What do these services currently offer?

Community Home Assessment and Treatment Team (CHAT)

Who is the service for?

They work with people who have a learning disability who can't access mainstream services and who are at risk of placement break down and/or hospital admission.

The team is made up of learning disability nurses and intervention workers and where required they can access other from the Learning Disability community hubs, but there can sometimes be a delay in accessing this support.

What do they do

Provide 2 weeks of intensive assessment and treatment. 
Operate 7 days per week from 8am to 10pm

Transforming Care Liaison Service (TCLS)

Who is the services for?

This team work with autistic people and/or those who have a learning disability who access mainstream services and who are at risk of placement break down and/or hospital admission.

They are a multi-disciplinary team which includes psychiatry, speech and language therapy, occupational therapy and psychology.

What do they do

They provide liaison to mainstream mental health services to make reasonable adjustments to enable people to access care and treatment.

They also provide in reach into mainstream mental health or specialist inpatient services to ensure timely discharge for people with a learning disability and autistic people.

There is currently no limit to how long the team can work with a service user.

Operate Monday to Friday 9am-5pm

What are we looking to change?

From this review we want to achieve the following outcomes for people with a learning disability and/or autistic people:

• Reduce inequity
• Reduce avoidable hospital admissions
• Support a no wrong door approach 
• Provide seamless transition between teams
• Hold the person at the core and wrap services around them at times of crisis
• Provide clinicians with the right skills to provide the highest quality of care
• Maximise current resources for the best experience and clinical outcomes
• Support staff health and wellbeing

Proposal

Our proposal is to restructure the two current teams to provide:

• Learning disabilities and autism (LDA) enhanced community care
• Learning disability and autism enhanced in-reach into mental health hospitals
• Community liaison

The enhanced model would provide:

• 7 day per week support between the hours of 8am – 8pm for people at risk of placement breakdown and/or hospital admission.
• Support for up to 12 weeks with access to psychiatry, psychology, speech and language therapy and occupational therapy.
• Liaison with mainstream services to support reasonable adjustments.
• In-reach into mainstream mental health services to ensure timely discharge.

Benefits and challenges

Benefits

Benefits of the new model are:

• Reduce inequalities between service delivery.
• Focus on patient needs, rather than diagnosis.
• Combining skills, knowledge and expertise will allow a more bespoke offer.
• Opportunities for our staff to learn new skills and develop.
• A multi-disciplinary team which includes psychiatry, speech and language therapy, occupational Therapy and psychology
• Able to implement bespoke service offer for individuals in crisis requiring an adjusted, not just reasonably adjusted service, where their needs are directly related to their learning disability or autistic distress.
• Allows for realignment of current resources. 
• Reduces duplication and increase direct support available.

Challenges

• Demand for new offer is unclear and may be challenging for current team capacity 
• Additional training may be required for some staff to support patients with different needs.
• Mainstream services understanding the purpose and function of the new team.