2020-21 was challenging year across learning disability services.  Most face-to-face activity was discontinued, non-essential social activities, groups and day opportunities were closed.  Many staff, who people have good working relationships with, were repurposed into front line delivery roles.  People with learning disabilities had to be supported to understand and adapt to these changes to normal life.

However, in spite of the global pandemic, passionate, committed and enthusiastic learning disability teams across Cardiff and the Vale of Glamorgan contacted and supported many people with learning disabilities through the pandemic continuing to deliver positive outcomes and put people at the centre of their activities.

Funding Stream Funding No of Staff* Direct Social Value
Integrated Care Fund £1,111k 22 £42.3k

* Full time equivalent posts

The following projects were supported:

Transition into adult life

The Multi Agency Transition Review Interface Group (TRIG) transition process for those most vulnerable and in need of continued care and support into adult life is now well established in Cardiff and maintained within the Vale of Glamorgan.  Good attendance was reported for meetings despite pressure on partner’s time due to the pandemic.

  • 41 young people received multiagency discussions to enable a successful transition to the right support as adults
  • 47% of young people were allocated an adult learning disability social worker
  • All young people’s views and wishes now included in their transition assessment.

The Ty’r Bont project

Based at Ty Gwyn Special School in Ely (which supports pupils aged 3-19 with Autism and /or profound and complex needs), the Ty’r Bont pilot is in its second year of funded support staff working alongside and building relationships with the young people whilst in their education setting.  Seven pupils have been supported to transition from school to adult life whilst remaining in their local community.  This is an excellent example of partnership working between Education, Health and Social Services to deliver the best support and care for young people with complex needs in preparing to leave school and move into adult services.

The Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q)

The CAIDS-Q pilot was developed to support practitioners to assess the level of learning need to support next steps in transition planning. This tool provides an easier way of identifying children/young people who are likely to have an intellectual disability and may go on to require the support of Adult Learning Disability Service. This assessment has been successful as a pilot in supporting earlier identification of need and support transition discussions and will be shared with all Cardiff and Vale of Glamorgan schools.

Supported Accommodation

More integrated health, social care and housing is a challenging aim to improve life chances and services and allow funding to be used more effectively.

The Cardiff Supported Living team adapted to COVID-19 by:

  • Taking a lead role in supporting providers with complex COVID risk plans
  • Running a weekly consultation risk assessment clinic
  • Management of learning disability isolation beds
  • Management of respite for those with an urgent need

As the service moved into recovery, the team also achieved:

  • 9 positive accommodation moves
  • 8 accommodation moves in progress (4 from residential colleges and 4 supported to live in local communities)
  • A business analyst recruited to provide data about future need

Transition Support Planning

Transition is a time in your life when you are growing up and getting ready to   leave school, start or leave college and be an adult.

Transition support planners have been working with young people with learning disabilities to help plan for adulthood. This new role, works alongside social workers to support young people to explore opportunities to take part in as they move through into adult hood.

Learning Disabilities Support Planner Bethan Evans
Learning Disabilities Support Planner Gillian Banks

They had to be creative during the pandemic to offer alternative opportunities to support individuals with learning disabilities. They identified meaningful activities to run as an online alternative. Baking sessions, pamper sessions, learning to dance and mindfulness activities enabled people to maintain contact with friends and their community.

As activity restarted, they have also:

  • Received 7 referrals (Vale of Glamorgan)
  • Received 5 referrals (Cardiff)
  • Received 100% positive feedback from people who have been supported

Bespoke Respite

The COVID pandemic has had an impact on the safe delivery of respite and support services throughout 2020-21.  The Adult Placement Team in the Vale of Glamorgan support people with learning disabilities to access short breaks with carers, and also support the maintenance of long-term placements. The service and workforce expanded last year to support people with learning disabilities across the Vale of Glamorgan and Bridgend.

During 2020-21, the Adult Placement Scheme team supported:

  • 28 long term placements in the Vale of Glamorgan
  • 36 respite placements in the Vale of Glamorgan

Improving Lives

Learning Disabilities Liaison Nurses

The improving lives programme supports the delivery of two Acute Liaison Nurses for Learning Disabilities. Their role is support people with Learning Disabilities when in hospital to support access to assessment, treatment and investigations. Our hospitals are large and busy acute settings, and these two posts help people in hospital across the Cardiff and Vale Health Board area.

The ALNs have had positive feedback from the people they support and success in maintaining the legal duty of reasonable adjustments.

They also recruited at least 20 learning disabilities champions across the health board.

 

Learning Disabilities – Community Health Care Assistants

Welsh Government Integrated Care funding enabled the recruitment of two, Health Care Support Workers.

These staff members work within the Community Learning Disability Teams to support people with learning disabilities to access health services and take up the Annual Health Check.

 

The aim is for more people with a Learning Disability living healthier lives as a result of this additional support.

The Health Profile for Adults with a Learning Disability

The ‘Health Profile’ is a personalised 4-page document that people with Learning Disabilities can take to appointments to inform health care providers of their individual health needs and will help them to get the right healthcare at the right time.

Part of the Learning Disability Improving Lives programme delivered by Improvement Cymru, in November 2020 the partnership team worked with Cardiff People First and Vale People First to recruit eight people with a learning disability to assist their peers in the creation of a health profile and to promote the health profile across professional and carers networks

A perfect example of co-production. Quotes from the People First teams:

“I think it is a great idea it will really help everyone explain their situation and take the stress away. I am really proud to be part of the team, I feel like I am doing a worthwhile job”

”Being on this project has changed me for the future it’s helped me to follow my dreams as I love working with people with disabilities it makes me happy knowing they are happy. The team leaders are great to be working with they are always there if we get stuck the health profiles have been a great experience to do as they have helped a person with a disability to understand the importance of the health profile”


“It’s eye opening to give accessible information and to know everyone with a learning disability are aware of their health rights, this makes me feel valued because health professionals take in our feedback, implementing it into their work and take us seriously. From my perspective it’s a slow progress but we’re getting there. I enjoy working closely with Public Health Wales and Vale People First”

I personally feel I am making a difference, because health can be important to all human’s quality of life. As I’ve been encouraging people to take up a Health Profile it feels as though I’m helping others.

 

Workforce development for health and social care staff

Cardiff and Vale University Health Board and Hijinx – the professional theatre company working to pioneer, produce and promote opportunities for actors with learning disabilities and/or autism – have launched a new series of online training videos to train health and social care staff to effectively communicate with, appropriately care for, and support people with learning disabilities and/or autism.

Thirteen training modules are now freely available to anyone delivering healthcare to people with learning disabilities.

Existing projects

In 2019-2020 services for adults with learning disabilities focused on four main areas of development. With a particular focus on supporting adults with the most complex needs to remain closer to home and within their own communities. These are:

  • Supported accommodation
  • Development of bespoke respite provision
  • Enhanced day opportunities
  • Establishing new and sustainable ways of supporting individuals who do not need statutory intervention.

Supported Accommodation for Young Adults with Learning Disabilities and Complex Needs

The Supported Accommodation service provides a multiagency approach to assessing young adults with the most complex needs. This service undertakes comprehensive assessments to identify a person’s needs, and supports them to be able to live in suitable accommodation as independently as possible. As a result, young adults have been able to live close to their families and existing networks. Previously, this group of individuals have accessed residential support out of their local area, either as an interim measure until suitable supported accommodation is found, or on a longer term basis.


Bespoke Respite for Adults with Learning Disabilities

The Bespoke Respite pilot has been established to regionalise a respite approach and offer across Cardiff and the Vale equitable access to respite that is tailored to meet individual needs. The vision for this pilot is to have a menu of options for respite, to include overnight respite within a residential respite service, a range of adult placement schemes, direct payments and access to a range of day opportunities (see below). Currently, residential respite services across Cardiff and the Vale struggle to meet the needs of those with complex needs due to a lack of fully accessible provision. Similarly, there are a number of people who access residential respite who could access their respite via Adult Placement or Direct Payments.


Enhanced Day Opportunities for Adults with Learning Disabilities and Complex Needs

Day opportunities are provided across Cardiff and Vale of Glamorgan for adults with learning disabilities. Over recent years, Cardiff and the Vale’s internal day provision has focused on meeting the outcomes and needs of people with complex health and social care needs. Due to increased demand, on occasion, this has not be possible, and out of county placements have had to be made.

 

Supporting those with more complex needs has been achieved by supporting additional day care staff within Cardiff to increase capacity of the service, and accessing training for staff members to build on their skills. Having the opportunity to acquire additional resources, such as IT equipment, craft materials and to purchase sessions from tutors to support enrichment activities, has enabled the day opportunities services to be able to meet the needs of those individuals with varying degrees of needs both on site and within the communities. Specialist equipment has been secured in both authorities, which has enabled some adults with more complex needs to access the service.


Learning Disability Enablement Project

This project continues the work of the previous Welsh Government funded Regional Collaboration Fund. It provides a review function within social services to support adults with learning disabilities and complex needs to access packages of care, which are proportionate to their needs and closer to their homes than earlier provisions may have been. This is a regional service offering an aligned approach across Cardiff and the Vale of Glamorgan.