Autism Commissioning Plan draft



Autism Commissioning Plan 2013 - 20151.0 Introduction and National Policy Context 1.1The Autism Act 2009 is the first ever piece of legislation passed in England that is Disability specific. The act puts a duty on Government to produce a national strategy for Adults with Autism and provide guidance to councils and NHS bodies to support its implementation. 1.2The government’s national strategy: Fulfilling and Rewarding Lives 2010, sets out how local services for people with autism should be developed and identifies 7 key outcomes and 3 service ambitions that local councils and health commissioners should meet.1.3Seven quality outcomes that will show progress: adults with autism achieve better health outcomes:Adults with autism are included and economically active adults with autism are living in accommodation that meets their needsAdults with autism are benefiting from the personalisation agenda in health and social care, and can access personal budgets adults with autism are no longer managed inappropriately in the criminal justice systemAdults with autism, their families and carers are satisfied with local services Adults with autism are involved in service planning 1.4Service ambitions Local authorities and partners know how many adults with Autism live in the areaA clear and trusted diagnostic pathway is available locally ; andHealth and social care staff make reasonable adjustments to services to meet the needs of adults with autism 1.5Dudley’s autism strategy was first agreed in 2007 and updated in 2011, this commissioning plan has been developed through consultation with Dudley Autism Partnership; a multi agency board including carers and people with autism . This plan sits alongside the Dudley Strategy for Adults with Autistic Spectrum Conditions 2011 – 2014 and focuses solely on the needs analysis of the known population of people with Autism within Dudley. 2.0Definition 2.1For the purpose of this plan the term Autism refers to people who have a known Autistic Spectrum Condition including people with Aspergers Syndrome. Autism is defined as “a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them” (NAS) 3.0Service Ambition: Local authorities and partners know how many adults with Autism live in the area3.1As a spectrum condition where few people have at present received formal diagnosis, the numbers of people known to the local authority who have Autism will need further validation over time, the recording of people with autism on the SNR is a relatively new data set. The data shown below has included people where records state they have autistic tendencies, for these people their primary disability will be a learning disability.3.2The prevalence rate for people with autism within the general population is estimated to be 1.1% (Autism Spectrum Disorders in adults living households throughout England – report from the Adult Psychiatric Morbidity Survey 2007, published 2009). Based on the 2001 census figures this would suggest that there are 2400 adults with Autism within Dudley.PANSI population data suggests that there is likely to be 1837 people with Autism in Dudley aged 18-64, projections for future years up to 2030 do no show any significant increase in likely numbers of people aged 18- 64 overall. See table below Age of People with ASC in Dudley as predicted by PANSI 2012201520202030Male Female Total Male Female Total Male Female Total Male Female Total 18 -242362426023024254207222292272425125-343243736134939388369414103333837135-443654240733139370329383673944443845-543924443640946455385444293333837155-6433538372329373663534039336442405TOTAL people 18-64165218518371649185183316431851828165118518363.3The table below shows People with Autistic Spectrum Conditions known to the Special Needs Register in Dudley June 2012 by Age Group.Age >14-1718-3031-4041-5051-6061 plusTotalsAutism485417964138Autistic Tendencies111192125Aspergers Syndrome104310018ASC team cases (excluding Aspergers)310313622129Totals6217234251073103.4The above information is separated by the source of information; the information has been checked to ensure there is no double counting. The categories ASC team Cases and Aspergers Syndrome relate to people with higher functioning Autism. The other two categories above include people with learning disabilities and Autism, and young people in transition. 3.5The information regarding young people coming through transition (Aged 14-17) is gathered from the Children with Disabilities Team and the Carers Network. The Carers Network operates in a similar way to the SNR as a voluntary register; the disability information is provided by parents and carers and therefore may require some validation. The question of whether the child/ young person has a formal diagnosis is not presently part of the profile taken by the carers network. 3.6Transition information relating to young people with Autism is gathered as part of the Transition Operation Group meetings, when young people reach the age of 18 the SNR writes to the young people/ family carer to invite them to be included within the SNR Data Base. The ASC team work with people aged 18+. 3.7As a spectrum condition the number of people identified by the SNR includes people with autistic tendencies/ people who also have a learning disability, 3 of whom are noted to have PMLD. There is no specific prevalence data for people who have Autism and a learning disability. 4.0Gender 4.1Of the 310 people identified gender is broken down as 20% female and 80% male, showing that Dudley has identified a higher percentage of females with Autism that would be expected; the gender prediction on PANSI shows a ratio of 90% male to 10% female. 5.0Ethnicity 5.190% of people known are White British, 2.9 % are of Asian or mixed Asian background, 2.9% are of black / mixed black/Caribbean background and the remaining 4% are either unknown or other white ethnic group. The ethnicity breakdown is largely consistent with Dudley’s general population demographic. 6.0Accommodation 6.141 people with Autism are identified as living in residential care, 19 people are identified as being in receipt of Support funded by Supporting People, and 19 people funded through Learning disabilities budgets for people in Supported Living services. Of the 310 people Identified, 148 (59.7%) live with Family6.2There are 19 people funded by Dudley who are out of area, these are people who have a learning disability and complex needs including Autism and are living in residential homes. 6.3There are a number of people who have not disclosed address and accommodation type, and others who will have their own tenancy and purchase support via a personal budget that we have not been able to count. 6.4The chart below shows people with Autism known by ward area.6.5People with High functioning autism / Aspergers syndrome often experience problems finding suitable accommodation and in the right location. The nature of their disability often means that they would have difficulty living in new areas as adapting to change is a common difficulty experience by people with Autism. Provision for adults with learning disabilities is not usually appropriate for those with high-functioning autism, as they have different needs, but much mainstream housing is equally unsuitable. There is a lack of affordable supported housing for people with autism, particularly in the south of the borough. Many people also express a preference for living alone, as opposed to sharing a tenancy, as they can find interaction difficult. Separate flats with a common area allow people their own space and independence, but with the option of seeking company. 6.6People with Aspergers and high functioning Autism often need low level support to maintain their tenancies, help with paying bills, dealing with correspondence and help with organising appointments etc. 6.7The Disability Housing Group is a sub group of the Learning Disability Partnership Board but considers the needs of all people with a disability within the borough. The needs of people with autism has been raised within this meeting and will continue to be flagged up when potential suitable opportunities arise. 7.0Carers7.1There is no accurate data held at present for the number of carers of people with Autism. The list of services Appendix 1 however includes support groups for carers. 7.2Carers are represented on the Dudley Autism Partnership Board, the membership of the board, the terms of reference and dissemination of information is being reviewed in 2013. 8.0Current Spending in relation to care and support services for people with Autism & personalisation 8.1Sources of funding for care and support in Dudley and total expenditureFunding sourceSupport typeExpenditureLearning Disabilities Budget Residential ?4mLearning Disabilities BudgetSupported Living?1,5mSupporting People Spend Housing related support?35,000Total ?5,535,000 8.2There are approximately between 40 – 50 people with Autism who are in receipt of a personal budget/ direct payment, work will be undertaken to monitor the data for people with autism in receipt of direct payments.9.0Information / Data Capture to inform service planning 9.1The data held on the SNR register regarding people with Autism and Young people with Autism is a relatively recent development and further work is required enable a full breakdown of the needs and circumstances of people with autism within Dudley, including gathering information from Mental Health Commissioners and GP practices. 9.2Data held will need to be validated / cross referenced with GP surgeries to confirm accuracy of numbers. As part of the link work with GP surgeries in addition to the need for autism awareness, understanding of the way GP’s within Dudley use the read codes to identify people with autism will need to be explored; there are currently 6 read codes for autism. 9.3The promotional material for the Special Needs Register is largely aimed at people with a learning disability, a leaflet that specifically outlines the benefits of the register for people with autism may prove useful9.4The Specialist Health Service provided by BCPFT at Ridge Hill can only support people with autism if they also have a learning disability. Regular contribution from the service is made to the Dudley Autism Partnership board.9.5The number of people with autism who are supported by Mental Health services is also an area that needs to be addressed to achieve better links for data sharing with Mental Health services. The list of people with Autism held by the SNR identifies 48 people with Mental Health issues, however none of these people have a primary Mental Health diagnosis. 10.0Gaps in Information 10.1Information regarding people with autism in Dudley is currently gathered from the ASC team, Transition Operational Group and historic information on the SNR. 10.2Engagement and formal information pathways with CCG’s and Mental Health need to be agreed and formalised to ensure data about the numbers of people with Autism is effectively captured. A promotional event targeted at GP’s would assist with raising awareness and setting out expectations and partnership arrangements in line with the Autism Act, national and local strategies. The promotion of the Dudley e-learning for autism awareness should also be showcased at such an event. 10.3The BCPFT contract does not include people with Autism; however people with dual diagnosis are supported by the service, metrics within the contract do not separate out specific conditions. The review of the contract should consider what useful information can be provided to inform commissioning. 10.4The CTLD Community Nurses are linked to named GP surgeries; part of the link role is to raise awareness of the needs of people with learning disabilities. Autism awareness raising within GP practices, highlighting or reinforcing best practice in terms of reasonable adjustments and autism screening would be beneficial. 11.0Employment 11.1The ASC register has been cross referenced with the Employment Plus Teams list of clients to identify people in paid work or voluntary work. There are 4 people (1.2%) known to be in paid work and 7 people (2.2%) known to be volunteers. Further validation of the ASC register may identify people in work where their employment status is currently unknown. According to information quoted on the National Autistic Society website, nationally only about 15% of people with Autism are in paid employment. 11.2The Employment Plus team criteria includes adults with Autism, a job coach dedicated to supporting people with Autism into employment is to be recruited. The Local Authority has 2 Service level agreements focused on providing employment training, one in Catering and the other in horticulture; people with Autism are eligible to access both these training opportunities. Referrals for the training are via the employment team.11.3BCPFT OT’s have recently set up a pilot work programme to support people who wish to gain employment – the group is focused around people with learning disabilities but may include people who have autism in addition to their learning disability. 12.0Gaps in employment services for people with Autism 12.1Feedback received through members of DAP has indicated that staff at Job centres have a lack of Autism awareness. Support for people with autism into employment is currently only provided by the Local Authority and independent sector. The importance of health engaging in the employment agenda for people with Autism should be recognised by Health Commissioners; being economically active has clear benefits to people’s health and wellbeing. 12.2Job centre staff are also often reported to have a lack of awareness or understanding regarding autism. Promotional activity linked to the Employment plus team and e-learning training should be extended to Job Centre Plus and other mainstream services. 13.0Health Needs Of People With Autism 13.1Specific health concerns for people with Autism within Dudley can not be reliably reported at present, GP’s have up to 6 read codes they can choose from to record Autism but at present data from GPs is not collated. The SNR will link with GP surgeries and health informatics teams to establish more accurate data for top line numbers and start to identify the specific health needs and trends. 13.2The national strategy recommends that young people in transition who do not have a formal diagnosis should at least have some form of health action plan. People with Autism are not included in the Direct Enhanced Services Health Action Plan scheme unless they also have a learning disability. GP’s receive financial remuneration for completing health checks for people with learning disabilities, at present there is no financial or other incentive for GP’s to do the same for people with Autism. 13.3A CQUIN target focused on identifying people with Autism could be suggested for Health Commissioners to consider, this would also serve to raise awareness of Autism and support data capture thus providing information about the population and health needs of people with Autism.14.0Services For People With Autism Within Dudley 14.1Dudley has a dedicated Autistic spectrum condition Team who are working with approximately 125 people with autism, (there are 84 open cases). There are 32 people with autism receiving support via supporting people funding provided by an independent care provider, this funding is primarily low level housing related support, helping people retain their tenancies. 14.2A list of services known to be supporting people with Autism in Dudley is detailed in Appendix 1, not all these services are listed on the Community Information Directory. There are 11 organisations listed on the Dudley Community Information Directory who state that they provide care and support for people with autism, only one of these organisations has NAS accreditation. 15.0Service quality15.1There are presently no Dudley providers on the National Autistic Society accreditation scheme though one Dudley provider of residential care is noted to have been working towards accreditation since 2007. The current contracts do not specify any specific training or quality assurance with regards to Autism, in order to ensure that providers have the requisite knowledge and skills a preferred training package or set of outcomes to measure quality could be introduced. A starting point for this could include the Autism e-learning module being developed and the QCF Autism modules offered by DMBC training.16.0Ambition 2 :A clear and trusted diagnostic pathway is available locally16.1A regional centre and diagnostic service has been developed in Edgbaston, Birmingham. The centre, known by the acronym SPARC (Specialist Autism Resource Centre), is being set up as an independent charity involving Local Authorities, clinicians, the University of Birmingham and Autism West Midlands. The service will provide a diagnosis and individual support plan, it emphasises that local partnerships and support are essential so that people are clear that post diagnosis support and or signposting is provided locally.16.2Consideration of different models, services and pathways will be considered. Leicester, Sheffield and Liverpool have established models which may provide useful information. Action relating to establishing a clear and trusted diagnostic pathway is outlined in the main Dudley Autism Strategy 2011-2014.17.0Ambition 3: Health and social care staff make reasonable adjustments to services to meet the needs of adults with autism17.1Care and Support Contracts issued in 2012 now state that Provider’s should have an awareness of Autism and Autism is listed as an expected training topic for all providers. Commissioned care and support providers are contractually required to submit an annual data return, this year Autism training has been included to establish a baseline of care staff that have completed some form of autism training. The finding of the data will be reported to the DAP board.17.2Within Dudley there are a number of care and support providers who are currently supporting people with Autism, at present the contracts are written primarily for people with learning disabilities though some minor recent amendments have been made. Dudley does not operate a formal framework agreement with regards to the contracting process but does have an approved provider list of those organisations that hold contracts. The benefits of a specific contract or framework will be considered, this may be by way of inviting existing providers to opt into an approved list for providers providing care and support for people with autism whereby they would need to demonstrate that they have sufficient knowledge understanding and experience to provide high quality support to people with autism. The process could be managed through desk top activity and evidence submissions but should involve some validation by people with Autism if possible. Commissioning Action Plan 2012-2015Standard / ExpectationAction Required Responsible Officer Timescale Local authorities and partners know how many adults with Autism live in the areaDevelop and improve the accuracy of data held on the SNR by cross referencing and having regular updates with : GP surgeriesthe ASC social workersEmployment PlusMental Health Team Carers Network/CDTCriminal Justice teamJC / SNR Co-ordinator Sept 2013Develop separate Autism transition data and higher functioning autism data with the SNR JC / SNR Co-ordinator/ MSSeptember 2013SNR to record where people have health action plans, health checks & record specific health needsJC / SNR Co-ordinatorNovember 2013Standard / ExpectationAction Required Responsible Officer Timescale Develop Autism specific leaflet for SNR to raise awareness of the register as a planning tool for service development.JC / SNR Co-ordinatorNovember 2013SNR to record where people have formal diagnosis or diagnosis via GP or other JC / SNR Co-ordinatorThe needs of people with autism should be taken into account in local housing planning The housing needs of people with autism in Dudley to be raised within the Disability Housing Group JC/MSCompleted Encourage housing staff to undertake the Autism e- learning courseJC/MSMarch 2014Health and social care staff make reasonable adjustments to services to meet the needs of adults with autismEncourage providers supporting people with autism to register their details on the Dudley Community Information Directory JCDec 2013Standard / ExpectationAction Required Responsible Officer Timescale Health and social care staff make reasonable adjustments to services to meet the needs of adults with autismSpeak to DCID about having a special tag (s) or filter for services for people with Autism to enable people to quickly identify servicesJCOctober 2013Audit autism training in respect of independent care providers commissioned by the council & report to DAPJCNovember 2013Autism awareness training to be mandatory for council staff AP/MSOctober 2013Identify tiered training approach for professionals and clinicians including awareness training for GP’s Council / BCPFT / CCG’s March 2014Consider linking awareness training and feedback to Autism Friendly resource monitoring – may link to Dudley LD website or DCID JC /MS March 2014Standard / Expectation/ Gap Action Required Responsible Officer Timescale Health and social care staff make reasonable adjustments to services to meet the needs of adults with autismSuggest Autism CQUIN for CCG’s to identify next year – to identify/ screen/ code and flag people with autism AP to take to BC Programme board Dec2013Awareness workshop targeted at GPs AP /MS/JCMarch 2014Consider approved autism provider list / framework and additional specification for contracts. JCMarch 2014Standard / Expectation/ Gap Action Required Responsible Officer Timescale Community Nurses linking with GP surgeries to raise awareness of Autism and need for people to be identified / screened/ health checked/ signposted and coded appropriately JC to raise with CCG/ BCPFT Dec 2013Identify the number of carers of people with autism Carers information to be added to the SNR profiles for people with autism where permission is given. JC / SNR co-ordinator Dec 2013People with autism are benefiting from the personalisation agenda and can access personal budgetsIdentify the number of people with autism who have direct payments and personal budgetsEstablish an ongoing recording process for people with autism in receipt of DP’s / PB’s . JC/MSSeptember 2013Consider any autism related reporting that can be provided by BCPFT or other providersJC/APStandard / Expectation/ Gap Action Required Responsible Officer Timescale People with autism are included and economically active Increase the number of people with autism supported into paid employment in DudleyMSRaise awareness of the needs of people with autism with Job Centre Plus staff and other mainstream agencies via promotion of e-learning course and links with E-PlusMS/ E-PlusAppendix 1Autism Specific Services within Dudley ASC team Ladies Walk Centre Sedgley DudleyDY3 3UA 01384 81 1587 / 1590Two social workers make up the team to support adults (aged 16 plus) with higher-functioning autistic spectrum condition. Referrals are accepted direct from people with autism, professionals, carers, parents or other family/friends who feel they have social care needs. The assessment may result in work with the client to access services, which may include areas of employment, education/training, leisure activities or in activities to help build their social skills. Other support to the client and those involved in their care may also be possible if a need has been identified. The assessment may involve the thoughts of carers/parents etc, providing the client provides consent. The team may also be a source of information to enable signposting to other services. The team may also be involved in developing other services to support this client group as need arises. Autism Drop In Group - Tuesday 10.00am-12.30pmBonded Warehouse Canal StreetSTOURBRIDGE,West Midlands.DY8 4JB Contact Richard or Helen For further information :01384 81 1587 / 1590Autism/Attention Deficit Hyperactivity Disorder ( ADHD ) Support GroupThis is a group for parents of children affected by an Autism Spectrum disorder (Autism, Asperger's Syndrome, ADHD).Meets Every other month on a Wednesdays 1.00-2.30pm Stourbridge Children and Family Centre,Forge Road,STOURBRIDGE,West Midlands.01384 818780 stourbridge.familycentre@.uk Supporting People Team (Autism service)Ednam House No Limits Community Project –Working 4 AutismNO LIMITS Community Project is a registered charity NO LIMITS Community Project is happy to work in partnership with any groups interested in working with our members to enhance and improve their opportunities. No limits lists partners & affiliates as Dudley CVS, The Coach House, Attend and the national lottery. The project is interested in developing employment opportunities through partnerships.Chris Morgan, Project Manager, on 01384 376796 or email chris-nolimits@ NO Limits Pool team Meetings are the first Monday in the month at a pub in STOURBRIDGE. 7.30 to 9.00pm. Captain is Bruce Collier, Vice-Captain is James CurrienIf you are interested in joining our pool team and want more information, in the first instance, contact: Chris Morgan, NO LIMITS Project ManagerEmail: chris-nolimits@ ,or 01384 376796(Information courtesy of No Limits Website) Aspirations Drama Workshop –Friday Afternoons 2-4 at the Coach HouseCoach House, Oldswinford (Corner of Rectory Rd & The Steeples, DY8 2HL) Here is an opportunity to have fun and write your own script. Create your own characters. Learn how to put on your own Play / panto. Make your own props and scenery. Create your own costumes. It’s what you make it!! Facilitated by MEL ELLWOOD, an experienced special needs drama tutor. (Information courtesy of No Limits Website) Gym ClubGym Club is run every Wednesday morning at 11.15am to 12.15pm Our Qualified Instructor is Jason Harper and he is keen to help you to become fitter and healthier.? Dietary advice given. At The Coach House(Information courtesy of No Limits Website) 5 a side Foot Ball The Kewford Colts/EaglesA group of members join The Kewford Colts/Eagles on Sunday Mornings, 10:00am until 11:45am. Trained Special Needs FA coaches, ?3.50 a session. Crestwood School, Kingswinford. Every 4th Sunday training / league games at Villa Park Academy. Initial one off payment of ?10 for kit, shirt, shorts, socks and fleece. Provide own boots & shin pads (Information courtesy of No Limits Website) T.O.A.D.S. A support group for parents/carers of teenagers/adults in the Dudley borough with Asperger's Syndrome/ Autistic Spectrum Disorders. The group is called TOADS-Triumph Over Autism Dudley Support. Ages 16 upwards - no upper limit. Contact: 01384 279621 The Rainbow Club Indoor activities for adults with autism or a learning disability every Monday from 9.15am to 12.15pm. The Rainbow Club is based at the Richardson Hall Cottage, Lawnswood Road, Wordsley. Members are asked to pay ?2.50 each week, which includes tea or coffee. Carers and visitors have free admission and drinks, but voluntary contributions will be gratefully accepted. Board games?and football games, but members will be able to influence future activities depending on funding. e.g. computer games, such as Nintendo Wii. Contact : Mike Hands 07891 226184 Dudley Autistic Support Group .uk Is open to all parents and carers living in the Dudley borough who have a child with an autistic spectrum condition and to the interested professionals who support them. parents and carers who live out of the borough who have no support group in their locality are also welcome - aims to support children up to the age of 16 who have an autistic spectrum condition. the needs of siblings are also seen as important and many of our activities are family events - campaigns for the rights of young people and parents who have been subjected to discrimination as a result of their family member’s autism - holds parent support group meetings on the 2nd Tuesday of the month at the Samson & lion public house in Wordsley (opposite the Wordsley school) where parents can share common experiences and concerns. sometimes guest speakers talk to the group - campaigns for better services for our children in terms of service provision and endeavours to maximise family incomes to achieve a better quality of life - arranges social events for parents - organises events for all the family such as holiday activities during school breaks - produces a newsletter for all group members - offers telephone and face to face support to parents experiencing difficulties and issues - can signpost to other sources of help and support - runs a telephone advice line on 01384 823487 Mon – Fri 7 – 9pm - website providing information about Autism –Compiled and designed by Neale Pilkington & Chris Hampton with support from Dudley Autistic Support Group. Provides a Support Group for teenagers with mild Autism meets every second Monday 7.30- 9.00pm at Dudley United Reformed Church, Trinity Rd, Dudley. For more information contact Chris on 0752 873 4407 or visit autismdontpanic.co.uk The Den The Den is a website developed by the Autism Education Trust specifically for use by young people who are on the autistic spectrum and or their friends. The website promotes itself as an “information Hub” and covers areas such as health, work, study , travel , the law, money and home life. & National Organisations Autism Services Directory - National Autistic SocietyA comprehensive directory of services?and support for people with an autism spectrum disorder, their families, and people who work with them Autism - West MidlandsProvides information and support to families, professionals and individuals who have an autistic spectrum disorder.0121 450 7575 Helpline info@.uk Tel: 0121 450 758018 Highfield Road,Edgbaston,BIRMINGHAM,West Midlands.B15 3DU ................
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