['AIS'] Instructions to Staff and CQC Assessments Lincolnshire County Council Adult Social Care - Find a freedom of information request

NHS Accessible Information Standard ['AIS'] Instructions to Staff and CQC Assessments Lincolnshire County Council Adult Social Care

Please disclose:
1 Your instructions to staff telling them how to identify, record, flag, share and meet the communication needs of disabled individuals.
https://www.lincolnshire.gov.uk/downloads/file/1840/adult-care-accessible-communication-policy https://www.cqc.org.uk/guidance-providers/meeting-accessible-information-standard :
2 The Care Quality Commission [CQC] Assessments of your application of AIS

https://www.cqc.org.uk/guidance-providers/adult-social-care/person-centred-care ''Adult social care ratings characteristics explicitly include AIS under:
R1. How do people receive personalised care that is responsive to their needs?
R1.5 How does the service identify and meet the information and communication needs of people with a disability or sensory loss? How does it record, highlight and share this information with others when required, and gain people's consent to do so?''

I can confirm that the information requested is held by Lincolnshire County Council. I have detailed below the information that is being released to you.

1. At the time of the introduction of the Accessible Information Standard, a guidance document was developed and issued “Making information accessible - A guide for Adult Care staff” .

The current version is in the process of being reviewed and updated and, once finalised, will be added to the Council’s internal staff intranet for staff reference and use. The link for this is not provided as it will be available on an internal staff intranet. At the time of the introduction of the Accessible Information Standard, guidance and updates were issued to staff through bulletins, newsletters and guidance documents. This covered the requirements of the Accessible Information Standard, and the requirement to Identify, Record, Flag, Share and Provide information relating to the need for accessible information. LCC’s social care case management system supports the recording of communication needs.

Guidance documents are available to staff in the case management hub (staff access only) and gives guidance on the electronic recording of communication needs in line with the Accessible Information Standard. This will mean that any communication needs identified as part of the assessment/conversation process are recorded on the person’s electronic social care record.

The link for this is not provided as it will be available on an internal staff intranet. A training package using an E-learning for Health course is provided to staff on the LCC E learning portal.

This is included in the mandatory Adult Care induction programme for new staff on the E-learning platform. The link for this is not provided as it is hosted on an internal e-learning platform for which staff members need to be registered for a user account. Adult Care staff have access to an Adult Care Procedures manual which is aimed at staff, as its audience.

This provides guidance and advice on the duties arising from the Accessible Information Standard. There is a link to “A Practitioner’s guide to supporting people with communication needs in Lincolnshire”. Staff are advised that the method of communication used should reflect that requested by the person and any specific communications needs they may have. A public document is available on LCC’s website “Accessible Communications Policy”. This document, which is available to staff as well as the public, is currently subject to review and update.

2. R1. We ensure this through both our social work approach and through our standards for commissioned services. In respect of social work approach to ensure people receive personalised care:

•We follow a Strengths based approach to care and support planning – identifying what is unique to the person, including their strengths and assets, to build these into personalised care and support plans. Our strength-based practice model supports people to make choices that balance risks with positive choice and control in their lives. •People are supported to coproduce person centred care and support plans that maximise their involvement by understanding their communication needs, involving their representative and / or people who know them best and this may include the use of a Care Act advocate.

•Outcome focus when care and support planning – we work with people to understand what matters to the person, including their interest and aspirations.

•Providing Direct Payment to enable the person, with support if needed, to arrange their own care and support. •Commissioned providers are expected to also develop care and support plans with people that reflect day-to-day needs.

•We complete regular reviews with people, their representatives and care providers to understand what is working well or not working and to consider what outcomes should change if it does not meet the person’s care and support needs. In respect of standards for our commissioned services: Below taken from LCC Residential Framework Agreement 2022.

Service Description

7.6 On accessing residential services, the new Resident and/or their family/Carer/Advocate must be issued with:

· a copy of the complaints procedure in an accessible easy to read format

· a welcome pack about the service in an accessible format

· any additional services to those described within this specification offered by the Provider.

7.7 Information must be accessible using a variety of formats and methods.

Meeting Communication Needs

26.1 The Provider must ensure it meets the communication needs of all Residents.

26.2 Communication both verbal and written shall be conducted in a way that is understandable to the Resident and in a way in which the Resident can make themselves understood.

26.3 The communication needs of each Resident shall be identified and include recognition of visual, hearing and cognitive difficulties. The Provider shall ensure it finds sources of information and advice and understands how to deal with any difficulties relating to communication.

26.4 Communicating in inclusive ways will be dependent upon:-

· An individualised care plan using accurate information on how to get communication right for each Resident.

· Staff awareness and knowledge of a range of resources that support inclusive communication approaches

· Having and using a range of resources that support inclusive communication

· Enabling the use of digital media e.g., SKYPE or other similar communication method

· Support from management and senior Staff

· Use of relevant external support when required, e.g. speech and language therapy

· Understanding primary language if English is not the individual’s first language

26.5 The Provider and Staff shall communicate and provide written information in a format that each Resident and/or their representative can understand.

26.6 Residents shall be supported to interact with others and express themselves.

26.7 The Provider shall adapt and facilitate activities, meetings, menus, and feedback and complaints procedures in order to include Residents.

26.8 Referrals shall be made to advocacy services where this is necessary.

26.9 The Provider shall apply the Accessible Information Standard to all communications where the person comes within the scope of the standard.

26.10 The Provider shall have due regard for the duty on public authorities to ensure that employees who work in a public facing role speak a level of English which is sufficient to enable them to effectively carry out their role. Contained in Part 7 of the Immigration Act 2016, and known as the 'Fluency Duty', the duty will not initially apply to the voluntary sector or private sector providers of public services. However, part 7 of the Immigration Act 2016 gives the power to extend the duties to these sectors at a later date.

Quality Assurance and Continuous Improvement

50.4 The Provider shall actively seek the views and experiences of Residents who are unable or find it difficult to communicate due to disability, impairment or sensory loss. Some Residents may need extra help to reflect upon and express their views and the Provider shall support them in compliance with the 'NHS England Accessible Information Standard'. Appropriate adjustments will be specific to the Resident but may include:

Accessible formats e.g. audio, braille, easy read, large print,pictorial Support from a communication professional e.g. British sign language interpreter, Communication support tools, Observational techniques With regards to contract management, the following table is taken from our contract management document:

Care Files

R1.5 Please see response given to question 1 above re: AIS.

Excerpt taken from CQC LA Assessment Report for LCC 17/11/23:

“People with lived experience told us that there were opportunities for them to get involved in co-production in relation to the accessibility of the information provided by the local authority. For example, people with a learning disability had been involved in developing easy read formats and some staff have had training in the use of alternative communication methods so that they were able to gather views from more people.

The local authority website had information on it about how to change some of the accessibility options so that users can change their preference, including a voice activation option. The local authority were committed to improving the accessibility and there was a function on the website for people to make suggestions for improvements. Staff told us that they were able to request information in alternative languages and that they did not have any problems in obtaining interpreters when needed.”