Big Plan Summary Engagement Report

The Big Plan:
Oxfordshire Learning Disability Strategy
2015-18
Summary Engagement Report
Consultation on the draft strategy
Introduction
The draft Big Plan (Oxfordshire Learning Disability Strategy 2015-2018) was
developed with people with learning disabilities, their families and carers, and other
partners. A workshop was held by the Adult Health and Social Care Partnership
Board in December 2013 which was attended by a mix of providers, people with
learning disabilities, family carers, health and social care professionals. Other
discussions took place at the Learning Disability Partnership Board in February and
April 2014, plus three other meetings which took place in 2014.
The Big Plan has attracted interest from members of the public and other key
stakeholders across Oxfordshire.
Once the draft Big Plan was written, the views of the public were sought.
Why the public consultation was done
Oxfordshire County Council and Oxfordshire Clinical Commissioning Group
embarked on a period of engagement from the 10th November 2014 to 9th February
2015. Throughout the consultation the aim was to gather feedback from stakeholders
on the draft Big Plan.
The consultation covered Oxfordshire County Council’s and Oxfordshire Clinical
Commissioning Group’s vision and priorities for people with learning disabilities in
Oxfordshire and the strategic and commissioning intentions for services from
January 2016.
How the consultation was carried out
A wide variety of engagement methods were used to support this consultation.





Online engagement methods on the Oxfordshire County Council website
were used with an online questionnaire (also available in hard copy)
Direct feedback via emails and phone calls
Twenty-six meetings, including four public meetings were held for
parents/carers/professionals and people with a learning disability across
the county to find out more about the Big Plan and proposed model and to
give their feedback in person
Sessions specifically for people with learning disabilities
Sessions in learning disability day services, both in the voluntary sector
and in county council run services.
1
Key Findings
A large range of responses were received to the consultation. There were 411 people
who took part by attending the consultation meetings, and 118 people responded to
the questionnaire online. Through groups specifically for people with learning
disabilities 140 people took part. There were 20 submissions by email from members
of the public and stakeholder groups/organisations, one letter and three phone calls.
All the responses were analysed. The following themes emerged:
There was overall support for the proposed Big Plan, alongside some concerns
and reservations, particularly about the possibility of achieving the aims within the
expectation of reduced funding. Respondents also wanted to know more of the
detail.
Key themes from stakeholder meetings, the questionnaires and written
feedback were:
 Overall support for the priorities and vision was clear.
 People with learning disabilities welcomed more choice and control; families
and support staff were concerned about them being exploited or hurt.
 Families welcomed the concept of an intensive support team, with an
additional respite resource for people who have high levels of need.
 There is a need for more partnership collaboration and working across
organisations that will need to work together to change attitudes and culture.
 There is a need to ensure that primary care (GPs) and other health services
are ready to engage with the mainstreaming of learning disability health
support.
 Concern was expressed by respondents as to whether Oxfordshire County
Council and Oxfordshire Clinical Commissioning Group can deliver these
services safely, given the financial constraints.
 Communities could support people better but will need to learn how and
also address risk issues.
 Volunteers to support people with Learning Disabilities may not be available
in sufficient numbers or quality, and they will need supervision and training
 People will need help to navigate the systems.
 More consideration needs to be given to the care of people who have
medically complex conditions and profound and multiple learning
disabilities.
 There is concern about the ability of mainstream mental health inpatient
services to meet the needs of people with autism and very complex
behaviours that challenge in a mainstream mental health environment.
2
 There was concern about the support offered to people with learning
disabilities and dementia.
 Joint work between the learning disability and mental health services may
improve outcomes and efficiency but this will not happen without investment,
engagement, training and focus.
 More clarity is needed regarding the role of specialist beds for people with
the most complex needs.
 More clarity and detail is required about the responsibilities of the
Reasonable Adjustments Advisory Team.
 Training and qualifications for paid carers should be a priority, and
recruitment issues addressed.
 Many people do not have sufficient understanding of personal budgets to
use them effectively.
 Work and volunteering were welcomed, but currently there are limited
opportunities, so much more needs to be done to educate employers and
address the barriers.
 Health promotion and prevention are important to prevent problems and
crises further down the line.
There was a broad consensus that respite needs to be reviewed as a priority both planned and emergency, as there are problems now. Some older carers rely
on daytime support services as an important source of respite.
Questionnaire Responses
The pie charts below represent the questionnaire responses to the Big Plan. The
questionnaire was answered by 54 people with learning disabilities, 51 ‘others’
included family members or carers, representatives from voluntary and community
organisations, provider organisations, NHS and Oxfordshire County Council
representatives or employees, and elected members and User-led organisations.
Thirteen respondents didn’t complete the ‘About You’ section.
The Vision
Question 1 - Is our Vision for the lives of people with learning disabilities and their
carers in Oxfordshire right? (113 people answered this question.)
3
People with Learning Disabilities
Others
2%
3%
6%
14%
31%
No
No
Not Sure
Not Sure
Yes
61%
30%
53%
Blank
Yes
Blank
61% of people with learning disabilities agreed with the vision, along with 53% of
other respondents. 31% and 30% respectively indicated they were not sure. 6% of
people with learning disabilities and 14% of others respectively disagreed that this
was the right vision.
Priority 1 – Choice and control
“We will support people who have a learning disability to have more choice and
control over their lives”
Question 2 – Do you agree with Priority 1? (112 people answered this question.)
People with Learning Disabilities
Others
4%
3%
9%
14%
No
22%
No
Not Sure
19%
Yes
65%
Not Sure
Yes
Blank
64%
Blank
65% of people with learning disabilities agreed with Priority 1, along with 64% of
other respondents. 22% and 19% respectively indicated they were not sure. 9% and
14% respectively disagreed that this was the right vision.
Priority 2 – Being part of Oxfordshire
“We will enable people with learning disabilities to take an active part in their
community, through work, volunteering, friendships, and other opportunities”
4
Question 3 – Do you agree with Priority 2? (113 people answered this question.)
People with Learning Disabilities
Others
4%
3%
7%
14%
No
No
Not Sure
35%
54%
Not Sure
24%
Yes
59%
Blank
Yes
Blank
54% of people with learning disabilities agreed with Priority 2, along with 59% of
other respondents. 35% and 24% respectively indicated they were not sure. 7% and
14% respectively disagreed that this was the right vision.
Priority 3 – Living in the right home
“We will enable people with learning disabilities to make choices about where they
want to live, and support them and their families with their decision”
Question 4 – Do you agree with Priority 3? (113 people answered this question.)
People with Learning Disabilities
Others
2%
3%
9%
11%
No
20%
No
17%
Not Sure
Yes
69%
Not Sure
Yes
Blank
69%
Blank
69% of people with learning disabilities agreed with Priority 3, along with 69% of
other respondents. 20% and 17% respectively indicated they were not sure. 9% and
11% respectively disagreed that this was the right vision.
Priority 4 – Healthy and safe
“We will have the right support in place for people with learning disabilities to enable
them to remain safe and keep well”
5
Question 5 - Do you agree with Priority 4? (99 people answered this question.)
People with Learning Disabilities
Others
4% 4%
3%
5%
26%
No
22%
Not Sure
Not Sure
Yes
Yes
Blank
66%
No
Blank
70%
66% of people with learning disabilities agreed with Priority 4, along with 70% of
other respondents. 26% and 2% respectively indicated they were not sure. 4% and
5% respectively disagreed that this was the right vision.
Question 6 - Please indicate whether you agree with the strategic intentions.
(100 people answered this question.)
People with Learning Disabilities
Others
2%
4%
15%
No
Not Sure
44%
37%
28%
34%
No
Not Sure
Yes
Yes
Blank
Blank
36%
44% of people with learning disabilities agreed with the strategic intentions, along
with 34% of other respondents. 37% and 36% respectively indicated they were not
sure. 15% and 28% respectively disagreed that this was the right vision.
Question 7 - Do you agree with the overall plan to re-shape services in line with the
proposed service model? (110 people answered this question.)
6
People with Learning Disabilities
Others
2%
3%
22%
22%
No
27%
25%
No
Not Sure
Not Sure
Yes
Yes
Blank
Blank
54%
45%
22% of people with learning disabilities agreed with the re-shaping of services, along
with 25% of other respondents. 54% and 45% respectively indicated they were not
sure. 22% and 45% respectively disagreed that this was the right vision.
Question 8. What are your views on the proposal for Tier 1 services and how could it
be improved?
The most common responses were:




Work and volunteering were good ideas in theory
This is all right for those who have some capacity but not for those who don't,
is this realistic?
People need support to access the right care
Support existing services to reorganise
Question 9. What are your views on the proposal for Tier 2 services and how could
it be improved?
The most common responses were:



There has to be proper independent scrutiny
The reasonable adjustments need to be defined
What about training regarding people who have more complex
communication or medical needs?
Question 10. Are there any health and social care needs of people with learning
disabilities for which mainstream services may not be the best solution?
7
People with Learning Disability
Others
2%
11%
6%
13%
No
23%
Not Sure
28%
Yes
48%
No
Not Sure
Yes
Blank
69%
Blank
28% of people with learning disabilities felt that mainstream services may not be the
best solution, along with 69% of other respondents. 48% and 23% respectively
indicated they were not sure. 13% and 6% respectively disagreed that this was the
right vision.
Question 11. What are your views on the proposal for Tier 3 services and how could
it be improved?
The most common responses were:



Good idea/great if it works
‘Specialist' help = expectancy of 'personalised' treatment?
Building relationships with service users through long term work is a
protective factor
Question 12. What are your views on the proposal for the Tier 4 services and how
could it be improved?
The most common responses were:



“Good, but in reality will it work?”
Have to have the right service in place
People with learning disabilities asked – “What does this mean for me?”
Question 13 - Please give your comments on the Social and Community Impact
Assessment. Have we missed anything? People said:







It underplays the risks of using mainstream services.
Need more focus on complex and severe needs
Include supported housing in assessment
Support minority ethnic people to participate
More comprehensive analysis of the weaknesses of the current system
Issues for elderly parent carers
The very real and significant health inequalities for people with learning
disabilities.
8
Conclusion
Overall there was support for the priorities and vision within the Big Plan. However
there is some concern that the plan is too ambitious and the time frame too short for
the degree of cultural and organisational change it demands.
People with learning disabilities welcomed more choice and control and families
welcomed the concept of an intensive support team, with an additional respite
resource for people who have high levels of need.
There was a clear ambition for the whole of Oxfordshire to be part of supporting
people with learning disabilities. A clear message was that all parties need to work
together to change attitudes and culture and that communities could support people
better, but will need to learn how and also address risk issues.
There was concern about a range of people with more complex needs, in relation to
multiple medical conditions and in relation to people with very complex behaviour
that challenges their living situation. Also there was concern in relation to those with
multiple conditions (such as learning disabilities and autism or learning disabilities
and dementia).
Next Steps
The findings in this consultation report will be given consideration by the
commissioners in the writing of the final version of The Big Plan: Oxfordshire’s
Learning Disability Strategy 2015-2018. The final version of the Big Plan will be on
the agenda of Oxfordshire County Council Cabinet on 17th March 2015.
A copy of this engagement report will be made available by electronic or hard copy to
all those that participated in the online and direct engagement. It will also be
available for download at Oxfordshire County Council’s e-consult website:
www.oxfordshire.gov.uk/bigplan
Acknowledgements
Oxfordshire County Council (OCC) and Oxfordshire Clinical Commissioning Group
(OCCG) are grateful to all individuals who took part and gave their views, and to
partner organisations that helped to distribute the consultation more widely.
Engagement Team
Oxfordshire County Council
Social and Community Services
February 2015
9