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Getting it right for people with complex needs: whose responsibility? David Behan, Director General Getting it right for people with complex needs: whose responsibility? David Behan, Director General Social Care Local Government and Care Partnerships

Introduction • The role of the Department of Health in ensuring good outcomes for Introduction • The role of the Department of Health in ensuring good outcomes for people with complex needs • The DH response to Winterbourne View • Time for questions 2

DH role: setting the policy framework Valuing People Now • sets out the policy DH role: setting the policy framework Valuing People Now • sets out the policy for people with learning disabilities • More needs to be done to support people with more complex needs • Vision is the same as for everyone 3

DH role: setting the policy framework • Vision for adult social care • Revised DH role: setting the policy framework • Vision for adult social care • Revised Carers strategy • Reforming adult social care – Caring for our future: shared ambitions for care and support launched on 16 September – How to ensure quality of social care system • Equity and Excellence: Liberating the NHS - Reforming health care 4

DH role: to promote best practice • • Mansell 1 and 2 Raising our DH role: to promote best practice • • Mansell 1 and 2 Raising our sights Guidance on commissioning Guidance on communication 5

Safeguarding Adults: Balancing risk and regulation • Safeguarding requires effective local coordination and participation Safeguarding Adults: Balancing risk and regulation • Safeguarding requires effective local coordination and participation of key agencies • Publication of Statement of Government Policy on Adult Safeguarding: 16 th of May • Statutory Boards will require membership from key agencies • Legislation alone will not ensure people’s safety: we must support people to maintain control of their lives and make informed decisions 6

DH role: setting outcomes • Outcomes frameworks • What does good look like? – DH role: setting outcomes • Outcomes frameworks • What does good look like? – Good person centred plans – Creative commissioning of services – Involving people and families – Personalised services – The right staff mix – Flexibility on budgets 7

Role of commissioners • Commissioning for quality services: – Developing personalised services that meet Role of commissioners • Commissioning for quality services: – Developing personalised services that meet people’s needs – Involving service users and families – Improving local service development and alternative models of provision – Reducing out of area services – Developing expertise in challenging behaviour – Understanding need – Using the Health Self Assessment Framework to monitor outcomes 8

Role of providers • Providers have a duty of care: – Demonstrate leadership and Role of providers • Providers have a duty of care: – Demonstrate leadership and supervision – Good clinical governance – The right staff levels and skills mix – Training –eg positive behaviour support – Monitoring quality and safety of care – Developing the market for alternative provision 9

Role of professionals • Providing and commissioning quality care and support: – Training in Role of professionals • Providing and commissioning quality care and support: – Training in working with people with complex needs – Person centre planning – Integrated care pathways – Monitoring individual’s progress – Reviewing plans – Safeguarding – Whistleblowing – Good understanding of Mental Capacity Act/Mental Health Act interface and human rights 10

Role of the regulator - CQC • Registration • Inspection - assuring compliance with Role of the regulator - CQC • Registration • Inspection - assuring compliance with the essential safety and quality requirements • Revised whistleblowing procedures • Monitoring the operation of the Mental Health Act 1983 • Undertaking special reviews and investigations 11

Local delivery What are the levers to encourage good practice at a local level? Local delivery What are the levers to encourage good practice at a local level? LOCAL AUTHORITIES – Role of Learning Disability Partnership Boards – Health and well being boards 12

Winterbourne View • Panorama TV programme on 31 May showed shocking abuse • Owned Winterbourne View • Panorama TV programme on 31 May showed shocking abuse • Owned by Castlebeck Care • 51 people in total have been there • Now closed 13

Government Review Led by Bruce Calderwood Department of Health With help from: • Mark Government Review Led by Bruce Calderwood Department of Health With help from: • Mark Goldring – MENCAP • Prof Jim Mansell • Anne Williams, former National Director for learning disabilities. 14

Government review Many Strands: • Police Investigation – 11 arrests • Care Quality Commission Government review Many Strands: • Police Investigation – 11 arrests • Care Quality Commission – Internal review – Review all Castlebeck Care services – Wider review of 150 other learning disability hospitals • Serious Case review • Castlebeck Care internal review • NHS Review 15

Department of Health Review • Will look closely at all the investigations and reports Department of Health Review • Will look closely at all the investigations and reports – at why this happened • A report on what is found. • Recommendations to make changes 16

Department of Health Review What we are doing: • Talking to people about the Department of Health Review What we are doing: • Talking to people about the review: – People with learning disabilities, autism and families – commissioners, health and care professionals, providers and the Care Quality commission – other stakeholders • Looking at the evidence 17

Department of Health Review • Too soon to make recommendations till we have all Department of Health Review • Too soon to make recommendations till we have all the facts BUT • Do want to get your views on: – Emerging issues – Making a real change in the model of care 18

Police and CPS Castlebeck Care 2011 DH Review - Winterbourne View – Key milestones Police and CPS Castlebeck Care 2011 DH Review - Winterbourne View – Key milestones 2012 June July Aug Sept Oct Nov Dec Jan Feb March Internal Management Review Clinical review Police investigation and CPS prosecution CQC Reports on Winterbourne View and 23 other Castlebeck Care services published CQC Internal management review CQC Wider Review of LD services NHS Serious Untoward Incident Review DH Serious Case SUI Phase 1: review of 150 LD services Phase 2 evaluation : alternative provision Report end September to feed into SCR and DH review Serious Case Review To. R published Expert Panel 1 st meeting 5 th September DH Review Reports to Ministers CQC national report Final report and timetable dependent on police prosecutions Final report and timetable dependent on SCR etc 19

Questions for the review What are the changes you would like to see? • Questions for the review What are the changes you would like to see? • For the people who use services and their families? • For the people who buy services – for commissioners? • For services like Castlebeck? • For the Care Quality Commission? Do you have any other comments 20 for the DH review?

Contact the DH Review Sheila. Evans@dh. gsi. gov. uk DH Review - Winterbourne View Contact the DH Review Sheila. [email protected] gsi. gov. uk DH Review - Winterbourne View 221 Wellington House 133 -155 Waterloo Road London SE 1 8 UG 21