Building the Right Home: Transforming Care for People with Learning Disabilities

1. Building the right home 12th December 2016 Housing LIN London 9th January 2017

2. Transforming Care Programme • NHS England’s learning disability programme is working to transform the care and support for people with learning disabilities by: • Closing inappropriate inpatient facilities • Building up community capacity to prevent future admissions • Building the right support • This three year programme of work is aiming to reduce inpatient capacity by up to half by March 2019 and build up community capacity. • To achieve this vision, NHS England are working with LGA and ADASS to deliver new, better care options in the community and 35-50% reduction in total inpatient numbers by March 2019. • In 2015, 48 Transforming Care Partnerships (TCPs) were established across England to improve community capacity and reduce the need for specialist hospital care by March 2019.

3. Who are the Transforming Care cohort? Individuals do not ‘slot neatly’ into any single grouping – they overlap, people’s needs change over time, and often a large part of the challenge for local services will be to understand what combination of factors lies behind an individual’s behaviour.

4. National service model 1. I have a good and meaningful everyday life. 2. My care and support is person-centred, planned, proactive and coordinated. 3. I have choice and control over how my health and care needs are met. 4. My family and paid support and care staff get the help they need to support me to live in the community. 5. I have a choice about where I live and who I live with. 6. I get good care and support from mainstream health services. 7. I can access specialist health and social care support in the community. 8. If I need it, I get support to stay out of trouble. 9. If I am admitted for assessment and treatment in a hospital setting because my health needs can’t be met in the community, it is high-quality and I don’t stay there longer than I need to. • Key principles • People should be offered a choice of housing • Choice about housing should be offered early in any planning processes. • Everyoneshould be offered settled accommodation. • Future needs should form part of local housing strategies. • Where people live needs to be understood from the individual perspective.

5. Building the right home • To support the ambition of Transforming Care we need to see : • A significant expansion in housing options • An improvement in the quality of housing options • Housing delivered in the right place at the right time A significant increase in housing options for people with a learning disability and/or autism will enable people to access the right home and support at the right time. Inevitably, this will also support the reduction in overall inpatient capacity by March 2019. • Settled accommodation does not include: • Long-stay healthcare residential facility or hospital • Registered care home • Registered nursing home • Temporary accommodation/hostel • Housing with occupancy of six or more can quickly become institutionalised • Housing should not create new campus sites, avoid creating schemes of multiple units within close proximity. • People should have separate housing and support contracts

6. Housing Strategy • To support the ambition of Transforming Care we need to see : • A significant expansion in housing options • An improvement in the quality of housing options - inappropriate housing can increase the likelihood of behaviour that challenges and lead to placement breakdown • Modelling suggests that of the estimated13,500 adult patients we expect to be discharged between July 2016 and March 2019: • 1,100 will be returning to existing accommodation • 2,400 would require new living arrangements, mainly supported housing and bespoke housing options. 1All forward projections on discharges are estimates based on historical Assuring Transformation data

7. NHS capital grant • NHS England has £20 million of capital grant to spend per year between 2017 and 2021 (totalling £80 million). • This grant is for settled and short-term accommodation options for children, young people and adults with learning disabilities and/or autism who display behaviour that challenges. • The capital funding can be used for new accommodation, adaptations and remodelling to enable them to live in settled accommodation in the community. • People with learning disabilities and/or autism who display behaviour that challenges will have packages of care and support in place upon discharge from hospital. • Capital funding requirements should be submitted by a sponsoring CCG