PARTNERSHIP WORKING LEARNING DISABILITY FORENSIC COMMUNITY TEAM AND LOCAL STATUTORY AND NONSTATUTORY

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PARTNERSHIP WORKINGLEARNING DISABILITY FORENSIC
COMMUNITY TEAM AND LOCAL STATUTORY AND
NON-STATUTORY ORGANISATIONS.
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AIMS

• The presentation will discuss how the existing
  community team within the Tees, Esk and Wear
  Valleys NHS Trust has developed and how it is
  adapting to meet the needs of the individual
  clients from a wide variety of geographical
  areas.
• To discuss the referral criteria and associated
  tiers of working within the team .
• The development of the necessary partnerships and
  liaisons that are required in order to
  successfully provide a service to this client
  group.
• To discuss treatment/interventions carried out.
• To discuss future challenges for the team.

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Developmental History of Learning Disability
Forensic Service

• September 1996, opened a 13 bedded mixed sex unit
  and Community Learning Disability Forensic Team
• September 1999, opened new unit with 11 beds
  (Beechwood). Opened 7 bedded rehabilitation
  house (Oakwood)
• November 2000, opened Day Service provision
• December 2002, additional bed at Oakwood
• June 2003, opened 10 bedded womens unit
  (Sandalwood)
• May 2006, Sandalwood relocated and beds increased
  to 11. Beechwood relocated and increased to 12
• January 2007, new 12 bedded male unit opened
  (Maplewood)
• January 2007, Farne Villa in Durham transferred
  to LDFS as 8 bedded rehabilitation unit for the
  north of the Trust
• January 2008, Community LDFS team for Durham
  fully operational

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Service Rational

• The service was developed in response to a
  recognised need to provide locally based services
  (Mansell, 1992..Reed,1994)
• Multi-disciplinary/multi-agency service
• Works with criminal justice agencies and
  mainstream learning disability services
• Provides assessment, treatment and rehabilitation
  to people with learning disabilities (PWLD) at
  risk of offending

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• The demand for learning disability forensic
  service has become more prominent in recent years
  due to the following factors-
• Prison and criminal justice services becoming
  more adept at identifying PWLD-prison in-reach
  teams, prison health care delivered by the NHS
• Custody diversion
• PWLD being appropriately dealt with by the
  criminal justice agencies, in the past people
  with a learning disability who offend may have
  been admitted informally or placed in a civil
  Section MHA 1983 rather than processed through
  the courts
• Closure of the long stay hospitals and the move
  to community care
• Development of research and evidence based
  interventions e.g SOTP, Fire setting programmes,
  Anger management

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Current Service Provision

• Community Intensive Support Team
• Currently supporting approximately 45
  community clients and receiving regular new
  referrals from the Durham, Teesside and North
  Yorkshire Localities. A new team to provide
  intensive support and treatment for the Durham
  and Darlington Locality was commissioned in
  October 2007. Some staff work across inpatient,
  rehabilitation, day services as well as community
  e.g. consultants, social workers and
  psychologists.

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Continued

• Low secure inpatient services - the Castleton
  unit, St Lukes Hospital, Middlesbrough.
• Beechwood 12 male beds
• Maplewood 12 male beds
• Redwood 14 Male beds
• Sandalwood 11 female beds
• Community Rehabilitation Service
• Oakwood 8 Male beds
• Farne Villa 8 Male beds (Earls House)

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Referral Criteria

• The Learning Disability Forensic Service is a
  treatment service for offenders with a learning
  disability who are aged nineteen years or older
  and who reside within the boundaries of the Tees,
  Esk and Wear Valleys NHS Trust.
• In order for a referral to be accepted into
  the Service, the person must-
• Function within the range of learning
  disability as defined within ICD-10 (the
  International Classification of Disease Mental
  and Behaviours Disorders 10th Revision).
• In particular, they must have a measured IQ
  of less than 70, which is associated with
  evidence of significant impairment in social
  functioning.

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continued

• They must be subject to a legal order (such as
  under the Mental Health Act or Court Sentence) as
  a consequence of their offending behaviour
• OR
  
  
• 
  
• They must be engaging in offending behaviours
  that have been sufficiently severe as to be
  putting the safety of others at grave and
  imminent risk and has been reported to the police
• OR
• Had a previous conviction for a serious offence
  against others and currently engaging in
  behaviours likely to lead to re-offending
• That treatment is likely to improve personal
  functioning/quality of life and significantly
  reduce the possibility of re-offending
  
  
  

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Partnership working with criminal justice services

• Probation
• Custody Diversion
• Police Public Protection Unit
• Prison Service

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Partnership working with Voluntary of

• Generic Teams
• Health Facilitation
• Residential Establishments
• Self Advocacy Groups
• Voluntary Agencies
• Education
• Local Authority

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Areas of joint working

• Joint assessment to establish learning disability
• Joint risk assessment and Management plans
• MAPPA
• Development of move on accommodation
• Development of employment opportunities
• Development of leisure opportunities
• Training

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Interventions

• Sex Offender Treatment Programme
• Relapse Prevention
• Understanding Emotions
• Behavioural Interventions
• Anger Management
• CBT and DBT
• Risk Assessments and Management
• Social Skills
• Drug and Alcohol
• Citizenship
• Sex Education

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Organisations we deliver training to

• Probation Services
• Police
• Group Homes
• Educational Establishments
• Generic Learning Disability Teams

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Types of Training Delivered

• What is a Learning Disability?
• Risk Assessment and Management
• Mental Health Act Legislation
• Care Programme Approach
• Personality Disorders
• Borderline Personality Disorder
• Client Specific

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Future Challenges

• Size and geographical area
• Employment
• Prison in-reach
• Disclosure
• Move on accommodation
• Public perception of client group
• Carer Involvement

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The End

• Thank You Very Much