Learning Disabilities Partnership Board

Health Sub Group

Notes of the Health Sub Group meeting

Held on 2nd June 2011

North Huyton Primary Care Resource Centre

Present:

Johanna Lee / Clinical Lead Nurse: LD Team, Knowsley Integrated Provider Services (KIPS)
Rachel Mayner / Health Facilitator/Community LD Nurse: LD Team, KIPS
Michelle Standing / Engagement & Involvement Manager: KIPS
Lorna Pink / Speech & Language Therapist, Knowsley LD Intensive Support Team 5 Boroughs Partnership Trust
Barry Kelly / Service Manager, Local Authority Adult Provider Services
Ray Cleary / Locality manager Brothers of Charity
Lisa Woods / Self advocate: Being Involved Group
Sarah Jones / Community LD Nurse, LD Team KIPS
Jan Peet / Service Manager: Local Authority Adult Provider Services/KMBC /PCT
Stuart Sheridan / Project Officer: Knowsley Integrated Commissioning Team
Tracy Henry / Lead Service Manager: Community Integrated Care Ltd (CIC)

Apologies:

Paul Jones / Service Manager: Brothers of Charity (BOC)
Michelle Lawlor / Community LD Nurse, LD Team, KIPS
Christine Gibson / Community LD Nurse: LD Team, KIPS
Joyce Duckworth / Manager KDC
Katie Hardaker / Development Worker: Being Involved Group
Jill Lockett / Team Manager Community Partners Knowsley
Gary Worrall / Nurse Team Leader, LD Team, KIPS

1.  Welcome, introduction & apologies

.

2.  Notes of last meeting: matters arising: reviewed and all agreed correct

3.  Engagement and Involvement:

Michelle Standing explained to the meeting that she is the Manager of the Engagement and Involvement Service in Knowsley Integrated Provider Services (KIPS) @ 5 Boroughs Partnership NHS Trust. She is currently scoping out what is happening regarding engagement and involving in KIPS services.

If appropriate she would like to work in partnership with relevant learning disability (LD) services to ensure that people with learning disabilities, families and carers are involved in consultation and engagement regarding health and health services. Michelle explained that she can also give advice and support to the LD Partnership Board Health Sub Group and other LD services regarding consultation and engagement.

All the members of the meeting agreed this was appropriate and relevant given the DOH national agenda regarding inequalities in health and learning disabilities advocates that people with LD’s, their families and carers should be consulted and involved in decision making regarding NHS health services. Lorna explained that soon there will be a consultation taking place in Knowsley. This is commissioner led by Debra Lawson Knowsley LD Commissioner in partnership with Karen Green from the 5 Boroughs Partnership NHS Trust. The consultation will be around the proposed new ‘Model of Care’ which includes delivering hospital in patient bed services in the community. This will involve a transfer of current in-patient unit services from Willis House in Prescot to the Byrom Unit in Warrington: with a reduction in beds from eight to two. Lorna suggested it may useful to contact Debra to see if it is appropriate for Michelle to be involved in this consultation. Michelle agreed to do this.

Barry explained that it would be useful to have the support from Michelle to work with LD services to explore various methods to engage with people with LD’s, their families and carers. Discussion took place regarding various methods of engagement: survey, focus groups, 1-1 etc including appropriate local venues and how to capture the views of individuals with LD’s, their families and carers who do not and cannot attend various consultation events, yet want to express their views and opinions. Michelle agreed she can support services with this work, she also agreed to be a member of the LD Partnership Board Health Sub Group.

Actions /
By
Who?
Terms of Reference, dates of future meetings to be sent to Michelle. / Johanna
Contact details of Debra Lawson & Karen Green to be given to Michelle. / Lorna

4. Whiston Hospital Discharge Policy:

Johanna informed the group that Phil Dearden, who is Head of Clinical Flows and the chairperson of the LD Pathway Group in Whiston Hospital has sent out the current policy. This policy has a section in it on learning disabilities. Phil has requested that Knowsley LD Partnership Board and the Health sub group review the policy and make comments and give him feedback.

Actions /
By
Who?
Knowsley LD Partnership Board Health Sub group members to review the Whiston Hospital Discharge policy and send any comments to Phil Dearden via
Policy to be resent to members with notes of meeting / All members
Johanna

5. LD CQUIN: Commissioning for Quality and Innovation for Knowsley Integrated Provider Services (KIPS)

Stuart and Johanna explained to the meeting that a CQUIN is a national payment framework for local agreed quality improvement schemes. It is agreed between commissioner and provider with active clinical engagement. It encourages a continuous quality improvement. It is a one off payment which should see clinical outcomes and improvements embedded into patient clinical activity. The Knowsley LD CQUIN is reasonable adjustments.

Johanna further explained that Sue McGuire Head of Performance andBusiness Development in KIPS has requested support from her to enable KIPS services to implement the LD CQUIN.

Therefore Johanna has worked with Rachel to develop a ‘reasonable adjustments checklist’ for KIPS staff to incorporate into their patient recording system (PARIS). This will support them to ’flag’ , identify and track the patient journey as well as having a recording system to evidence any reasonable adjustments they make when e on the role of chairperson, co chairperson and vice chairperson.

Johanna and Rachel are really pleased and excited about the LD CQUIN. They both feel this is a really good thing for people with LD’s, their families and carers; it will further assist to address the health inequalities agenda and further improve access to health care services.

6. Care Quality Commission (CQC) Framework for Knowsley Integrated Provider Services (KIPS) Johanna explained that all services in KIPS are required 3 monthly to complete a CQC framework for KIPS clinical governance department. Within that framework services need to evidence compliance. Johanna and Rachel have recently worked with the CQC lead and have added a section to the framework: ‘reasonable adjustments’ and learning disabilities, and made some amendments to the consent section. This means that all KIPS services will be required to evidence how they comply with putting reasonable adjustments in place for people with learning disabilities.

7. Learning Disability (LD) Health Self Assessment Framework: NHS North West: this framework was initially part of Valuing People Now 2009. The North West LD Health Equalities Group (NWHEG) was set up to support and monitor improvements in the health of people with LD’s across the North West. They also make sure that the Health Self Assessment process was carried out. The members of the Board are health professionals, people with LD’s and their families and carers.

Each PCT nominated a lead to be involved: the lead for Knowsley is Stuart; Johanna supports him to ensure the information required is collated. The framework requires each health service area to provide information about the services they buy and provide for people with learning disabilities. The information will also help people providing health services to understand how well they are working and what further work needs to be done.

Stuart outlined what data is required to complete the framework. There will also be a ‘Big Health Check’ day whereby relevant services and people will be invited to help gather the information. This day will likely be in the last two weeks in July. Submission of the information to the North West HEG is required by end of September.

Johanna suggested sending out letters to health services: public health service, hospitals, GP’s, Primary Care Team etc giving details of the Health Self Assessment and reasons why the requested information is needed.

Actions /
By
Who?
Letter to be sent to all Knowsley health care services giving details of HAS and information required. / Stuart
Big Health Check date to be sent out / Stuart

8.Training: Jan and Barry discussed that there are a lot of people coming through transition and other people with LD’s who have complex health needs and the staff in supported living and day care provider services require further knowledge and skills to competently work with them. Due to the complexity of the health needs the required training / awareness / education sessions include management of:

·  Diabetes / BM

·  Stoma care

·  Enteral feeding

·  asthma

Jean Perkins from KMBC training department is liaising with relevant services / clinicians to facilitate this training

Jan and Barry have also met with Johanna and Jean to agree training that will be developed and delivered by the LD nursing team. Dates have been set for:

·  Epilepsy

·  Buccal midazolam

·  Supporting people with LD’s to access health ( HAP’s / Health Passport/LD awareness session)

Further sessions need to be developed with dates set for:

·  Self Harm & LD

·  LD Awareness session (probation, police, etc) needs to be developed and delivered as a joint LD Health & Social Team.

Gaps in training required for service providers include:

·  Behaviour

·  Autism

·  Dementia & LD

·  Mental Health & LD

·  Communication:

Discussion took place regarding the need for all training to be standardised and embedded in service contracts to ensure staff in care provider services are competent, skilled and attend relevant required training. Without this often incidents / behaviours that challenge services increase thus referrals to the LD team. It was agreed that it would be useful if service contracts ‘prescribe’ what training services should have and it would be essential to have a monitoring system in place.

A query was raised if there is any recorded evidence with the safeguarding team via incidents raised as a result of challenging behaviour

Actions /
By
Who?
Discuss with Linda Crawley Head of Safeguarding if there is any record of incidents relating to behaviour. / Jan
Discuss with Debra Lawson commissioner if there are standards in service provider contracts relating to training for staff in services. / Stuart
Communication training to be re provided to Knowsley LD services. Discussion required re planning. / Lorna, Barry, Jan

9. Health Sub Group Action Plan: this has been reviewed and updated to reflect current work.

Actions
Send out the action plan to all members. / By
Who?
Johanna

11. Any other business:

KPAC: Lisa explained to the meeting that she is a member of this group. The group meet every Tuesday 6-8pm at the Old School House. The group would like someone from the Health sub group to attend a future meeting to let them know what is happening in Knowsley to improve the health and well being of people with LD’s in Knowsley.

Discussion took place about the recent Panorama TV programme which showed abuse and neglect of adults with LD’s in a care setting. It was agreed that this will and has caused concern and anxieties for families and carers in Knowsley and it may be useful if Knowsley issued a global statement regarding open policy.

Actions
Contact Helen or Graham on 0151 481 0047 for further information / By
Who?
Johanna
Feedback concerns to line managers / All members

12. Date and time of next meeting: Thursday 1st September 9.30 to 11.30

Venue: upstairs meeting room in North Huyton Primary Care Resource Centre, Woolfall Health Avenue, Huyton, Liverpool L36 3TN.

7

Partnership Board Health Sub Group notes 2nd June 2011