SPECIFICATIONS FOR COMPLEX NEEDS
What are the needs of individuals requiring accommodation and support? What Training, knowledge and skills do providers need to support these individuals?· Individuals who present with a LD and complex challenging behaviour. Can present a risk to themselves and others. A Significant number of these young people have a dual diagnosis of LD and Autism, some have experienced early trauma as a result of abuse/neglect, Sensory processing difficulties / and have diagnosed mental health issues.
Skills: /training (not exhaustive list)
· High staffing levels required
· Support must be person centred, proactive planned and coordinated
· Skilled in both the assessment of Risk and in devising and implementing Positive Risk Management plans
· Staff trained in Positive behaviour support planning
· Training in Autism, and understanding the impact of anxiety and communication and Sensory processing difficulties –This needs to be General but also understanding how the effects the individual they are supporting.
· Expertise in communicating with individuals with communication difficulties.
· Understanding the importance of structure/ How proactive support can keep someone well
· Knowledge of the MCA and HRA.: Ensure any restrictions are Least restrictive, necessary and proportionate to the risk of harm and in the person’s best interest
· Staff trained in De-escalation and breakaway techniques, and in the management of violence and aggression, including the use of restraint
· Training in administrating medication.
· Training in Trauma informed care.
· Good staff support
· Able and willing to work proactively with specialist services, including psychology, occupational therapists, speech and language therapists, psychiatry and behavioural support.
What are the needs of individuals requiring accommodation and support? What Training, knowledge and skills do providers need to support these individuals?
Individuals who have a diagnosis of ASD /FASD moderate LD:
Key Skills:
· Varying levels of direct support including access to floating support
· Practical Support with Daily living skills, including budgeting and managing finances, Social inclusion
· Preparation for adulthood: Supporting young people to develop the necessary skills to move to more independent living environment of their choosing wherever possible.
· Understanding, Autism, impact of LD and FASD
· Vulnerable to mate crime/financial and sexual exploitation
· Good understanding of Attachment difficulties/ Impulsive behaviour including risk taking
· Good understanding of MCA and HRA and supporting people in making choices
· Supporting people to make and maintain Healthy relationships – working with them when relationships breakdown
· Knowledge of the MCA and HRA. including working with COP orders : Ensure any restrictions are Least restrictive, necessary and proportionate to the risk of harm and in the person’s
· best interest
Bradford Context:
What is in place now…
· Social Work + Continuing Care working well together
· Relationships – consistent support
· Multi-disciplining/agency working shared decision making
· Detailed plans in place
· COP – focus on getting things done provided drive co-ordination
· Family involvement
· All professionals working together to secure the right physical environment
· Good formulation – team work – all clear of role/responsibility and involvement
· Evidence of some flexible approaches to working together eg carers providing support in ATU – positive outcome and support discharge
· Care Treatment Review – aid to multi-disciplinary work
· Shared responsibility encouraged confidence – not being too risk-averse
· Professional relationships – community based/Intensive Support Team/Social Work
· No blame culture developed if things become challenging
· Clear focus on individual’s need
· Commitment – finance – level of support enhances support for others
· Most providers conscious of staff well-being, respect for them, positive working environment, being responsive
· Social Workers working with staff – problem solving – “Will this work..”
Bradford Context:
Gaps in local provision.
· Disconnect between within the clinical teams - Psychiatry input – not part of team discussions/formulating plans
· Difficulty to find the right placements that are suitable
· Good environment not available
· Different perspectives – medical/social e.g. medication
· Well planned physical environment with space for family/staff/visitors/use of outdoor space
· Responsibility – damage – financial – housing provider – care provider – may hold things up – result in hospital admission
· Complexity – autism, dementia à need specialist environment
· Mismatch availability à people, building
· Providers who claim they can deliver complex packages and not!
· Flexibility of support on discharge – step up/down support
· Immediate leadership – weak/team leaders lacking confidence
Bradford Context:
Gaps in skills for providers.
Workforce development needs
· Intensive interaction
· PBS training – specific/detailed
· Safe handling/positive handling
· ABC records – monitoring
· Develop understanding of shared or 1:1 hours
· Active/engaged support
· Clear standards across the boards
· Detailed support planning shared and understood
· Quality Assurances
· Need to consider complex discharge planning from general hospital settings such as Bradford Royal Infirmary.
PROVIDER EVENT-29th January, 2018.
Specification work:
What do we need to consider to get our specification right?