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Joint Commissioning Strategy

2014 - 2019

Adults with Learning Disabilities in Hertfordshire

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Introduction

This is the big plan for adults with learning disabilities

in Hertfordshire. It is called the Adults with Learning

Disabilities Joint Commissioning Strategy 2014 –

2019

It has Market Position Statement that goes with it.

This is for providers of social care services for people

with learning disabilities. It is to help them know

what we need in Hertfordshire so they can provide

the right services that people need

The big plan (strategy) is based on:

o What the government have been told we should

be doing

o What we felt worked well or didn’t work well

from the last big plan 2010 – 2013

o What people have told us

The big plan is for people with learning disabilities

and their families who use services and people who

work in the services that are paid for by Hertfordshire

County Council and the NHS Clinical Commissioning

Groups.

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Making it happen

This big plan will have an action plan that will check

that the things we say in the strategy happen

The plan is for 5 years and will be checked each year

to make sure that it still in right for Hertfordshire

Population – people who live in Hertfordshire

Information from 2012 - 2013:

There are 1.1 million people living in Herts, more

than half of these are adults (784,440)

About 20,600 of these are adults with learning

disabilities

About 4,300 needed lots of help from people

In over 3,000 adults got help from social care

services

GPs knew about 3,559 people with learning

disabilities

1,434 people received help from doctors/nurses and

other health workers working for Hertfordshire

Partnership University NHS Foundation Trust

There were 1,276 young people with learning

disabilities aged 14-19

2014 - 2019

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What we know

There are lots of people with learning disabilities we

do not know about

There are more children born with learning

disabilities and lots of health problems who now live

for longer

Generally people with learning disabilities live much

longer lives than they used to

There are more adults with autism

Where to find more information about this:

Hertfordshire’s Joint Strategic Needs Assessment

http://atlas.hertslis.org/IAS/hwb/priorities/learningdis.ht

ml

This gives information about what we know about

people with learning disabilities in Hertfordshire and

helps us plan for future services

Improving Health and Lives (IHaL) learning

disabilities observatory

http://www.improvinghealthandlives.org.uk/profiles/

This gives national and local information on health and

social care, you can compare Hertfordshire and other

areas in England

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What is happening nationally

Because there have been some bad things happening

in some health and social care services in the country

the government are bringing in some new laws and

guidance to help make things better.

These are some of them:

The Care Bill 2013 – new protection and support

Think Local, Act Personal - making personalisation

happen in social care services

Transforming Care – a national response to

Winterbourne View 2012, making sure people live in

the community with the right support, and not in

special hospitals

What is happening in the Hertfordshire

We have local plans to help make things better like:

Health and Wellbeing Strategy – it has big areas,

called priorities, for fulfilling lives for people with

learning disabilities and supporting family carers to

care

Carers Strategy

Learning Disability Partnership Board work plan

Clinical Commissioning Groups strategies

Health and Community Services plan

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This big plan is about Personalisation

That means that all services and support is shaped to

suit each person

There are 4 important areas to this plan:

Choice and control - this means that people with

learning disabilities and their families having a say,

being listened to and making choices about their

support with workers

Living in the community as a full citizen - this

means people with learning disabilities having the

same opportunities as everyone else, live locally

and being safe

Better health – this means supporting to people to

be as healthy as possible

Good staff - this means staff that can do the job

and listen to the people they work for

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Choice and control

Nothing about us without us

We want people with Learning Disabilities and their families:

• To be involved in and make their own decision about their lives

• Have good information about money and budgets

• To say how they want to be supported

• Have good advocacy to help if they need it

• To have a personal health budget and personal budget for social care by direct payments

• To see things happen as planned

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Making this happen

• Have people to help buy services that are right

• Personal budgets for everyone

• Have people to help to check agreements to see that what is paid for is what you get

• People and families involved saying what they like and don’t like about services

• Development of eMarketplace

• Clear information about money

• Good advocacy services

• Person-centred planning in all services and roles

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Living in the community as a full citizen

Being part of your community

We want people to live a life that is right for them including getting housing, work, learning, friendships and leisure this means people having:

• A choice about housing

• Being able to do things in the day, evening and weekend

• People in hospital are seen often by their social worker and have plans to move on from hospital

• Staff help people to do things for themselves

• People find better ways to support people who need lots of help

• Staff think more about how to make sure people do things rather than not doing them – this is known as positive risk taking. And stand up for the rights of people with learning disabilities

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Making it happen

Work with people to make it happen:

• People in housing

• People who provide transport

• People who help people find jobs

• Give people, families and staff good information:

o about having your own home

o about making decisions

o about support there is to help you when things go wrong

o about listening to people and supporting people to plan their own life

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Better health

We want people with learning disabilities to be supported to be as healthy as possible, that means:

• Social care services being better at supporting people’s health needs

• All services to sign up to the new big plan for Challenging Behaviour support

• More people having Annual Health Checks, with good Health Action Plans

• All health services work to make the changes that Confidential Inquiry into the premature deaths of people with learning disabilities (CIPOLD) and the Mencap Charter for Clinical Commissioning Groups say are needed to improve health services

• All health services sign up to the Purple Promise

• Health and social care services take part in the Joint Health and Social Care Self Assessment Framework

• People who work in health services get better at communicating with people with learning disabilities and make the right changes called reasonable adjustments to support people properly

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Making it happen

• Change social care contracts so services know that they have to support people properly

• Check health services are making improvements from the CIPOLD report and Mencap charter

• Check the use of the Purple Folder, and how good are Annual Health Checks and Health Action Plans

• Have a special group called the health partnership review group to check what is happening

• Start using the Health Equality Framework to help check what we are doing

• Use what we learn from the Joint Health and Social Care Self Assessment Framework to help make things better and check how we are doing each year

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Good staff

We only want people to work in services if they can

do the job well. They must have the right attitude

and behaviours; this means things like having

respect for the people they support and listening to

them. We want:

• Everyone who works in services knows about and is working to the this big plan

• Employers to check that their staff have the right attitudes and behaviours

• Commissioners who buy services properly check that services are doing this

• People with learning disabilities and their families are properly involved in choosing new staff

• People with learning disabilities and their families help train health and social care workers

• The right people are employed for the care and support of people with the highest needs including people who have challenging behaviour

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Making it happen

• Involving people with LD and their families in choosing staff and training staff

• Check the skills of people working in services – this is called an audit

• Make sure training and work to make staff better in Hertfordshire is based on the what we find out is needed from the audit

• Support employers to make the changes that are needed to improve or change how people work with people with learning disabilities

• Work better together in partnership across services and teams with people, families and commissioners. This is called co-production