Item 8 - Sheffield Health and Social Care

• Develop provision within our popular mentalhealth respite facility at Wainwright Crescentin light of the new Crisis House opening inSheffield in spring 2013. This will build on thesuccessful development last year of step-downbeds at Wainwright Crescent• Further implement Self-Directed Support. Thereare now over 445 people who have an agreedsupport plan in place and 823 others who havean identified indicative budget and are in theprocess of developing their support plan. This is asignificant increase on what we achieved last year,and well towards our expected number of 1500people across Sheffield by the 31st March 2016• Submit a tender for the Mental Health FloatingSupport Service. This service aims to delivershort term (up to 6 months) intensive support toservice users with mental health problems. Thesupport relates to housing issues, to make surepeople have sustainable tenancies and includesfocusing on crisis situations, hospital dischargeetc. This support to clients compliments thework of CMHTs• Seek to expand the Home Environment Servicethat helps clients with cleaning support as partof their Recovery, within the Mental HealthFloating Support Service.Beighton Road Learning Disabilities Service2.4.1.3 Learning Disabilities DirectorateThe Learning Disabilities Directorate works inpartnership with the Local Authority to providespecialist services as part of the Joint LearningDisabilities Service. The services provided consist of:• Specialist challenging behaviour and mentalhealth services• Community multi-disciplinary health supportas part of integrated Community LearningDisability Teams• Accommodation and support services:– Nursing and registered care homes inpartnership with housing associations– Supported living services– Tenancy support• Respite care for people with complexneeds, including profound and multiplelearning disabilities• Case Register• Older Carers Support Service.The following is a summary of our main activityduring the 2012/13 period:• This year has been a period of considerablechange and development for the specialistservices – previously the Improving MentalWellbeing Team, the Community Assessmentand Intensive Support Service (CAISS team, forchallenging behaviour), and the Assessmentand Treatment Unit (ATU). Based on a businesscase developed to deliver best practice in a newmodel of community-focussed services, thethree services have come together to create theIntensive Support Service (ISS). The focus is onensuring local capacity to support people withcomplex needs and maintain provider capabilityto reduce out of city placements. A new buildinghas been commissioned to replace the currentATU and provide the community base for theISS, scheduled for opening in May 2013.The accommodation services have performedwell over the year with all inspected servicesachieving full compliance with the CQC.They are all part of a commissioning-ledreconfiguration programme that is aiming toreduce costs and modernise services. Options arebeing explored for all these services to enablethem to be more personalised, giving peoplemore choice and independence. This will lead tosome refurbishments and some restructuring ofpremises to provide more individualised services.New models of support and staffing structureshave been developed and implemented tohelp meet the aims of the programme, whilstmaintaining quality service provision• New business has been developed to respondto the demand for support for people withcomplex needs who have personal budgets.We have successfully developed a flexible andresponsive service that can provide short or longterm support. For example, this has includedresponding to a crisis need for someone withcomplex behaviour at risk of having to be placedout of city, as well as long term support forsomeone coming through the transition fromchildren’s to adult’s services• The Community Learning Disability Teamshave focussed on developing care and supportpathways to ensure effective and timelydiagnosis and interventions. These havebeen completed for dementia, challengingbehaviour and autism, with others currentlyin development, leading to the developmentof professional practice as well as improvedsupport for carers and providers• Investment from the PCT to reduce out of cityplacements has enabled the multidisciplinaryOut of City Team to successfully return a numberof people with Learning Disabilities to Sheffield.In partnership with the Local Authority, providershave been supported to set up new specialistservices for some of the people with the mostcomplex needs. This will be an on-goingprogramme and includes assessing everyoneplaced out of city and ensuring quality andappropriate services regardless of whetheror not they intend to return to the city.As with the other directorates, we face severalcurrent challenges and issues for the future:• A new requirement for registration with theCQC led to pressures and challenges for someof the services. The premises for the ATU andthe specialist respite services based at theNorthern General Hospital site were consideredinsufficient and non-compliant with registrationrequirements. This was not a new issue and soplans for replacement buildings were already indevelopment and have been accepted by theCQC. The new building for the ISS will bring thatservice into full compliance, however the solutionfor the respite service is more elusive and remainsa pressure. Active negotiations are underway withpotential partners for alternative premises• There are uncertainties around the futureof the accommodation services as the LocalAuthority considers the best options for eachscheme in the reconfiguration programme. TheTrust Board has also been considering the bestoptions for the future services of the Trust andconcluded that it should not continue to provideregistered care home services but should focuson services that provide specialist support forpeople with more complex needs. Plans arebeing put in place to de-register the remainingregistered care homes, but it is not yet certainhow contracts for support will be agreed andmanaged in the longer term. To mitigate theuncertainty the Trust is currently negotiatingnew contracts and is an active partner inexamining alternatives for the future of directlyprovided services with the Local Authority1718