Learning Disability Partnership Board in Surrey Minutes of our May 2015 Meeting. Chaired by Debbie Taylor and Lisa Nash. Held at Leatherhead Leisure Centre 9.30am 12.30pm At our May 2015 meeting we talked about: Assessment and Treatment Services Dr..Karen Dodd updated us Acute Hospital Liaison Service Lynne Ramnanansingh updated us. Updates from Partnership Board members. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 1
Assessment and Treatment Services Dr. Karen Dodd updated us about this subject Karen is a Co-Director of Services for People with Learning Disabilities for Surrey and Borders NHS Foundation Trust This is a very important subject because of what happened to people with Learning Disabilities who lived at Winterbourne View. People with learning disabilities were badly abused at Winterbourne View. Many people had lived at Winterbourne View for a long time. This was wrong. It was an Assessment and Treatment Unit. People should have only stayed there a short time. We have been planning the future for our Assessment and Treatment services in Surrey. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 2
These are the main issues about Assessment and Treatment Units. They should not be people s homes. People should only be there if they really need to be. People should be assessed and treated in their own homes wherever possible. There should be far fewer people in inpatient beds. Better support should be given in the community for people with the most needs like behaviour that challenges and mental health problems. NHS England have told us: That Care and Treatment Reviews need to be held for all people in inpatient units who don t have a date for leaving. That we need to reduce the number of inpatient beds. X That the community support needs to be Improved. P The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 3
We need to give extra support to some people people in their own homes. People may need extra support because: They behave in a way that challenges others. They have mental health problems. If people don t get the extra help they need they could have to move out of their home. X We call this extra support Intensive Support Services. This is a team who visit people at home and give them the support they need. This will help to make sure people can stay at home and not have to move into an inpatient unit. The team works evenings and weekends as well as daytime hours. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 4
Surrey and Borders Partnership NHS Foundation Trust has two inpatient units. April Cottage has 7 beds for Surrey People It is an Assessment and Treatment Unit. It s near Gatwick Airport and the building is not good. We are moving it to Epsom. The building is bigger, been redecorated and all the bedrooms will have their own toilet and bathroom. We hope to move by the end of the year. Bramdean is a 7 bed Step Down unit It is in Staines. People should stay for a short time before moving to a community placement. All the people there are ready to move out. They should have moved out before now and do not need intensive support. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 5
Surrey and Borders Partnership NHS plan for the future. We plan to close Bramdean and use the money to support people better in the community. We will set up an Intensive Support Service. This is a team of people to support people in the community. We will make the Community Teams for People With Learning Disabilities better. The new April Cottage will open in Epsom to offer inpatient beds for people who need them for a short while. This diagram shows how our service would work in the future. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 6
Partnership Board Members Feedback Should the new April Cottage have a new name? Barry Hobbs suggested that April Cottage should have a new name once the service opened. He said some people may have bad memories of the old service from the past. Who will work for the new Intensive Support Service? Dr. Karen Dodd explained that: We don t know how many staff there will be. They would work evenings and weekends as well as office hours. The team would have nurses, support workers and behaviour specialists in it. They would be supported by therapists. The Commissioners are supportive. Antony McCallum explained that: This change means that health and social care commissioners will need to work closely together. People agreed that organisations who provide housing and support service are important. They need to understand about the Intensive Support Service and refer people to it when they need extra help. We need providers of these services to get better at supporting people who may need extra support. It s important providers only take on supporting people they have the ability to support. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 7
Partnership Board Members Feedback Involving advocacy groups. David Muir explained that advocacy groups should have a say. Dr. Karen Dodd agreed and said this needs to be done quickly. Barry Hobbs said he would discuss it at the advocacy groups this month. NHS Buildings. Antony McCallum explained that NHS Buildings used by housing providers are hard to change. Planning takes a long time. Andrew Price said he has been working with NHS England and NHS Properties to make this process easier. Involving family carers. Lesley Wilson told us that a family who used April Cottage has been involved in these plans from the beginning and other families have been involved too. Partnership board members then talked further about what they thought about the changes in small groups. Their views are explained on the next page. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 8
Small Group Feedback Partnership Board members commented about the plans to close Bramdean. People supported the idea of closing Bramdean and using the money to develop the Intensive Support Service. People we worried that Surrey did not have enough housing and support providers who could offer services to people whose needs are more complex. Houses are very expensive in Surrey There is a concern that this lack of providers could lead to people having to be placed in services outside of Surrey. It is more expensive to set these services up in Surrey because houses are very expensive and staff costs are higher. People can contact Dr.Karen Dodd with any comments they have about these plans Phone: 01372 205767 Email: DrKaren.Dodd@sabp.nhs.uk Address: Dr Karen Dodd, Co-Director of Services for People with Learning Disabilities, Associate Director for Therapies - Learning Disabilities, Surrey and Borders Partnership NHS Foundation Trust Ramsay House, West Park, Horton Lane,Epsom, Surrey KT19 8PB The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 9
Acute Hospital Liaison Service Lynne Ramnanansingh updated us about this work. The Acute Liaison Services covers all five Surrey hospitals. Royal Surrey County Hospital Lauren Bowler is the full time Liaison Nurse at this hospital. Epsom General Hospital Sarah Lalljee is the part time Liaison Nurse at this hospital. East Surrey Hospital Sarah Lalljee is the part time Liaison Nurse at this hospital. Frimley Park Hospital Collette Meredew-Lynch is the part time Liaison Nurse at this hospital. St. Peter s Hospital Collette Meredew-Lynch is the part time Liaison Nurse at this hospital. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 10
The Acute Liaison team did an evaluation of their service. They found out how many people with learning disabilities went to each hospital during 3 months in 2014. We need a surrey wide agreement about collecting figures as we couldn t get figures from one hospital. How many people had a stay in hospital? Royal Surrey Epsom General Frimley Park East Surrey St.Peter s 49 people 47 people 60 people 233 people Unable to get figures. How many people had a hospital appointment? Royal Surrey Epsom General Frimley Park East Surrey St.Peter s 280 people 325 people 109 people 377 people Unable to get figures. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 11
How many people visited Accident & Emergency? Royal Surrey Epsom General Frimley Park East Surrey St.Peter s 92 people 67 people 29 people 109 people Unable to get figures. The evaluation asked for feedback from lots of people. People with learning disabilities visited hospitals to do peer reviews. Family carers were involved. Other nursing staff and social care staff gave their views. We looked at the experiences of 10 people that each Liaison Nurse supported. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 12
What we found out about the Liaison Nurse Service at Royal Surrey County Hospital What is going well We have a good office base at the hospital. We work well with the senior nurse team at the hospital. Our liaison nurse is invited to steering groups for safeguarding, dementia, and the learning disability group. We give training to health care assistants, nurses, midwives, junior doctors and consultants. We receive a lot of referrals. What needs to be better? We need to get better at collecting figures about numbers of people with learning disabilities using the hospital. We need to make sure we work more with people with learning disabilities who have Outpatient appointments. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 13
What we found out about the Liaison Nurse Service at Epsom General Hospital What is going well We have good access to computers and the internet. Our liaison nurse goes to the safeguarding steering group. We get a lot of inpatient referrals. We train health care assistants and therapists. We have been doing work on hospital signage. What needs to be better We have a temporary office.? We need to go to other hospital steering groups. We need to train doctors. We need to get better at collecting figures. We need to offer more support to people who have Outpatient appointments. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 14
What we found out about the Liaison Nurse Service at East Surrey Hospital What is going well We give training to junior doctors, therapists, nurses and health care assistants. Our liaison nurse goes to the safeguarding steering group and other steering groups. We have good links with special care dentistry. We run afternoon tea feedback sessions. What needs to be better We need to get more people to make referrals to our liaison service.? We need to get better at collecting figures. We need to be training Consultants. We spend a lot of time advising people on the Mental Capacity Act. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 15
What we found out about the Liaison Nurse Service at Frimley Park Hospital What is going well We give training to junior doctors, midwives, nurses and health care assistants. Our liaison nurse goes to the special needs meeting. We take part in Skills Blitz days. We have good links with occupational therapists and the Dementia Nurse. What needs to be better We need to have better computers.? We need to go to more acute hospital meetings. We need more referrals to our service. We need to train Consultants. We need to link better with senior nurses. We need to get better at collecting figures. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 16
What we found out about the Liaison Nurse Service at St. Peter s Hospital What is going well We give training to junior doctors, nurses and health care assistants. Our liaison nurse goes to the Equality & Diversity, Disability Awareness and Safeguarding meetings. We take part in events like communication events. What needs to be better We need to have better access to computers.? We need an office base at the hospital. We need more referrals to our service. We need to train Consultants. We need to get better at collecting figures. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 17
Lynne told us about other things the evaluation found out. Helping more people use the Liaison Service There are people with learning disabilities who go to hospital who the liaison service do not know about. It helps having the liaison nurse based at the hospital. There are fewer referrals when the nurse is not at the hospital. The liaison team need to have good computers, internet and links with senior nurses at the hospital. The Liaison service gets very good feedback from people it supports 96% of people said the service was very helpful and the other 4% said it was helpful. We need to work on our training We need to involve people with learning disabilities and train Consultants. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 18
We need to get better at collecting facts and figures about people with learning disabilities in hospital We need to make sure we collect figures the same way at each hospital and get the information on time. We need to make sure the figures are accurate. Each hospital has a flagging system to let them know when a person has a learning disability. Lynne told us about things that should happen in the future. These are recommendations from the evaluation. Each hospital should have one full time Liaison Nurse as a minimum. The nurse needs an office base at the hospital with a good computer and internet access. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 19
These are recommendations from the evaluation. There should be a proactive approach to referrals, we are looking into using a Choose and Book system. The Liaison nurses need to work closely with senior nurses and safeguarding leads in each hospital. Review how we ask people s consent for hospitals to flag that they have a learning disability. Train all levels of staff at the hospitals and involve people with a learning disability. Develop a local learning Disability Steering Group with acute hospitals and Clinical Commissioning Groups involved. Work more closely with work happening across the UK. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 20
Partnership Board members comments and questions about Lynne s presentation. Do the Liaison nurses get involved in Discharge Planning? Yes, we do get invited to discharge planning meetings. How will you make sure you are aware of people with learning disabilities when they go into hospital? We are working with GP s around making sure the codes of their computers are correct. We are also making sure GP s mention in their referral letters to hospitals that the person has a learning disability. Antony McCallum thanked Lynne and her team for all their hard work which is having a positive impact. How to contact the Acute Liaison Service. If you, or someone you care for is visiting one of Surrey s hospitals please contact the learning disability acute liaison service. Contact Lynne Ramnanansingh: Phone: 07717 850309 Email: lynne.ramnanansingh@nhs.net The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 21
Updates from members Mike Leat updated us about the Surrey County Council Transport Survey. The project team are proposing that there will be no changes to how people can use their disabled bus passes. These proposals need to be agreed by the Surrey County Council Cabinet. People would still be able to travel free before 9.30am and use their companion pass. There are some changes proposed to bus routes. To find out more go to: surreycc.gov.uk/transportreview The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 22
Surrey Police Disability Awareness Training. Debbie Taylor told us that eight members of the Surrey Self Advocacy network did four workshops with Surrey s Police Officers to help them to understand people with learning disabilties. We shared our own experiences of the problems we ve had. We showed some of the Hate Crime films. We stressed that Surrey police really need to get to know the disabled people in their areas. We talked about the different communication needs of disabled people. National consultation on Making Right Better and Listening to People. The Government are asking questions about how to make people s lives better. You can tell them what you think You have until 29 May 2015 to tell them. The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 23
Our members Members who came to our May 2015 meeting are typed in black. Members highlighted in blue sent their apologies Co Chairs Mary Hendrick Co-chair Linda Stonestreet Co-chair Darren Power Co-chair Debbie Taylor Co-chair Mel Few Surrey County Council Elected Member Local Valuing People Group Chairs Cath White - RAD South East Surrey Nicky Palmer - Surrey & Borders Partnership NHS Foundation Trust South West Surrey Andrew Price Surrey County Council - North West Surrey Sally Dubery CVS North East Surrey People with learning disabilities Tori Longley Barry Pullen David Muir Ann Collins Barry Roberts Michelle Davis George Feldwick Suzanne Slingo Linda Stonestreet Amanda Price Stuart Sharkey Family Carer Representatives Marion Price MBE Gaynor Gibbins Caroline Farnes Gemma Roulsten Sara Truman MBE Jen Fookes Voluntary Organisation Representatives Chris Botton - Mencap Alison White Surrey Coalition of Disabled People Mark Packer - Welmede Deborah Tosler and Alan Wilmot Surrey Care Association Barry Hobbs, - Kingston Advocacy Group Lu Dash Prospect Housing Ginny Willis - Surrey Careers Service Karen Melhuish Surrey Choices The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 24
Our members Members who came to our May 2015 meeting are typed in black. Members highlighted in blue sent their apologies Surrey County Council representatives Jo Poynter Area Director East Surrey Andrew Price Commissioning Chris Esson Commissioning Tom Moore Commissioning Debbie Aitkin Commissioning Lisa Nash Communications and Engagement Karina Jones SCDC Waverley Doug Strachen SCDC Epsom Rebecca Casalicchio SCDC Marnie Cotterill SCDC Tandridge Annie Henley-Ashton Public Value Review Team Lisa Woodwood Surrey Adult Learning Kathryn Telford Carer development Jean Hills Safeguarding Adults Julie Pointer Transition Development Worker Steven Ward Personal care and Support Christina May Transition Team Claire Holland - Public Value Review Team Isabelle Bloin Public Value Review Team Sally Dickens - Assistant Senior Manager Observers Mike Leat CCP Ltd Health representatives Lesley Wilson SABP NHS Foundation Trust Dr. Karen Dodd SABP NHS Foundation Trust Kathryn Fisher Guildford and Waverley CCG Jane Ship and Jane Owens Surrey Healthwatch Jill Rasmusen GP with special interest Antony McCallum - North East Hampshire and Farnham CCG Phil Boulter SABP NHS Foundation Trust Lynne Ramnanansingh SABP Liaison Team Manager Gemma Hare Primary Care Liaison Nurse Catherine Croucher - Public Health Consultant Haley Bath - Surrey Downs CCG Danny Bailey Guildford & Waverley CCG Andrew Moody Guildford and Waverley CCG Nick Parkin NE Hants and Farnham CCG The Learning Disability Partnership Board in Surrey - May 2015 Minutes Page 25