Getting it right for people with complex needs: whose responsibility? David Behan, Director General Social Care Local Government and Care Partnerships.

Getting it right for people with complex needs: whose responsibility?

David Behan, Director General Social Care Local Government and Care Partnerships

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Introduction

• The role of the Department of Health in ensuring good outcomes for people with complex needs

• The DH response to Winterbourne View• Time for questions

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DH role: setting the policy framework

Valuing People Now • sets out the policy for

people with learning disabilities

• More needs to be done to support people with more complex needs

• Vision is the same as for everyone

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DH role: setting the policy framework

• Vision for adult social care• Revised Carers strategy• Reforming adult social care

– Caring for our future: shared ambitions for care and support launched on 16 September

– How to ensure quality of social care system• Equity and Excellence: Liberating the NHS - Reforming

health care

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DH role: to promote best practice

• Mansell 1 and 2• Raising our sights• Guidance on commissioning• Guidance on communication

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Safeguarding Adults: Balancing risk and regulation

•Safeguarding requires effective local coordination and participation of key agencies

•Publication of Statement of Government Policy on Adult Safeguarding:16th of May

•Statutory Boards will require membership from key agencies

•Legislation alone will not ensure people’s safety: we must support people to maintain control of their lives and make informed decisions

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DH role: setting outcomes

• Outcomes frameworks

• What does good look like?– Good person centred plans– Creative commissioning of services– Involving people and families– Personalised services– The right staff mix– Flexibility on budgets

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Role of commissioners

• Commissioning for quality services:– Developing personalised services that meet people’s

needs– Involving service users and families– Improving local service development and alternative

models of provision– Reducing out of area services– Developing expertise in challenging behaviour– Understanding need– Using the Health Self Assessment Framework to

monitor outcomes

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Role of providers

• Providers have a duty of care:– Demonstrate leadership and supervision – Good clinical governance– The right staff levels and skills mix– Training –eg positive behaviour support– Monitoring quality and safety of care– Developing the market for alternative provision

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Role of professionals

• Providing and commissioning quality care and support:– Training in working with people with complex needs– Person centre planning – Integrated care pathways– Monitoring individual’s progress – Reviewing plans– Safeguarding– Whistleblowing– Good understanding of Mental Capacity Act/Mental

Health Act interface and human rights

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Role of the regulator - CQC

• Registration• Inspection - assuring

compliance with the essential safety and quality requirements

• Revised whistleblowing procedures

• Monitoring the operation of the Mental Health Act 1983

• Undertaking special reviews and investigations

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Local delivery

What are the levers to encourage good practice at a local level?

– Role of Learning Disability Partnership Boards

– Health and well being boards

LOCAL AUTHORITIES

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Winterbourne View

• Panorama TV programme on 31 May showed shocking abuse

• Owned by Castlebeck Care • 51 people in total have been

there• Now closed

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Government Review

Led by Bruce Calderwood -

Department of Health

With help from:• Mark Goldring – MENCAP• Prof Jim Mansell• Anne Williams, former National Director for learning

disabilities.

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Government reviewMany Strands:• Police Investigation

– 11 arrests• Care Quality Commission

– Internal review– Review all Castlebeck Care

services– Wider review of 150 other

learning disability hospitals• Serious Case review• Castlebeck Care internal review• NHS Review

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Department of Health Review

• Will look closely at all the investigations and reports – at why this happened

• A report on what is found.

• Recommendations to make changes

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Department of Health Review

What we are doing:• Talking to people about the

review:– People with learning

disabilities, autism and families – commissioners, health and

care professionals, providers and the Care Quality commission

– other stakeholders• Looking at the evidence

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Department of Health Review

• Too soon to make recommendations till we have all the facts

BUT

• Do want to get your views on:– Emerging issues– Making a real change in

the model of care

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June Aug SeptJuly Nov

2012

DH Review - Winterbourne View – Key milestones

2011

Ca

stl

eb

ec

k C

are

CQC Internal management review

DecOct Feb March

Reports on Winterbourne View and 23 other Castlebeck Care services published

Jan

Internal Management Review

SU

IS

eri

ou

s C

as

e

Re

vie

w

Report end September to feed into SCR and DH review

CQC national report

ToR published Expert Panel 1st meeting 5th September

Clinical review

Phase 1: review of 150 LD services

CQ

C

CQC Wider Review of LD services

Phase 2 evaluation : alternative provision

NHS Serious Untoward Incident Review

Serious Case Review

DH

Re

vie

w

Final report and timetable dependent on police prosecutions

DH Review

Final report and timetable dependent on SCR etc

Reports to Ministers

Po

lic

e a

nd

C

PS

Police investigation and CPS prosecution

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Questions for the review

What are the changes you would like to see?

• For the people who use services and their families?

• For the people who buy services – for commissioners?

• For services like Castlebeck?

• For the Care Quality Commission?

Do you have any other comments for the DH review?

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Contact the DH Review

[email protected]

DH Review - Winterbourne View

221 Wellington House

133-155 Waterloo Road

London

SE1 8UG