A national plan to develop community services and close inpatient facilities for people with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition

Building the right support

October 2015

EasyRead

What is in this guide

1. About this guide 1

2. Why things need to change 4

3. The plan for change 6

4. What commissioners need to do 10

5. What happens next 19

6. What the words mean 20

Some words are in bold. We explain whatthey mean the first time we use them orat the end of this booklet.

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1. About this guide

The Association of Directors of AdultSocial Services (ADASS) and LocalGovernment Association (LGA) andNHS England wrote this guide.

The Local Government Associationand Association of Directors of AdultSocial Services helps local councils usegovernment plans in their area.

NHS England works with other healthand care organisations to look afterthe running of the NHS, including NHSservices for people with a learningdisability and/or autism.

This guide is about a national plan forchanging services in England.

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This means changing the way thatpeople with behaviours that challengeservices are supported.

This guide is about different people.Some people will have a learningdisability. Some people will haveautism. Some may also have a mentalhealth problem.

Mental health means how you feeland how your feelings affect you.

A mental health problem is a problemwith someone’s mind. It makes itdifficult to cope with feelings.

Challenging behaviour means peoplewho may hurt themselves or others,and who may damage things (breakwindows or smash things up).

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They may do this because they areunhappy about their service orsupport.

This is why we say ‘people whochallenge services’.

People should be able to get supportclose to home. People should only goto hospital when they really need to.

Commissioners are in charge of buyingthe right services for people.

Commissioners will use this guide toplan and buy better services to makethis happen.

You can read the full report and moreabout this work at www.(add link)

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2. Why things need tochange

More people should be supported tohave good lives in the community.

Too many people are in specialhospitals.

Many of these hospitals for people witha learning disability and/or autismhave closed.

A TV programme about a hospitalcalled Winterbourne View madeeveryone think about if enoughhospitals had closed.

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People were treated badly inWinterbourne View and things had tochange.

The government said they would moveeveryone with a learning disabilityand/or autism out of hospital whoshould not be there.

Things have changed in many parts ofthe country. But some people still haveto go into hospital to get the care theyneed.

The government’s plan is to spendmore money on people at home sohospitals can close.

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3. The plan for change

What needs to change

People with a learning disability and/orautism have the same rights aseveryone else to:

· Live where they choose.

· Get health support in thecommunity.

· Get treatment near their homewhen they need it.

· Only stay in hospital for as long asyou need to.

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The government wants to supportpeople in their homes and close somehospitals or treatment units.

They want to change things in 9 ways,we call principles.

These will make sure services are moreperson centred.

You can read more about them in theservice model EasyRead.

www.(add link)

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The 9 principles will help people say:

1 I have an interesting life that Ienjoy.

2 My care and support is wellplanned.

3 I have choice and controlabout my care and support.

4 I live in the community withthe support I need.

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5 I have a choice about where Ilive and who I live with.

6 I get good care from healthservices.

7 I get help from experts in thecommunity when I need it.

8 I get help to stay out oftrouble with the police if Ineed it.

9 If I have to go into a hospitalbecause my health needscannot be met in thecommunity, it is high-qualityand I don’t stay there longerthan I need to.

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4. What commissionersneed to do

Commissioners need to do 3 things:

1. Move people out of hospital whoshould not be there.

2. Have the right services to supportyou where you live.

3. Stop you going into hospital unlessyou really need to.

By March 2019 the government wantsto spend more money on services inthe community and less money onhospitals for people with a learningdisability and/or autism.

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They can learn from the 6 Fast Tracksites and use the ideas to changethings in their local area.

Fast Track sites are making sure thereare services in the community using£10 million of government money.

They are also looking to change theway hospitals look after people.

One of these hospitals is CalderstonesPartnership NHS Foundation Trust.

People call this hospital Calderstones.

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Some of the Fast Tracks are going tospeak to local people and change theway Calderstones works.

We expect Calderstones services tomove to the community or otherhospitals, and the Calderstones siteeventually will close.

Doing the work across England

There will be 49 Transforming CarePartnerships in England.

This means there will be groups ofpeople made up of commissionersfrom the groups in charge of localservices, these are called CCGs, localcouncils and NHS England workingtogether.

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This change means thatcommissioners and services need toget better at listening to people.

They will work with people with alearning disability and/or autism, theirfamilies, carers and all the differentservices to change care.

They will find new ways to plan andpay for services for people with alearning disability and/or autism.

Commissioners at the moment onlybuy services for a few people in theirarea.

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If they work together they can planservices for more people.

This can help them to use moneybetter and change things quicker.

They will:

· Look at what is happening now.

· Find out what is needed.

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· Write a plan for the future.

· Agree how to make this happen.

· Make the changes.

· Check how things are going.

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Checking if things have changed

Transforming Care Partnerships willcheck what is happening in their area.

They make sure that:

· The quality of life for people inhospital and community improves.

· The quality of care for people inhospital and community improves.

· The support in the community isbetter and that less people have togo into hospital.

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NHS Quality Checkers will involvepeople with a learning disability and/orautism to ask people what they thinkabout the services they use.

They will ask about things people witha learning disability and/or autism saidwere important to them.

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Paying for the changes

The government wants commissionersto spend money differently to getbetter services.

They can do this by:

· Putting health and social caremoney together.

· Spending money on communityservices instead of hospital care.

· Using the money they save whenthey close special hospitals.

If you have been living in hospital for 5years or more the NHS will give yourlocal council money for your care tomove you to a new home.

To help, the government will give localareas £30 million to change care.

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2018

5. What happens next

Transforming Care Partnerships mustwrite the plan for their area and startto make the changes by April 2016.

They must make the changes by March2019.

People in different parts of the countrywill need different services.

Transforming Care Partnerships willwork on the plan with people who useservices, carers, local people and allthe services that support them.

Each local area will have its own ideas.But they must follow the government’sguide for what should be in the plan.

We will look at how things are going bythe end of 2018. The government willcheck what has happened and see ifwe should do even more.

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6. What the words mean

AdvocacySomeone who speaks up for you or supports you to speak up foryourself.

Association of Directors of Adult Social ServicesA charity made up of the people who run social services, theywork to make social care better.

Care and Treatment Reviews (CTRs)A way of planning that stops you being sent to hospital whenyou do not need to be. It also tries to make sure that, if you dogo to hospital, it is for a short time.

CCGsClinical Commissioning Groups, the groups in charge of localhealth services.

Challenging behaviourWhen you get angry or worried and do things that upset or hurtother people or yourself.

CommissionersPeople who work for the NHS or local council and plan and buyservices.

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Fast Track sites6 places in England that are trying out the government’s ideasfor better services for people with a learning disability or autism.

Clinical Commissioning Groups (CCGs)Groups of local GPs who decide what health services peopleneed in their area and plan and pay for them.

Health Action PlanA personal plan about what you need to do to stay healthy. Itsays what you want to happen and any help or support youneed.

Health PassportA booklet you can take with you when you go to the doctor orhospital. It has information about your health and says how youwant people to communicate and support you.

Mental healthHow you feel and how your feelings affect you. A mental healthproblem is a problem with someone’s mind. It makes it difficultto cope with feelings.

Personal budgetsA personal budget is money to pay for your care. You choosehow you want to spend it to meet your assessed needs.

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PrinciplesImportant ideas to make services better that we are callingprinciples.

Transforming CareThe government’s plan for better services for people with alearning disability or autism and challenging behaviour.

Transforming Care PartnershipsCommissioners from Clinical Commissioning groups (CCGs), localcouncils and NHS England working together. They will find newways to plan and pay for services for people with a learningdisability or autism and challenging behaviour.

Credits

This paper has been designed andproduced for NHS England by theEasyRead service atInspired Services Publishing Ltd.Ref ISL 070/15. October 2015.

www.inspiredservices.org.uk

It meets the European EasyReadStandard.

It has been user-checked by theMaking It Easier Group of people withlearning disabilities.

Artwork includes material from theInspired EasyRead Collectionand cannot be used anywhere elsewithout written permission fromInspired Services.

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