New joint guidance has been issued by NHS England, the Local Government Association and ADASS focussing on the housing demand arising out of the Transforming Care Programme. It represents a fantastic opportunity for the NHS and Local Authorities to work with housing providers, housing associations and registered social landlords to design bespoke solutions for these complex service users.
Please click here for the full guidance. It was published towards the end of December 2016 and is guidance for commissioners of services for people with learning disabilities / autistic spectrum disorders and behaviour that challenges – focussing on housing provision.
It stems from the Transforming Care Programme (aimed at reducing inpatient population for learning disability and autism by 2019). It's a useful guide and provides some interesting information about housing models and funding streams.
The basic message is to encourage commissioners to forward-plan with local housing providers for the circa 2,400 service users that it is anticipated will require supported living/own home arrangements upon discharge from hospital by March 2019. The aim is to offer all of those service users their own tenancy or own home.
Don't forget that these service users require complex legal frameworks to support the interferences with their human rights in the community setting. A lot of these service users present with very challenging behaviours – and it means that techniques to manage those behaviours, which traditionally would only have been used in hospital setting, are needing to be used in a community setting. They require legal frameworks because they are often quite invasive.
It is the responsibility of commissioners and providers to ensure that those interferences are recognised and that appropriate legal frameworks are put in place.
The way that the law is evolving, whilst it will be unusual at the moment for the housing provider/landlord to be directly responsible/liable for putting these frameworks in place, they are likely to be considered as a public body for the purposes of the Human Rights Act 1998 (as they are carrying out a function of a public nature) and as such, have a series of reciprocal duties arising to check that providers in their properties are aware of and abiding by the legal frameworks and making referrals to the relevant Local Authority safeguarding boards where there are any concerns. In addition, if the housing provider delivers any care/support (e.g. "extra-care" providers), they may well be directly responsible for putting in place the legal frameworks.
If you would like to discuss restrictive care packages in the community setting, please get in touch with Hannah Taylor.
You should also be aware that Part 3 of the CQC consultation that is currently ongoing deals with the registration of residential services for people with learning disabilities. It indicates that if the design of new residential (whether inpatient or care home) services does not comply with the national plan set out in "Building the Right Support", it is unlikely that they will be registered by CQC. This will have a real effect on the design of any new residential care units for people with learning disabilities.