Notes Bournemouth Learning Disability Partnership Board Monday 20th May 2013, Town Hall, 2.00pm - 4.05pm Who came? Amanda Frost Tim Branson CO-CHAIR, Bournemouth People First CO-CHAIR, Adult Social Care Kellie Salter Hilary Evans Kate Cuthbertson Mark Harris Chris Pacey Integrated Team Manager Strategy Lead, Vulnerable Learners Senior Practioner, Integrated Team NHS Clinical Commissioning Group Dorset Health University Foundation Trust Sally Baxter Bournemouth and Poole College Anna Braczek Louise Bate Valerie Roach Dianne Coles Alison Ridealgh Anthony Giles Anna Harris Rosemary Tagg Debbie Barnfield Jenny Bennett Jenny Phillips Dorset Race Equality Council Healthwatch Parent/Carer Parent/Carer Bournemouth People First Time Keeper Bournemouth People First Minute Taker Bournemouth People First Bournemouth People First Bournemouth People First 1
Who could not come? Apologies from: Nadine Evans Jo O Connell Sue Ross Amanda Parsons Francis Stevens (left for new job) Jo Findlay (Left for new job) Val Cope Amanda Frost, Co-chair, welcomed everyone to the meeting. Everyone introduced themselves Tim Branson, Co-chair, went through the notes of the last meeting and checked on the actions. Kellie to send Bournemouth People First a list of which staff will go to each sub group. - Kellie said the list will be finished and sent in the next few weeks. Page 4 - Changing Place Toilet in Charminster Library - Anna Harris said that this is in the action plan of the What We Do in the Community sub group. Page 8 - easy read Housing Options booklet - Anna Harris said this will be for Bournemouth and Poole. The draft should be ready for the next Where We Live sub group in June. 2
Page 12 - Previous Action - Nadine to report back on what was agreed at the Joint Management Board about people with a learning disability going to their meetings. Outcome - Kellie said that the last meeting was cancelled. Page 13 - Previous Action - report about the Self Assessment form to be on the May Agenda. Outcome - Rosemary said that Jo O Connell is going to a South West Regional meeting in June so will report to our July meeting. Louise Bate, the Community Engagement and Outreach Officer told us about Healthwatch. It is a new service which started in April this year. It covers the whole of Dorset, including Bournemouth and Poole. It is being run by 3 local organisations:- Citizen Advice in Dorset Dorset Race Equality Council Help and Care (who ran LINks before) Healthwatch will:- Ask people how good or bad they think local health and social care services are. Be there to hear about any worries about services. Keep a record of what people tell them. Tell the NHS and local councils what people have told them, and suggest how services could be made better. 3
Give people information about local health and social care services. Help people choose which services to use. People can ring Healthwatch with their story, or fill in a form online. They do not have to give their name. Healthwatch are on Facebook and Twitter. There will be a tweet chat on the last Wednesday of every month from 1pm - 2pm. This month the chat will be about how to use people s stories to make services better. The address is #HwatchDorset Healthwatch s e-mail address is:- enquiries@healthwatchdorset.co.uk Louise said she would like us all to be Healthwatch Champions. This means we would tell other people what Healthwatch can do for them, and how to get in touch. Louise then told us about a Wellbeing Show taking place at the Lighthouse in Poole. It will be from 11am - 3pm on Saturday 8th June. This is a joint event with the local NHS, Councils, Healthwatch and the Health and Wellbeing Board. Tim asked what are the differences between Healthwatch and LINks. Louise said Healthwatch will look at children's services as well as adults. There is a Healthwatch England which is part of the Care Quality Commission. This means problems can be shared in all parts of the country. 4
Tim asked about their contract. Louise said it is for 3 years and it may be extended. Louise said they will be making a report every year, and there will be a newsletter on the website every month. They will also write reports on the various subjects they have looked at. Tim thanked Louise, and said any of us interested in being Healthwatch Champions could contact her. The update was given by Jenny Phillips, supported by Jenny Bennett, both from Bournemouth People First. Jenny Bennett said she might not be able to answer all questions, but would pass them on to Val Cope. The report is about what the working groups have been doing and the confidential inquiry into the premature deaths of people with learning disabilities. this meets at Poole Hospital. It has been looking at easy read information about health care and treatment. The group is working on people having a hospital passport that can be used in any hospital in Dorset. - there is a care pathway for anyone who has dementia. There is a special pathway linked to this for people who also have a learning disability. The group will be asking all services to make sure there is easy read information about dementia available for service users and carers. - the oral care pathway for adults who need carer and support services will be given to care and support providers. 5
The group is asking care and support providers to have Oral Health Care Champions. The Community Teams now have a part about oral health care when they do assessments. The group wants High Street dentists to have easy read information and to think about how they can make their services more accessible. there was a 2 year inquiry that looked into the deaths of people with learning disabilities. It looked at the details of 247 people to find out:- The cause of death What happened before they died What would make services better It found that people with learning disabilities often have more medical problems. Some of the people died at a younger age than expected. Reasons for early death:- People with learning disabilities did not always get treated quickly enough. Services did not make changes so that people with learning disabilities could use them easily. There were problems with planning the health care and support that people needed. Some people went into hospital when their health problem could have been managed with better support in the community. Professionals did not always follow the Mental Capacity Act about decision making. Some people with learning disabilities needed someone to speak up for them. 6
18 things have been suggested to make things better. The main ones are:- The need for all health professionals to know if people have a learning disability. People with lots of medical problems should have one person who makes sure they have a good health action plan. People with learning disabilities should get the same investigations and treatment that other people get. Learning Disability Teams should help people who have difficulty in using medical services. The government should make better information available about people with learning disabilities who have died. The Health Action Group will be looking at the report more closely at their next meeting. Health Action Plans (Yellow Health Books) will be used as part of the planning for when someone goes into hospital. A single Care Passport will be used in all hospitals. People can fill it out on a computer and then e-mail it or print it. More work will be done with support providers to plan for good health. When reviews are done the Community Team will check that people have been offered health checks, and that they have a Yellow Health Book. - 7
The Community Team will work with GP surgeries and hospitals to make sure services know who has a learning disability, and any extra support they may need. The Mental Capacity Act team offer training to providers or groups of professionals. Amanda Frost said that she went to a meeting at Bournemouth Hospital and was shown some information in easy read. People using the hospital have said this information is not easy to get hold off. Anna Harris asked about the Single Care Passport. Jenny Bennett had a copy that had come from Surrey and that will be changed for use in Dorset. It includes what the person likes and does not like, and how they communicate. Chris Pacey said that it would replace the hospital grab sheet. Anna said that most of the deaths that the inquiry looked at had happened in hospital. She wondered what is being done to make the care in hospitals better. Jenny Bennett said that the Health Champions will be doing some work in hospitals. Chris Pacey said that all new staff in the west of Dorset visit Dorset County Hospital as part of their induction training. Chris Pacey said she had given a presentation about the Inquiry report. She will be looking at the recommendations and seeing where the NHS in Dorset is now. Kellie said there is a person in her team that links in with Bournemouth Hospital. When the hospital has a patient with a learning disability, the community nurse supports the hospital nursing staff. 8
Val Roach asked about Poole Hospital. Kellie said her lead nurse is trying to link up with Poole Hospital. Tim said there is a social work team based in Poole Hospital who deal with all Bournemouth residents. Chris Pacey said they are hoping to make a care pathway for hospitals to use. As long as they know where the person lives it will tell them who to call for support. Anna Harris said that the Inquiry covered people living in residential homes. It said that some people were living in homes that did not meet their needs. Anna asked how we know that things are ok for people in residential homes. Kellie said this would be picked up at the annual review. She also said the Community Nurse would be involved. They are now asking more questions about health. The contract monitoring teams who visit residential homes also ask more questions about health. Kate Cuthbertson said she has been part of the Transitions sub group on behalf of Steve Scott who is on training until August. The Transitions Nurse has left, but her replacement will be part of the Transitions sub group. Everyone had copies of the action plan. The main actions are:- Develop a better way of health, education and social care working together. Find out who the people are aged 14+ with a learning disability that may need support when they reach 18. Understand the pathway for young people going 9
Make sure young people and their families can find the right information about services. Find out what it is like to go through transition, so that we know what could be better. Get ready for the new Education, Health, and Care Plans. Rosemary asked about the new Transitions Protocol. Kate said they are still working on the Transitions Protocol. Anna Harris said she was pleased to see that there is a Transitions Action Plan. Tim said that it is good that some of the actions have already started, and that the colours in the plan should match this. Amanda Frost said that Kate had done very well to cover for Steve Scott. Amanda Frost talked about the Bill of Rights Charter. In 2004 Bournemouth People First wrote a Bill of Rights with members of Poole Forum and People First Dorset. Dave Hingsburger helped make the Bill of Rights, and in 2011 he helped to update it. The 3 groups feel that their message should be spread to as many people as possible, so they have made it into a Charter. The charter is for organisations, services and individuals to sign up to. This means they agree to support the Bill of Rights - rights that most people take for granted. If people wish to sign up, they must contact Bournemouth People First. They will then add the organisation s logo to their website so that everyone can see they are supporting the Bill of Rights. 10
Bournemouth People First want to hear about how people use their charter. These comments will be added to their website too. Bournemouth People First want their members to look out for organisations or people that do not stick to the Charter. They can than challenge them about it. They want to make sure that all their Rights are respected. Amanda F asked if the Board would like to sign up to the Charter. Everyone voted Yes. Anna, Anthony, and Amanda presented the Summary NHS Campus Reprovision Final Report. 52 people were part of this project to move out of hospital living and into housing in the community. 36 people out of the 52 filled out questionnaires they moved. 44 people filled out questionnaires they moved. 33 people filled out questionnaires they moved. They compared the answers of the 33 people before and after they moved. - they asked if people used their local shops. The reasons for those not using the shops included health problems or difficulties with transport. 11
- they asked people if they were happy with what they do. They also asked if they saw their friends. A lot of people s interests have developed since moving. Some people miss the friends they used to live with. Some family members felt that staff were entertaining themselves rather than the people they support. - they asked if people liked their home. Some people are in homes that are unsuitable for them - homes with stairs, no bath (just a shower), no enclosed outside space. They would have expected homes to be right for people, after all the time and resources put into finding and supporting people in their new homes. - they asked people if they can choose when and what they eat and drink. They also asked if they can choose their own clothes. This is an area of very big change about the most basic choices people make. Having the freedom to make basic choices has helped people make other choices in their lives. 12
- they asked people if staff are kind and treat them with respect. People s answers show they were happy with their staff before they moved, and even happier after they moved. A number of staff moved with the individuals which was helpful. People have become more independent because their support has become more person centred. - they asked people if they were happy with the support they get with their money. This is an area that has not changed so much. The comments made show that looking after the money itself seems more important than supporting people to look after their own money. People had problems with banks, the local authority, and proof of ID. The way that money is looked after assumes that people cannot make any decisions for themselves. 13
- they asked people if the staff and people they live with are kind. They also asked if people feel safe in their own home. Some people felt safer because they were no longer living with other residents who scared them. Staff said that aggressive behaviour and behaviour they find challenging has been reduced. - overall, lives have changed for the better, but there is more to be done before we can say that everyone is living as an equal citizen. Support for people to be more actively involved in the area where they live. Support for people with friendships and opportunities to meet people socially. Support plans to be made involving the individual and their circle of support. People to live in homes that are right for them as their needs change. Support for people to build on their right to exercise free will and choice. Consistency of support staff. 14
People having more control over their own money. Continue to monitor how people are kept safe. Continue to recognise and understand what can limit citizenship. Anna asked if there were any questions. Val Roach said she had been asked by other parents whose children had moved on from hospital living to bring a huge problem to the Board. When people were to be moved, the parents looked very closely at the different service providers and chose Ridgeway. The contract with Ridgeway was for 5 years and seemed to offer the best package. After 2 years Ridgeway have merged with Southern Health. The staff contracts are being changed. They now get no extra payment for night or weekend working. This has meant they get paid much less. Some of these staff have been with the clients for many years. They were happy to move from the NHS to Ridgeway, but they are now being forced to leave. Val said as their children have no verbal communication, it is important for them to have well trained and experienced staff to look after them. Val wanted to know what is happening to the rest of the money paid to Southern Health. Kellie said she knows that concerns have been raised, and that the Contracts team are talking to the providers to get a clear picture of what is happening. 15
Dianne Coles said that staff will not get paid any extra for taking the client on holiday. Dianne said this means their children will not be able to go on holiday, and the parents are all very angry. Val said she has been told she will have to pay for extra staff to cover if someone does go on holiday with her son. Dianne said that having less experienced staff has already caused a problem with her daughter being given the wrong medication. Chris Pacey said that promises were made to staff that they would still be paid the same. Chris said she knows providers are having to look at their costs. She said they need to go back to see what was originally promised to all the families. Tim asked how this is being looked at now. Kellie said there were 2 things happening. 1. The Community Team is doing an in-depth review to check if the package of care is right for each person. 2. The contract team are checking that the providers are doing what they are supposed to. Anthony suggested that Val could speak to Healthwatch about their worries. Val said that the Bill of Rights includes the right for someone to chose their own carers. Even the basic rights are not being met. Val said there are 6 other families in the same position. 16
Tim asked who is funding the care. He was told it was Continuing Health Care. Chris Pacey said that 250 staff were transferred from the NHS. Agencies can change the terms and conditions of staff, but these staff were told they were protected by law. Val said these people cannot speak or sign. They will get very frustrated if they cannot make themselves understood. Dianne said that paying lower wages is not going to attract the level of staff that they have been used to. Tim asked if the staff have already left, or are giving notice to leave. Val said some had already left and others are saying that they will leave. Anna Harris said the Citizen Checkers work in residential homes is funded to the end of March 2014. Tim said the draft agenda for July is already full. There were no other items to add. Item 7 will be about the Terms of Reference and Action Plan for the Board. Anna Harris said that she had recently been asked for a copy of the Board s Terms of Reference and had been unable to find an up to date one. The Action Plan is also out of date. With all the changes we have made to the Sub Groups, she said we need to update the Action Plan. 17
Anna said we only have Guidelines and the Check List that the Sub Groups work to. Kellie said that she and Nadine had been talking about the Terms of Reference and Nadine is keen for the Board to have a Planning Day. Amanda said that Bournemouth People First s newsletter is now available. Amanda also told everyone that Bournemouth People First s AGM is on Wednesday 10th July at the Life Centre in Moordown. Kellie asked if we wanted to have our board meetings at the Town Hall, or if we wished to change the venue. She said that car parking is a problem at the Town Hall. Next Meeting Date: Monday 29th July 2013 Time: Place: 2 p.m. - 4.30 p.m. Bournemouth Learning Centre, Ensbury Avenue 18