gavin presentation (2)

8/20/2019 Gavin Presentation (2)

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Gavin HardingLearning Disability Adviser - Improving Lives

Team & Best Care Now Support Team

NHS England

Learning the Lessons, Improving

Lives & ensuring people receive theBest Care Now


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“All those people...

All those lives...Where are they now?”

Morrissey (1986)


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So...

What have we learned?

What’s changed?


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Every decade

since the 1970’s there

has been a national scandalinvolving the care of people

with learning disabilities


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1970’s – ElyHospital, South

Ockendon,

Farleigh,

Normansfield...

1980’s - St Lawrences Hospital,

Borocourt, Rampton...

1990’s - Longcare /Stoke place...

2000’s – Cornwall, Sutton &Merton, Atlas Care,

Winterbourne View...


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Death by Indifference...

Confidential Enquiry

(CIPOLD)...

Healthcare for All...

Six Lives...

Death by indifference - 74

deaths and counting...

Reports of Preventable Deaths


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Are we a profession

with a memory?


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Are we harnessing and

deploying all the

learning we possess inorder to ensure we

prevent a recurrence of

past failings?


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Are we truly the Leaders that we profess;

or are we merely Followers?


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WHO LISTENS?

When we

suggest change?

When we

suggest a

new idea?

When we

complain?

When we

blow the

whistle?

When we

challenge?

When we

won’t

collude??


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What does GOOD (enough) look like

for people with learning disabilities?


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Good

enough?


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For many people inhospital, restraint

and seclusion is

used too readily.Often in the

absence of otherinterventions...Good

enough?


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People with learning

disabilities experience

much higher rates ofprescribing of

psychotropic

medication, often with

no clear justification

and they take these

medications for long

periods without

adequate review.

Good

enough?


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Many people in

hospital are not in receiptof active treatment and do not

know when they are likely to be

discharged.

Good

enough?


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For many people who have close family ties, they end

up being placed miles away from home. In many cases

the persons family are not actively involved in

decisions about their loved ones care.

Good

enough?


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Huge inequalities

continue to exist forpeople with learning

disabilities, with

avoidable

contributory factors

having led to

hundreds of

premature deaths.

Good enough?


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For many people with learning disabilities placed

in specialist hospitals, communication and

engagement from their local services is very poor.

Good

enough?


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Are WE really doingeverything we can

to ensure the

people we supportand care for; lead

full & meaningful

lives?


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‘Stop telling us what

we already know!’

We would, but...

All of the previous slides remain a

reality for many people with

learning disabilities, their families

and carers...

Until we get things right and reallyachieve our ambitions, the issues

will remain...


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Reviewing Lives

To date, the Improving Lives Team and Best Care Now

team have undertaken over 120 reviews.

In addition, multiple Care & Treatment Reviews (CTR’s)have been carried out across the country .

The findings of these reviews have identified many

of the themes we have mentioned previously.

They also highlighted some novel and creative

practice and saw many people having a good life.


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All of the solutions are

out there...

But rather than bore you with bar charts & graphs...

Here are Seven Great Realities


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Reality Number ONE

Measured, well supported,

flexible risk taking enabled

Mary to be reintegrated and

start to enjoy meaningful

pursuits again. Prior to this,she had been living in long

term segregation for 4 years.


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Reality Number TWO

Genuine, wholesome

co-production

made all the differencewhen bringing together

all the different

knowledge people had

about Lucy and howbest to approach her

move to the

community.


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Reality Number THREE

Bringing together lots

of local stakeholders

to map out what local

capability andcapacity looked like,

really helped when

planning for a group

of people who hadchallenging and

complex

needs/’reputations’.


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Reality Number FOUR

Truly understanding and

implementing Positive

Behavioural Support in

order to build detailed

person centred

approaches,

significantly improvedJaved’s quality of life

and helped in the design

of a robust support plan


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Reality Number FIVE

Using effective

person centred

thinking and planningapproaches to create

a step-wise route to

employment, proved

extremely successfulfor Joanne who now

works full time in a

local restaurant.


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Reality Number SIX

Delivering intensive

support as part of an

integrated servicemodel helped to

prevent unnecessary

admissions to hospital

and develop muchmore flexible

approaches within the

community.


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Reality Number SEVEN

Where inpatient services

had clearly defined

pathways of treatment,interventions and

measurements of

outcomes, individuals

length of stay was shorterand discharges were

more successful.


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What’s your reality?

1) Practical Risk Taking

2) Meaningful Co-production

3) Knowing Capability and Capacity

4) Proper Positive Behavioural Support

5) Effective Person Centred Approaches

6) Available & Responsive Intensive Support

7) Clearly Defined Pathways

?


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Thank you for listening

Gavin HardingLearning Disability Adviser - Improving Lives

Team & Best Care Now Support Team

NHS England

[email protected]

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