To consider the progress and make recommendations on the learning disability strategy to date.

The committee noted an error in paragraph 6 of the report where the figure should have read 2000, instead of 200.

The head of care commissioning introduced the item. The committee received a presentation led by the senior commissioning officer. The presentation included video clips recorded by two residents with learning disabilities about their lived experience. The chairperson requested that thanks be passed on to them on behalf of the committee.

The chairperson invited questions and comments from committee members to which officers responded. The principal points of the discussion are summarised below:

1.     Officers confirmed there were no specific criteria for identifying young people who would be able to live independently with support. All cases were considered on an individual basis with a focus on setting as many achievable goals as possible in line with the strengths based approach. It was sometimes necessary to have honest but sensitive conversations and to challenge the perceptions of young people, their parents or carers and those working with them about what was achievable.

2.     The committee heard about a supported living scheme which had accommodated 9 people who needed support to live independently. Officers explained that Herefordshire has quite low numbers in supported living compared with other councils so pathways and systems were being developed to pick up individuals who might benefit from such housing earlier and to be better sighted on vacancies. Agreements with social landlords were in place and the council’s housing team were very supportive.

3.     It was noted that there were challenges where individuals had been living in residential care for some time to get them to consider different arrangements.

4.     All young adults who appeared to be needing health and social care were now referred to one transitions team who would then work with experts to see what pathways were suitable for each individual.

5.     The committee heard that the supported living framework, which was aimed at working age people, was currently being revisited.

6.     It was disappointing that the council and NHS had not yet progressed becoming exemplar employers of people with learning disabilities.

7.     The impact of the coronavirus pandemic may have created opportunities for employment, for example in delivering products, picking and packing, hospitality and in increased home working. The committee felt that these opportunities should be explored as the economy began to recover.

8.     The impact of the pandemic had required adaptations to some planned activities and presented challenges for people with learning disabilities but work was in progress to look at opportunities for learning, particularly around the use of assistive technology.

9.     Benchmarking was carried out against other authorities locally and nationally, and the council sought to continue to improve against its own past performance;

10.  Retention of social workers was not a significant problem, but it did sometimes prove hard to appoint experienced people when vacancies occurred. Officers reported they were working with HR on ways to attract more experienced social workers as well as developing the skills of existing staff. In relation to a query on continuity of contact with a designated social worker, officers confirmed that records held in the mosaic system were audited by a separate team to make sure they were of good quality and ensured that when new social workers were assigned to an individual they did not need to cover the same ground over again.

11.  It had always been challenging to recruit nursing staff and the exit from the EU had not had any particular impact on recruitment of caring staff.

12.  Committee members were concerned that achieving savings could have an impact on users. Officers confirmed that all projects came from the premise of making improvements and that it was expected savings would be delivered by getting the right level of care and support for each individual. The challenge was to think differently rather than take services away and to make sure that all services were accessible for people with learning disabilities. This aligned with the strengths based approach adopted in the adults and communities directorate.

13.  Committee members requested more detail in future updates, that a list of partners in partnerships and networks be provided and that future reports were clear what was meant by the term partners in each context.

14.  Committee members praised the bill of rights and felt it was important this be promoted.

15.  The health needs of individuals with learning disabilities were noted, with annual health checks being available and promotion of support for carers. Officers highlighted the work of the LeDeR programme and that no individuals with learning disabilities had been lost to covid. The next piece of work will focus on the primary care networks and how to be more proactive on health for this group. The issues caused by Herefordshire residents accessing healthcare through GPs based in Wales were highlighted as a complication.

16.  Officers explained that healthwatch had developed information around reasonable adjustments which had recently been published on their website. It was hoped that in future there would be a scheme for businesses to achieve accreditation for standards on reasonable adjustments.

17.  The plan to reduce waiting times for assessments for autism was welcomed. The aim was to be an 18 week period from referral to starting the process. The service for children was previously taking up to a year for an assessment but this was reducing as additional capacity had been put in. The adults’ service had only recently been commissioned. Covid had caused delays as some elements of the assessment required face to face contact that could not be replicated online.

The cabinet member health and adult wellbeing addressed the committee. She highlighted that:

·        the strategy was a joint endeavour between the council and CCG and the importance of continuing to collaborate;

·        the priority was to look after the needs of residents and the strategy showed the holistic approach;

·        the relationship between someone in need of support and the supporter was important;

·        the savings target was spread over 16 months;

·        non-financial benefits of projects and activities to improve services were also important.

The lead for mental health, learning disability and children at Herefordshire and Worcestershire CCG addressed the committee. She highlighted the importance of collaboration between the council, the CCG and other partners and how the governance structures functioned. Despite the join up of the CCG with Worcestershire, there continued to be a focus on Herefordshire and the larger footprint provided opportunities to work across the wider area on projects such as the complex needs strategy.

The committee considered recommendations. The recommendations below were proposed by Councillor Alan Seldon and seconded by Councillor Tim Price. The recommendations were agreed unanimously by the committee.

It was resolved that the committee recommends the following:

a)     Herefordshire Council and NHS partners urgently progress becoming exemplar employers of people with learning disabilities (ref LD2.09);

b)     the council take advantage of employment opportunities emerging during the recovery from coronavirus, such as in the hospitality industry and utilising increased working from home;

c)     Include in the dashboard benchmarking against local and national comparators to give a clearer picture of the council’s performance;

d)     Include in the dashboard figures on the numbers of complaints and appeals to illustrate the impact of savings plans on service users;

e)     That the bill of rights be widely promoted;

f)      A briefing note be provided to the committee on continuity of contact with social workers for regular service users; and

g)     A briefing note be provided on providers.