Big Plan addendum 2024

Introduction

Over the last 3 years partners across Health and Social Care have worked together to deliver the key priorities and actions as set out in the original Joint Health and Social Care Learning Disability Strategy 2020 to 2023.

The delivery of the Big Plan has improved the outcomes for people in Leicester with a learning disability and their families. This includes developing training and resources for our staff to better communicate and share information with people with a learning disability in easy read formats. It also includes work that means more people with a learning disability are now having an annual health check and getting a health action plan.

Our partnership working also provided the good governance and commitment needed to take forward the city’s response to COVID-19 in relation to people with learning disabilities. Building on our joint working around the strategy (Big Plan), we were able to lead work from city and county partnership boards ensuring that Leicester was one of the first places in the country to offer priority vaccinations to people with learning disabilities.

Drawing on our health inequalities work we were able to develop a learning disability and autism vaccine programme, including specialist person-centred vaccine clinics.

You can see all of our ‘You Said, We Did’ updates on leicester.gov.uk to find out how we worked together to make it happen.

Read the full strategy Big Plan.

Where are we now?

We have worked closely with people with a learning disability, their carers and key partners to understand what the priorities are in Leicester for people with a learning disability. We know that more needs to be done to improve the lives of people with a learning disability and their family carers. Therefore, we have decided to extend our strategy (Big Plan) and carry forward some key priorities and actions for a further 2 years. We will continue to focus on 3 key aims that focus on empowerment, enablement and prevention:

Ensuring that people with a learning disability can have equal access to health, social care and wider community and universal services through reasonable adjustments.
Ensuring that people with a learning disability are well supported into meaningful, paid employment and that the job centre and employers know how to support them well.
Ensuring that carers of people with a learning disability can have short breaks to support them in their caring role and that our support services in Leicester can provide good breaks for people with a learning disability.

Our Joint Health and Social Care Learning Disability Strategy (Big Plan) 2024 to 2026 will also support our work around Early Intervention and Prevention in Leicester. This will ensure that all of our council services are focussed on becoming more accessible for people with a learning disability.

Work is also being undertaken to refresh the data and intelligence in our Learning Disability Joint Strategic Needs Assessment. This will inform the delivery of this strategy (Big Plan) and enable partners to plan effectively how best to deliver on our priorities responding to the needs of the population, recognising that these have changed, particularly since the COVID-19 pandemic.

Areas if focus

Working on the Big Plan for a further 2 years will enable us to build on the good work that has already happened to fulfil our ambitions and to make a positive impact in areas that couldn’t take priority during the COVID-19 pandemic. We know that these areas are still important to people with a learning disability helping them lead good lives.

To ensure the Big Plan is successful and can make a difference, we have identified 3 priority areas which we will focus on over the next 2 years:

Equal health, social care and community access

Our health inequalities work has ensured that people with a learning disability have had good access to COVID-19 support and were talking to their GPs during the pandemic. There is a need to build on this work to ensure GPs stay in touch with people with a learning disability and that we continue to address health inequalities.

Over the last 3 years, we have done lots of work together to make sure that more and more people are having their annual health checks. We need to continue this good work so no one gets left out and so that people can get treatment and support as early as possible to stay healthy.

During the last 3 years, we have set up a new Learning from Lives and Deaths Review (LeDeR) steering group and this has meant that we’ve been able to put our Learning into Action to make sure people get the right support. This has included giving better support, equipment and training to GPs.

The LeDeR annual report 2022-23 identified that people with a learning disability from minority ethnic communities appeared to be dying significantly younger so work was undertaken by NHS England (NHSE) and the Race and Health Observatory to understand what was causing the additional health inequalities.

It was found that where general population life expectancy is on average 80 years old, for a person with a learning disability, this is 60 years old and for a person with a learning disability who is South Asian, this is 30 years old. Using the recommendations from this report, Integrated Care Boards will be expected to show that they are taking action to reduce this health inequality.

We also need to do more work as a city to encourage all of our services to become more accessible to people with a learning disability by providing the right advice, support and guidance. This includes bus services, leisure centres for example.

Support into work

Many businesses stopped running and/or employing people during the COVID-19 pandemic and this means that there is now a lot more work to do to ensure people with a learning disability get the right support to find and stay in a job that they want. Adult Social Care Outcomes Framework (ASCOF) measures for 2014 to 2021 show the employment rate for people with a learning disability drawing on adult social care support was 4.8% in Leicester, ranking the city 99th across the country. We know we have a lot of work to do to make Leicester a more inclusive city for employment.

Our Supported Employment service for people with learning disabilities and autistic people launched in January 2023, supporting people into meaningful and lasting employment while supporting employers in the city to become Disability Confident. This programme will support a legacy of employers equipped and interested in supporting people with a learning disability into employment, and the learning from the outcomes of this programme will enable the council to better understand barriers to employment and inform what work is needed to ensure meaningful opportunities to enter employment remain in the city going forward.

Short breaks for carers

There are a range of different ways that carers can access a short break. We need to work together with people with a learning disability and with carers to make sure that these services are of high quality and are able to support people with profound and multiple learning disabilities and people with complex support needs.

We also need to make sure that carers know all the different ways they can access a break and how to get support with this.

Governance

To support the delivery of actions outlined in the Joint Health and Social Care Learning Disability Strategy and the underpinning delivery plan, 3 groups will bring together relevant partners to deliver on the 3 priority areas. The Leicester Leicestershire and Rutland Health Inequalities Group, the Supported Employment Working Group and the Leicester Adult Social Care Accommodation Board. Each of these groups will be responsible for providing updates to the Learning Disability Partnership Board who will oversee the delivery of the Big Plan. The Learning Disability Partnership Board brings together representatives from social care, health, Job Centre Plus, Leicestershire Police and the voluntary sector and has responsibility for ensuring that work between the groups is joined up and for monitoring risks and issues.

The Leicester Leicestershire Rutland Learning Disability and Autism Collaborative will update the Learning Disability Partnership Board on work being undertaken across Leicester, Leicestershire and Rutland to improve the lives of people with a learning disability and will ensure that coproduction is at the heart of its delivery and governance.

The Learning Disability Partnership Board will provide updates on progress against the strategy to the Leicester Joint Integrated Commissioning Board and to the Leicester Health and Wellbeing Board.

Key primary strategic partners

Leicester Learning Disability Partnership Board
We Think participation group for people with a learning disability
Leicester, Leicestershire and Rutland Carers Support Service for carers of people with a learning disability
Leicester Joint Integrated Commissioning Board
Leicester Health and Wellbeing Board
Leicester, Leicestershire and Rutland Learning Disability and Autism Collaborative

Leicester, Leicestershire and Rutland Delivery and Transformation Group
Leicester, Leicestershire and Rutland Health Inequalities Group
Leicester, Leicestershire Rutland Engagement and Coproduction Group
Leicester, Leicestershire and Rutland Quality Group

Key secondary strategic partnership boards

Leicestershire Learning Disability Partnership Board
Rutland Learning Disability Partnership Board
Leicester, Leicestershire and Rutland Autism Partnership Board
SEND Strategic Partnership Board
Leicester Safeguarding Adults Board
Leicester Mental Health Partnership Board

Partners

The governance and oversight of Leicester’s Joint Health and Social Care Learning Disability Strategy (Big Plan) recognises that the delivery of our strategy is not the responsibility of a single agency but is owned by all partners that work with people with a learning disability locally.

Since the Big Plan was first written, we have established a new way of working as a partnership to address health inequalities and transform the lives of autistic people and people with learning disabilities, across Leicester, Leicestershire and Rutland. Read about the ambitions of our learning disability and autism collaborative at www.leicspart.nhs.uk.

To support the ambitions and aims laid out in this strategy a number of partners will work in partnership to make sure that their organisations are delivering on the commitments they have made in the strategy (Big Plan).

To ensure the Big Plan is a success and that it is making a difference to the lives of people with a learning disability, it is important that the voices of people with a learning disability and their carers are heard and that they are involved in delivering on and overseeing the strategy (Big plan). The We Think Group for people with a learning disability and the Carers Support Service will ensure that this happens.

Other partners identified include:

Adult Social Care and Commissioning
Adult Social Care Learning and Development
Children’s Social Care and Commissioning
Leicester, Leicestershire and Rutland Integrated Care Board
Leicestershire NHS Partnership Trust
Department for Work and Pensions
Job Centre Plus
Local employers
Housing
Schools and colleges
Leicestershire Police
Voluntary and community sector
We Think Group
Leicestershire Carers Support Service
Big Mouth Forum
NHS Continuing Health Care
Connexions

Key priorities

Priority area 1

Health, social care and community inequalities

Action

To look at complaints procedure and ensure that people with learning disability can use this and raise a complaint independently.
We will use lessons from LeDeR reports (LeDeR looks at why a person with a Learning Disability has died) to help us make services better for people with a learning disability.
We will work together to find out why some people with learning disabilities are missing out on their health checks.
Training will be provided to all staff on:
- learning disability awareness
- reasonable adjustments
- equality and diversity
We will ask care and support professionals to design a healthy eating and lifestyle plan to be included care assessments or support plans.
Work to support the stop over medication people (STOMP) initiative and provide information and guidance to.
We will speak to the local bus companies and offer them advice on how to ensure their services are inclusive and support people with a learning disability to access them.
We will support the work of ‘accessible places’ and provide more support to this project to ensure the work can make a difference.
We will build a network of recreation and leisure services that are able to recognise and provide good services to people with a learning disability.

Priority area 2

Work, college and money

Action

We will work with job centre plus and other partners to write an action plan to make things better.
We will continue to offer employment opportunities within Leicester City Council for people with learning disability to access.
We will work with Leicester College and other partners to understand how colleges meet the needs of students with learning disabilities.
We will work to increase the number of companies that register as ‘Disability Confident’ recruiters and leaders in the city.
We will contact all our ‘Disability Confident’ care providers and ask for their views and advice on how we make things better.

Priority area 3

Support for carers.

Action

Short break needs for carers of people with complex needs and profound and multiple learning disability need to be met.

Key drivers

Making improvements to the lives of people we support is referred to in the Adult Social Care strategic priorities, noting that “The purpose of Adult Social Care is to protect and empower the most vulnerable people in Leicester”.

Key local policies/strategies

Leicester Joint Strategic Needs Assessment (JSNA). Health and social care needs associated with learning disabilities, 2016. (to be refreshed)
Supported Living and Extra Care Strategy 2021 to 2031
Joint Health, Social Care and Education Transitions Strategy Refresh 2022 to 2024
Joint Integrated Commissioning Strategy for Adult Mental Health 2021 to 2025
Leicester, Leicestershire and Rutland Autism Delivery Plan (to be published)
Leicester, Leicestershire and Rutland Joint Carers Strategy 2022 to 2025

Key national legislation/guidance

Care Act 2014 - The Care Act 2014 helps to improve people's independence and wellbeing. It makes clear that local authorities must provide or arrange services that help prevent people developing needs for care and support or delay people deteriorating such that they would need ongoing care and support.
Social Care Reform white paper - The white paper sets out a 10-year vision for care and support in England and is based around three key objectives: People have choice, control and support to live independent lives. People can access outstanding quality and tailored care and support. People find adult social care fair and accessible.
NICE Guidelines - are evidence-based recommendations for health and care in England. They set out the care and services suitable for most people with a specific condition or need, and people in particular circumstances or settings.
Transforming Care - all about improving health and care services so that more people with a learning disability and/or autistic people can live in the community, with the right support, and close to home.
Mental Health Act 1983 - The Mental Health Act (1983) is the main piece of legislation that covers the assessment, treatment and rights of people with a mental health disorder.
Mental Capacity Act 2005 - provides a statutory framework to empower and protect vulnerable people who are not able to make their own decisions. It makes it clear who can take decisions, in which situations, and how they should go about this. It enables people to plan ahead for a time when they may lose capacity.
Mental Capacity Act 2019 - introduces a new process for authorising deprivations of liberty for persons who lack capacity to make a particular decision.
Valuing People White Paper - Valuing People sets out how the Government will provide new opportunities for children and adults with learning disabilities and their families to live full and independent lives as part of their local communities.
Equality Act 2010 - The Equality Act is a law which protects you from discrimination. It means that discrimination or unfair treatment on the basis of certain personal characteristics, such as disability, is now against the law in almost all cases.
Building the right support for people with a learning disability and autistic people - An action plan to strengthen community support for people with a learning disability and autistic people and reduce reliance on mental health inpatient care.
Think Local Act Personal (TLAP) - a national partnership of more than 50 organisations committed to transforming health and care through personalisation and community-based support.
Learning from Lives and Deaths - People with a Learning Disability and autistic people (LeDeR) - LeDeR reviews deaths to see where we can find areas of learning, opportunities to improve, and examples of excellent practice. This information is then used to improve services for people living with a learning disability and autistic people.
Stopping over medication of people with a learning disability, autism or both (STOMP) - a national project involving many different organisations which are helping to stop the overuse of these medicines. STOMP is about helping people to stay well and have a good quality of life.
NHS Long Term Plan – sets out the ways that the NHS wants to improve care for patients over the next ten years.
Supporting adults with a learning disability to have better lives framework (LGA and ADASS) - The aim of the framework is to help directors of adult social services work with their colleagues and partners to identify how they can improve how they support adults with a learning disability and how they can be assured that the care and support in their area is good value for money.
We deserve better: Ethnic minorities with a learning disability and access to healthcare - This review spans the last two decades and gives a deep insight using mixed research methods into the access and experiences of healthcare services for people with a learning disability from Black, South Asian (Indian, Pakistani or Bangladeshi heritage) and minority ethnic backgrounds.