Agenda item
Life Chances of Adults with a Learning Disability in Brent
The report addresses how the local authority and its partners are helping to improve outcomes across social care, health, education and employment for adults with learning disabilities living in the Borough.
Minutes:
Councillor Krupesh Hirani (Lead Member for Community Wellbeing) introduced the report which examined how the Local Authority and its partners were helping to improve outcomes for adults with learning disabilities living in Brent across social care, health, education and employment. The New Accommodation for Independent Living (NAIL) project had been successful, with a wide range of units (with capacity ranging from 6 to over 90) provided. However, despite the plans to expand the NAIL provision, there had been a number of challenges as it had been difficult for families to adjust to the changes made as their properties had been converted. Councillor Hirani concluded his presentation by saying that the Transforming Care Partnership and the Brent Learning Disability Forum were examining how the way services worked together could be improved.
Members asked questions that related to the life chances of adults with learning disabilities and enquired if these were better in Brent than in other boroughs. In response, Councillor Hirani said that housing and employment were the only areas in which specific targets had been defined. As people’s life expectancy increased, this put additional pressure on services which had to adapt to meet the rising needs of residents. Transport had been an area of uncertainty - there were barriers associated with the cost of travel for carers and although a number of options were available, it had not always been clear what they were entitled to. In relation to Brent’s provision, Duncan Ambrose (Assistant Director at National Health Service (NHS) Brent CCG) noted that the Borough had performed well in relation to annual health checks with 90% of residents registered with a General Practice (GP) surgery receiving a health check, which exceeded the national target of 64%. Furthermore, health passports had been introduced to summarise patients’ needs and options to migrate these to an electronic format were explored. Reasonable adaptations to services had been made – a Blue Light Tool Protocol had been developed to support individuals who had been considered to be at risk of inpatient admission to ensure that there were arrangements in place to provide urgent interventions to support them to stay in the community. Members heard that Brent was progressing the work around the Green Light Tool Kit to audit and improve mental health services so that they were effective in supporting people with learning disabilities, including autism (for further details, please see paragraphs 10.11 and 10.12 of the report on page 18 to the Agenda pack).
Helen Woodland (the Council’s Operational Director for Social Care) said that not everyone who had a learning disability would be diagnosed with one as some residents could be able to use mainstream services without needing additional support. She pointed out that the number of people with learning disabilities was increasing and their needs were becoming more complex. She directed Members’ attention to section 7 of the report (page 14 of the Agenda pack) which contained information about a survey the Adult Social Care Directorate had undertaken in relation to the support available to people with learning disabilities. She noted that regular Learning Disability Forums were taking place and these provided an opportunity for residents to share their views about the services available to them.
Members heard that an area which required improvement was the number of people in employment. The Council had commissioned Royal Mencap to deliver the GOLDD Employment Programme to people who had a learning disability and/or autism aged between 16-24; Brent Works (the Council’s job brokerage service) provided one-to-one advice and guidance towards finding employment, connecting residents to jobs and apprenticeships with in the Borough; Brent Start (the Council’s adult education service) offered pre-apprenticeship training programme to 19 to 24 years old Brent residents with little or no work experience; and The College of North West London was completing a hospital internship initiative for students with a learning disability. Although employment rates in Brent had improved over the last year, these remained lower than the London average. One reason for this could be the fact that some initiatives had been successful in the short term only. Achieving the London average rates was a key priority and actions had been taken to improve the take-up of the employment support services available in the Borough.
The Committee challenged the fact there were not any other specific targets apart from those for housing and employment and questioned why Brent-specific data had not been provided in the paper (paragraph 13.2 on page 25 of the Agenda pack). Ms Woodland explained that it would have been difficult to obtain Brent-specific data on the entire population of the Borough as the information available was related to clients of the Adult Social Care Directorate. Referring to the table in paragraph 13.2 of the report, Ms Woodland provided the missing figures.
|
National Population |
Brent |
Cost/person |
people in mental health hospitals |
2,510 |
<15 |
180,000 |
people in social care residential or nursing homes |
29,000 |
190 |
65,000 |
people receiving social care support in the community |
100,000 |
123 |
27,000 |
people living in the community and accessing low level support, e.g. receiving an annual health check from their GP, receiving welfare benefits due to their learning disability |
700,000 |
640 |
Lowest cost ltd. to cost of GP and welfare benefits |
In relation to life opportunities, it was pointed out that support plans were in place and they allowed individuals to receive the required support to enable them to remain in the community. Efforts were made to move people back to the Borough and place them in independent settings, but it had to be acknowledged that this could take time. Reintegration to the community would be supported by health and social care and there were plans to integrate the teams over the course of the next year to ensure resources were used effectively to meet the needs of residents. The Integration Plan formed part of the Brent Joint Learning Disability Strategy, which had been signed off by the Brent CCG in October 2017 and was overseen by the Health and Wellbeing Board. From an operational perspective, day centres delivered enablement services to support people to develop life skills that would allow them to lead independent lives.
The Committee noted that the scope of the paper had been broad as it covered a number of services. Phil Porter (the Council’s Strategic Director of Community and Wellbeing) suggested that it could be possible to scrutinise individual services as the Council’s focus had been on people who were eligible to receive services under the Care Act 2014. He emphasised the Council’s aim to create a vibrant market and develop properties for people with specific needs, e.g. the NAIL programme looked at individual properties for individual people and five people from residential home settings had been moved to the community.
In response to a Member’s question about the number of people who had been signed up to the Green Light Tool Kit, Mr Ambrose said that there had been challenging cases which had been managed appropriately in non-psychiatric settings. Moreover, the Blue Light Tool Protocol had been well imbedded across England and integration with neighbouring boroughs was a priority. He noted that it was important to acknowledge that service delivery was measured across North West London rather than by specific borough.
Members of the Committee directed their attention to expenditure and enquired about the current budget challenges. Mr Porter said that the NAIL project had been contributing to relieving financial pressures by reducing expenditure – for instance, moving people living in a challenging family environment to supported living could save costs on support services and relocating people from residential or nursing homes to independent living meant that accommodation costs could be covered by Housing Benefit rather than the individual’s care package. Mr Ambrose added that the CCG was examining ways in which available resources could be used for the benefit of residents.
RESOLVED:
(i) The contents of the Life Chances of Adults with a Learning Disability in Brent report, be noted;
(ii) The measures already in place to support adults with a learning disability in the Borough be noted;
(iii)The further actions planned as part of the Learning Disability Strategy be noted;
(iv)An update on employment rates of residents with learning disabilities living in Brent be provided at a future meeting of the Committee;
(v) Targets measuring the implementation of the Brent Joint Learning Disability Strategy 2017-2020 be set; and
(vi)The Joint Commissioning Plan and the Joint Investment Plan be presented at a future meeting of the Committee, with greater level of detail provided including information about resources and outcomes.
Supporting documents:
- 08. Life Chances of Adults with a Learning Disability in Brent, item 8. PDF 215 KB
- 08a. Brent Joint Learning Disability Strategy 2017-2020, item 8. PDF 1 MB
- 08b. Transforming Care Partnerships (TCP) Summary, item 8. PDF 474 KB
- 08c. Adult Social Care User Survey Results, item 8. PDF 128 KB