This National Framework is used across all disciplines in Wales. Within ABUHB, Complex Care (Adult/General), Mental Health and Learning Disability use the same framework, the paperwork attached and processes involved.

There will be a care coordinator attached to the person who is normally a Social Worker or Community Psychiatric Nurse.

Funding of Section 117 comes from a range of avenues, but within normal circumstances is funded by the Local Authority.

Should the persons needs by more complex, intense or unpredictable, the Local Authority may seek Health funding. A person in receipt of Section 117 Aftercare is still entitled to a CHC assessment under the Continuing NHS Healthcare framework 2022.

A Section 117 meeting is routinely held every 12 months which involves the CPN, Social Worker and any additional commissioners. At this meeting a funding split is discussed. For example, should a person be in a nursing home under Section 117, Health fund the FNC portion of the care with no further identification of complexity, intensity and unpredictability.

Any Section 117 meeting should have recorded minutes that are held on file. The commissioners should be part of the meeting to agree funding at the time of the meeting, they will then take this away to their respective panels for agreement of funding split.

A person can also be removed from a Section 117 Aftercare Order if the professionals involved feel this appropriate.

Please see the 'How To' guides for training on a Section 117 meeting.

When a fast track assessment is requested from a NHS professional, the framework indicates that this should be done within 2 days of that request.

A Fast track, be that 1 or 2 needs to be supported with a medical opinion by a medic. This could be the GP, Palliative doctor/consultant. This must be sent alongside the Fast Track Paperwork.

A Care Plan must be devised when submitting a fast track application. This will identify the care requirements for the patient and inform the carers within a community package of care, or the nursing home upon admission.

All submissions of fast track must be sent to complex.care@wales.nhs.uk.

There is a cut off for Fast Track 2's to be submitted to the Complex Care Team which is a Thursday at midday. The reason for this, is that a care package cannot be sourced at that point for community care, or a safe discharge to a nursing home. Please contact the complex care team if we wish to disuss any cases.

In order to be funded under Mental Health Commissioning, there needs to be a primary diagnosis of a functional mental health disease/disorder with a primary health need or reason to believe it is above what local authority can provide legally under the Social and Wellbeing Act 2014.

Contacts below:

Mental Health Case Managers:

Simon.carne@wales.nhs.uk

Pauline.gething@wales.nhs.uk

emily.gilbert@wales.nhs.uk

Please complete the Staff Outcome Survey around Complex Discharges to better inform us of training needs across the sites.

There is a wider team under secondary care of discharge Liason nurses and assistants that support discharges out of hospital. Annie Lewis is the head of discharges for ABUHB.

Positive Approach to Care is a framework of care that encourages staff to understand the person's perspective. There are specific techniques that enable staff to reflect on how they physically engage with a person, how to start conversations and support the person in any aspect of care. There is an emphasis on promoting independence by empowering choice. A popular technique is 'hand under hand', used for physically assisting hand / motor coordination (meal times, personal care).

The sessions are co-facilitated by Matthew Galloway and Amanda Strange, band 4 assistant practitioner. We are both trained as trainers and I am trained as a PAC coach. This means I am able to work along side staff and offer support in using PAC techniques.

Amanda Strange is taking a lead in offering ward 'bite size, refresher sessions to ward staff.

The staff training is 1 day, open to all inpatient staff, community teams and now there are limited spaces to care home staff. I have witnessed hand under hand being used and I've received positive feedback from care staff regarding PAC, plus, all the sessions are formally evaluated.

Regarding 1:1, I also facilitate Therapeutic Observations and Engagement training. There is a significant emphasis on engagement, use of 'this is me', life story work and how to develop positive, helpful relationships.

Contact Matthew Galloway for more information and upcoming training dates.

matthew.galloway@wales.nhs.uk

Worcestershire won their case in court and it transferred to Swindon as the responsible body.

In essence this judgement indicates that wherever the person is detained is responsible for their aftercare services.

Mental Health Act and case law update training sessions are offered to all members of staff working within the Mental Health and Learning Disability Directorate of ABUHB. The sessions include an Introduction to Mental Health Law; Key Concepts in Mental Health Law; and Policy Requirements of the Code of Practice. Training also includes the interface between the Mental Health Act and the Mental Capacity Act. It has been designed to provide professionals engaged in the delivery of mental health services both with an understanding of mental health law, and the ability to apply that knowledge to every day scenarios. 

Upon successful completion of the training, staff should demonstrate knowledge and understanding of key provisions of mental health law and have an appreciation of the consequences of an unlawful application of mental health law. 

Contact Helen Moon for more details around upcoming dates.

helen.moon@wales.nhs.uk

Learning Disability:

Sarah.Summerfield@wales.nhs.uk

Jon.Povall@wales.nhs.uk

Venessa.May-Thorpe@wales.nhs.uk

Attached are the presentations that Digital Communities Wales did for the MAS team, here are the links to the videos that were shown:

Ballerina https://youtu.be/wlAXKJfesBM

Alexa- A Digital Lifeline https://youtu.be/U5vwhVDRT_8

Free Tech Support & Information | AbilityNet Abilitynet provides free tech support to older and disabled people, their family and friends, and the people who care for them.  Calls can be made to their helpline, or their network of volunteers can provide support to older and disabled people in their own homes.

If a patient is on the ward and a CHC assessment has been requested, this does not have to delay discharge. The patient can be discharged into their long term environment where they will then be assessed. The framework indicates a 'home first' approach to ensure that the patient is in the correct environment when assessed.

Follow the process of the CHC assessment which you can find on the 'How to Guides'

Link in with your local CHC team for any support or advise, contacts of which are held under the Continuing Healthcare Section. If in a hospital environment, your MDT facilitator can support and advise, contacts of which are under Discharges from hospital.

Tel No: 01495 745801  

Email: dols.team@wales.nhs.uk

This Padlet will inform around all things enhanced levels of care.

For more information please contact 01495363123 or email complexcareot.abb@wales.nhs.uk

This means that the decision is in Dispute and the policy attached is to be applied.

This is not the same as an appeal and there is an alternate process for this. Should family disagree with the recommendation at the DST meeting, they should be advised to submit their intent to appeal in writing within 28 days.

As with persons' commissioned by Complex Care the teams below will assess the person using the CHC Framework following the same processes to indicate if there is eligibility for CHC.

Dietician

Specialist Nurse (Diabetes, MND, Parkinson etc)

Physio

OT

SALT