Learning Disabilities Service Review - TOR

Summary

The requester asked for the Terms of Reference and the name of the appointed organization for the Learning Disabilities Service Review. Manx Care disclosed a confidential outline proposal detailing the review methodology and phases but redacted the specific costs, timeline, and the full name of the appointed organization.

Key Facts

• The review covers adult learning disability services including delivery models, funding, and strategic options.
• The proposed methodology includes five phases: Desktop Review, Fieldwork, Further Analysis, Follow-up Fieldwork, and Reporting.
• Fieldwork involves visiting all 18 services, with 14 receiving a 'Short audit' and 4 receiving a 'Deep dive' audit.
• The proposal was dated September 2024 and marked as Confidential.
• Specific financial costs and the total number of days for the project were redacted in the response.

Data Disclosed

• September 2024
• 18 services
• 14 homes
• 4 homes
• 90 minutes
• half a day
• team of four people
• 2024-11-19
• 2024-12-09

Original Request

Dear Sirs Please provide a copy of the terms of reference for the learning disabilities service review as referenced at the recent social affairs policy review committee hearing by Prof Tim O'Neil Please further confirm the appointed organisation who had been commissioned to facilitate the review.

Data Tables (1)

Full Response Text

© | Month Year 1 CONFIDENTIAL IN CONFIDENCE

1.1 Overview This outline proposal provides details of an indicative method, teams, delivery plan and costs to carry out a review of adult learning disability services including:
• The current delivery models and a high level review of quality assurance processes within the service. • Desk top review of the funding, outputs and benchmarked costs of the services.
• The future strategic options for this service. • Any immediate recommendations that arise from the review that require action to ensure safety and quality of service. We have developed this submission with limited insight into the detailed circumstances and we appreciate that one of the first steps is likely to be some revision and refinement of our suggested approach. 1.2 Phase 1: Desktop Review We will start this assignment with a launch meeting where you will have the opportunity to discuss and agree changes to our methodology and also any final steer in terms of what is required. There will also be an element of logistics as we will need to start to plan our field work at this point. This phase of work will look at material such as Care Plans, Budgets, Staffing deployment, LD specific policies, safeguarding reports and details of any investigations.
Demographic information on service users will also be useful etc. We would also hope to be able to conduct a small number of online interviews with key stakeholders. We will use this part of the review to look at best practice in LD provision and design a Service Audit Tool which we would use in our field work. The purpose of the tool is not to replicate the work of inspection but to look specifically at the services in terms of its alignment or not to modern best practice. We would create two versions of the tool, a ‘Short audit tool’ which would be used when we visit 14 of the homes and a ‘Deep dive audit tool’ to be used when we conduct more extensive visits to four of the homes. We will also commence the process of gathering benchmarking data, we anticipate that we will need to convince other providers to share information, and this always takes a little Manx Care Review of adult learning disability services: Outline proposal
September 2024

Manx Care
Review of LD services: proposal

© | September 2024 2 CONFIDENTIAL
time although we are conscious of only gathering enough material to inform this assignment. When we have completed this first phase, we will provide senior managers in Manx Care with an interim briefing to share our findings and reflections up to this point and also agree any particular steer required in relation to the field work. 1.3 Phase 2: Fieldwork We wish to visit all 18 services.
Fourteen of the visits would be to deploy the ‘Short Audit Tool’ and would take around 90 minutes per home.
Four of the visits would deploy the ‘Deep Dive’ version of the audit tool and we anticipate that this will take around half a day. In both cases we would expect to be able to speak with frontline staff, first line managers and the people who actually use the service. Although we are not decided, we think it would be useful to discuss the involvement or not of people’s relatives in this process, as they are one of the key stakeholders in this process overall. We would aim to use a team of four people which would ensure that this work can be completed quickly. We are suggesting that before we leave the island, that we provide a second interim briefing in person. 1.4 Phase 3: Further analysis and benchmarking We will review the field work findings and compare this with the information developed from the first phase of desk top review. We will also undertake the benchmarking of the services at this time to produce a clear picture of the performance level. We think that a third interim briefing at this point will be useful as we will be starting to form firmer and more evidenced views on the services. 1.5 Phase 4: Follow-up fieldwork We think it is likely that we may need to visit some services again, but this would be shorter and less intense than the previous field work and is likely to be highly targeted on the basis that we will know more precisely the information or understanding we require.

1.6 Phase 5: Reporting We will produce a first draft report which is as close as possible to the final output. We will share this first draft and then meet with you to discuss and agree amendments. We will then produce a final version of the report.

Manx Care
Review of LD services: proposal

© | September 2024 3 CONFIDENTIAL
We will finish this assignment with a sign off meeting you. 1.7 Costing, timing and team We appreciate that the methodology may change following further discussion but for the work described we would anticipate a cost of plus direct expenses and VAT. If direct expenses (flights, hotel, travel on the island etc) need to come out of the core budget then we will need to amend the methodology described.
This would relate to a total of around days of time. This is achievable because we will be using the following team Tom Noon – Chairman and founder of Cordis Bright responsible as the Project Director, leading on benchmarking and audit tool design. Tom will also form part of the field work team. Approximately days on this project. Kam Kaur – Director of Cordis Bright and responsible for professional practice and safeguarding oversight. Kam will also form part of the field work team. Approximately
days on this project. Joshua Butt – Principal Consultant responsible for overall project management, report production and will also form part of the field work team. Approximately days on this project. Anna Manning – Senior Consultant who will form part of the field work team. Approximately days on this project. We have considered the timing of this project in relation to pre-existing commitments and also the realities of benchmarking data gathering and the organisation of field work. We think that the end of January 2025 is a realistic end date for delivery of the final report.
We will however have provided three interim briefings before this point so which should enable early action on some issues. Provisional timeline Our provisional timeline is as follows: Formal launch meeting in w/c 07/10/24 - we would have been in discussion prior to this to get the most out of this session We allowed two weeks for Manx Care to gather the material we will need to review so the actual kick off in terms of our desk top work would be w/c 28/10/24. We would be aiming for the week commencing 18th November for the main field work, with the follow up field work probably in week commencing 8th December. We would start drafting before Christmas but finish in the first or second week of January, meet in the second or third week and then deliver the final report and have the sign off meeting w/c 27 January. Following this timetable would mean interim briefings as follows:

Manx Care
Review of LD services: proposal

© | September 2024 4 CONFIDENTIAL
• First briefing following desk top review w/c 11/11/24 • Second briefing in person following field work towards the end of w/c 18/11/24 • Third briefing online w/c 02/12/24 • Meeting to review first draft of report w/c 13/01/25 A full timetable is included below. Experience Tom Noon, Chairman
Tom Noon has undertaken numerous service reviews, investigations and inquires specifically into learning disability services. These have included the following: On two separate occasions for large national charities, we have reviewed service portfolios which had been subject to numerous safeguarding concerns by the relevant local authorities. In each case we identified specific issues and provided detailed recommendations for further action. On behalf of the Housing Ombudsman, we reviewed a safeguarding situation which had arisen in shared supported housing for people with learning disabilities. A précis of our findings and recommendations for restitution was included in the Ombudsman’s annual report.
We have undertaken more focused investigations into incidents of a person with pica consuming dangerously large amounts of non-food items, a person who used a PEG feeding tube because of serious risk of aspirating but was given food and drink by mouth by staff and a person who sustained numerous injuries follow epileptic seizures and falling from their bed. In all these cases we were able to produce outputs which met the requirements of the local authority and assisted the providers in making the appropriate changes to their operations. Tom has also led much of Cordis Bright’s work in relation to benchmarking. This has looked at a wide range of cost and performance issues. Most recently he conducted a large scale benchmarking operation (covering 17,600 clients, 22,000 staff) amongst providers of accommodation based services for people with learning disabilities. This looked specifically at safeguarding activity and medication errors. Kam Kaur, Director and Safeguarding Lead Kam has extensive experience of carrying out reviews, both for Adults and Children. She is social work qualified (Social work registered) and has an enhanced DBS check. Kam is also trauma informed trained by the Trauma Academy. Kam has specialist experience of Inspection and Regulation, in her role as an Inspector for HMIP, where she inspected areas across England and Wales. A key role at Cordis Bright is overseeing all aspects of fieldwork of both children and adults, both by way of briefing and de-briefing staff and handling of any potential safeguarding alerts.

Manx Care
Review of LD services: proposal

© | September 2024 5 CONFIDENTIAL
Relevant experience: • Review of Safeguarding approaches and production of 35 personalised care plans following an Inadequate CQC Inspection for a Housing association. This involved fieldwork as a team to 10 residential homes, interviews with stakeholders and final reports. • Review for a Hospital trust – commissioned by the hospital CEO to carry out a review of a serious case review following the death of a child. This included onsite visits, review of medical notes, as well as interviews with key stakeholders, and sharing of findings with the parents. • Audit and practice review of Liaison and Diversion teams across West Yorkshire which included Adults with Learning difficulties. • Serious case reviews and MAPPA reviews commissioned by Local Authorities
• Service Reviews of teams; to explore models of practice and best practice, which has included staff roles as well as resource. Joshua Butt, Principal Consultant
Over the past nine years working with Cordis Bright, Joshua has led and participated in a wide range of evaluations, research and reviews across a variety of Adult Social Care settings, with a focus on services for people with a learning disability.
For example, his work has included evaluating the quality of practice in care homes for older people in Nottingham in relation to effective medicines management, use of technology aides, and enhanced provision for residents with dementia. He has also supported teams specifically set up to identify and intervene in care homes showing evidence of declining performance and at risk of closure or no longer being eligible for local authority placements.
More broadly, Joshua has worked with a range of social care providers to support the development of different models of care and support, including providers of support seeking to ensure that their offer to clients follows modern best practice in terms of person centred-care.
Joshua is an experienced project director and would oversee the delivery of this project. He will have responsibility for producing the final report, with input from colleagues.
Joshua has an MSc Social Policy for London School of Economics.
Anna Manning, Senior Consultant
Anna will support the team with additional capacity to conduct fieldwork and analysis. She brings a wide range of experience evaluating and conducting fieldwork in services for adults with a range of different needs, including people experiencing multiple disadvantage with complex physical and mental health needs.

Manx Care
Review of LD services: proposal

© | September 2024 6 CONFIDENTIAL
She is experienced at implementing observational research techniques and has a background working in the homelessness sector supporting homeless adults.
Anna has a BA degree in Human Geography from the University of Oxford and an MA degree in Geography Research from Royal Holloway, University of London.

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 4259209 6 December 2024

Dear

We write further to your request, received 19 November 2024, which states:

"Dear Sirs

Please provide a copy of the terms of reference for the learning disabilities service review as referenced at the recent social affairs policy review committee hearing by Prof Tim O'Neil

Please further confirm the appointed organisation who had been commissioned to facilitate the review."

Our response to your request is as follows: I have enclosed copies of the information.

While our aim is to provide information whenever possible, in this instance the information is exempt from disclosure under section 30 of the Act as disclosure would be likely to prejudice the ability of Cordis Bright and weaken its ability to be competitive for future similar reviews. As section 30 is a qualified exemption, it is subject to a public interest test. The public interest must be something that is of serious concern and benefit to the public at large.

Factors in favour of disclosure There is public interest in Manx Care's expenditure particularly, given the current financial pressures.
There is also ongoing general interest in how public funds are spent.

Factors in favour of withholding Release of the information may compromise the ability of Cordis Bright to submit competitive tenders for similar, future work.
The age of the information has been considered and as the information is current, the provider's commercial interests could be more likely prejudiced.
The provider is aware of this request, they are in agreement to the terms of reference being released with necessary redactions made to protect their commercial interests.

In taking these factors into account the Manx Care determined that the factors in favour of maintaining the exemption outweigh the factors in favour of disclosing the information.

Please quote the reference number 4259209 in any future communications.

Your right to request

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