Essex Learning Disabilities and Autism Transformation Programme:

Meaningful Lives Matter

Who are we? Jessica Stewart - Head of Strategic Commissioning and Policy Learning

Disabilities (LD) and Autism

Lindsay Darby- Team Manager- Enhanced Social Care Support Team for with LD and Autism- In-reach

Victoria Rendel- Deputy Team Manager- Behaviour Advice- Enhanced Social Care Support Team for Adults with LD and Autism- In-reach

Amber Stevens- Team Manager- Enhanced Social Care Support Team for Adults with LD and Autism- Out-reach

Slido

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#MLM

“what does a meaningful life mean to you?”

The Meaningful Lives Matter (MLM) programme aims to improve outcomes for people with learning disabilities and/or autism by changing the approach to their support.

People with learning disabilities and/or autism want to lead meaningful lives and do the things that most people take for granted. They want to go to the local shop, study at college, get a job, have relationships and friendships and enjoy leisure and social activities

The Essex Adult Social Care vision:

“For every adult to be able to live as independently as possible and to enjoy a good and meaningful life”

Meaningful Lives Matter

“People with a learning disability and/or autism should thrive in their community, have a place to call home, someone to love and be loved”

Meaningful Lives Matter Programme

Commissioning Meaningful

lives

Market Shaping and

Engagement

Health and Integration

Whole Life Pathways

Transforming Social Care

Programme structure – 5 key workstreams

Essex Learning Disabilities and Autism 100 Day Challenge

What Changed for people who took part: from support to collaboration

Who is Nick?Nick Bunyon is an apprentice within the LD&A Commissioning Team. He has autism and moved into the Goldlay Square Supported Living Scheme last year for young people

What is Nick’s rule? Nick has been working on the LD&A 100 Day Challenge and is a member of the leadership team. He developed “Nick’s Rule” based on the principles of the 100 day challenge – a bottom up process to spark innovation and testing of ideas which inform greater commissioning and delivery decisions. Nick thinks that everyone should follow this rule to flex governance and allow change for the better. The 100 Day Challenge leadership team agree and are thinking about how Nick’s rule can be made sustainable to continue the great work that is happening.

Nick’s rule

All ideas are heard

Everyone has voice

Decisions can be made by people who are not in the most senior positions

People have the freedom to carry out their ideas

People have the resources to allow them to carry out their ideas and plans

Small audit by NDTi of social work a targeted review was commissioned to understand more about the culture and practice changes needed to reach our vision and ambitions.

Peopletoo worked closely with the social work teams including interviews, audits and workshops. The following 6 themes were identified

o KEY THEME 1: STRENGTHS BASED PRACTICE o KEY THEME 2: RISK ASSESSMENT AND POSITIVE

RISK TAKING o KEY THEME 3: ENSURING COST EFFECTIVE

SOLUTIONS AND BEST VALUE FOR MONEY o KEY THEME 4: PROPORTIONATE RESPONSE AND

MAXIMISING USE OF RESOURCES o KEY THEME 5: AN ENABLEMENT APPROACH o KEY THEME 6: RECORDING, DOCUMENTATION,

PROFESSIONAL PRACTICE AND LEGAL COMPLIANCE

PeopletooWhat did Peopletoo find?

Positives(The Good)

Engaged, passionate and committed staff group

Good leadership

Quality Supervision

Natural peer support and mentoring

Culture of learning

Good practice – outcomes achieved, quality of work and recording, legally compliant

PeopletooAreas of Focus(The Bad)

Need to further develop strong Strengths Based Practice

Develop confidence in Risk Assessment & Positive Risk Taking

Assure Best Value and Cost Effectiveness are part of any care and support

Proportionate Response and Maximising Use of Resources

Enablement Approach

Recording, Documentation, Professional Practice, Legal Compliance –related largely to evidence that the right legislative framework is used

Peopletoo

Next Steps (The Ugly, ie. The hard work starts here )

A revised continuous professional development offer across the frontline staff including focus on the Recovery Model

Practice forums that provide a sounding board for staff as they formulate how best to drive independence for the adults

Meaningful Lives Matter 2019TU in 2018❑ Living in hospital

❑ Detained under MHA

❑ Significant restrictions on his movement

❑ Sharing a ward with a number of males with a range of different needs

TU in 2019❑Has his own front door

❑ Is out in his local community

❑ Is looking for paid employment

❑ Is volunteering at a number of schemes

❑ Is growing flowers and vegetables in his garden

❑ Is maintaining a bench in remembrance of his friend

❑Co-produces and leads his own meetings

Meaningful Lives MatterCommunity Care Live 2019

DRIVE

We want adults with a learning disability/autism to live their best life

STRIVE

In order to achieve this we need open conversations and co-production with our workforce, the adult/advocates and families and even closer partnership working

THRIVE

The outcome will be that people with a learning disability and/or autism will thrive in their community, have a place to call home, someone to love and be loved.

Positive Behaviour Support (PBS) 10 staff members embedded in social care rather than health, with a

strong ECC commitment to the PBS model

Qualified in Intellectual and Developmental Disabilities (Tizard)/ PBS

Use the principles of Positive Behaviour Support and Applied Behaviour Analysis in role

Core work - behaviour assessments, service specifications, review support levels , working alongside social workers toward the best outcomes with a whole life pathway approach.

PBS is now in guidance (NICE/ DOH)

http://www.bild.org.uk/capbs/pbsinformation/introduction-to-pbs/

Transforming Care Provision Project

Identified Transforming care cohort of individuals in hospital with opportunities to move back into their community

Health and Social Care commissioners worked together alongside behaviour advisors from the inception of the project, consulting on the environment

Careful transition planning including health and social care teams, social workers, mental health practitioners.

Use behaviour advisors service specifications to consider triggers, behaviour support strategies and support PBS plan.

Current early outcomes, e.g. Able to build own bbq, own gardening area/ vegetable patches, voluntary jobs with a view to obtaining paid employment

Supported Living Scheme Reviews

Reach Standards for Supported Livinghttp://www.paradigm-uk.org/reach-standards

What is Supported Living in Essex?

A living environment with an element of shared core day or night support available to meet the needs of the tenants

A cluster of single occupancy units which are grouped together either within a purpose-built block or defined area or a shared house or bungalow where tenants have their own bedroom but share every other part of the property

All properties are tenancy based, with the landlord separate from the support provider.

What are Supported Living Scheme Reviews? Reviewing all adults in the same scheme at the same time- spending time getting to know the

adults, provider and home situation well

Working alongside adults and their support networks to identify assets, strengths and ambitions

Information gathering to enable evidence based plotting of individual needs across the scheme

Identifying how shared core support can be utilised to maximise independence

Identifying individual support to meet person centred outcomes

Clear proposals for any re-modelling of support (which can include contracts and commercial teams involvement)

Person Centred Tools

Helen Sanderson Tools:

Good Day Bad DayPerfect WeekRelationship CircleWorking Not Working

http://helensandersonassociates.co.uk/person-centred-practice/

Building relationships which inform person centred assessments and planning

Individualised support which is focussed on outcomes and progression

Use of shared support which is flexible and responsive- giving greater control to the adult

Working alongside providers to develop support which maximises independence and embraces positive risk taking

Outcomes through Scheme Reviews

Technology & Supported

Living Scheme Reviews

Just Checking

Safer Walking Technology

Ring Doorbell

Property Exit sensors

Fall detectors

Epilepsy sensors

Mobile phones

Apps around fitness, health and wellbeing

Smoke, flood, heat, Co2 ……………..

Virtual digital assistants ( Google/Alexa etc)

Positive risk takingAnna -34 years old has Autism and a mild learning disability.

Anna’s experience of growing up was very traumatic suffering physical and emotionalabuse and include concerns relating to risks of sexual abuse into adulthood

During her childhood it appears Anna was told by her parents that she would be cured ofautism once she grew up and got married. Anna has ‘concrete thinking’ and this deep-seated belief resulted in her developing high-risk behaviours to attract a boyfriend. Shewill approach strangers offering sex in the belief they would become her boyfriend, shewould get married and be cured of autism

Anna lives with her own tenancy in supported living. She has developed skills in manyareas associated with independent living and has consistently requested to live moreindependently; Anna agreed to support when accessing the community but wanted towork towards going out alone and being able to keep herself safe

Positive Risk Taking and Assistive Tec

Anna was supported by her staff team to develop self-management skills. Tools including social stories and pictorial aids were used to help Anna understand how to keep herself safe.

An ‘arms’ length’ approach with trips to the local supermarket; staff waited in a local café whilst Anna shopped independently. Anna always returned at the agreed time, no incidents.

Anna wanted to go to the local shops on her own she was central to the planning, agreeing to phone support workers to confirm when arriving and on her way home

Anna wanted more time in the community and to travel further . Safer walking technology (GPS) was explored. Anna led on an agreement around how this would be used. There have been no incidents, next step to review if the safer walking technology should continue

What Anna thought….

This approach:

o Supported positive risk taking

o Enabled increased independence

Anna has greater control over her own life, is more confident in her skills to manage risky situations and is driven to live as independently as is possible.

Thank You!

Questions and Answers………