A range of care and support services are in place across the region to support adults with LD to live fulfilled lives within the community.
1. ‘A Change in Approach’: Coproduction and Involvement
Following the 2015 PNA particular focus has been placed on developing an ethos of co-production. The support and care services have aimed to include people with LD in all aspect of the care and support delivery plans in West Wales. The focus on co-production has led to the presence of service users on committees such as the RILP and the formulation of the ‘Dream Team’ and production of the West Wales LD Charter.
The Dream Team is a collaboration of people and members from the Pembrokeshire and Carmarthenshire People First charities, together with representatives from Ceredigion. The members of the Dream Team consist of citizens with first-hand expereince of living with a LD. The Dream Team are a group of individuals with an LD who advise care providers and the local authorities on what really matters, to hold the services to account and to ensure that the care and support needs that matter most to people with LD are being met.
LD Charter (https://www.ldcharter.com/)
Over the past 5 years, the LD community in Carmarthenshire, Pembrokeshire and Ceredigion have worked together to develop a Charter – a simple list of things they expect, and need, to live fulfilling lives.
“The West Wales LD Charter brings together our rights, our needs, and our wants, in a simple document aimed at everyone in our community. “It covers crucial areas like support, health and relationships, and brings them all together in a document anyone can – and should – sign up to. “I wasn’t sure about using the words “we demand” – but we do! It’s only fair that we demand to be treated like everyone else, to have a social life, to do things that fulfil us, and to be treated with dignity and respect.”
James Dash, Co-Chair of the Learning Disability Programme Group
The West Wales LD Charter has been developed with support from the Welsh Government’s Intermediate Care Fund, the West Wales Care Partnership, and Pembrokeshire College. It is supported by the County Councils of Carmarthenshire, Ceredigion and Pembrokeshire, and the Hywel Dda University Health Board. The Charter has been developed and led by the Dream Team, people with LD’s, and not professionals, social services or even charities. The Dream Team are also involved in holding people to account. They visit businesses and organisations to get them to sign up – and checking that they really do follow through on their commitments.
The LD charter underpins all the future planning and provision for LD services in West Wales and has been designed by people with LD for people with LD.
2. Current work and important initiatives in the West Wales Region
In combination with the LD charter and co-production approach, several other initiatives have been put into action. These projects have had capital investment and are all designed to address the varying gaps and needs outlined by the previous PNA. The key to these initiatives is to ensure that citizen’s voices are heard/listened to and ensure citizens can access the right information, when it is needed, in the way they want it and use this to manage and improve their well-being.
2.1 Health check champions
PwLD supporting their peers to access Annual Health Checks thereby, reducing prevalent health inequalities.
2.2 Tech apps
Co-producing accessible digital solutions to paper-based systems such as Health Passports and Care Plans and access to other on-line support, such as travel information.
2.3 Repatriation and Progression project
A virtual team reviewing residential care placements to develop appropriate alternatives to long-term institutional care in -line with individual assessed needs
2.4 Regional LD Employment and training project
Support to address limited opportunities for people with LD to engage in volunteering or paid work as identified in the LD Strategies across the region, by scaling-up a successful pilot in Pembrokeshire.
2.5 Exercise buddies
Increasing the health and well-being of adults with a learning disability and their parents/carers, by developing a range of supported exercise and activity groups.
2.6 Supported accommodation
Improving access to supported accommodation through improved policies, systems, processes and engagement with Registered Social Landlord (RSL) partners.
2.7 Transformation of day opportunities
An engagement programme to develop a future model of day opportunities. Aimed at transforming day opportunities by developing alternative delivery models and piloting of new ways of working.
2.8 Prime of our lives
Developing partnerships, disseminating information, sharing experiences, providing mechanisms to ensure that the voices of older people with learning disabilities are heard and responded to.
2.9 Carms PBIS
Local services that support PwLD and their families, to reduce reported incidents of challenging behaviour, number of placement breakdowns and high cost of out of county placements.
2.10 LD Innovation Fund
Opportunities to test alternative service delivery models to support and empower those with learning disabilities by piloting innovative and co-produced services that meet gaps in provision.
3. Hywel Dda UHB Support and Care Services
Across Hywel Dda UHB there are a arrange of services and specialists that help to care and support people with LD, these include: Consultant psychiatry, psychology, community nursing, Speech and Language Therapy, Occupational Therapy and Physiotherapy. In addition, there are several services specifically available to the LD community across the Hywel Dda UHB to help ensure people with LD have access to the services and care they need and minimise any health inequalities. These include:
3.1 Community Team Learning Disability (CTLD) service
There are four Community Team Learning Disability (CTLD) services across the Hywel Dda area. The teams work together and are made up of learning disability nurses; occupational therapists; physiotherapists; speech and language therapists; psychologists; psychiatrists; behaviour practitioners; and social workers. The teams also work in the community supporting primary care, GPs and private providers, including clients in supported living and residential units, while also supporting individuals living on their own. The teams also support carers, families, and day services.
3.2 Learning Disability Health Liaison Service for adults and children
The Learning Disability Health Liaison Service is for adults and children with learning disabilities who are having or due to have hospital treatment and may need advice and support.
Provides training to staff about the needs of people with LD.
Provides advice about following the LD pathway and using the ‘Care Bundle’
Liaise with the hospital staff to ensure that reasonable adjustments are in place
Provide advice and support to individuals and their carers during their hospital admission
Provide support to ease communication between the patient, carers, and hospital staff
3.3 PMLD/Complex Health Needs Clinic
A new clinic due to be commissioned. The PMLD/complex health needs clinic aims to ensure that people with profound and multiple learning disabilities have access to consistent high-quality health support from the Learning Disabilities Service. Individuals are identified by members of the CTLD and referred to the PMLD Pathway. Aims and objectives of the clinic are:
Identify individuals who require multiple specialist LD health professionals
Complete coordinated assessments and reviews in clinic setting
Complete MDT care plan to meet complex needs and share with SU/carers/families
Identify interventions required and training needs for carers/families
Signpost to other professionals as required.
3.4 Learning Disability Intensive Support Team (LDIST)
The Learning Disability Intensive Support Team (LDIST) is a pilot scheme. The LDIST consists of LD and MH nurses and health care support workers to provide intensive or additional support for adults with LD during a time of need. Support is available for a limited period to help manage or overcome a certain issue, problem or change. The support may include advice over the telephone, individually, in groups, by observational methods, assessments, via direct support, short term treatment, training to carers or through meetings. The LDIST work closely alongside CLDT and provide support that requires an increased level of input for a short and focused amount of time. The LDIST is community based, supporting people with LD/ their families or their care providers where they ordinarily live to continue delivery of care over the longer term.
The specific care and support options do vary across the different LA, with specifics available from: Carmarthenshire family information service, Pembrokeshire People First and Ceredigion Community Team for Learning Disability.