Agenda item

Consideration was given to an update on the current situation regarding the Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) adult learning disability respite provision. Led by TEWVs Durham, Tees Valley and Forensic Care Group Director of Operations & Transformation (CAMHS & LD), and supported by the TEWV Managing Director – Durham, Tees Valley and Forensic Care Group and Deputy Chief Executive, past and current context was noted as follows:

·         TEWV is commissioned to provide adult learning disability (ALD) respite services for the population of Teesside from two sites – Asgarth (Durham Road, Stockton – 6 beds) and Bankfields Court (Middlesbrough – 5 beds).

·         As previously noted during the last update to the Committee (December 2021), in 2019, the Care Quality Commission (CQC) identified that these facilities did not meet Mixed Sex Accommodation (MSA) guidance – action was undertaken to comply with requirements, a by-product of which was a reduction in the number of days families were able to access services.

·         In 2020, a project steering group completed a comprehensive review of delivery models and building options. This work was paused due to the pandemic but restarted recently upon the appointment of a new director and general manager in ALD services – this included engagement with families, around 70 of which access this offer.

·         The estate is a significant challenge, with both buildings remaining in poor condition due to age.

The Committee was then informed of TEWVs vision for these services, the longer-term aim being to provide creative health and social care options that are responsive, with fair and equitable access, reflective of the evolving needs of the population, and go beyond a solely bed-based service. Recent developments towards this goal included the re-opening of conversations with stakeholders systemwide (including Local Authorities across Teesside and the NENC ICB) to explore new models of sustainable respite provision across ALD in Teesside, engaging with regulators to inform registration requirements linked to ‘Right Care, Right Support, Right Culture’, and the September 2023 appointment of a Programme Lead for transforming TEWVs ALD bed model. Officers provided assurance that TEWV remained in regular contact with families regarding the existing situation and fully recognised the profound disabilities of those accessing its services.

Members responded by requesting clarification around whether the number of beds available at the two sites had reduced – officers agreed to confirm any recent changes following this meeting.

Reflecting on the existing offer, the Committee noted that some may misguidedly view the service as a hospital, and questioned if TEWV was proposing that respite provision should be delivered by social care partners. Drawing attention to the regulatory requirement on TEWV to provide a certain level of service based on the licence it holds, officers confirmed that nothing was being ruled out in terms of future delivery options, though providing the best support for families would remain the priority. Potential alternatives to the existing offer would need to be worked through with partners as part of a broader conversation on ALD services, and assurance was given that TEWV was not attempting to offload this element despite previous regulatory challenges.

Referencing the systemwide-focus, the Committee welcomed the broader engagement with, and by, partners. However, there remained an issue with those leaving education who were, along with their families, at risk of feeling alone without the appropriate support in place as they moved into adult services. Officers stated that challenges around transition were very much recognised and an area which required improvement – TEWV would be working on this with the NENC ICB and other partners. Developing other models of support away from the bed-based-only offer may help with making the service more accessible to those transitioning into adult provision.

Emphasising the value of the respite offer for families and thanking those who cared for their loved ones (in turn, saving health and care organisations significant money), the Committee asked if services were flexible enough to meet the needs of those accessing them. TEWV reiterated its continuing close engagement with families who were not giving any indication of a lack of flexibility regarding access, highlighting the positive feedback it had received via the Friends and Family Test, as well as the soon-to-be-restarted service-user group. In addition, a Lived-Experience Lead had been brought into the ALD service to aid developments. Opportunities for families to submit their views were also promoted via a regular newsletter – the Committee subsequently requested a recently issued example of this communication.

AGREED that:

1)    the Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) adult learning disability respite provision update be noted.

2)    further information be provided by TEWV as requested by the Committee.