Partnership Board Progress Reports 2010/11 Alison Copeland Gyles Glover Supported by the Department of Health

Introduction All the regional partnership boards were asked to answer some questions about the provision of services for people with learning disabilities in their local area in 2010/11. This report gives a brief summary on priority areas Local Picture Health Housing Employment

Partnership Board Annual Reports 118 out of 153 boards sent in an annual report 84 reports (72%) were signed by the Partnership Board co-chairs. Yorkshire & Humber were the most successful, with all 14 reports being signed by the Partnership Board co-chairs. The East of England had only 4 out of 9 (44%) signed. 74 reports (63%) were signed on behalf of members with a learning disability. The South East managed to have 12 out of 13 (92%) reports signed on behalf of members with a learning disability (although reports were in a different format). Only 4 out of 9 reports from the east of England were signed. 72 reports (61%) were signed on behalf of members who are family carers. Yorkshire & Humber had all 14 of their reports signed on behalf of members who are family carers. The North West had just 6 out of 17 reports signed.

Section 1: Local Picture Each partnership boards was asked to provide information on the local picture for their area. This includes information on: Joint strategic needs assessments Numbers of people with a learning disability Spending on people with a learning disability Personal budgets Jump to Section 2

Since 1 April 2008, Local Authorities and Primary Care Trusts have had a duty to produce a Joint Strategic Needs Assessment (JSNA) to help plan all local care needs. Partnership Board were asked whether their JSNA contributes to understanding and commissioning for people with learning disability. Does JSNA Contribute to Understanding and Commissioning? Back to Section 1 Index

Does JSNA Contribute to Understanding and Commissioning? 61% of those who answered said their JSNA does contribute (dark purple) 39% said it does not contribute (light purple) Areas not coloured did not send a report. Yorkshire & Humber were the most successful region with 86% of Boards reporting their JSNA was helpful for people with learning disability. In the South East none of the 13 Partnership Boards who answered this question reported this. Back to Section 1 Index

How Many Adults Aged 18 and over have a Learning Disability? Partnership Boards were asked how many people they knew in their area who had a learning disability who were aged and 65 and over The map shows how many this was in total per 1,000 adults living in their areas. On average, they reported 3.8 per 1,000 adult population. Boards in the North East of England reported higher rates (5.3 per 1,000). Boards in the East of England reported lower rates (2.8). Back to Section 1 Index

How much is spent on services for Adults with a learning disability? Partnership Boards were how much was spent on services for adults with a learning disability in 2010/11. They were asked how much was spent by the NHS, by the Local Authority and jointly. The map shows the total reported amount per person known with a learning disability. The average across England was £36,680. London reported the highest spend - £41,000 per person. The South West, Yorkshire & Humber and the North East all reported lower spend - £34,000 per person. Back to Section 1 Index

How Many Adults had a Personal Budget in 2010/11? Personal budgets are intended to let people to choose for themselves the services they need to help them live independently. Partnership Board were asked how many adults with learning disabilities have a personal budget. The map shows their answers. Overall, 1 in 4 adults (25%) with learning disabilities had a personal budget. The East of England reported the highest rate with 40% having a personal budget. The South West reported the lowest rate at 15%. Back to Section 1 Index

Do Services for Children offer Personal Budgets? Partnership Boards were asked whether their services for children offered personal budgets. Those reporting they did are shown in dark purple on the map. 39% of all Partnership Boards said they offered personal budgets in childrens services This was most common in the Yorkshire & Humber and East Midlands regions where 57% of Partnership Boards reported offering this. In the South East no board reported this. Back to Section 1 Index

Section 2 - The health of people with learning disabilities Partnership Boards were asked if they had completed an annual self assessment completed an annual self assessment This is a joint exercise where all the professional carers meet with self- advocates and family carers to discuss whether their local services meet a set of standards. They rate themselves as red (poor) amber (average) and green (good) on lots of detailed targets and four top overall targets. The four top targets are: Safety Valuing People Now NHS large accommodation closures Health Inequalities The section also asked about Health ChecksHealth Checks Jump to Section 3

Just under half of all Partnership Boards reported their SAF was complete. A further 38% were working on it. The map shows this varied between regions and could reflect different regions doing it at a different point in the year. Has a Self Assessment Framework (SAF) been completed? Back to Section 2 Index

SAF - Closures of Large Scale Accommodation for People with Learning Disabilities The first top target is to move everyone out of the large scale living accommodation that was the old asylums and into community-based settings. Of the 99 Partnership Boards answered this question: 75% rated themselves as Green Only 1 Partnership Board rated themselves as Red 9 Partnership Boards were still working on their SAF 7 Partnership Boards who had completed their SAF did not answer this question. Back to Section 2 Index

SAF - Addressing Health Inequalities Partnership Boards were asked how well they were doing at addressing health inequalities for people with learning disabilities. Of 96 partnership boards that answered this question: 22% rated themselves as Green 76% rated themselves as Amber - this included all that answered in the North East, East of England and East Midlands. 12% of boards who had done a Self- Assessment did not answer this question. Back to Section 2 Index

SAF - Making Sure People are Safe Partnership Boards were asked to assess how effectively they were keeping people with learning disabilities safe from abuse, neglect and mistreatment in services. Of 97 Partnership board that answered this question: 34% rated themselves Green None rated themself Red Yorkshire and Humber region scored best, with 64% of Partnership Boards rating themselves Green In the North West, all partnership boards who responded rated themselves as Amber Back to Section 2 Index

SAF - Continuing to achieve other ‘Valuing People Now’ health commitments Partnership Boards were asked to rate their progress at achieving other ‘Valuing People Now’ health commitments. Of 97 Partnership Boards that responded, 26% rated their progress as Green. Only 1 rated their progress as Red. Most (73%) rated themselves as Amber. Yorkshire and the Humber Region had the highest proportion (57%) of Green ratings. In the North East, all Partnership Boards rated themselves Amber.. Back to Section 2 Index

Annual health checks are a key Reasonable Adjustment in general practice care for people with learning disability. Health Checks are currently provided by GPs in England as a Directed Enhanced Service. Adults with learning disabilities are eligible for these checks if their disability is known to both their GP and their local social services Department. Each year PCTs send a report to the NHS Information Centre saying how many people they know are eligible and how many have had a health check. You can read more details about this on our annual health checks page. annual health checks page How many adults with learning disabilities had an Annual Health check? Back to Section 2 Index

How many adults with learning disabilities had an Annual Health check? The partnership boards that answered said health checks had been done for 50% of eligible adults. This is similar to the annual figure for the whole of England (49%). Partnership Boards in the South West produced the best regional score (72% of eligible people). The North East was least successful (34% of eligible people). Back to Section 2 Index

Section 3 - Where People Live Each Partnership Board was asked to provide information on where people with learning disability in their local area live. This included information on: Housing needs analysis for people with learning disability People living in their own homes or with family Funding of residential or nursing homesFunding of residential or nursing homes outside the LA Disputes Jump to Section 4

Many people with learning disabilities need specific types of accommodation or support to allow them to live as independently as possible in the community. Partnership Boards were asked if they had done a comprehensive learning disability housing needs analysis as part of their annual local authority housing strategy. Do you have a comprehensive learning disability housing needs analysis that is part of the local authority housing strategy? Back to Section 3 Index

Nearly half (47%) of the Partnership Boards who responded said their local authority housing strategy included a learning disability analysis. 36% were working on this. 14% had no learning disability analysis. 3% did not answer this question. The South East was the most successful region. 69% of Boards reported having one. Do you have a comprehensive learning disability housing needs analysis that is part of the local authority housing strategy? Back to Section 3 Index

Overall, Partnership Boards reported that 65% of people with learning disability live in their own home or with family. The South West reported the lowest proportion (53%). The figure for the South East reflects only 3 Partnership Boards. Others did not answer this question. How many People with Learning Disabilities Live in their Own Home or with Family? Back to Section 3 Index Figures on graph show number of people

Sometimes local health or social care services place people with learning disabilities in homes outside their own area. Partnership Boards were asked how many people in total live in placements outside the Local Authority area. % People with learning disability Living Outside the Partnership Board Area Back to Section 3 Index

% People with learning disability Living Outside the Partnership Board Area 97 areas answered this question. They reported that overall 9% of people with learning disability were living in placements outside the local authority London reported the highest proportion (24%) Other areas reported figures between 5% and 10% The figure for the South East was very low but this represented only one Partnership Board area. Most of the Boards in the South East did not answer this question. Back to Section 3 Index Figures on graph show number of people

Local authorities sometimes place clients in residential care facilities outside their area. This may be because there is insufficient local accommodation, for special types of care, or for cheaper locations. Partnership Boards were asked how much they were spending on placements in residential care settings of several types outside the Local Authority (LA) area. We have presented this as a proportion of the social services residential budget and as pounds-per-placements. % Local Authority (LA) Budget Spent on People living Outside the LA Back to Section 3 Index

Spend on people placed outside the LA as a proportion of total residential spend Overall 18% of the social services budget in England is spent on caring for people living outside their home LA area. London reported the highest proportion (34%) The South West reported the lowest figure (11%) None of the Partnership Boards in the South East answered this question. Back to Section 3 Index Figures on graph show spend outside LA

On average, out of area placements cost £49k per person. The North East reported the highest spending per person at £93k The South West reported the lowest spending at £36k per person. None of the Partnership Boards in the South East answered this question. Spend per person on people placed Outside the LA area Figures on graph show spend outside LA Back to Section 3 Index

When people with learning disability need to live in nursing or residential homes, this care may be provided by the local authority or the care may be provided by private companies but paid for by the LA. Partnership Boards were asked what proportion, in terms of spend, was provided by the LA itself (i.e. ‘in house’). What proportion of residential care is provided in house? Back to Section 3 Index

On average, Partnership Boards reported 17% of their spending on residential care was on in- house provision. Partnership Boards in the North West reported the highest level of spending (28%) on ‘in house’ provision. Partnership Boards in the South West reported the lowest (18%). 10 Partnership Boards reported not spending any of their housing budget ‘in house’. Partnership Boards in the South East did not answer this question. What % of Market (Expenditure) is Provided ‘in House’? Figures on graph show spend (£0,000s) in house Back to Section 3 Index

When a person with a learning disability has been assessed as requiring a package of care, it has to be paid for. This is the responsibility of the LA where the person lives. However sometimes a LA will have a disagreement with another LA whether they should pay for the care, saying that the person in fact lives in another LA and is therefore their responsibility. Disputes over funding care Back to Section 3 Index

Disputes over funding care In total there were 323 disputes as a placing authority (the LA paying for the care). London had the highest number of disputes as a placing authority (64). In total there were 303 disputes as a host authority (the LA providing the care) in 2010/11. Yorkshire & Humber had the highest number of disputes as a hosting authority (107). Back to Section 3 Index Figures on graph show number of disputes

Section 4 – Employment Introduction Each Partnership Board was asked a number of questions relating to employment for people with learning disability. We show the results for how many people each Partnership Board had in paid employment (full or part time) in 2010/11how many people each Partnership Board had in paid employment (full or part time) in 2010/11 the remaining questions can be seen in the table. Jump to Conclusion

How many People are in Paid Employment? Many people with a learning disability want to work, but may find it difficult to find employment. Each Partnership Board was asked how many people they have in full and part time paid employment. We show the proportion of people known to have a learning disability who are working. Overall just 7% of working age people with learning disability have paid jobs. The North East reports the worst figures at just 5%. London reports the best figures at just 9%. Figures range from 0% in the Isle of Wight and Hampshire to 39% in Rutland. Back to Section 3 Index Figures on graph show numbers in work

Conclusion Only 118 out of 153 Partnership Boards returned a report compared to 153 in 2009/10. Partnership Boards reported that 50% of people with learning disability received an annual health check in 2010/11, this is 9% points higher than last year (although less Boards replied). The majority of Partnership Boards reported doing well at closing large scale accommodation despite most saying in the previous year that they would find it difficult. Partnership Boards were doing less well at addressing health inequalities, with only 22% self reporting they were doing well. More people with a learning disability (65%) live in their own home or family than in the previous year. More people with learning disabilities had jobs in 2010/11 compared to previous years, but the figure remains low at just 7%.