1. NHS Continuing Healthcare Is it different for people with a learning disability? Cath Roff: Strategic Director – Adults, Health & Housing, Derby City Council

2. Where do people with learning disabilities live?

3. Introduction: Beyond Winterbourne View DH have facilitated and co-ordinated a number of work streams leading to their own initial report in June 2012. This Final report and partnership-wide Concordat due October 2012 A second Panorama programme recently screened Following the incidents highlighted in the Panorama programme in 2011, a Serious Case Review was initiated (South Gloucestershire). The report was published in August 2012, with 43 recommendations. Criminal proceedings have concluded and the 11 people charged have pleaded guilty. CQC undertook 150 inspections of Treatment & Assessment Units (and similar provision) and published a report and analysis in June 2012. Internal Management Reviews undertaken by CQC and the NHS also highlighted a range of required improvements.

4. Key Issues / Findings Incidents at Winterbourne View have sent a powerful message that such abusive behaviour will not be tolerated Services must be more efficient, effective and humane. Hospitals for people with learning disabilities and autism should not exist, but they do. While they exist they should be regarded as high risk services. … Serious Case Review Clear provider failure to protect and provide a quality service Too many people are being admitted to Treatment & Assessment Units (or similar closed services) and they are staying too long Alternative, community based models of service need to be developed more widely and properly commissioned

5. Key Issues / Findings (contd) Need for improved joint commissioning of these services across health and social care, and commissioning practice to be improved People within these establishments need to be more visible and have regular, ongoing contact with commissioners, families and friends Staff need to be properly trained, supervised and supported There needs to be improvement and strengthening of multi- agency safeguarding referrals and responses, ensuring that clear pictures of referrals/issues/trends are tracked and considered CQC inspection approaches need to be reviewed and improved to ensure Providers are working to and delivering services to a high and safe standard Establish Quality Frameworks for Provision and Advocacy

6. Key issues / Findings (contd) The Department of Health are working closely with all stakeholders to establish a clear framework for performance outcomes linked to the main areas for improvement. It is proposed that this will be monitored through the National Partnership Board for Learning Disabilities, which is jointly chaired by someone with a Learning Disability and the Minister for Care Services. The Concordat (to be published in October) will set out a wide range of commitments from all key stakeholders saying what they will do to ensure these improvements are made. This will also form part of the accountability framework.

7. Our guiding principles People with learning disabilities should: Have a sense of living valued lives as men and women with support needs Their services should be characterised by social inclusion, respect, dignity and choice Local ties to their community and families should be sustained We should ensure the availability of quality choices that draw on local strengths and build assets to strengthen community support and care A commitment to personalised services should under pin this approach