Like many of us working in social care, I’m passionate about what I do. I’m determined to focus that passion on driving change and improving standards of care that is so desperately needed for autistic people and people with a learning disability.
Earlier this year we established our Learning Disability and Autism Expert Advisory Group (EAG). This group brings together people with lived experience, organisations representing them, groups representing care providers and other strategic stakeholders.
The EAG has helped us to identify our priorities for the next couple of years to ensure that the work we’ve done so far in establishing Right Support, Right Care, Right Culture is firmly embedded as the framework of good practice for providers and systems to work to.
We know that autistic people and people with a learning disability are far more likely to suffer inequality in healthcare access. The LeDeR (Learning from Lives and Deaths Review) annual report shows that a lack of access to medical appointments and health screening is leading to people dying much earlier than in the wider population. Our work with the EAG has helped us identify where we can have the most impact in reducing these inequalities in three key areas:
- Health and reducing mortality, through access to GPs and quality of annual health checks.
- Reducing restrictive practice – ensuring everyone in health and social care is working to reduce restrictive practice in their services.
- Community – enabling people to get the best care where they live, including access to specialist support and commissioning of the right care and housing options.
Sharing best practice is key. One of the ways we share best practice is through our inspection reports. Recently I was pleased to hear how colleagues at New Key, a care service in Totnes, Devon, had helped to develop a person-centred, inclusive and empowering service for the people they cared for. They provide care and support to people living in several supported living settings in the local area, helping them to live as independently as possible in their own homes.
It was inspiring to hear people tell us that staff encouraged them to set goals they might not have otherwise believed possible. For example, staff supported one person who wanted to travel independently by helping them meet local taxi drivers. This helped them find someone they felt safe and comfortable with.
The leaders at New Key clearly value the importance of person-centred feedback and meet regularly with people. They also use an external agency run by autistic people and people with a learning disability to meet and gather feedback from people independently.
The spirit of openness and collaboration we saw there is a great example of how leaders can combat the threat of the development of closed cultures. I’d encourage you to look at this report to see what potential ideas and improvements you could adopt.
So, what about our next steps? We’ve developed a new cross sector policy position on restrictive practice. Seen through the lens of people with a learning disability, autistic people and people with mental ill health, the policy is clear that we expect all care to be person-centred. Leaders of services, systems and sectors need to understand events that led up to the use of restraint, seclusion or segregation and learn from them. They are not just as moments in time but are potentially a result of failures in people’s pathways of care, including potential failures in system partner collaboration. Where there is no other safe option, and regardless of which registered setting restrictive practice occurs in, we expect that the board or its equivalent will analyse incidents and work to reduce them.
We’ll continue to work together to tackle health inequalities in the three key areas identified and continue the work we began in our EAG meetings. There’s a lot to do. Let’s get on with it!
You can get involved in our work by following us on CitizenLab, our online participation platform, and making sure you’re subscribed to our regular bulletins.