Welcome to our engagement on transforming care for people with learning disabilities in the Black Country.

Following the investigation into abuse at Winterbourne View in 2015 and other similar hospitals, there has been a cross-government commitment to move all people with learning disabilities who were inappropriately placed in such institutions into community care.

The local NHS clinical commissioning groups, the organisations that plan and pay for many of our health services, in partnership with the local authorities, have been working to make improvements in care and support following the Winterbourne investigation.

The Transforming Care Programme was established to build on that work and accelerate progress to transform care and support for people with a learning disability who display behaviour that challenges, including those with a mental health condition or behaviour. It is a nationally mandated programme that is being rolled out across the country.

In the Black Country our work in this area aims to:

·         Improve quality of care for people with a learning disability

·         Improve quality of life for people with a learning disability

·         Enhance community capacity, thereby reducing inappropriate hospital admissions and length of stay.

Our work so far has focussed on areas such as: early intervention to minimise the development of challenging behaviours; crisis prevention to provide the right kind of support to prevent and reduce instances of crisis; addressing crises by responding effectively to stabilise an individual’s situation, and ensuring effective discharge to avoid repeat hospital admissions.

All of this means developing more community-based teams with specially trained social workers, nurses, psychologists, psychiatrists and other staff working more closely together around the needs of the child, young person or adult and their family. With fewer hospital admissions, we are intending to free up resources from existing assessment and treatment units which can be invested in the community model.

This public engagement exercise is seeking people’s views on the community-based services that have been put in place in the Black Country and the impact on specialist inpatient assessment and treatment beds for adults with learning disabilities.

It follows the service-user engagement that has been carried out to develop and test the community services. It will ensure people living in the Black Country, regardless of which area they live in, have had the same opportunity to share their thoughts and views on the services and support we are putting in place for adults with learning disabilities.

The Black Country Transforming Care Programme is also developing services around autism and for children and young people and will engage separately on these pathways.

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* 1. What impact do you feel it will have if care and support is being delivered in your community as outlined in the introduction to this survey, rather than in hospital?

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* 2. What impact do you feel it will have if care and support is being delivered in the community rather than in hospital for a person with a learning disability and/or autism displaying challenging behaviours?

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* 3. What impact do you feel it will have if care and support is being delivered in the community rather than in hospital for a service user’s family members or carer?

By treating more people with learning disabilities in the community we are reducing the need for inpatient beds but we will need some. Clinicians believe the unit that can best provide a safe and effective service is Penrose House, Small Heath Lane Hospital in West Bromwich, Sandwell.  This site can treat men and women in separate facilities and has access to emergency services 24/7. Locating the unit here will mean the accommodation at Ridge Hill in Dudley and Orchard Hills/Daisy Bank in Walsall will remain closed

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* 4. If the assessment and treatment centre was based at Penrose House what would the impact be for you?

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* 5. If the assessment and treatment centre was based at Penrose House what would the impact be for family/carers?

The following three questions – Q6, Q7 and Q8 – ask about the importance of specific support for people with learning disabilities in different circumstances:

·         To reduce the likelihood and severity of challenging behaviour

·         In times of crisis

·         When moving between hospital and community/home

We will use this information to inform further development of our community model.

How important are the following services in giving early help to reduce the likelihood of challenging behaviour being displayed, and the frequency and severity of challenging behaviour?
Please specify how important each type of support is by ticking the appropriate box.

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* 6. Support with daily life activities – help with day to day living e.g. washing, dressing, cooking, shopping

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* 7. Communication – help communicating with people

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* 8. Behaviour – help to understand which situations lead to challenging behaviour and how to avoid them or stop them getting worse

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* 9. Personal support / being active in the community – help with making relationships and playing a part in family and community life

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* 10. Environment / home life - help with getting a good quality of life e.g. participating in wider activities, the opportunity to follow interests, trying new things

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* 11. Help to have the best physical environment eg housing

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* 12. Help to deal with changing environments eg moving home, moving out of hospital, the right kind of housing

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* 13. Family carer support/ additional support - giving breaks to those being cared for, and their carers

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* 14. Information and advice – good information and advice to help make good decisions and to know what support is available

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* 15. Please provide further details about your answers above and also tell us about any particular support that you feel would make a real difference:

When a crisis happens, how important are the following services to prevent hospital admission?
Please specify how important each type of support is by ticking the appropriate box.

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* 16. Support with daily life activities - help with day to day living e.g. washing, dressing, cooking, shopping

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* 17. Communication - help communicating with people

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* 18. Behaviour - help to understand which situations lead to challenging behaviour and how to avoid them or stop them getting worse

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* 19. Personal support/being active in the Community - help with making relationships and playing a part in family and community life

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* 20. Environment/ home life – help with getting a good quality of life e.g. participating in wider activities, the opportunity to follow interests, trying new things

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* 21. Help to have the best physical environment – eg housing

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* 22. Help to deal with changing environment: moving home, moving out of hospital, the right kind of housing

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* 23. Family carer support / additional support - giving breaks to those being cared for, and their carers; support with helping a child progress to adulthood

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* 24. Information and advice - good information and advice to help make good decisions and to know what support is available

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* 25. Please provide further details about your answers above and also tell us about any particular support that you feel would make a real difference:

When someone is discharged from hospital, how important are the following services to prevent them going back in?

Please specify how important each type of support is by ticking the appropriate box.

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* 26. Support with daily life activities – help with day to day living eg washing, dressing, cooking, shopping

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* 27. Communication – help communicating with people

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* 28. Behaviour – help to understand which situations lead to challenging behaviour and how to avoid them or stop them getting worse

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* 29. Personal support / being active in the community - help with making relationships and playing a part in family and community life

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* 30. Environment / home life – help with getting a good quality of life e.g. Participating in wider activities, opportunities to follow interests, trying new things

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* 31. Help to deal with changing environments eg moving home, moving out of hospital the right kind of housing

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* 32. Help to have the best physical environment eg housing

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* 33. Family carer support / additional support – giving breaks to those being cared for, and their carers

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* 34. Information and advice – good information and advice to help make good decisions and to know what support is available

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* 35. Please provide further details about your answers above and also tell us about any particular support that you feel would make a real difference for people when they moving out of hospital and into the community:

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* 36. In your experience what stops or delays a person getting the right support in the community? (For example, not enough funding for community services being available or in place).

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* 37. From your experience please tell us what can go wrong with being supported/ supporting someone in the community? (For example, not having the support in place for the person early on).

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* 38. Are you answering this survey as a:

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* 39. How satisfied are you with the way this public engagement exercise is being run?

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* 40. How did you find out about this public engagement exercise?

Equalities monitoring

We recognise and actively promote the benefits of diversity and we are committed to treating everyone with dignity and respect regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex (gender) or sexual orientation. To ensure that our services are designed for the population we serve, we would like you to complete the short monitoring section below. The information provided will only be used for the purpose it has been collected for and will not be passed on to any third parties.

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* 41. Which area/district do you live in?

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* 42. What are the first four letters of your Black Country postcode?

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* 43. What is your gender?

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* 44. If female, are you currently pregnant or have you given birth within the last 12 months?

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* 45. What is your age?

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* 46. What is your ethnic group?

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* 47. Do you look after, or give any help or support to family members, friends, neighbours or others. Please note this is not referring to the person you care for if you have specified carer or if you are completing this survey on behalf of someone else?

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* 48. Are your day-to-day activities limited because of a health condition or illness which has lasted, or is expected to last, at least 12 months? (Please select all that apply)

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* 49. What is your sexual orientation?

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* 50. Are you:

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* 51. What is your religion and belief?

Thank you for taking the time to read this and tell us what you think.



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