winterbourne pbs amanda & alison

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  • 1.WINTERBOURNE There MustbeAnother Way.But What Is It ? Network Name Lancaster & Preston Community LD Teams

2. Who We AreWe are Amanda Tiley and Alison Riley.We are Community Learning Disability Nurses based in Preston and Lancaster respectively.We work with people who challenge services and may be subject to being sectioned under theMental Health Act.We liaise with all members of the multidisciplinary team, including police, solicitors, social workers, commissioners, psychiatrists etc. Network NameLancaster & Preston Community LD Teams 3. Aims of the WorkshopTo raise awareness of Positive BehaviouralSupports.To work collaboratively in a multi-professionalforum in order to develop strategies to minimisethe risk of abuse of vulnerable adults.To generate action plans to put into practice withinthe workplace.Network Name Lancaster & Preston Community LD Teams 4. ExerciseWhen you hear the words Winterbourne Viewwhat does it mean to you?Network Name Lancaster & Preston Community LD Teams 5. These are some of the thoughts mycolleagues and I felt.. Safeguarding Torture Restraint Guidance Abuse Lack of Lack of caresupervision Sadness Anger Despair Threat EvilNetwork Name Lancaster & Preston Community LD Teams 6. Winterbourne View Review Concordat orAgreement Programme of Action After the Panorama Programme was aired, an inquirytook place identifying what went wrong and why. Recommendations were made not only to frontline staff and service providers but also tocommunity teams, commissioners, social workers,housing and CQC.Network Name Lancaster & Preston Community LD Teams 7. Simon Tovey was at Winterbourne view because the care home hed lived in for 16 years needed extra staff to cope with his behaviour. They asked the council for an extra 600 a week.The council and other agencies decided he neededassessing and moved him out of area.Assessment was supposed to take 6 months, but Simon wasaway for 3 years.He ended up at Winterbourne View.Network Name Lancaster & Preston Community LD Teams 8. Winterbourne One Year OnSince the inquiry, Simon has moved back to the care home near his family that he didnot want to leave in the first place. It costs 1,400 a week less than it did for him to stay at Winterbourne View. His mother, Ann Earley says:All this could have been resolved in his current home. Heneed never have had those three years of hell.Network Name Lancaster & Preston Community LD Teams 9. What led us to Winterbourneand the Mental Health Act asan answer?Working with people who challenge services when distressedmay cause risk of serious harm, not only to the personthemselves, but members of the public and staff teamssupporting them. Physical intervention, restrictive practices andthe use of the Mental Health Act have historically been used toreduce the risk of harm, sometimes disproportionately.When developing care plans for these people, we have toconsider risk, duty of care and proportionate responses. Network NameLancaster & Preston Community LD Teams 10. So what is the other way? Today we will be discussing: positivebehavioural supports, legislation and guidancearound the protection of vulnerable adults. As a group we will be working together to lookat ways forward to avoid the possibility ofthese scenes occurring again.Network Name Lancaster CommunityCommunity LD Teams & Preston LD Team 11. As a group What can we change? Keeping it Local - are the Mental Health Actand Out of Area Placements the only way tosupport people who challenge the service? Leadership - who is in charge? Accountability - what is the line ofaccountability? Supervision, training, support,burn out, competency?Network Name Lancaster & Preston Community LD Teams 12. Associated Legislation CARE IN THE COMMUNITY ACT (1990)OUTLINED - PLANS FOR HOSPITALTO COMMUNITY TRANSFER THE HUMAN RIGHTS ACT (1998) THE CARE STANDARDS ACT (2000) -RECOGNISED ABUSE IN CARE HOMESLEADING TO CSCI INSPECTIONS THE CARE STANDARDS ACT (2000) - RECOGNISED ABUSE IN CARE HOMESLEADING TO CSCI INSPECTIONS MENTAL CAPACITY ACT (2005) AND DOLS PUTS BEST INTERESTS INSTATUTE LAW SAFEGUARDING VULNERABLE GROUPS ACT 2006 MENTAL CAPACITY CODE OF CONDUCT(2007) - PROVIDES FRAMEWORK TODETERMINE MENTAL CAPACITY THE EQUALITY ACT 2010 PREVENTS DISCRIMINATION AGAINST A PERSONBECAUSE OF PROTECTED CHARACTERISTICS WINTERBOURNE ENQUIRY 2012Network Name Lancaster & Preston Community LD Teams 13. What is positive behavioursupport? Positive Behavioural support approaches have become established asthe preferred approach when working with people with learningdisabilities who exhibit behaviours described as challenging. The strengths and successes of positive behaviouralsupportapproaches provide the reason for the increasing support for their use.They are fundamentally rooted in person centred values, aiming toenhancecommunity presence, increasing personal skills andcompetence and placing emphasis on respect for the individual beingsupported. They also use quality of life improvements for the person,both as an intervention and as an outcome measure.(BILD)Network Name Lancaster CommunityCommunity LD Teams Lancaster & PrestonLD Team 14. Staff responses to behavioursthat challenge services.As reported at previous sessions of PBS formanagers training.They are attention seekingIts a slippery slope, what if it gets out of controlThey know exactly what they are doingThey are doing it to wind us upThey have already had (biscuit/brew..)You are giving in to themI dont get paid enough to be attacked at workWhy do people respond in this way?Network Name Lancaster CommunityCommunity LD Teams Lancaster & PrestonLD Team 15. This Person could saveyour lifePlease Dont DiscriminateNetwork Name Lancaster CommunityCommunity LD Teams Lancaster & PrestonLD Team 16. GROUP EXERCISETo reduce the potential for Challenging Behaviour what needs to be in the care plan?Network Name Lancaster & Preston Community LD Teams 17. Gold Standard Care PlanIs this the WAY????Or have we forgottensomething??? Network NameLancaster CommunityCommunity LD TeamsLancaster & PrestonLD Team 18. What is involved in a PBS Plan? Personal Information Health Action Plan Person Centred Plan Mental Capacity Assessment/Consent Communication Passport Person Centred Risk Assessment High Density of Preferred ActivitiesNetwork Name Lancaster & Preston Community LD Teams 19. What is involved in a PBS Plan? Functional Assessment (including SupportPlan) Sensory Assessment Medication Primary and Secondary Prevention Strategies Reinforcement Inventory Motivational Assessment Network NameLancaster & Preston Community LD Teams 20. Risk Assessments Human rights joint risk assessment andmanagement plan (hr-jramp) How can we develop person centred riskassessments that keep people safe and happy(as opposed to safe and unhappy or happyand unsafe) How can we work together for asolution Network NameLancaster & Preston Community LD Teams 21. What do we need in order to improve? More community based enhanced services - environments tailored to individual needs. More specialised skilled services to deal withthese behaviours. Using the Mental Capacity Act as opposed tothe Mental Health Act as a legal framework. Meaningful life. Keep it local.Network Name Lancaster & Preston Community LD Teams 22. Any questions?Network Name Lancaster CommunityCommunity LD Teams Lancaster & PrestonLD Team

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