The Programme is divided into three phases:
- Phase 1 November 2021 – January 2022: Undertake the Safe and Wellbeing reviews and take immediate action in response to any safety and wellbeing concerns raised during the review.
- Phase 2 November 2021 – February 2022: Assurance, oversight and challenge of review findings and evidence how findings of the reviews feeds into the ICS delivery plan.
- Phase 3 February 2022 – March 2022: Develop a regional summary report detailing the findings, themes and actions to be taken from the reviews and evidence how findings of the reviews feed into the Regional delivery plan; triangulate regional findings and set out a National response and next steps; share findings and intelligence with the Care Quality Commission (CQC); Ensure key findings feed into relevant National Learning Disability and Autism Programme workstreams.
The approach adopted for the Safe and Wellbeing Reviews is one that listens to and considers the views and information available from a range of sources including:
- The individual
- Family and loved ones
- Responsible clinician and multi-disciplinary team (MDT) including community
- Commissioner – this could include the host commissioner and the placing commissioner.
The approach also requires reviewers to determine their level of confidence in the care provided (not at all confident; somewhat confident; confident; highly confident), to think ASK, LISTEN, DO and to identify actions and to feedback on these actions and the outcomes to the individual.
The Safe and Wellbeing Reviews have four steps
Step 1: desktop review of the two most recent C(E)TRs and CPA records to include:
- a review of the quality of the completed documents, associated action plan and areas covered within them
- identification of any points to escalate and actions to be taken.
Step 2: telephone/virtual meeting to gather feedback regarding the care being delivered:
- with the individual’s permission, discussion with the individual and family/friends/advocates regarding the care being delivered prior to the face-to-face meeting with the individual.
Step 3 and Step 4: face to face review of the individual and the care delivered to them (this can form part of the six to eight week oversight visit or C(E)TR to include:
- review of the individual’s safety, physical health assessment and treatment, mental health assessment and treatment, and quality of life and must include direct conversations with the responsible clinician/consultant responsible for the individual’s inpatient care and the therapeutic team including care assistants
- meeting with the individual and find out what they think of their care and action any matters raised by the individual with the service during the visit
- considering that there may be differing views on the type of care delivered or how the care is delivered for example between the individual and their team
- undertaking the ‘sit and see exercise’ to get a sense of how the individual experiences living at the service.
This Programme will provide placing commissioners with a comprehensive overview of the care being delivered to autistic children, young people, and adults and those with a learning disability who are in mental health inpatient hospitals. The review of each individual’s safety will have been informed by information gathered from a number of different sources and the reviews will identify where individuals are inappropriately placed or where there re barriers to discharge.
The Programme offers an opportunity to review how the quality of existing mechanisms, for example, C(E)TRs, CPA and six to eight week oversight visits are being monitored locally and to strengthen these arrangements.
It will also provide CCGs and host commissioners with key intelligence regarding the quality of specific inpatient services.