Learning Disability Specialist Community Service

Services we provide

The service includes:

· A single point of access (SPA) for all referrals.· Three community hubs - multi-disciplinary teams which provide the whole range of specialist learning disability professions.· The Physical Health Liaison Team supports people with learning disabilities to access primary and secondary health services ensuring reasonable adjustments are considered.· County-wide community home assessment and treatment team.

 Services we are not comissioned to provide:

· A diagnostic service for assessment of learning disabilities.· Support with learning difficulties i.e. dyspraxia, dyslexia.· Specialist health interventions for people with autism or ADHD who do not have a learning disability diagnosis.

Referrals

The service will work with adults over 18 who have a diagnosis of learning disability and associated physical and/or mental health needs who are registered with a Lincolnshire GP.

Please contact your local community learning disability hub team if you wish to discuss a referral. One of the team will be happy to go through the process with you and provide advice and guidance, including signposting to other appropriate services as required.

For routine non-urgent referrals, a referral form, with guidance, can be obtained from our website: www.lpft.nhs.uk/our-services/adults/learning-disabilities or via SPA.

For urgent referrals to the community home assessment and treatment (CHAT) team, contact can be made through SPA or directly to the team.

Contact details for the community hubs, Acute Liaison Nurses and the CHAT team can be found on page 11.

Community Learning Disability Hubs

The service is provided in three hubs across Lincolnshire

•  Beech House, Boston
•  Sycamore Centre, Grantham (satellite office in Spalding)
• Unit 2, St George’s, Lincoln

We have three community hubs around the county which provide an integrated multi-disciplinary approach to supporting people with a learning disability. Each hub has specialist nurses, psychology, psychiatry, occupational therapy, physiotherapy and speech and language therapy. Through an integrated team approach, and working in partnership with other organisations, we have a single assessment process to reduce how often people have to tell their story.

The hub team will discuss all referrals and allocate the appropriate professional to carry out an initial assessment and plan appropriate interventions.

Liason with health services

In each hub there are liaison staff for physical health. They will work with service users, their carers and health care professionals to ensure equal access to mainstream services, promoting the use of reasonable adjustments through liaison, consultation and training for other organisations.

Community Home Assessment Treatment (CHAT)

Working closely with the community hubs, the team provide home assessment, intervention and treatment anywhere in Lincolnshire to service users in their home environment, whether that be a family home, supported living or a care home.

The CHAT team works to a positive behaviour support model to provide intensive support to people who are experiencing a deterioration in their mental health, or an increase in behaviours of concern and associated risk to self and others.

The service will respond quickly and positively to assess the level of risk and put in place a plan of care to address the immediate concerns. CHAT would offer support for up to two weeks. Once the immediate risks have been addressed and a clear plan is in place, the CHAT team will liaise with the community hubs who will then continue with the ongoing care plan as needed.

Transforming Care Liaison Service

The Transforming Care Liaison Service work with other teams and services across the Trust to provide support and intervention for Autistic Individuals and/or Individuals with a Learning Disability who are currently resident within Mental Health/Specialist inpatient services, who are at risk of admission to these services, who are at risk of placement breakdown, or who require reasonable adjustments to access mainstream services.

This support is primarily through liaison, advice, training and consultation with other Trust services and with wider system partners including the Integrated Care Board, Lincolnshire County Council, United Lincolnshire Hospitals NHS Trust, Police, and Voluntary and Third Sector Organisations.

The Transforming Care Liaison Service can also offer community based support to any Trust wide teams in relation to providing reasonable adjustments within their services for all Autistic adults or adults with an Intellectual Disability to support access.
 

The Transforming Care Liaison Service can:

• Provide specialist assessments, including sensory assessments, language and communication assessments.
•  Support the co-production of psychological formulations to understand distressed behaviours within the context of Autism and/or Learning Disability.
• Support with case consultation and liaison between teams and services.
• Support teams to develop, review and implement reasonable adjustments to increase accessibility to other services and recommended interventions.
• Provide joint interventions where this is required. For example, within inpatient units for person centred specifications, communication plans and environmental adjustments, or in the community to support staff with complex assessments or adapting psychological interventions for the Transforming Care cohort.
• Support access and signpost to specific resources.
• Providing Peer Support for individuals and reverse mentoring by experts with lived experience for professional teams.
• Organise and/or provide co-produced and co-delivered training in relation to Autism and/or Learning Disability.
• Support teams to better understand and engage with Care, Education and Treatment reviews and/or Local Area Emergency Protocols.
• Provide Trust oversight of the Dynamic Risk Register for Autism and Learning Disability.

Autism spectrum disorder diagnosis and post diagnostic support

We provide a diagnostic pathway for adult autism which follows NICE guidance. Referrals for diagnostic assessment should be made via our Single Point of Access (SPA) and are available for adults with learning disabilities. Once a referral is received, an initial triage document will be sent to the service user. This will then be considered at an Autism triage meeting and a letter will be sent which will confirm the outcome.

Should a further assessment be appropriate, the referral will be allocated to a specific professional who will contact the service user to arrange an appointment. We provide person-centred recommendations with our reports as well as a feedback session.

Feedback is sent to the referrer and onward referral to the post diagnostic team is considered. The post-diagnostic team will work with an autistic adult for up to 12 hours to support them to adjust to their diagnosis.