1. East Sussex response to Winterbourne Recommendations Sue Culling Strategic Commissioning manager –LD LD Provider forum 24 th October 2012

2. Winterbourne serious case review (August 2012) findings (1): Winterbourne Hospital was neither commissioned nor used by local NHS/LA. Primary Care Trusts monitoring systems failed to identify the abuse that took place by the staff employed by Castlebeck Care Ltd at Winterbourne View. There were deficiencies in the way that each commissioner of care contracted for and monitored the care of patients which meant no shared intelligence about the quality of the care in the unit

3. Winterbourne serious case review (August 2012) findings (2): The Primary Care Trusts placed undue reliance on the fact that Winterbourne View had been registered by the Care Quality Commission. There was no single picture of the pattern of safeguarding alerts relating to Winterbourne View recorded via the NHS or shared across commissioners. There was a lack of clarity of roles within NHS commissioners between the commissioning and the monitoring of the care for patients at Winterbourne View Staffing – the brochure indicated that the hospital had professional staff teams – in practice it was senior care workers who ran the wards on a day to day basis Use of restraint – was unmonitored and included dangerous and unapproved /abusive practice

4. In East Sussex ….. There are 2 private hospital Assessment and Treatment Units in county – one in Ticehurst and one in Bexhill the marketed service model is one of multi disciplinary specialist health professionals/therapists The placements at both are commissioned on a spot purchase basis predominantly by areas outside of East Sussex NHS East Sussex spot purchase LD Assessment and Treatment unit beds at Selden (Worthing ) which is operated by Sussex Partnership NHS Foundation Trust NHS East Sussex spot purchase private hospital placements if the locally commissioned NHS facilities are full

5. Some points to ponder…… Do we have the right services, at the right cost and quality for people with Learning Disability and challenging behaviour /complex needs in East Sussex? Do provider services have the right support to deliver complex placements? What criteria is used in order to make placements for people with learning disability and complex needs ? A key issue was the “light touch” quality monitoring and allowance of self -investigation – what is the best way of gauging quality outcomes for people with learning disability and complex needs

6. An invitation to Providers …. If you provide services that support people with challenging behaviour and complex needs and would like to participate in a working group to explore the position in East Sussex Contact Suzanne.Culling@eastsussex.gov.uk by 9 th November 2012