Mark Burton - Developing and Managing High Quality Services for People with Learning Disabilities

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DEVELOPING AND MANAGING HIGH QUALITY SERVICES FOR PEOPLE WITH LEARNING DISABILITIES

To all Manchester's learning-disabled people, their families and the staff who support them.

Developing and Managing High Quality Services for People with Learning Disabilities

Edited by
Mark Burton
and
Mike Kellaway

First published 1998 by Ashgate Publishing

Reissued 2018 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright Mark Burton and Mike Kellaway 1998

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Publisher's Note
The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent.

Disclaimer
The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact.

A Library of Congress record exists under LC control number: 97049091

ISBN 13:978-1-138-31285-2 (hbk)

ISBN 13:978-1-138-31288-3 (pbk)

ISBN 13:978-0-429-45798-2 (ebk)

Contents

Guide

The contributors are all staff of the Joint Learning Disability Service in Manchester, employed either by The Mancunian Community Health NHS Trust, or by the City of Manchester Social Services Department.

Editors

Mark Burton Head of Development and Clinical Services

Mike Kellaway Head of Joint Learning Disability Service

Other contributors

Christine Adcock Clinical Psychologist

Allen Briscoe Network Manager

Ian Crabtree Practice Advisor, Occupational Therapy

Dave Crier Assistant Network Manager

Bernie Gibbins Community Learning Disability Team Manager

Karen Goodman Quality Development Officer

Nigel Hoar Assistant Network Manager

Pauline John Area Manager

Jane Jolliffe Practice Advisor, Speech and Language Therapy

Phil Jones Clinical Manager

Sylvia Jones Speech and Language Therapist

Lynsay Juffs Speech and Language Therapist

Jean Lally Clinical Psychologist

Iain Larkin Network Manager

Cathi McKessy Occupational Therapist

Maxine Martin Community Learning Disability Team Manager

Jude Moss Clinical Psychologist

Mike Petrou Network Manager

Andrew Pope Project Leader: Complex Needs Day Service

Linda Prinsloo Occupational Therapist

Dave Ruane Residential Manager

Rachel Samuels Speech and Language Therapist

Helen Sanderson Quality Development Officer

Moira Speechley Occupational Therapist

Debbie Windley Occupational Therapist

• ANM assistant network manager
• CLDT community learning disability team
• ELP Essential Lifestyle Planning
• GAS Goal Attainment Scaling
• IPP Individual Programme Plan
• LETS Local Exchange Trading Scheme
• PAM profession ancillary to medicine
• QAG quality action group
• RSW residential social worker
• SI sensory integration
• TAG training action group

The challenges facing services for people with learning disabilities have probably never been greater for those managing and providing them as well as for those using them. The climate is one of financial retrenchment with little hope of relief. There is the prospect of further structural change as trust mergers and service reconfigurations gather pace. The shifting, though often unfocused, boundary between primary and community care, and between this and secondary care, creates confusion and uncertainty for everyone and can compound low morale among staff who already feel insecure and vulnerable.

Under the weight of such pressures, it would be all too easy, if understandable, to become negative about the future and to feel disempowered and overwhelmed by the sense that it is all too difficult and rather pointless. For those in that position, this book should serve as something of a tonic, offering hope in the midst of despair and despondency.

The authors do not evade the difficult problems and pressures they confronted in setting up the Joint Learning Disability Service in Manchester but they are able somehow to convey an abiding optimism and deep commitment to their work which not only shines through the book but allows them, and their colleagues, to find solutions to the problems facing them and to make a difference.

Evidence of this commitment and obvious enthusiasm is the appearance of this book which is unusual in that it is written by those whose job it is to manage and provide the Joint Learning Disability Service. In the academic literature much is made of the need for practitioners to stand back and reflect on their work and to communicate something of the flavour of life on the front line at a time of change. The fact that few practitioners manage to find the time or have the energy or inclination to achieve this makes this book particularly welcome and can only strengthen its appeal.

I first discovered the Joint Learning Disability Service in 1995 when I was invited to join the panel of judges for the Health Service Journal Management Awards. The Service had been shortlisted in the community and primary care category and it was the entry I chose to visit. I did not regret it. More importantly, it subsequently gave me great pleasure to see the Service win the award in its category against tough competition.

My brief visit could not do justice to the complexities and subtleties of the Service. But 1 was struck by the overall positive atmosphere, commitment, sense of purpose and sheer energy of the staff I met. There was clearly goodwill on all sides in negotiating problems, getting round red tape and bureaucracy, and putting users' preferences uppermost. What was particularly impressive about the Service was its jointness. In my notes on the visit I wrote: 'as far as a joint service was concerned there was no issue about the health/social care divide - it simply did not exist'. The central focus was on the user and their needs with the specialist expertise and staff skills coalescing, as appropriate, to meet them.

It had not always been like that, however, with a 'Berlin Wall' in evidence between health and social services. While the wall had been dismantled, it was acknowledged that tensions between the different perspectives persisted. But these were regarded as a positive feature contributing to the whole being greater than the sum of the parts. The blending of skills in place of tribalistic rituals and warring factions was an impressive feature of the initiative. Much is to be heard these days about joint commissioning, rather less about joint provision despite its obvious importance in terms of realising truly seamfree care.

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