Learning Disability Commissioning Strategy Action Plan 2017- 2020 1. Delivering the National Outcomes Framework What needs to change to deliver the outcomes? What is happening already? What would success look like? Agreed Actions Person Responsible &Timescale 1.1 All services to ensure they deliver against the national outcomes framework Some contracts are outcome focused e.g. Supported Living Framework and internal services have adopted outcome approaches All services (internal and commissioned) deliver services which are focused on outcomes delivery, progression and 1. Report that remaining contracts have been re-written to build in National Outcomes, progression and co-production 2. Ensure that internal services co-productively re-focus delivery against national outcomes and progression. Mark Campisi (Community Care)/Rachel Evans (SP) April 2018 Cathy Murray April 2018 1.2 We need a sufficient staff compliment to deliver the change required in assessment and care management Development of a new practice framework Increasing use of approaches A workforce that can deliver the change agenda and on outcomes, progression and co-production 1. Report that the Community Support Team (CST) and Transition Team have engaged within the Practice Framework development 2. Ensure that the CST structure and set is fit for purpose Mark Campisi/Team Leaders October 2017 Mark Campisi/Team Leaders April 2018 1.3 The Individual Service Agreement arrangements need to be A new Individual Progression Agreement has been developed and is part of the new Supported Living Framework Agreement All services target support towards the delivery of outcomes and progression and work co-productively (incl. day care, domiciliary care and residential care) 1. Implement the new Individual Progression Agreement across all services (internal and externally commissioned) Mark Campisi (Community Care)/Rachel (SP)Cathy Murray April 2018
updated to reflect and outcomes, progression, approach 1.4 We need a peer framework for outcomes sitting alongside other arrangements Commissioning arrangements have been re-shaped to make them co-productive and some work has taken place to review services against outcomes and this needs to be built on especially in relation to residential and domiciliary care All services deliver against the national outcomes and people with a learning disability are actively involved in monitoring and measuring the performance of services against outcomes 1. Service Provider Forum, Commissioners, Swansea People First and carers to work together to co-produce a monitoring and measuring tool for measuring outcomes in both internal and external services Mark Campisi/Rachel Evans (Planning & People First and Providers May 2018 1.5 The Learning Disability Provider Forum needs to be A new Supported Living Framework Provider Forum will be formed The current Provider Forum is considering what arrangements will support a collaborative approach to service delivery Provider Forum’s that support a collaborative, innovative and partnership approach to the delivery of outcome focused services and progression for people with a learning disability in Swansea 1. Develop new collaborative provider forum arrangements Mark Campisi/Rachel Evans/Provider Forum November 2017 2. Control over day to day life I know and understand what care, support and opportunities are available and use these to help me achieve my well-being I can access the right information, when I need it, in the way I want it and use this to manage and improve my well-being re-
I am treated with dignity and respect and treat others the same My voice is heard and listened to My individual circumstances are considered I speak for myself and contribute to the decisions that affect my life, or have someone who can do it for me 2.1To ensure our processes and approaches support people to have control over day to day life A new Practice Framework for Assessment and Care Management is developed Whether people are treated with respect Whether people are in control of their daily life Whether people are involved in decisions about their care and support Whether people receive the right information when they need it 1. Report that people with a learning disability and their carers are involved in the development of the new Practice Framework Mark Campisi Citizens October 2017 2.2 Improvements to our information, communication and engagement arrangements Co-productive commissioning arrangements People and their carers would be informed, would feel communicated with and would feel they had a valued stake in the design, delivery and evaluation of the services they receive. 1. Pull together a working group of staff, commissioners, people with a learning disability and carers to review current information, communication and engagement arrangements to co-produce a new approach Mark Campisi/Rachel Evans May 2018 3. Physical/Mental health and emotional wellbeing I am healthy and active and do things to keep myself healthy I am happy and do the things that make me happy I get the right care and support, as early as possible 3.1 Support people to organise themselves to live healthier lifestyles People attend health checks Time to Meet Carers Centre Whether people say they feel healthy physically and mentally Life satisfaction Whether people are living a healthy life style 1. Consider peer approaches to supporting people with a learning disability and their carers to overcome the barriers to healthier lifestyles Swansea People First/Carers Centre/Mark Campisi/Rachel Evans April 2018
People with a learning disability, their families and services/support would support each other to live healthier lifestyles 3.2 Better access to health and a better experience leading to a reduction in health inequality Enhanced GP contract – health checks Health Pathway for people with a learning disability Bereavement Leaflets and sessions held by SPF Increased take up of health checks Better access to primary and secondary care Decrease in health inequality 1. Through local GP networks and the patient representative groups look at issues of access, experience and health equality 2. Local providers to build health access into delivery e.g. support to attend annual health check and support to access health services. 3. Report that Individual Care Plans explain how people will be supported to access health checks and health care Health Rachel Evans (Contracting) April 2018 Mark Campisi/Team Leaders June 2018 4. Protection from Abuse/neglect I am safe and protected from and neglect I am supported to protect the people that matter to me from abuse and neglect I am informed about how to make my concerns known 4.1 Support people with a learning disability to keep themselves safe within the communities they live How much abuse and neglect takes place Whether people say they feel safe 1. Support people with a learning disability to develop a peer led strategy around keeping safe Swansea People First September 2018
4.2 Communities need to develop a better understanding and in some instances a tolerance of people with a learning disability 1. Develop a strategy for raising awareness and understanding of learning disability within the community and mainstream services Swansea People First April 2019 4.3 Access to good quality advocacy provision Current advocacy provision in place Development underway of a new Independent Professional Advocacy Service 1. Development of a new, Independent Advocacy Service Rachel Evans (Planning) 2018 5. Education, Training, Recreation I can learn and develop to my full potential I do the things that matter to me 5.1 Support peer approaches to organising recreational activities Time to Meet currently supports activity on a peer basis Adult learner outcomes and qualifications Whether people are able do the things that matter to them 1. Support people with a learning disability to organise peer approaches to recreational activities Swansea People First September 2019 6. Domestic, Family, Relationships I belong I contribute to and enjoy safe and healthy relationships 6.1 A Peer led strategy to address Development of social groups which An increased sense of community
loneliness and belonging meet in the evenings and day time Time to Meet Decrease in people reporting loneliness carers to develop a peer led strategy to address building strong relationships and social networks Centre with group April 2020 6.2 Care management and Services work together to develop people’s social networks building on their strengths and capabilities Development of social groups which meet in the evenings and day time Time to Meet The new ISA is outcome focused 6.3 Carers to be better supported to live active lives that are not hindered by their caring responsibilities Carers assessments Services provided to the cared for person – day, respite etc. Carers Grants Benefits 7. Contribution Made to Society I engage and make a contribution to my community I feel valued in society 7.1 More people we support to have a role in services and their community Development of member led services Services are looking at increasing links to the communities they are based in and are making connections WDS – community presence and Reciprocal relations grow Connections are made Geographical approaches to service provision emerge Peer community grows % of people who volunteer Whether people think the things they do in life are worthwhile Participation in society increases 1. Report that services are increasingly focused on supporting people with a learning disability to be an active part of community Swansea People First/Service providers/Carers Centre with group July 2018
contribution e.g. NEAT Team 7.2 Work, Poverty, Independence I contribute towards my social life and can be with the people that I choose I do not live in poverty I am supported to work I get the help I need to grow up and be independent I get care and support through the Welsh language if I want it 7.1 Develop Social Enterprises Movement towards member led services within internal provision Developments within Work Development Service People working Gap in life expectancy between least and most deprived 19-24 year olds who are not in education, employment or training Material deprivation 1. Consider and report where opportunities exist to develop social enterprises Cathy Murray/Rachel Evans (Provider Forum/Planning) March 2018 7.2 Inspire people to take up work More people with a learning disability are in work 1. Work Development Service (WDS) members to share their stories to inspire others to consider work Cathy Murray/WDS members April 2018 7.3 Carers supported to work if this is what they want Carers Assessments Service provision for their cared for person More carers who want to work are able to work Fewer people giving up work because of caring responsibilities 1. Develop a carer led strategy to address how more carers can work, if this is what they want Carers Centre with the group December 2017 8. Suitability of Living Accommodation I live in a home that best supports me to achieve my well-being 8.1 We need to make sure that all accommodation options support Some progress in working in an outcomes focused way Accommodation options support the delivery of people’s individual outcomes 1. Update the Accommodation Strategy for People with a Learning Disability addressing the issues raised in this Commissioning Strategy Rachel Evans (Planning)/Mark Campisi March 2018
people to achieve their wellbeing 8.2 Understand the views of younger people with a learning disability and their carers in relation to accommodation requirements Accommodation options available for people coming through from transition are appropriate to needs 1. Ensure the views of younger people and their carers are captured when developing accommodation options Rachel Evans (Planning) March 2018 9. Managing Demand/changing the model of support Delivery of the Act and Social Services Model Prevention, Early Intervention, Progression 5% shift towards prevention/early intervention What needs to change to manage demand/change the model? What is happening already? What would success look like? Agreed Actions Person Responsible &Timescale 9.1 A new, sustainable model for Supported Living Co-productive engagement Some consideration on time approaches Some consideration of progression A financially sustainable model of support that delivers the outcomes that matter to people 1. As part of the Accommodation Strategy work with Providers on the new Supported Living Framework, tenants, family carers and commissioners to co-produce a Rachel Evans (Planning )/Mark Campisi (Contracting) March 2018
return to previous living arrangements 9.8 We need a co-produced strategy for day opportunities and people need to be involved with developments and changes from the outset Internal services have an established culture of change and development focused on delivering outcomes and progression Each service will have at the heart of its delivery Services will deliver the outcomes that matter to people More people will be supported to access mainstream services and establish community links 1. Consider the development of a co-produced strategy for the delivery of day opportunities, both internal and external 2. Develop co-productive planning and delivery arrangements within each internal service Cathy Murray/Mark Campisi/Rachel Evans (SP) April 2019 Cathy Murray/Lisa Banks/external providers 2019 9.9 Ensure the we have taken account of the CCSIW National Inspection recommendation We have considered the recommendations 1. Report that the recommendations contained with the CCSIW National Inspection of Care and Support for People with a Learning Disability have been addressed locally Rachel Evans (SP)/Mark Campisi (CC) April 2018
9.10 Better understanding of unmet need We have developed a new outcomes focused approach for accessing resources and have built in unmet need A good understanding of needs that are going unmet which inform future planning 1. Report that the capacity for recording unmet need is being utilised and that the information it generates is directed to inform future planning Mark Campisi November 2017 10. Managing costs Sustainable Swansea What needs to change to manage costs? What is happening already? What would success look like? Agreed Actions Person Responsible &Timescale 10.1 Review high cost care packages in supported living and residential care Western Bay currently reviewing all residential care packages above £600 per week Paul Bee currently reviewing high cost supported living packages An increasing focus on transition Packages of care would be directly related to the support requirements of people 1. Understand and track the impact on the budget of the outcomes focused assessment work being undertaken by Western Bay and Contracting Mark Campisi April 2018 10.2 Support packages are appropriately from the outset and an emphasis is given to progression and Paul Bee is working with care managers to implement the new Individual Service Agreement and focus on progression The Resource Allocation process supports care Support packages achieve the right balance between meeting the needs of people, keeping people safe whilst promoting increased independence and move-on from the outset of the package being put in place 1. Monitor and review, through the accommodation group, whether packages are being better targeted and progression is being emphasised Mark Campisi April 2018
move- on from the beginning managers to think about outcomes, targeted resources and progression – raising awareness of resources The Accommodation Group will influence care managers to think increasingly about progression and move on. 10.3 Ensure all staff have the training and support engage in the Continuing Health Care (CHC) process Mark Campisi is attending CHC meetings Dave Howes is looking at resourcing legal support to promote an understanding amongst staff of the legal situation, the process and how to challenge decisions Staff are better informed and more able to navigate the CHC process for the benefit of their clients 1. Establish a corporate approach to training and advice for when engaging with the CHC process Mark Campisi December 2017 10.4 All high cost packages need to be reviewed (over 1K per week) Packages are being identified People eligible for CHC will receive it 1. Review all high cost packages to determine eligibility for CHC Mark Campisi December 2017 10.5 Work together with the Health Board to look at mechanisms for Decisions regarding CHC are made efficiently without impacting or delaying the care package for the individual 1. Establish a mechanism for deciding funding splits between Health and Social Care Mark Campisi/Health March 2018
deciding funding splits between social care and health 10.6 time support arrangements need to be understood more clearly Current Intermediate Care Fund (ICF) bid to make use of assistive technology to lessen the reliance on night time support where it is not needed. A programme of review is taking place across two supported living providers to understand the requirements for night time support 1. Finalise the programme of night time review across supported living providers and consider the implications for the new providers who come onto the Supported Living Framework Rachel Evans (Contracting) December 2017 10.7 We need to understand how we can make better use of our externally commissioned day care and respite support for people with challenging behaviour Some discussions have place Better use of resources – economies of scale Better links to other provision Increased progression and move-on 1. Review arrangements for the external commissioning of day and respite support for people with challenging behaviour Mark Campisi/Health March 2018 11. ‘People’ Commissioning – Strategic Priorities and Gaps What to change? What is happening already? What would success look like? Agreed Actions Person Responsible &Timescale
11.1 Pooled resources across directorates for play and leisure opportunities Paper with recommendations tabled for Cabinet. We have a range of high quality, value for money services. 1. Subject to Cabinet agreement, undertake a procurement exercise across Child and Family and Poverty and Prevention to recommission Play and Leisure Opportunities for Children & Young People with disabilities. Family Support Continuum Commissioning Group - March 2018 11.2 Need more domiciliary care provision for children and young people with disabilities Paper with recommendations tabled for Cabinet. Demand would be met. 1. Subject to Cabinet agreement, expand the capacity within the in-house Flexible Home Support Services. Family Support Continuum Commissioning Group - March 2018 11.3 Parental engagement needs to be better managed and aligned across service areas Paper with recommendations tabled for Cabinet. Consistent approach Improved engagement 1. Subject to Cabinet agreement, undertake a procurement exercise across Child and Family, Education and Poverty and Prevention to commission a service. Family Support Continuum Commissioning Group - March 2018 11.4 Need increased early intervention and preventative family support interventions Paper with recommendations tabled for Cabinet. More people will have their needs met outside statutory support systems Educational psychologists freed up to focus on their actual role 1. Subject to Cabinet agreement, undertake a procurement exercise across Child and Family and Poverty and Prevention to source a partner organisation. Family Support Continuum Commissioning Group - March 2018 11.5 A more strategic approach to young carers commissioning, Paper with recommendations tabled for Cabinet. ICF money has been granted for a Western Better placed to meet anticipated increase in demand. 1. Subject to Cabinet agreement, undertake a procurement exercise across and Family and Poverty Family Support Continuum Commissioning Group - March 2018
including young carers voice Bay post to look at young carers voice in commissioning and Prevention to source a partner organisation. 11.5 School counselling for 10-18 year olds 1. Report that the arrangements for School based counselling for 10-18 year olds have been reviewed and tendered September 2018 11.6 Families First commissioning arrangements are due to expire family support commissioning arrangements need new consideration New Welsh Government Guidance to be published in the Autumn which will inform commissioning arrangements going forward to 18/19. 1. Report that Family Support commissioning arrangements have been reviewed and recommendations have been made that align with WG Guidance and the Family Support Continuum Family Support Continuum Commissioning Group - March 2018 11.7 Improve overnight respite arrangements for Children and Young People with Disabilities Paper with recommendations tabled for Cabinet. A of residential and fostering short breaks options will be available 1. Subject to Cabinet agreement, undertake a procurement exercise across Child and Family and Poverty and Prevention to source a partner organisation. Family Support Continuum Commissioning Group - March 2018