechanisms are in place to ensure they can manage the payments safely. The Director: Adult Social Care also confirmed that direct payment was an area which the Council would like to increase to be able to offer people more choice and control on how to receive their care and support.

 

Members requested for the strategy action plan that was referenced in the report to come to Committee with agreement of report presenter.

 

The Director: Adult Social Care confirmed to the Committee that the strategy action plan would be available to bring to Committee for review.

 

Members requested to view the baseline figures for current and future progress in order to compare and understand the effectiveness of the strategy.

 

The Director: Adult Social Care advised that baseline figures could be provided to the Committee in order to compare progress of the strategy going forward.

 

Do we have a breakdown of statistics of how many people are living with their parents and are you forecasting ahead if they will need supported living?

 

The Director: Adult Social Care confirmed to the Committee that data showing the statistics of people living with older carers is available and enables planning for supported living. The data also helps to inform the Specialist and Supported Housing Strategy.

 

Do we have a breakdown of the ages of adults with a learning disability?

 

The Director: Adult Social Care confirmed to the Committee that data showing the breakdown of ages is available.

 

Are there any concerns over the stability of the care sector and are we still in the same positon locally?

 

Members requested a written response for the above question to be provided by the Director: Adult Social Care outside of the meeting.

 

The Committee thanked the Director: Adult Social Care for their attendance and answering Members’ questions.

 

RESOLVED – that the content of the report and appendices be noted by the Committee and the consultation on the draft Learning Disability Strategy be supported and promoted.