PARTNERSHIP WORKING LEARNING DISABILITY FORENSIC COMMUNITY TEAM AND LOCAL STATUTORY AND NON-STATUTORY ORGANISATIONS.

1. PARTNERSHIP WORKINGLEARNING DISABILITY FORENSIC COMMUNITY TEAM AND LOCAL STATUTORY AND NON-STATUTORY ORGANISATIONS.

2. AIMS The presentation will discuss how the existing community team within the Tees, Esk and Wear Valleys NHS Trust has developed and how it is adapting to meet the needs of the individual clients from a wide variety of geographical areas. To discuss the referral criteria and associated tiers of working within the team . The development of the necessary partnerships and liaisons that are required in order to successfully provide a service to this client group. To discuss treatment/interventions carried out. To discuss future challenges for the team.

4. Developmental History of Learning Disability Forensic Service September 1996, opened a 13 bedded mixed sex unit and Community Learning Disability Forensic Team September 1999, opened new unit with 11 beds (Beechwood). Opened 7 bedded rehabilitation house (Oakwood) November 2000, opened Day Service provision December 2002, additional bed at Oakwood June 2003, opened 10 bedded women�s unit (Sandalwood) May 2006, Sandalwood relocated and beds increased to 11. Beechwood relocated and increased to 12 January 2007, new 12 bedded male unit opened (Maplewood) January 2007, Farne Villa in Durham transferred to LDFS as 8 bedded rehabilitation unit for the north of the Trust January 2008, Community LDFS team for Durham fully operational

5. Service Rational The service was developed in response to a recognised need to provide locally based services (Mansell, 1992..Reed,1994) Multi-disciplinary/multi-agency service Works with criminal justice agencies and mainstream learning disability services Provides assessment, treatment and rehabilitation to people with learning disabilities (PWLD) at risk of offending

6. The demand for learning disability forensic service has become more prominent in recent years due to the following factors:- Prison and criminal justice services becoming more adept at identifying PWLD-prison in-reach teams, prison health care delivered by the NHS Custody diversion PWLD being appropriately dealt with by the criminal justice agencies, in the past people with a learning disability who offend may have been admitted informally or placed in a civil Section MHA 1983 rather than processed through the courts Closure of the long stay hospitals and the move to community care Development of research and evidence based interventions e.g SOTP, Fire setting programmes, Anger management

7. Current Service Provision Community Intensive Support Team Currently supporting approximately 45 community clients and receiving regular new referrals from the Durham, Teesside and North Yorkshire Localities. A new team to provide intensive support and treatment for the Durham and Darlington Locality was commissioned in October 2007. Some staff work across inpatient, rehabilitation, day services as well as community e.g. consultants, social workers and psychologists.

8. Continued Low secure inpatient services - the Castleton unit, St Luke�s Hospital, Middlesbrough. Beechwood 12 male beds Maplewood 12 male beds Redwood 14 Male beds Sandalwood 11 female beds Community Rehabilitation Service Oakwood 8 Male beds Farne Villa 8 Male beds (Earls House)

9. Referral Criteria The Learning Disability Forensic Service is a treatment service for offenders with a learning disability who are aged nineteen years or older and who reside within the boundaries of the Tees, Esk and Wear Valleys NHS Trust. In order for a referral to be accepted into the Service, the person must:- Function within the range of learning disability as defined within ICD-10 (the International Classification of Disease; Mental and Behaviours Disorders � 10th Revision). In particular, they must have a measured IQ of less than 70, which is associated with evidence of significant impairment in social functioning.

10. continued They must be subject to a legal order (such as under the Mental Health Act or Court Sentence) as a consequence of their offending behaviour OR They must be engaging in offending behaviours that have been sufficiently severe as to be putting the safety of others at grave and imminent risk and has been reported to the police OR Had a previous conviction for a serious offence against others and currently engaging in behaviours likely to lead to re-offending That treatment is likely to improve personal functioning/quality of life and significantly reduce the possibility of re-offending

11. Partnership working with criminal justice services Probation Custody Diversion Police Public Protection Unit Prison Service

12. Partnership working with Voluntary of Generic Teams Health Facilitation Residential Establishments Self Advocacy Groups Voluntary Agencies Education Local Authority

13. Areas of joint working Joint assessment to establish learning disability Joint risk assessment and Management plans MAPPA Development of move on accommodation Development of employment opportunities Development of leisure opportunities Training

14. Interventions Sex Offender Treatment Programme Relapse Prevention Understanding Emotions Behavioural Interventions Anger Management CBT and DBT Risk Assessments and Management Social Skills Drug and Alcohol Citizenship Sex Education

15. Organisations we deliver training to Probation Services Police Group Homes Educational Establishments Generic Learning Disability Teams

16. Types of Training Delivered What is a Learning Disability? Risk Assessment and Management Mental Health Act Legislation Care Programme Approach Personality Disorders Borderline Personality Disorder Client Specific

17. Future Challenges Size and geographical area Employment Prison in-reach Disclosure Move on accommodation Public perception of client group Carer Involvement

18. The End Thank You Very Much