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Debbie Endersby –Head of LD commissioning And

Sue Culling Strategic Commissioning manager –LD June 18th 2014

Aims of the program of work • To understand the range and context of Restrictive

Interventions (RI) that are being used by LD providers in East Sussex

• To have systems in place to assure stakeholders that where RI are used that they undertaken in a safe and ethical way for example are individualised , based on positive behavioural support and recovery models and are recorded

• To ensure a focus on reducing the use of all RI • To ensure that services and staff are supported • To ensure best practice is promoted and shared

Purpose of the focus group June 2nd • to co produce/assist with the development of

East Sussex service specifications for people with a learning disability who may challenge services and where RI is in use

• to assist with a notification process to record where RI is in use particularly for physical restraint

• to share approaches and good practice around RI

Positive and proactive care (DH 2014) indicates 4 overarching themes

• Improving care

• Leadership , assurance and accountability

• Transparency

• Monitoring and oversight

What needs to be in place • Use of positive behavioural support approaches and individual

behavioural support plans • Service Providers to have RI Reduction programs in place • Service Providers to have Board level accountability for RI • Service Providers to have audits of quality of practice

including post incident analysis• Service Providers to have skilled staff trained by accredited

trainers if using physical restraint • Good record keeping

Where we are now

• We shared the draft specification with the focus group

• We proposed a notification process for providers to inform commissioners that RI is being used

• Discussion about approaches as to defining what good looks like

• Discussion around current LD Provider training to support continuous improvement in services and promotion of best practice

Key themes and issues (1)

• Some providers indicated that they were already doing what the guidance required but that policies and procedures would need updating to reflect the new guidance requirements

• Some providers had already started to look at the implications of the guidance for their organisation for example Restrictive Intervention reduction programs

• Main issue was the new language and consistency of use of definitions to describe key elements

Key themes and issues (2)

• In addition to training -there was a recognition that some of the practical issues were about recruiting the right staff to work with the client group

• Needed to consider how best to share information and involve service users and carers

Some suggested areas for ongoing work • To circulate examples and exemplars of good

practice • Involvement of people with learning disability

and their carers in reviewing process and procedures

• An East Sussex network to share good practice and ideas

We would like to know …

• What works in practice ? • What needs to be avoided? • Are there quality measures that you use that

would be useful to share?

• Please contact me suzanne.culling@eastsussex.gov.uk