Post-Winterbourne: An enhanced intervention team

A pilot service for people with learning disabilities whose behaviour presents significant challenges
Dr Karin Fuchs, Dr Peggy Ravoux , Julie McKendry (MHLD Psychology Services, South London & Maudsley NHS Foundation Trust), October 2014

Winterbourne
OOA services
+ others in
social care
funded
OOA + people
in crisis locally

People with learning disabilities are at risk

of developing behaviour that challenges

Positive Behaviour Support Formulation workshops

Systemic approaches

Training

Historical over-reliance on out-of-area

(OOA) placements

CPA case coordination &

risk management

Benchmarking service
quality

4. Outcomes: 10 months in
Crisis intervention:

2. Solution
Return
to area

Standard MHLD

Strengthen local services

Integrated working is essential: partnerships

with families, Local Authority, health services, providers and
commissioners

Prevention and rapid response to crisis are two sides of

the coin: essential to provide both

5 people supported through crises locally

Level of demand for service design (from a clinical

perspective) for return to borough higher than expected

Reduction in behaviour that challenges & family stress

Need for careful contracting

Improved QoL & capability of environment

Responsive, intensive input has been highly valued

Financial savings to CCG and LA

Ways forward often bespoke thinking outside the box

Clinical service planning & transition back to borough:

Putting families at the centre

1 person from ATU successfully living in the community in

the borough & attending college

Integrating a systemic approach (co-creating

4 people successfully back in borough from OOA

less restrictive environments
2 people living with family

Enhanced intervention pilot service, funded by Local Authority,

to complement existing Mental Health of Learning Disabilities
(MHLD) services:

Positive outcomes demonstrated (behaviour, QoL, financial)

Rapid, intensive, flexible clinical support at times of crisis

Ongoing training & consultation for:

Clinical service planning / developing capable environments

and supporting transition back to borough

respite services to create capable environments for short

term breaks and crisis support

Strengthening the capacity and capability of local services

social work team, contracts monitoring , and support

planning team for capable environments

Small team (1.6 WTE) of Clinical Psychologists & Behaviour

Specialist, plus Speech & Language Therapy input

Learning & reflections:

Accountable to Winterbourne View Steering Group:

enables strategic overview and multiagency commitment

Insufficient local capacity for skilled

support and crisis prevention/intervention

Crisis
intervention

5. Key ingredients

3. Approaches

1. Problem

solutions as a network of support around a

person) with PBS effective

Focus on capable environments is key

Demonstrating outcomes

Strengthening services:

Acknowledgements & contacts

London Borough of Southwark
Southwark Winterbourne View
Steering Group
Contact: karin.fuchs@slam.nhs.uk
B&D CAG, SLaM

Guys & St Thomass NHS Foundation

Trust (Speech & Language Therapy)

or

peggy.ravoux@slam.nhs.uk