CAMHS Learning Disability (LD) Services Staffing

Whole Time Service Role Band Equivalent (WTE) Psychiatrist Consultant 0.6 Locum Consultant Child and Adolescent Psychiatrist Consultant 0.6 Team Manager 7 0.6 Clinical Psychologist 7 0.5 Specialist Services Community Community Children's Learning Disability Learning Disability Nurse 6 1.5 Positive Behaviour Support (PBS) Kingswood Hub, Alma Road, Practitoner 5 2.35 Support Worker 3 0.6 Medical Secretary 3 0.6

Senior Medical Secretary/Admin Lead 4 0.4

Clinical Services Administrative Assistant 2 0.8

Clinical Psychologist and PBS Lead 8b 0.5 Clinical Psychologist 8a 1 Assistant Psychologist 4 0.5 Psychiatrist Consultant 1 Bristol Specalist Registrar (SPR) SPR 0.6 Specialist Services Community Senior Psychologist 8b 0.2 Learning Disability Psychologist 8a 0.5 Woodland View, Thornfield Psychologist 7 1 Road, Brentry, Bristol Nurse 6 1 Support Worker 3 3 Admin 3 0.6 Nurse 7 0.8 Nurse 6 1.95 Team Manager 7 0.8 Senior Psychologist - Positive Behaviour 8b 0.5 Support (PBS) Lead Assistant PBS Psychologist 4 2.5 Senior Medical Secretary 4 1 Secretary 3 0.7 Support Secretary 2 0.6

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Whole Time Band Service Role Equivalent (WTE) Community Service Manager 8a 1 - vacant Autism Diagnostician (Lead) 7 0.6 Autism Diagnostician 6 0.6 Clinical Nurse Lead 7 0.8 Team Manager 7 0.6 Community Nurse 6 2.1 - 1wte vacant Physio 6 0.6 vacant LD/Autistic Spectrum Disoder (ASD) Speech & Language Therapist 6 1 Occupational Therapist 6 0.8 Service Nurse 5 1.4wte vacant Swindon Support Worker 4 1.9 Admin 4 1.8 Admin 3 0.18 Consultant Psychiatrist Consultant 1 Senior Psychologist 8a 0.6 Senior Psychologist 8b 0.7 Psychologist 7 1 Psychology Assistant 4 0.6

Consultant Psychiatrist Consultant 3 LD Community Administrator B4 1.8

Psychologist 8b 0.5 LD Psychology K and NW Psychologist 8a 1.6

LD Psychology Bath and North East 8b 0.8 Somerset Psychologist

Community Service Manager 8a 1 Team Manager 7 1 Intensive Nurse 6 2 LD Intensive Support Service Nurse 5 2 - 1 vacant Recovery Worker 4 5 - 1 vacant Administrator 3 1 vacant

Team Manager 7 0.8 Clinical Psychologist 8a 1.6 Learning Disability Forensic Team Nurse Practitioner 6 1 Nurse 6 1 Admin 3 0.6

Modern Matron 8a 0.6 Ward Manager 7 1 Deputy Ward Manager 6 1 Clinical Psychologist 8a 0.6 Psychology Assistant 5 1.6 Consultant Psychiatrist Consultant 0.4 Daisy Inpatient Unit Nurse 6 5 Nurse 5 1 Support Worker 4 5 Health Care Assistant 3 17.2 Occupational Therapist 6 0.4 Speech & Language Therapist 6 0.6 Administrator 3 1

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Service Role Band WTE Speciality Doctor 0.4 Consultant Psychiatrist 0.5 Psychologist 8a 0.5 Psychologist 7 0.6 Assistant Psychology 4 1 Speech & Language Therapist 6 1 Ward Manager 7 1 Senior Practitioner 7 0.5 Modern Matron 8a 0.2 Cary Ward, Blackberry Hill, Bristol Nurse 6 3.36 Nurse 5 9.52 Healthcare Assistant 3 9.97 Admin 3 0.4 Occupational Therapist 5 0.8 Occupational Therapist 6 1 Occupational Therpaist tech 4 1 Forensic Social Worker 6 0.6 Specialist Pharmacist 8a 0.1

Consultant Psychiatrist 1.5 8a 1 Forensic, Intellectual, Neuropsychiatric Senior LD Nurse Psychologist 8b 0.6 & Developmental Disorders (FIND) Psychologist 8a 0.3 Blackberry Hill, Bristol Nurse 7 2.3 Administrator 4 1

X:\FOI\0 FOI requests\2019-20\Open\RFI-1760\Correspondence\Specialised & Secure LD Services staffing Aug 19 Specialised Services Learning Disability (LD) Services

Swindon LD/Autism Spectrum Disorder (ASD)Team This service offers a specialist service to people with Learning Disabilities who have a specialist health need that cannot be met be mainstream services with reasonable adjustments. They are a multidisciplinary team offering nursing, speech and language therapy, occupational therapy, psychology, physiotherapy and psychiatry. They also offer a diagnostic service for the assessment of Autistic Spectrum Conditions.

LD Psychology Kennet &North Wiltshire Psychology cover 4 areas in Wiltshire, providing psychological interventions to clients with LD referred to the Community Team for People with Learning Disability (CTPLD) and work with individuals above the age of 18

LD Psychology Bath and North East Somerset (BaNES) BaNES psychology works under Virgin care team and provides psychological input for individuals under this team. The team work with those over 18 years of age with a diagnosis of LD.

Specialised LD Intensive Support Service LD Wiltshire Intensive Support Service are an intensive support service for individuals over the age of 18 with a Learning Disability and eligible for services of CTPLD. This is a step-up service for when an individual may need more support.

The team work proactively to prevent (where possible) admission to hospital where they are involved early enough and can support the providers, carers and parents to prevent placement breakdown and to identify possible triggers for behaviours that challenge. The service is there to support clients to access mainstream services.

Specialised Learning Disability Forensic Team The Avon Forensic Community Learning Disabilities Team is a well-regarded service, based in Bristol, providing a service across Avon (Bristol, Bath & North-East Somerset; South Glos and ). The team is strongly committed to multi-agency working and works closely with local learning disabilities and mental health services and the criminal justice system. They provide forensic risk assessment and advice, individual and group offender treatments and carry out relevant research, within the context of seeking to promote awareness of the needs of offenders who have learning disabilities.

They provide forensic risk assessment and consultation on risk to partner agencies and the management of offenders with Learning Disabilities/ASD, as well as individual and group offender treatments. The service involves close collaboration with Health, Social Services and Criminal Justice System organisations across the Avon area.

Daisy Inpatient Unit Daisy is an inpatient unit for 5 individuals with learning disabilities, mental health needs, autism and complex needs including challenging behaviours.

People that are supported at Daisy will be franchised to be involved in their care, integrated into their family and community, and offered dignity and choices in their care. Daisy has been designed in partnership with service users, their family members, commissioners and architects to provide a supportive environment for the individuals there. The service uses Positive Behaviour Support as their model to support service users to develop their daily living skills and achieve their full potential.

All service users at the Daisy will be care coordinated by the local community learning disabilities services who will work with the service users and unit to identify discharge pathways. All service users will attend local services for appointments and will be encouraged to access the local community and actively participate in education, leisure and employment activities.

Secure Services Learning Disability Services

Secure Medium Inpatient Cary Specialised ward within medium secure inpatient services providing specialist care for individuals with LD and/or ASD who have a forensic background.

Secure FIND team The FIND (Forensic, Intellectual, Neuropsychiatric & Developmental Disorders) team provides a service for people with learning disabilities, autism spectrum disorders and/or acquired brain injury, where there is a significant risk of harm to others, such that secure hospital care may be needed.

The team provides gatekeeping for secure hospital services for this group from the West of , and if they enter secure hospital care, we then have a case management role. They also provide advice and consultation to other professionals.

AWP’s Specialist Service for Children with Learning Disability (SSCLD) for Bristol and South Gloucestershire

This team will work with children and young people with moderate, severe and profound learning disabilities who have severe, complex and enduring developmental, emotional, behavioural or mental health difficulties, which are leading to significant distress and/or functional impairment and which have not resolved with the usual primary interventions. (See next page for definition of learning disability).The service accepts referrals of children and young people up to the year of their 18th birthday (or 19th if in full time education). If young people are nearing their 18th birthday we would anticipate their needs would be best met by adult services and would advise that they are referred to the adult community learning difficulties team.

There is no lower age limit but the SSCLD would not become involved with a child until after the Community Child Health Team had completed an assessment of the child’s needs and his/her diagnostic and developmental status.

Moderate, severe and profound learning disability is defined by the World Health Organisation as an IQ of 50 or less. It is important to acknowledge, however, that IQ describes only one aspect of a child or young person and does not ‘capture’ the whole child. A child also falls roughly into the Moderate Learning Disability category if they are achieving at below half of the expectations for their chronological age.

We work collaboratively with young people, their families, schools and other support services to make an assessment and suggest appropriate intervention with the aim of supporting families in improving their well-being. It is not possible to give an exhaustive list of potential referral reasons but the following are some examples of difficulties which would be considered

 Aggression/Challenging Behaviour  Self-injurious behaviour  Children at risk of school exclusion and/or home  Placement breakdown due to emotional and behavioural problems  Severe difficulties adapting to puberty and adolescence  Sexual behaviours of risk to self or others  Problems with sexuality or gender identity  Complex, severe, enduring continence problems including faecal smearing  Feeding and dietary problems  Severe or abnormal reactions to loss and bereavement  Severe/complex relationship difficulties leading to significant impairment of functioning or well being  Medical problems significantly impacting on emotional health and well being  Severe anxiety  Obsessive compulsive problems  Low mood, self-esteem and depression  School refusal where mental health difficulties play a significant role  Offending behaviour where mental health difficulties play a significant role  Psychiatric disorders including psychosis