Our model service specifications are aimed at supporting health and social care commissioners to develop locally specific service specifications which support implementation of the national service model. They build on the service model by providing additional detail for commissioners about the purpose, functions and intended outcomes of three aspects of the service model. These are:
- Enhanced/Intensive Support (principle 7 of the service model)
- Community-based Forensic Support (principle 8 of the service model)
- Acute Learning Disability Inpatient Services (principle 9 of the service model)
These three aspects of the service model describe specialist health and social care provision aimed specifically at supporting people with a learning disability and/or autism who display behaviour that challenges. However, mainstream health and social care services can and should meet a large proportion of people’s everyday needs.
The following key principles (as described in the national service model) therefore apply to all three aspects of our provision described in this document:
- The starting point should always be for mainstream services to support people with a learning disability and/or autism, making reasonable adjustments where necessary and with access to specialist multi-disciplinary support as appropriate;
- A core element of any such specialist provision should therefore be on enabling mainstream services, and other partners, to support people directly. Where meeting health and care needs are particularly complex, more intensive specialist multidisciplinary support may be needed in order to ensure equity of outcome for people;
- The onus is on us to put forward a compelling rationale for any proposal to deviate from the principle of supporting access to mainstream provision, whether community or hospital based services.
Three advisory groups were established to support development of the three model service specifications.
“Children, young people and adults with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition have the right to the same opportunities as anyone else to live satisfying and valued lives and, to be treated with the same dignity and respect. They should have a home within their community, be able to develop and maintain relationships and get the support they need to live a healthy, safe and fulfilling life.” Vision statement, national service model 2015.
As set out in the service model, the underpinning approach to transformation must be based on a whole system approach to delivering high quality support and services for people. For this to be a reality, services need to demonstrate a strong commitment to a shared value base which place individuals and their quality of life at the centre everything they do.
This value base should reflect the ‘golden threads’ of the service model and be evident on the basis of capable environments within which care and support is delivered. Capable environments are characterised by:
- Positive social interactions,
- Support for meaningful activity,
- Opportunities for choice,
- Encouragement of greater independence,
- Support to establish and maintain relationships and
- Mindful and skilled family/carers and paid support/care staff