Here to help with questions relating to learning disability and its impact on family carers
The CQC calls the current situation unacceptable.
Its report describes that situation as follows:
Some people are struggling to get access to the mental health services they need, when they need them.
This can mean that people reach a level of ‘crisis’ that requires immediate and costly intervention before getting the care they need, or that they end up in inappropriate parts of the system.
Some people are detained in mental health services when this might have been avoided if they had been helped sooner, and then find themselves spending too long in services that are not suitable for them.
Too many people with a learning disability or autism are in hospital because of a lack of local, intensive community services.
We have concerns about the quality of inpatient wards that should be providing longer-term and highly specialised care for people.
We have shone a spotlight this year on the prolonged use of segregation for people with severe and complex problems – who should instead be receiving specialist care from staff with highly specialised skills, and in a setting that is fully tailored to their needs.
Since October 2018, we have rated as inadequate 14 independent mental health hospitals that admit people with a learning disability and/or autism, and put them into special measures.
This is an unacceptable situation. A better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments. We must all work together to make this happen.
We also know that people with the most severe and enduring mental ill-health do not always have access to local, comprehensive rehabilitation services and are often in inappropriate placements far from home. This weakens support networks and the ability of family and commissioners to stay in close contact, sometimes with devastating consequences.
We are seeing issues with the availability of care. There has been a 14% fall in the number of mental health beds between 2014/15 and 2018/19. While this is in line with the national policy commitment to support people in the community, it is vital that people in crisis can access support when needed.
All of this is underpinned by significant issues around staffing and workforce.
Our inspectors are seeing too many mental health and learning disability services with people who lack the skills, training, experience or clinical support to care for patients with complex needs. In the majority of mental health inpatient services rated as inadequate or requires improvement since October 2018, the inspection reports identified a lack of appropriately skilled staff as an issue.
“Children with special educational needs and disabilities are increasingly being failed by the system designed to support them, the Local Government and Social Care Ombudsman has found.
In its latest report about the Education, Health and Care (EHC) plan process, the Ombudsman has revealed it is now upholding nearly nine out of every 10 (87%) cases it investigates – a startling figure compared with its uphold rate of 57% across all cases it looks at, discounting SEND cases.
The new report, ‘Not going to plan?’ looks at the common problems the Ombudsman is finding when investigating parents’ concerns. Serious issues include severe delays of up to 90 weeks – and regularly of more than a year – when issuing a plan, not anticipating local needs, communication and preparation for meetings, and a lack of oversight by senior staff.”
Full details here: www.lgo.org.uk/information-centre/news/2019/oct/a-system-in-crisis-ombudsman-complaints-about-special-educational-needs-at-alarming-level and in the report itself, downloadable as a PDF via a link on this web page.
The report is only 29 pages long Read especially the Ombudsman’s Foreward from which this is an extract:
“… a system beset with serious problems, including:
> Severe delays – of up to 90 weeks but regularly more than a year
> Poor planning and anticipation of needs– such as council areas simply without any specialist provision available to them
> Poor communication and preparation for meetings – including regular stories of nonattendance and no, or insufficient, paperwork submitted
> Inadequate partnership working – with EHC plans regularly issued without advice from health or social care services
> Lack of oversight from senior managers – cases ‘drifting’ needlessly and attempts to farm out responsibilities to parents”
One particularly concerning development over the last two years has been examples we’ve seen of councils putting up additional barriers to services in efforts to ration scarce resources.
While sympathetic to the severe financial constraints which councils tell us they are working under, we can never accept this as an excuse for failing to meet the statutory rights of children.”
Also worth noting is the concluding section entitled “Scrutiny and the role of councillors” where the ombudsman, Michael King, lists the questions that councillors should be asking about their local authority (and, by implication, have not been asking).
As the Ombudsman Michael King puts it ” The challenging picture we see played out in the media on an almost weekly basis is very much reflected in the types and seriousness of the complaints we receive and the faults our investigations put right. Many of the issues we see appear to be driven by attempts to ration scarce resources, and we received and upheld more complaints about fees and charging this year than in previous years. While I recognise the challenging environment both commissioners and providers are operating within, any attempts to reduce costs must also properly consider the impact on the rights and dignity of people who use services, and must comply with both the letter and the spirit of the Care Act 2014″.
The Review is always worth a look. If nothing else, read the Ombudsman’s 2-page forward. Or follow the links and dig down to the league table spreadsheets – to see how any particular local authority has performed with regard to complaint-handling.
The NAS has long highlighted the twin problems affecting the diagnosis of autism in children; the postcode lottery and long-waiting times. (As a parent, I have had personal experience of both). The ending of a postcode lottery and dramatic cuts waiting times are admirable intentions, and we wish the Caudwell International Children’s Centre (CICC) all the best in these ambitions, although we note that the project is not without controversy
In the absence of public funding, a private individual, John Caudwell, billionaire founder of Phones4U, has paid for most of the development as an act of philanthropy. In 2017, when he initially pledged £9 towards the cost of the centre, he and his charitable foundation were criticised by some for espousing and supporting too many ‘alternative and non-scientific therapies’, notably in article by The Times’ Science Correspondent.
We hope and assume that the fact that the CICC is located within Keeele University means that academic and scientific rigour will be applied to its operation. We will await developments…
This is how the CICC announced the opening on its website:
Parliament debated the petition you signed – “Prevent avoidable deaths by making autism/learning disability training mandatory”
The petition: https://petition.parliament.uk/petitions/221033
The Petitions team
UK Government and Parliament