Driving Up Quality in Learning Disability Services Alicia Wood

A Tale of Two Centuries Debbie 1993 Raj 2008 Closing Institutions Moving in to residential care Living with other people Expected to fit in Doesn’t fit in Behaviour escalates Provider can’t cope Danger to others Moved on The story of her life Living in own flat Support to live independently Lonely and needs friendships and relationships Starts inappropriate behaviour Assaults woman Criminal charges Provider can’t cope Moved to ATU Stays for 3 years and loses flat Can’t come home because no housing or support

Spot the similarities? Debbie 1993 Raj 2008 Lack of person centred approaches to housing and support Lack of understanding what Debbie is saying and what she really needs Lack of imagination in planning services- using inflexible models Poor commissioning Poor service provision Lack of person centred approaches to housing and support Lack of understanding what Raj is saying and what he really needs Lack of imagination in planning services- using inflexible models Poor commissioning Poor service provision Nothing much has changed in 15 years. People with challenging behaviour are the last remaining group of people in our society who are routinely segregated from the rest of us. Some people need to be hospitalised for their own safety and the safety of others but most people don’t if we get their housing and support right.

Why do we need a code? We have the Challenging Behaviour Charter, CQC regulations, BILD accreditation, Making it Real, NHS Choices, REACH and many quality frameworks. Aspiration- expecting people to move on, have their own homes, relationships, jobs… The code recognises and draws on current frameworks to avoid replication Culture- how the organisation behaves with people, staff and other organisations Accountability Providers and commissioners being open and accountable about what they do Governance- how we run our organisations

Most importantly, this is developed and led by providers Most importantly, this is developed and led by providers. Providers need to take responsibility for changing how we do things and drive up quality even for those we don’t support. Providers need to be honest about what is going wrong (and going right) and restore confidence in good services

What we want the code to achieve? To drive up quality in services for people with learning disabilities that goes beyond minimum standards. To create and build a passion in the learning disability sector to provide high quality, values-led services. To provide a clear message to the sector and the wider population about what is and what is not acceptable practice. To promote a culture of openness and honesty in organisations. To promote the celebration and sharing of the good work that is already out there.

The Driving Up Quality Code The code The website Focus on 5 key areas Guidance Self Assessment Framework Good practice info and links against each area of the code Provider and commissioner sign up and reporting against 5 key areas

The board and senior management team make it their business to know about and take responsibility for the good and not so good things that happen in the organisation

How will the code work? Provider umbrella groups who are members of the Driving up Quality Alliance will ask their member organisations to sign up to the code. Providers will sign up publicly to the code on their website and evidence how they meet or are working towards the code. Links will be made to CQC reports, Making it Real reports and NHS Choices Provider Quality Profiles. Commissioners will be asked to sign up to using the code through their commissioning processes The CQC will take account of the code to register, monitor and regulate governance and service provision in registered services for people with learning disabilities. People who use services, their families, advocates and supporters will be informed about what they can expect from services and be empowered to hold providers to account. Launch in September 2013

alicia.wood@housingandsupport.org.uk