An individual’s experience of what constitutes high-quality care will be highly personal, particularly when they may be receiving lifelong support as can be the case for people with a learning disability and autistic people. However, there were a number of common themes that emerged from our conversations with trust leaders about their view of the features of high-quality care, which are outlined below:
- Trusts work in collaboration with service users and people with lived experience to plan services and, in some cases, help deliver them.
- Care is person-centred, family-friendly and trauma-informed: the issues service users are experiencing are seen in the context of past events and their care helps them feel safe and build on their strengths and the support around them.
- Care is holistic, taking into account meeting people’s general physical health needs as well as their wider personal, social and employment needs. One trust chief executive we spoke to emphasised clear sustained evidence of life planning with services users and carers is paramount to getting the best outcomes.
- Services are delivered by skilled staff from a range of disciplines with the right values and behaviours. Staff having respect, compassion, courage, understanding, and good communication skills are particularly important, as are staff being an advocate for the people in their care and trained in positive behaviour support (PBS).
- Secure, high-quality housing provision is available in places where people want to live alongside specialist community services with the capacity and resources to support people to remain living their life in their own homes.
- If inpatient care is required, it is specialist, short-term and focused on people’s return to recovery, supported by high-quality, robust and regular care and treatment reviews.
- Trusts take a collaborative approach within their organisation (e.g. physical health and learning disability and autism teams working well together) as well as with local system partners more broadly such as commissioners and social care and housing providers.
- In mainstream inpatient settings, when they are appropriate, reasonable adjustments are put in place for people with a learning disability and autistic people and staff supported to provide these through appropriate training, such as PBS, and awareness raising initiatives.
- All of the systems supporting these services, including governance and leadership, are “wrapped around the service user” to use a phrase used by one of the trust chief executives we spoke to