Equality Impact Assessment

Overview:

Assessment Name: LD Transformation Programme
Department: Adult Services Date Created: 16/02/2011 14:07:37
Lead Author: Elizabeth Murray Lead ID: sshqmhlz
Additional Authors (if applicable): Elizabeth Murray
Gareth Fairall
Alison Froude
Jessica Hutchinson
 
Aims and Objectives: A new Learning Disability Strategy for Hampshire (2009-11) entitled “Ordinary People Leading Ordinary Lives” was approved in February 2010. This strategy came out as a result of the ‘Ordinary People Leading Ordinary Lives’ consultation in 2008 and also the Valuing People Now report.

Valuing People Now states that we need to move away from the concept of day services and consider how people spend their time in a way that meets their own wishes and needs.

The majority of current LD services consist of traditional building based residential and day services. Domiciliary care services provided to service users in their own home consists of approximately one third of the Hampshire LD population accessing services. The traditional model of care is being recognised as more “institutionalised” care creating a culture of dependence on local authority care services, rather than supporting people to be independent.

HCC currently owns and runs 9 residential homes providing residential/respite care for adults with a LD. The 9 homes provide 99 bed spaces, inc 51 respite beds, 13 assessment beds and 34 long stay beds. During 2008/9, approximately 430 people accessed respite for an average of 28 nights per annum. Based on the strategic needs assessment, 38% of people who receive a funded service from HCC adult services use in-house respite.

A number of the building based residential and day care services are aged and considered no longer fit for purpose. Feedback from consultations with service users illustrates that many individuals would welcome access to mainstream service, especially in terms of social opportunities. In addition there is anecdotal evidence that increasingly younger people with learning disabilities choose not to use traditional day care services.

To address the requirements within the LD Strategy an LD Transformation programme has been established.

Main Activities: -To re-provide residential services, splitting into three separate services long stay , respite and crisis . Different services will be provided based on need.

- To re-provide day activities based in the community with keystone buildings and local community link day services based in the community .

Who's intended to benefit: People with learning disabilities, carers

Summary of Report:

Summary of Main Findings: Young people say that current services do not meet their needs and are too institutional.

The proposed new services are moving away from a 'one-size fits-all' approach to a range of person-centred day opportunities that are meaningful for the individual. Services will be offered for people with complex needs and for more able people with a learning disability, whatever their age, race, gender, disability, faith, socio-economic background or where they live.

Age:

What do you know about the breakdown of people who use your services compared to the community profile: Day

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Service User Age Groupings

18-30 154 19%

30-50 412 50%

50-64 222 27%

65+ 31 4%

Young people predominantly do not currently use our day services

Residential Services

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18-30 7 17%

30-50 22 52%

51-64 13 31%

65+ 0 0%

• Only 23% of 18-20 year old use day care compared to 58% of 41-50 year old

• 26% of 18-20 year old have opted for direct payment compared to 4% for 41-50 and 2% for 51-64

• There is local evidence of middle aged people with learning disability living with increasingly older carers resulting in greater reliance on day care solutions as a form of respite.

Staff

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The age group of staff working in both day and residential reflects the general age profile for HCC.

Will some people be unable to use or benefit from the service: Day Services

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Young people say that current services do not meet their needs and are too institutional.

The proposed new services are moving away from a 'one-size fits-all' approach to a range of person-centred day opportunities that are meaningful for the individual. Services will be offered for people with complex needs and for more able people with a learning disability, whatever their age. Young people will benefit from the proposed service changes as well as older people.

• Older carers and service users might find it difficult to accept new concepts (such as independence) and adapt to change: this might cause upset and worries in the short/medium term.

• Older carers from BME groups are less likely to speak and understand English well and may need additional support through the implementation to ensure good communication and their active invovlement in transition planning for their relative.

New services will meet the needs of all age groups.

Following consultation a more flexible approach in relation to the use of keystone day services and community links will be followed to ensure all people will have access to local day services and should not have to travel long distances to day services.

Residential and Respite Provision

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The proposed new respite services are moving away from a 'one-size fits-all' approach to a range of person-centred respite options depending on the individual need. Shared Lives respite services will be offered to more able people with residential respite being offered to people with more complex needs.

As part of individual transition planning transport requirements/ issues to respite units or services will be taken account of to ensure equal access.

Residential and Respite Services

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The proposed changes to the long stay residential services will lead to a reprovision of residential services to supported living based on person-centred assessments. National evidence identifies that people signficantly benefit from the supported living model.

Young people will benefit from the proposed service changes as well as older people .

Staff

There will be no staff redundancies in day services .Day service Manager have been offered voluntary redundancy. The staff will be asked to reolcate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases.

There is currently voluntary redundancy offered to residential staff. There may also be compulsory redundancy dependant on outcomes of Vol Redundnacy.

How could the iniative improve equality of access: Day Services

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Young people say that current services do not meet their needs and are too institutional.

The proposed changes will be more person-centred and improve access for younger people, in particular.

Also there is a projected increase in people with multiple /complex needs including physical disabilities .The new services will be able offer more choice to this client group.

By carrying out Person-Centred Reviews for all Day Service clients, older people affected by the changes will have their personal preferences, that may be related to their age, taken account of when developing their new weekly plans.

Following consultation a more flexible approach in relation to the use of keystone day services and community links will be followed to ensure all people will have access to local services and should not have to travel long distances to day services.

Residential Respite Services

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The proposed changes to respite services will not have any adverse impact on particular age groups of service users and may increase access due to an increase in the range of choices people will be offered.

Disabled People:

What do you know about the breakdown of people who use your services compared to the community profile: Everyone who accesses learning disability services in Hampshire has a critical or substantial need relating to their disability and will be impacted by the proposed changes. National data suggests that 2% of the overall population have a learning disability.

National data shows that an increasing number of people with complex learning disabilities are surviving to adulthood and these people may also have physical disabilities.

National and local data indicates a substantial increase in the number of people on the autistic spectrum.

The strategies contained within the documents 'Valuing People' and 'Valuing People Now' respond to people on the autistic spectrum who have a learning disability.

No statistics on staff with disabilities are available.

Will some people be unable to use or benefit from the service: Day Services

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The proposed changes will positively impact people with more complex needs. By providing a greater range of options for day opportunities, the level and range of services targeted at people with complex needs will increase.

Some people who have complex needs may have to travel greater distances to access the more specialist provision for people with complex needs.

The proposed changes will provide a more person-centred service aimed at people on the autistic spectrum although it may mean some of these people have to travel to this compared to their current service provider location.

Following consultation a more flexible approach in relation to the use of keystone day services and community links will be followed to ensure all people will have access to local services and should not have to travel long distances to day services.

Residential and Respite Provision

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The proposed new respite services are moving away from a 'one-size fits-all' approach to a range of person-centred respite options depending on the individual need. Shared Lives respite services will be offered to more able people with residential respite being offered to people with more complex needs.

As part of individual transition planning transport requirements/ issues to respite units or services will be taken account of to ensure equal access.

Residential and Respite Services

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The proposed changes to the long stay residential services will lead to a reprovision of residential services to supported living based on person-centred assessments. National evidence identifies that people signficantly benefit from the supported living model.

Staff

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There will be no staff redundancies in day services .Day service managers have been offered voluntary redundancy. The number of day service managers will reduce from 7 to 5 FTE initially. The staff will be asked to reolcate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases.

There is currently voluntary redundancy offered to residential staff. There may also be compulsory redundancy dependant on outcomes of Vol Redundnacy.

How could the iniative improve equality of access: Day Services

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The proposed changes will result in people with more moderate learning disabilities being able to access a far greater range of day opportunities in their local area that are planned on an individual basis.

All service users will be offered a Person Centred Review - these will promote social integration.

Residential Service

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The proposed changes will not result in a reduction in the respite allocation. There will be a range of different residential and non-residential (for example Shared Lives) respite options available dependent on the needs of the individual. The council will consider any challenges around transport which may result from these changes.

Individual person-centred-meetings for those people who access residential respite will be undertaken to develop an individual plan.

Our proposals will increase the proportion of ground floor respite rooms in our services to ensure DDA compliance and improve access for people with physical disabilites as well as a learning disability.

Faith:

What do you know about the breakdown of people who use your services compared to the community profile: No data collected on faith.
Will some people be unable to use or benefit from the service: Day and Respite Services

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There is a potential risk that an individual's needs linked to faith (for example fasting, dress code and death rituals) could be ignored by service providers however the council will strive to ensure that this is taken into account when doing person-centred-reviews and undertaking any individual assessments.

People maybe attending a different respite unit or day service and there may be new staff who aren't familiar with the service users faith . Faith will be coverered in the individual transition plans to ensure continuity of need. For example :Access to other religious establishments will be ensured.

How could the iniative improve equality of access: Day Services/ Residential

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By taking a proactive approach to identifying needs associated with faith during person-centred reviews.

The principles around the day and residential service proposals are based around meeting people's individual's needs, taking on board their different religions and beliefs. This will underpin the person centred reviews and indicdula transition plans.

The EMLD project can provides training and support for staff when needs linked to faith identified. This project is linked to the LD Transformation Programme.

Gender:

What do you know about the breakdown of people who use your services compared to the community profile: • Of the 2153 people receiving a service funded by HCC, 1176 are female, 975 are male.

Day Services Staff

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69% Women

31% Men

Residential Services Staff

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72% Women

28% Men

Will some people be unable to use or benefit from the service: Day and Residential Services

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All service users will continue to be offered services . However these may be in a different loaction and provided by different people

Carers in some established BME groups tend to be female and are less likely to speak and understand English (see below). This may limit their ability to understand the proposed changes and to take part in person centred reviews or indivdual planning meetings. Because of the language barrrier, there is potentially a risk that the carer's views points and detailed understanding of their relative's needs might be missed.

Staff

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As there are more women than men working in LD in-house services, any voluntary or compulsory redudancies will have a disproportionate impact on women. There will an element of relocation to new bases requiring further transport time and cost incurred.

There will be no staff redundancies in day services .Day service Manager have been offered voluntary redundancy. The staff will be asked to reolcate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases. As community link bases will be in the community, staff will be required to park in public car parks and pay for parking. It is the policy across the council not to pay for staff parking and to encourage more environmentally friendly forms of transport.

There is currently voluntary redundancy offered to residential staff. There may also be compulsory redundancy dependant on outcomes of Vol Redundnacy.

How could the iniative improve equality of access: Day and Respite Services

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EMLD project provides training and support for staff on the LD Transformation Project and wil link up with this training programme. Translators will be made available for meetings involving carers and service users as necessary.

Race:

What do you know about the breakdown of people who use your services compared to the community profile: Nationally, data shows that the overall proportion of people with a moderate or severe learning disability is increasing , especially within BME groups.

• The number of people with learning disabilities from BME groups getting a service from HCC has not increased and is below that expected given the local population make up, particularly for the Asian population

Ethnicity - for day service clients only

Asian 8 1%

Black 2 0%

Chinese 2 0%

Mixed Race 4 0%

Nepalese 2 0%

Other ethnic group 1 1%

White British 803 96%

White Irish 3 0%

No data on staff race is currently available

Will some people be unable to use or benefit from the service: Day Services

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The services will be flexible to meet individual needs and be person centred .

Services will be community inclusive. Work with local relevant ethnic community groups will need to undertaken to develop respect and tolerance and to enable links are developed for people.

Older carers from BME groups are less likely to speak and understand English well and may need additional support through the implementation to ensure good communication and their active invovlement in transition planning for their relative.

Residential Services

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The proposed changes will not result in a reduction in the respite allocation. There will be a range of different residential and non-residential (for example Shared Lives) respite options available dependent on the needs of the individual. The council will consider any challenges around transport which may result from these changes. This might be relevant to those BME groups who have limited transport means such as travellers and housed travellers.

Staff

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There will be no staff redundancies in day services .Day service Managers have been offered voluntary redundancy. The staff will be asked to reolcate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases. As community link bases will be in the community, staff will be required to park in public car parks and pay for parking. It is the policy across the council not to pay for staff parking and to encourage more environmentally friendly forms of transport.

There is currently voluntary redundancy offered to residential staff. There may also be compulsory redundancy dependant on outcomes of Vol Redundnacy.

How could the iniative improve equality of access: Day and Residential Services

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The principles around the day services proposals are based around meeting people's individual's needs, taking on board their different cultural practices. This will underpin the person centred reviews.

The EMLD project to work with communities to raise awareness and information on Learning disability issues.

EMLD project will liaise with in-house LD services, to alert people to their rights and help them identify their needs.

Interpreters and translators will be used where critical to ensure the right support package is put in place.

The EMLD project will positively promote opportunities that will help people learn and practice English

Gay, Lesbian, Bisexual:

What do you know about the breakdown of people who use your services compared to the community profile: No data collected has been collected for this group.
Will some people be unable to use or benefit from the service: No
How could the iniative improve equality of access: The principles around the day services proposals are based around meeting people's individual's needs, taking on board their sexuality will underpin the person centred reviews.

Socio Economic Factors:

What do you know about the breakdown of people who use your services compared to the community profile: National evidence show that families with a disabled member are more likely to experience economic hardship

Where family members are disabled (either adults or children) average (median) incomes are reduced and in particular the chances of having a high income are much reduced. (Mc Kay & Atkinson, 2007)

Local evidence shows that a low number of people with learning disability hold meaningful paid employment.

Residential

Currently 9 Res Homes.

Residential staff would be at risk of redundancy ( across Hampshire)

Will some people be unable to use or benefit from the service: Day Services

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There will not be a reduction in services in these areas, rather they will be provided in different ways in different locations. There will be potentially 2 or 3 new builds for specialist Key stone services.

The service will available to all groups in respective of income.

Residential Services

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All service users will continue to be offered services . However these may be in a different location and provided by different people. It is proposed that some of the residential respite units will be closed and alternative respite services offered to service users either at another residential respite unit or through shared lives or a personal budget.

Units in Aldershot , Winchester ,Eastleigh and Fareham are proposed to close.

Aldershot is a socially deprived area . The choice of which untis to close was based on very robust criteria and detail analysis

As part of the individual transition planning for service users issues relating to transport and travel to services will be taken into account of to ensure continued equality of access.

Staff

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No day service staff would be at risk of redundancy if proposals are implemented.

Day service Managers have been offered enhanced voluntary redundancy and would reduce from 7 to 5 so 2 posts would be at risk.

Staff

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There will be no staff redundancies in day services .. The staff will be asked to relocate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases. As community link bases will be in the community, staff will be required to park in public car parks and pay for parking. It is the policy across the council not to pay for staff parking and to encourage more environmentally friendly forms of transport.

There is currently an enhanced Voluntary Redundancy offer available to people in in-house Residential Services. It is hoped that Compulsory Redundancy will be avoided, but this may be necessary for the in-house residential service.

The residential proposals may put staff at risk living in the vacinity of Aldershot, Farham , Eastleigh and Winchester.

How could the iniative improve equality of access: Day Services

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The principles around the Launchpad Service (supporting more able people) will result in people maximising their independence and where possible gaining employment. This project is linked to the Supported Employment contract ('You Trust') where 60% of the candidates for work preparation courses will be drawn from the existing in-house day services users.

Residential Services

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By providing alternatives to in-house residential respite services such as Shared Lives, service users may find they have less distance to travel and fewer travel costs to get them to their respite of choice.

• Self directed support/ individual budgets could allow support provision to be tailored to meet the working patterns of carers

• People will be offered training to acquire work skills.

• Supported employment will be offered to more able people as a step towards paid employment

Staff

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As part of the Residential respite proposals we are planning to increase the number of Shared Lives carers across Hampshire . A number of staff have expressed an interest in changing careers to become Shared Lives carers. This provides an alternative source of employment where the in-house service may contract.

The voluntary redundancy process, followed by slotting in preferences would mean that every staff member would have the best chance of continuation of employment based on preferences and then through selective interview. This removes the potential inequity of making staff redundant only because they work in a particular home which is proposed to close. This may also mitigate the impact upon particularly disadvantaged areas of Hampshire.

In summary there is an HR Strategy-

Providing an enhanced VR offer for all at risk

There will be a selection process which gives staff an equal right to a job in any nearby unit- slection will be based on merit.

Other wider redeploymnet opportunities would be offered should there be no nearby unit which the staff member is selected for.

potenatial self employment opportunities through shared lives

continuation of a north crisis service in the aldershot area

There will be potential job opportunties in the independant sector as more day opportunity are developed in Hampshire are developed for people with a learning disability.

Rural Isolation:

What do you know about the breakdown of people who use your services compared to the community profile: Day and Residential Respite Services

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Whilst no detailed analysis has been undertaken on this, we know that a significant proportion of service users and staff live close to the existing residential and day services.

The current day and residential services are located in a range of urban and rural settings.

The only units based in rural settings include:

New Forest Day service, New Milton ,New Forest

Fernmount Residential Unit, New Milton New Forest.

Housed travellers tend to be traditionally housed in a compounds often in isolated areas. Transport would need to be taken into account.

Will some people be unable to use or benefit from the service: Day Services

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There will be Community links and satallite services that will be based in local rural communities in the New Forest. People who live in rural areas, such as the New Forest will continue to be able to access local services.

The proposed changes for day services have been developed to be more flexible around the use of Keystone Day Services and Community Links - some service users may use both. However, given the more flexible approach people will not only have to go to a Keystone building and can use their local community link. This will mean that some service users travel further distances on certain days of the week to access a Keystone. This is in response to consultation feedback around concerns about segregating people and having further to travel.

Residential Respite Services

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The proposed changes are to reprovide a residential respite service in the vicinity of the new forest and to offer other respite services using shared lives across the New Forest.

Staff

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As part of the Residential respite proposals we are planning to increase the number of Shared Lives carers across Hampshire. A number of staff have expressed an interest in changing careers to become Shared Lives carers. This provides an alternative source of employment .

The voluntary redundancy process, followed by slotting in preferences would mean that every staff member would have the best chance of continuation of employment based on preferences and then through selective interview. This removes the potential inequity of making staff redundant only because they work in a particular home which is proposed to close. This may also mitigate the impact upon particularly disadvantaged areas of Hampshire.

In summary there is an HR Strategy-

Providing an enhanced VR offer for all at risk

There will be a selection process which gives staff an equal right to a job in any nearby unit- slection will be based on merit.

Other wider redeploymnet opportunities would be offered should there be no nearby unit which the staff member is selected for.

potenatial self employment opportunities through shared lives

continuation of a north crisis service in the aldershot area

There will be potential job opportunties in the independant sector as more day opportunity are developed in Hampshire are developed for people with a learning disability.

The staff will be asked to reolcate to new bases. These maybe further away than their current base. HCC's HR policy on travel costs in relation to changes in bases will be followed in these cases. As community link bases will be in the community, staff will be required to park in public car parks and pay for parking. It is the policy across the council not to pay for staff parking and to encourage more environmentally friendly forms of transport.

How could the iniative improve equality of access: Day Services

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The proposed changes for day services have been developed to be more flexible around the use of Keystone Day Services and Community Links - some service users may use both. This may mean that some, less able service users travel further distances on certain days of the week to access Keystone. This is in response to consultation feedback around concerns about segregating people and having further to travel.

The proposed changes enable the new community link day services are based in community settings including rural locations such as New Milton or Brockenhurst.

Community Link Day services will be based in the heart of the rural communities and ensure inclusion in community activities and improved access to services.

Day Services Staff

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Staff living in these rural settings will continue to be employed supporting service users.

Other groups affected:

Are there other groups affected not already mentioned: None that have been identified.

Conclusions of Potential Impact:

Possible Impact: 1. Some BME people may find it harder to take part in day opportunities in the community .

Interpreters and translators must be used effectively for BME groups to benefit from this plan

2. Older carers and service users might find it difficult to accept new concepts (such as independence) and adapt to change: this might cause upset and worries.

3. Given the higher percentage of women who work within the services, it needs to be noted that it may appear to disproportionately impact upon them, although they are not being targeted specifically

4. Given the reduction in residential respite units and the number of Keystone Day Services some service users may have to travel further distances to access services .This will be miigated through transition planning for individuals and a more flexible approach to use of keystones and community links.

If any groups are disadvantaged is this likely to be unlawful: no
Group Affected: 1. BME people with LD in house day services & BME groups, people with English as a second language

2. Older service users and carers

3. Female staff

4. Some service users with complex needs who need to access a Keystone or residential respite unit.

5. Residential staff living close to aldershot Fareham, Eastleigh & Winchester

Evidence: Collected as part of the service user carer consultation and feedback from Proud 2 B group, see Consultation feedback report written by Rachel Dittrich March 2011.

Cases identified by EMLD project

Consultation events – questionnaire feedback

Based on the gender profile of staff working in direct service provision within adult services.

Further Actions to be taken:

Action: 1. Work with local relevant ethnic community groups will need to undertaken to enable links are developed for people

2. EMLD project to work with communities to raise awareness and information on Learning disability issues

3. The operational policies around the access to a Community Link and Keystone Service will be changed to ensure a more flexible approach giving opportunities all services in the local area.

4. The project will link with the EMLD project to ensure community inclusion and tolerance for people accessing the community.

5. Transition time to the new service model may take longer for older service users and carers.

6. Initial transition assessment will include transport and faith needs

Responsibility: Project Implementation Team
Timescale: Early Implementation in Eastleigh and Basingstoke Day Services will be completed by January 2012. Subsequent day service changes will follow on from this over a one year period. Changes to residential respite services will commence (subject to Executive Approval on 16 May 2011) in May 2011 with the first change to a residential units (Meadowcroft and Upton Grey) by December 2011. Subsequent changes will take place over the next year.
Expected Outcomes: 1. Community inclusion for this group. Communities accept this group access services in the community

2. Smooth transition to new services.

3. Improved choice of day and respite opportunities

4. More individualised, person-centred services.

5. Buildings and services fit for future demand.

6. Services fit for the introduction of Personalisation and SDS (Self Directed Support).

Review Summary:

Review Update: