To approve the Learning Disability Strategy 2018-2028.

The cabinet member health and wellbeing introduced the report and the interim director for adults and wellbeing and the senior commissioning officer set out the following key points:

·         the figures in paragraph 31 of the report required correction, the total annual spend on health and social care services for adults with learning disabilities in Herefordshire was £30.7 million, broken down to £7.4 million from the CCG and £23.3 million from the council;

·         the strategy aspired to enabling the same outcomes for people with learning disabilities as other residents;

·         although there were no specific savings targets there was an understanding of the financial constraints and the need to use resources as efficiently as possible;

·         the strategy had been produced in partnership with the CCG and the learning disability community, and both the adults and wellbeing scrutiny committee and the children and young people scrutiny committee had considered the strategy;

·         there was a need for a long term strategy as learning disabilities could be a lifelong condition, needs could range from those with minimal difficulties to those with profound and complex needs;

·         adults services would work with people with learning disabilities from the age of 14 as they prepared for the transition to adulthood;

·         there was a focus on the aspirations of people with learning disabilities in recognition that many wanted and expected to live as independently as possible and, for example, have paid employment.

Members of the cabinet expressed their support for the strategy and commended officers on the work that had gone into the document. In discussion of the item it was noted that:

·         the learning disability partnership board would have a significant role in delivering the strategy and work would take place to raise their profile;

·         work was underway with the communications team to put together a PR campaign for the strategy, which would include working with people with learning disabilities and an easy access version of the strategy;

·         the strategy was designed to be as flexible as possible so that it could react to emerging issues, the implementation plan would be refreshed every 2 years;

·         enabling people with learning disabilities to reduce their dependence on funded services could deliver efficiencies in the longer term and expand the range of opportunities;

·         Herefordshire was a high spending authority due to having a high proportion of people with learning disabilities in residential care, thresholds having been lower for admission in the past and it being complex to transition service users to other care models;

·         officers from the adults and children directorates had worked closely together on the strategy, particularly in the approach to young people preparing for adulthood, and this cross working would continue;

·         the council needed to work harder to be an exemplar of inclusive employment practice.

The chairs of the relevant scrutiny committees gave feedback from their consideration of the item.

The adults and wellbeing scrutiny committee were very happy to support the strategy but highlighted the challenges of keeping all partners on the same path and managing demands on the budget in the future. They supported the comment that the council should do more to employ people with learning disabilities.

The chair of the children and young people scrutiny committee reported that the committee had heard testimony from a young person who had recently been through the transition process and who had very positive things to say about the strategy. The committee had also heard from the service quality director of Aspire about some of the everyday challenges facing people with learning disabilities.

It was noted that the majority of the recommendations from the children and young people scrutiny committee had been accepted. The committee recognised that recommendation (h) covered an area which was not a function of the executive but had wanted to highlight the importance of holding partners to account for those elements of the strategy for which they were responsible. It was also acknowledged that recommendation (f) was perhaps not very clear. The chair of the committee clarified that the intent was to encourage GPs to work with other partners to provide support for people with learning disabilities to evidence their disability so that they could more easily access bus passes and other transport schemes. The responses from the executive would be discussed with the scrutiny committee.

Group leaders were invited to give the views of their groups. There was widespread support for the strategy and those who had worked on it were commended. Concern was expressed about the impact efficiency savings might have should they be required. It was considered important that the implementation of the strategy be monitored and that the relevant scrutiny committees reviewed progress.

In response to points raised it was noted that:

·         the council had implemented the requirements of the Care Act 2014 very successfully and was meeting its obligations, the new strategy was about meeting ongoing obligations and how to make sure that the right mix of services was in place at the right time ;

·         the strategy had been designed to be flexible to manage any changes such as revisions to NHS budgets;

·         the strategy was not viewed specifically as an adults directorate document and the close working between staff from the adults and children directorates would continue, all commissioners would be challenged to think more broadly;

·         it was widely regarded that Herefordshire had an excellent record of enabling home ownership for people with learning disabilities and was ahead of many other councils in this respect.

It was noted that the reference in recommendation (a) should be to paragraph 40, not 38 as originally published.

Resolved that:

(a)   the executive’s response to the recommendations of the children and young peoples’ scrutiny committee at paragraph 40 be approved; and

(b)   the Learning Disability Strategy 2018-2028 (Appendix 1) be approved.