“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.”
Service model for commissioners of health and social care services NHSE October 2015
The Dynamic Support Register aims to bring together information about local children, young people and adults with learning disabilities and autism to ensure they receive robust, proactive monitoring, intervention and support.
All agencies and services involved in commissioning and delivering care for people with a learning disability or autism in Staffordshire and Stoke-on-Trent are working together to develop a comprehensive, consistent, digital database.
As well as the Register there will be an agreed pathway to ensure bespoke additional support is put in place, outcomes monitored and any issues escalated.
Who will be included on the DSR?
The DSR is for everyone with a learning disability or autism (whatever their age) but will focus on those who are most likely to need hospital admission or whose placement is at risk of breaking down.
Those who are likely to be referred to the Register are individuals who are most at risk of admission to specialist placements, hospitals or Tier 4 services (children only). These are people who have a diagnosed Learning Disability and/or Autism and who present as a high risk to themselves or others when faced with difficult challenges in their lives.
Everyone who is identified as needing to go on the register will be given the opportunity to find out more and say whether they agree to be included. Not consenting to join the Register will not affect a person’s current support.
What are the benefits of the DSR?
At the moment there are lots of separate lists which hold different information. By developing a single register which has all the information needed about each individual, it will be easier to make sure people get the support they need in the community and avoid admission to hospital wherever possible.
People who are on the Register will be proactively reviewed to identify early whether any additional support is needed.
Information from these reviews will also be used to identify key themes, trends and service gaps. These will help to plan and develop future services.
What agencies and organisations are involved?
The key agencies and services who will provide input and communication through the DSR are:
- NHS Learning Disability and Autism Services
- NHS Mental Health Services
- Local Authority Social Care Services
- Local Authority Social Care Providers
- Local Authority Education
- West Midlands Ambulance Service
- Staffordshire Police
Each agency has signed up to the DSR information sharing agreement. This agreement stipulates that the agencies will share information that is relevant, appropriate and proportionate in line with Information Governance policy.
What information will the Register hold?
The information held on the DSR will be the minimum required to facilitate high quality communication of needs and actions, including;
- Name of Service User
- Date of Birth
- Place of Residency
- NHS number
- Key Professional Involvement, their names and contact details
- Current issues that relate to risk and the risk of this escalating
- What has been tried that could mitigate risk (including positive strategies to improve a person’s quality of life, by providing life opportunities that can increase a person’s self-esteem)
- What could be useful to further reduce risks
- Action plan moving forwards including recommendations for current and potential future service involvement
Information for professionals
It is essential that consent is gained from the individual or the person who legally has care for them to refer to the register and, therefore, it is very important that information about the DSR is clearly understood by those giving consent. Information about the DSR will be available in various formats to ensure that it is provided in a way that maximises the person’s ability to understand and be able to give informed consent. Consent, once given, can also be withdrawn at any time.
If a person is assessed as not having the capacity to give informed consent and no one holds Parental Responsibility or a Court of Protection appointed Personal welfare deputyship. A best interest decision can be made under the Mental Capacity Act for inclusion on the DSR.
It is important to know that not consenting to join the register will not affect the person’s current support although individuals will benefit from inclusion on the DSR through the increased scrutiny of the services and support they receive and the potential for access to other appropriate agencies as part of the DSR process.