Aberlour- South Ayrshire and Fife Knowledge Share Project Building Capacity in the Workforce

What do we mean by Capacity? 1. uncountable noun. The capacity of something such as a factory, industry, or region is the quantity of things that it can produce or deliver with the equipment or resources that are available. 2. countable noun. The capacity of a piece of equipment is its size or power, often measured in particular units. Synonyms: size, room, range, space   3. variable noun. The capacity of a container is its volume, or the amount of liquid it can hold, measured in units such as litres or gallons. 4. singular noun. The capacity of a building, place, or vehicle is the number of people or things that it can hold. If a place is filled to capacity, it is as full as it can possibly be.

What do we mean by Capacity? 5. adjective [ADJECTIVE noun]A capacity crowd or audience completely fills a theatre, sports stadium, or other place. 6. countable noun [in NOUN]If you do something in a particular capacity, you do it as part of a particular job or duty, or because you are representing a particular organization or person. 7. variable noun [oft with poss , NOUN to-infinitive]Your capacity for something is your ability to do it, or the amount of it that you are able to do. Synonyms: ability, power, strength, facility   

Who do we mean by Workforce? Specialist This is the workforce that works with people with a learning disability, including parents, as part of their core service e.g. Social Care providers, Health Learning Disability teams, Social Work teams etc General This is the workforce of services who do not have support for people with a learning disability but have responsibility to provide appropriate support as part of their general remit e.g. Maternity services, Health Visitor Services etc Fife and Ayrshire both have 1 NHS organisation, but Ayrshire has 3 Local Authorities. Fife only has 1 Local Authority, which made it easier to develop the Family Health Team. So far, Aberlour has only been able to make changes in 1 Ayrshire Local Authority.

The Three Main Requirements for Building Workforce Capacity Appropriate Culture and Practise Appropriate Information and Training Appropriate Tools

Appropriate Culture and Practice The challenge of change National guidance – SCLD The Journey from Guidance to Implementation National to Local – Local to National Learning from each other – Fife and Aberlour Learning together locally Hard won and easily lost – Sustaining change locally Building a network to celebrate best practice locally to influence strategic planning – The Parenting Task Group How do we achieve this when so many projects are challenged by the uncertainty of short term funding?

Appropriate Information and Training Both Workforce Groups require information and training to varying degrees. General workforce – Requires to have information and training to recognise that a client may have a learning disability, especially if the person has not received a diagnosis.

Appropriate Information and Training Fife Midwifery Service: Previously this service had no way of identifying whether someone had or might have a learning disability. For people who have received a diagnosis and are known to the Fife Adult LD Service a flag has been placed on their notes that will identify that they have a LD. This flag will be picked up by Fife Midwifery Service on referral to the Family Health Team that support parents with particular needs

Appropriate Information and Training Midwives also use a screening tool to establish whether parents who have been referred might have a learning disability (this is described in more detail in the Tools Section) All Community Midwives have also received an educational input from a Senior Charge Nurse from the Adult LD Service. This input is supplemented by an e-learning module available to all health and partner agency staff In Aberlour’s South Ayrshire Family Service 63% of parents do not have a diagnosed Learning Disability Encouraging pre-birth referrals and awareness of a wider definition of learning disability has been through the experience of collaborative working and input to team meetings.

Appropriate Information and Training Specialist Workforce Although specialist workforces will have direct experience and learning on how to identify and work with a person with a learning disability they still require ongoing information and training. Given the increasing longevity of the LD population we are learning more about the particular health needs that a person with a learning disability will have when they get older. Given the increasing longevity of the LD population we are learning more about the particular health needs that a person with a learning disability will have when they get older. The Scottish Observatory is now beginning to illustrate particular challenges in relation to Gastric and Heart issues.

Appropriate Information and Training We also continue to increase our understanding of what works most effectively in relation to communication. Talking Mats for example have been a useful addition to effectively communicating with people with more profound LD and complex communication needs (See below) Our shared experience across South Ayrshire and Fife has shown the importance of relationship based support where a trusted worker can help parents understand reports or contribute to meetings.

Appropriate Tools Both Workforce Groups require appropriate tools, mainly in relation to communication, to ensure effective support for the person with LD to achieve their personal wishes and outcomes. These tools can be specifically developed or be applied from tools for the general population of parents.

Appropriate Tools Screening Tool As well as being a helpful tool to potentially access appropriate professional support it has also increased the confidence of the midwives in both recognising and supporting a parent with a learning disability Although a screening tool is not used in South Ayrshire there has been a growing understanding across Health and Social Care of the wider definition of learning disability and the value of an early referral.

Appropriate Tools Accessible information Fife has the Communication for Health Website and service that stores appropriate examples of a wide range of accessible information. There is also the Good Information Fife Team (GIFT) which considers and advises on new pieces of accessible information. People with a learning disability are part of this group. From South Ayrshire Health and Social Care Partnership Dominic Jarrett has supported us to consider the challenges of how to present information in an accessible format and we have worked to raise awareness of how general information and reports can be made more accessible.

Accessible Information Database www.nhsfife.org/easyread

Appropriate Tools There are a variety of resources that can be very effective tools to support practice and people with a learning disability at certain stages in life. The Change materials as well as the Pregnancy Support Pack (created in NHS Fife) are examples of effective tools to support parents with a learning disability through pregnancy and beyond

Appropriate Tools Talking Mats This more specialised tool has proved very effective as a method of communication and discussion with people with varying degrees of learning disability.

Appropriate Tools General Parenting Supports PAMS Assessment – Offering a flexible and accessible assessment tool which recognises the potential for support and assessment to run concurrently. With the option of pre-birth assessment and capacity updates. A range of approaches to groupwork and individual support, both planned programmes and co-produced Whilst specially developed tools are both useful and welcome the potential applicability of more general tools used to support parents in general within universal services should not be discounted. The short Youtube video on Nappy changing is a good example of this

The 2 teams get money from different places The 2 teams get money from different places. The Family Health Team is supported by money that comes from the Scottish Government to NHS Fife. The Aberlour team is supported by Big Lottery funding, which they have to apply for every few years. Both teams could lose their funding in the future, and stop working.