AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH

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1 AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH NATIONAL CONTEXT Fulfilling and Rewarding Lives (2010) is the Government s strategy for adults with Autistic Spectrum Disorders. It sets out the Government s vision for delivering the requirements of the Autism Act The Government s vision for transforming the lives of adults with autism is that: All adults with autism are able to live fulfilling and rewarding lives within a society that accepts and understands them. They can get a diagnosis and access support if they need it, and they can depend on mainstream public services to treat them fairly as individuals, helping them make the most of their talents. A key part achieving this vision is ensuring that adults with autism have equal access and opportunity to services, life choices, education, and employment and can live as independently as possible. This requires a cultural shift, where autism is better understood by public services and the wider society. The Department of Health (DoH) has issued statutory guidance for local authorities and NHS organisations to support the implementation of the autism strategy. The guidance, issued under section 2 of the Autism Act , sets out four key areas drawn from the strategy to achieve the outcomes: 1) Training of staff who provide services to adults with autism 2) Identification and diagnosis of autism in adults, leading to assessment of needs for relevant services 3) Planning in relation to the provision of services to people with autism as they move from being children to adults 4) Local planning and leadership in relation to the provision of services for adults with autism 1 Section 3 of the Act says that the guidance is to be treated as thought it were guidance issued under section 1

2 Key Issues for adults with Autism The national strategy identifies that people with autism are often socially and economically excluded because of a failure to respond to their needs. Many are dependant on benefits and find it difficult to gain employment. They are also likely to depend on family and friends for support and care. Those without structured support networks are at greater risk of general and mental health problems, homelessness and offending behaviour. 2 It is recognised that the Council has much work to do to establish the key issues for adults with autism in the borough, however it is likely that the issues identified in the national strategy would be consistent with, and indicative of the types of issues that would be relevant to Greenwich at a local level. The Council is required to ensure that all its services (not just Adult Social Care) take account of the needs of people with Autism and should liaise with partners such as Health, Probation and Jobcentre Plus to address local issues and ensure equality of access. LOCAL CONTEXT - PREVALENCE OF AUTISM SPECTRUM DISORDER (ASD) IN GREENWICH Greenwich Council has not yet undertaken a survey of the number of adults with autism. The National Autistic Society (NAS) estimates that there are 1597 adults (aged 20+) with ASD in Greenwich 3. The majority (1277) are male. Greenwich Adults and Older People s Services 4 own data showed that there were only 60 adults know to services. This means that there could potentially be around 1537 adults with autism not receiving a service. It is likely that many will not satisfy the FACS criteria. However, it is clear that we need more information about the prevalence of autism to be better placed to meet the needs of people with ASD. The PCT commissions a diagnostic assessment service from an external provider. However Oxleas and CT also have information relating to people with ASD. There is therefore no single register of people who have received a diagnostic assessment, thus making it difficult to gather data. IMPLEMENTING FULFILLING AND REWARDING LIVES The attached action plan identifies and outlines the requirements on the Council to effectively implement the autism strategy. It has been split into four sections, in line with the four key areas identified in the guidance. 1) Training to staff who provide services to adults with autism 2 Fulfilling and rewarding lives Autism Strategy National Autistic Society Information Centre data held as at 5 January 4 LB Greenwich Learning Disabilities Needs Analysis carried out by the HIV & November

3 The strategy identifies raising awareness amongst staff as the foundation for the broader changes required to service planning and delivery. The Strategy states If frontline staff know more about autism, they will be better able to recognise the condition and respond to it. It requires that autism awareness training be available to all staff working in health or social care. As a minimum, autism awareness training should be incorporated into existing equality and diversity training 5.Other local authorities have made autism awareness training mandatory for all staff who are likely to come into contact with adults with autism. Within Greenwich autism training has been provided in the past but it is not mandatory for staff. We need to ensure that all relevant staff across the Council including Initial Contact s (ICO s), Contact Centre staff, social workers and commissioners receive awareness training. In addition, specialist training is required for staff in key roles, such as community care assessors, occupational therapists or residential care workers. In Greenwich this means: Identifying staff who should be included in a programme of autism awareness and specialist training Setting up a programme of ongoing autism awareness and specialist training with Learning and Development to ensure that existing and future staff receive appropriate training Liaising with external providers and stakeholders, ensuring they have appropriate training in place 2) Identification and diagnosis of autism in adults, leading to assessment of needs for relevant services Many adults with autism find it hard to get a diagnosis. In Greenwich, adults with autism are usually identified through other services such as the community learning disability or mental health teams. The act places a duty on the PCT to develop a clear pathway for diagnosis. It is however important for all relevant organisations, including adult social care, to understand the pathway to diagnosis. The Council is required to appoint a lead professional to develop diagnostic and assessment services for adults with autism. This should be done in partnership with Health. Once diagnosed it is important that the adult and their family have access to relevant information. In Greenwich there is little specific information available at the point of diagnosis for adults with autism. Reasons for this could be because the information does not 5 Good Practice in Supporting Adults with autism; guidance for commissioners and statutory services, For example, In Cornwall, the County Council created a jointly funded training post with the NHS 3

4 exist or possibly because structures are not in place for the sharing of this information. There is a clear need for access to information and correct signposting to be improved and made widely available throughout all Council services. To achieve the requirements of the guidance the Council need to: Liaise with the PCT and be aware of the pathways for diagnosis Establish links between care managers and commissioners to ensure levels of need are properly identified Develop and maintain contact details of local autism support services Ensure that the Council website and relevant points of contact have information readily available to adults with autism 3) Planning in relation to the provision of services to people with autism as they move from being children to adults The strategy recognises that transition from childhood to adulthood can sometimes be a very difficult for the child with autism and their family. Throughout childhood they would have been used to support through the school age years and they maybe left without any support when they enter adulthood if they do not meet eligibility criteria. Greenwich should consider the good practice guidance principles set out by the Transition Information Network (TIN) for effective facilitation of transitions. These principles include full participation of young people and their families, comprehensive multi agency engagement and high quality information. Locally, in Greenwich NDTi 6 has been commissioned to develop a transitions register to enable a smooth transition from children s to adults services. This register will provide information relating to the number of children with autism leaving school and the type of support they are likely to need. This register will be important in assisting the mapping and development of future services. 4) Local Planning and Leadership The strategy highlights the need for local authorities to develop specialist services for people with autism in response to needs that are identified locally. The key aim is that adults with autism can depend on public services to treat them fairly. Local planning does not necessarily mean developing new services, but ensuring that adults with autism form an integral part of mainstream commissioning processes. In Greenwich the Learning Disabilities Lead has been given the commissioning responsibility for adults with autism. Greenwich needs to gather information about the number of people with autism in the local area. Until we have an indication as to the number of people, we will not know if current services are sufficient. This information will also assist the to develop a 6 NDTi have been commissioned to develop a register of children transferring to adult services. The project is due to be completed by March. 4

5 commissioning plan that accurately reflects needs. Gathering this information will require close liaison with the NHS Greenwich and local and voluntary providers. The Council may want to consider commissioning an external organisation that has expertise in autism to carry out this piece of work 7. Local planning and mapping will have to involve close liaison with commissioning groups such as the Mental Health and Older Peoples lead commissioners. Some local authorities have set up dedicated Autism Strategy groups, while others have set up a sub group to their partnership boards. Guidance suggests that due to the fact many people with autism fall in a gap by not fitting into traditional services (i.e. no or MH needs) a specialist autism group would be the best option 8 Ensuing there are local services for adults with autism is also a key feature of the act. In Greenwich there are few dedicated support or advice services for adults with autism. G- NAS (National Autistic Society Greenwich) is the only organisation in the directory maintained by the National Society. Neighbouring boroughs such as Lewisham and Bexley have voluntary organisations dedicated to providing support to people with autism and their families. 9 It is important for Greenwich to adopt this same approach and look at what services need to be developed to support adults with autism. Key Findings The action plan that follows sets out in detail what needs to be done locally in terms of planning and leadership. In summary, however, the key actions for the Council to take forward are: - development of an autism training strategy, - the specific inclusion of Autism within the Transition strategy - ensuring that all policies and strategies specifically address how they relate to and/or include people with ASD. 7 Good Practice in Supporting Adults with Autism: guidance for commissioners and statutory services, Ben Higgins 2009, For example, Lewisham Council has conducted a needs analysis of adults with autism. The process was useful and enabled them to predict future service capacity to inform their commissioning priorities. From the needs analysis they have been able to develop a much clearer referral pathway for adults with autism who do not have a learning disability 8 ibid 9 files/supportgroupsinlondon.pdf 5

6 TRAINING Requirement Action Responsibility Timescale Training for all frontline public service staff in line with the needs of their job (2.7) Developing specialist training for staff in health and social care (2.15) Provide awareness training to Private and 3 rd Sector providers Involving adults with autism/families in training Develop an autism training strategy that will include the: identification of staff who need training identification and commissioning of a suitable organisation to deliver training set up a programme of induction and ongoing training needs - identify staff who will need specialist training e.g. care coordinators, occupational therapists, personal assistants - Consider commissioning general and specialist training for staff that require it locally or as part of shared services training with Lewisham and Bexley. - OED to provide 6 half day training sessions to Private and Voluntary Sector (PVI) providers on Learning Disabilities and Autism Awareness - Involve adults with autism, their families or carers in the delivery of awareness and specialist training - Set up process where adults with autism/their families can contribute to the ongoing assessment and delivery of training need ORGANISATION EMPLOYEE DEVELOPMENT (OED) SERVICE MANAGERS LEARNING & DEVELOPMENT Business Support & CT LEARNING & DEVELOPMENT LEARNING & DEVELOPMENT 30 April 30 April 31 March 2013 IDENTIFICATION AND DIAGNOSIS Requirement Action LA have a duty to assess a person who - Ensure s. 47 of NHS & Community Care Act 1990 applies to people with autism Responsibility Deadline Lead Professional PCT to who will develop CLARIFY diagnostic and DATES assessment 6

7 may be in need of community care services, this includes people with autism Develop a clear and consistent pathway for diagnosis (3.8) - Have a clear pathway to diagnosis in every area - Diagnostic services should be easily accessible - Review the current pathways to diagnosis in each area (e.g. health & social care) - NICE guidelines will set out a model care pathway(s) which will inform foundation for local commissioners to develop referral and care pathways centre for adults with autism Health Due to be published in July. All local organisations ensure they understand what the pathway to diagnosis is To be set To be set To be set Director of Adult Social Services is responsible for ensuring correct processes are in place within the local area - Local authority should appoint a lead professional to develop pathway to services for adults diagnosed with Autism - Establish who has lead responsibility on making assessments for people with autism - Establish links between care managers and commissioner to ensure levels of need are properly identified to inform commissioning plans Social work teams for relevant primary need (if autism primary need = CT) Done 30 April Ensure that adults diagnosed with autism are given access to information about autism and sources of support, - Prompt sharing of information between diagnostic services and adult services - develop and maintain contact details for local autism support services and voluntary groups, telephone help lines, local support groups - Ensure relevant national websites and contact numbers including representative groups, are on the relevant sections of the Greenwich internet and intranet Social work teams for relevant primary need Ongoing 30 April 30 May 7

8 at the point of diagnosis (3.26) - Ensure social work teams and other departments are aware of information and know how to access it - Ensure the correct Signposting to the Living with Autism section of the NHS Choices website are widely available to all Council services Service Heads Communications 30 April 30 May - Check all publicity information is in accessible formats (use guidance from Office of Disability Issues) PLANNING THE PROVISION OF SERVICES TO PEOPLE WITH AUTISM FROM BEING CHIREN TO ADULTS Transition plans for young people with autism - Ensure that the transitions register is maintained regularly and has information that is accurate and up to date when a child makes the transition from child to adulthood - ensure assessment of needs and the provision is required to meet the needs of all young people with statements - Ensure processes are in place where adults and children s services work with schools, families and young people to identify support needs during the transition to adulthood Adult Services s/ Transitions Coordinator Transitions Coordinator/ASD Outreach 30 April 30 April - Ensure Transition planning is person centred LOCAL PLANNING & LEADERSHIP Requirement Action Responsibility Deadline Director of Soc Services in each local Lead has been given responsibility for leading on Autism N/a Ongoing authority should ensure there is a joint commissioner/ - should work closely with the local specialised commissioning group such as MH, Older People etc and the lead senior professional in the local area Ongoing 8

9 manager who has in their portfolio a clear commissioning responsibility for adults with autism (6.10) responsible for developing the diagnostic and assessment services (3.10) - will ensure that adults with autism are an integral part of mainstream commissioning processes Ongoing - will participate in relevant local and regional partnership boards to ensure that the needs of adults with autism are being addressed at these meetings (including Valuing People regional delivery boards, Health and Wellbeing Boards) Ensure that adults with Autism can access services and receive the support they need (4.7) Equality Act 2010 requires all organisations to provide a service to the public and to make reasonable adjustments to ensure they are accessible for people with disabilities this includes autism - Include a specific section on autism in the Learning Disabilities Client communication plan ensuring it covers information on access to services - Liaise with the Contact Centre Manager to ensure the Customer contact centre is accessible Contact Centre Mgr 28 Feb - Identify what reasonable adjustments if any can be made to accommodate people with autism. Including making adjustments to web access and telephone communications as required CDLT/MH Lead s 31 Mar - Liaise with & MH services to ensure their offices/services are accessible in particular making reasonable adjustments if required) to premises, processes communications, planning and preparation CDLT/MH/ Lead s 31 Mar - Ensure providers commissioned by 31 Dec

10 the Council are adhering to the Equality Act requirements and that their offices/services are accessible in particular making reasonable adjustments if required) to premises, processes communications, planning and preparation - Find out what local services/groups exist for adults with autism completed 31 Apr 30 Apr - Work with G-NAS (Greenwich National Autistic Society) and support groups in surrounding boroughs to establish need for additional support groups for adults with autism in the borough - Explore how the Council can support local groups in planning and commissioning services locally for adults with autism Voluntary & Community groups Ongoing 30 June - Liaise with relevant partners in Health, Probation, DWP and other relevant stakeholders - Ensure adults with autism are supported to access personal budgets and direct payments of social care - Ensure Advocacy in Greenwich and other similar organisations are working with adults with autism to access personal budgets and direct payments Each local area should develop its own commissioning plan around services for adults with Develop services within the scope of existing resources and budgets - to develop a plan around services for adults with autism that reflects local needs 31 Dec 10

11 autism that reflects the output of the JSNA and all other relevant data around prevalence (6.9) - Establish what the current JSNA says about adults with autism - To inform the plan, up to date information will be gathered locally and fed into JSNA 1) The number of adults known to have autism in the area 2) The range of needs for support to live independently 3) The age profile of people with autism in the area 4) Number of adults with autism in employment in the local area 31 Dec Glossary ASD CT DoH FACS ICO s MH NAS NDTi PCT TIN Autistic Spectrum Disorder Community Learning Disabilities Team Department of Health Fair Access to Care Services Initial Contact Learning Disabilities Mental Health National Autistic Society National Development Team for Inclusion Primary Care Trust Transition Information Network 11

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