The local workforce is a key enabler to the delivery of the local vision of support to adults with a learning disability.
6.1 Introduction
The local workforce is a key enabler to the delivery of the local vision of support to adults with a learning disability. It is important that councils work closely with their partners to ensure the local workforce has the capacity and capability needed to meet the full range of care and support needs (which includes being able to meet multiple/complex needs, including behaviour that services may find challenging, in the community) of the adults with a learning disability who live in the area to enable them to: Lead the lives they want to lead, make progress toward their personal aspirations and maximise their independence safely. The workforce in scope, includes the assessment and care managers, care and support providers and staff in universal services used by adults with a learning disability.
6.2 What good looks like
The best councils ensure their own staff use strengths-based approaches consistently when working with adults with a learning disability including at first point of contact, throughout the assessment, care management and review processes. This must be checked and re-enforced through supervision and appraisal.
They monitor and analyse Social Care Workforce Data published by Skills for Care about the learning disability workforce in their area and benchmark themselves against others. This gives indications about workforce satisfaction, motivation, capabilities, and the attractiveness of a career in care and support. They use the data to forecast future workforce challenges and underpin council and joint workforce plans with these forecasts.
They work hard to develop and maintain a cultural and organisational commitment to strengths-based working beyond frontline practice. For example, leadership and administrative and management systems are aligned with a rights and strengths-based practice model which ensures that how health and social care workforce (including allied professionals) work is in line with their values, skill set and vocational calling.
They work in partnership with local care and support providers and other stakeholders to develop a shared value set, understand the local labour market and monitor its capacity and capabilities. They work jointly to:
- ensure the workforce has the skills needed to work with people with a learning disability
- ensure there is a career pathway for people working in the care and support sector
- promote the attractiveness of a career in the care and support sector
- collaborate on recruitment and retention initiatives
- understand the value of the care and support sector to the local economy so the local narrative is about the positive value the sector adds; rather than seeing it as a cost burden.
They use commissioning arrangements to require learning disability care and support providers (internal and external) to use human resources processes that help to: recruit, retain and motivate staff with the values and skills needed to use a flexible, personalised and strengths based approach to support people with a learning disability. For example, they use value-based recruitment, and manage, reward, train, develop and supervise staff to re-enforce the local people with a learning disability vision and strategy. They also ensure each worker has the skills and knowledge they need to deliver support flexibly and effectively. Key competencies include specialist communication and positive behaviour management skills.
They use procurement and contract management processes to ensure sustainable fees are paid so learning disability providers can pay a living wage, limit the use of agency staff except to cover temporary peaks in demand and to encourage investment in skills development in key areas such as how to manage risk positively, enable the development of the skills of daily living, work in an outcomes focused way.
They give jobs to adults with a learning disability as experts by experience, or in roles that provide assistance to other people with a learning disability.
6.3 Expected outcomes
In terms of outcomes councils that are implementing good practice should find that the:
- Satisfaction of adults with a learning disability and carers with the staff who support them increases over time.
- Continuity of support workers improves over time.
- Workforce job satisfaction improves over time while proxy measures of this such as staff vacancies/ shortages/ sickness rates should reduce over time if all other things are equal.
- Quality of the support (as rated by the Care Quality Commission and by the people with support) will improve over time.
- Number of adults with a learning disability employed as experts by experience, or to support other people with a learning disability by the council, by care/support providers and by local businesses increases over time.
- Proportion of adults with a learning disability supported locally and in the community rather than out of area and in bed-based support models increases over time.
- Quality of life reported by adults with a learning disability increases over time.
6.4 Developing the local care and support workforce Performance Indicators
| Outcome Indicators | To improve aim for | National/Local |
|---|---|---|
| Analyse Care Quality Commission ratings of local services in more detail and monitor the percentage of providers rated “Outstanding” or “Good” for the key lines of Inquiry on are they (1) Caring? and (2) Responsive to people’s needs? | Increasing percentage | National data |
| ASCOF (1E) Population of adults with a learning disability support in paid employment | Increasing percentage | National data |
| Number and proportion of key stakeholder organisations that are signed up to a shared statement of or a memorandum of understanding about learning disability care and support workforce values that they will promote. | Increasing percentage | Local data |
| Individual Experience Indicators | To improve aim for | National/Local |
|---|---|---|
| Ask people who use services and carers to assess their experience compared to the Making it Real “I” statements domain “The people who support me – Workforce. | Increasing percentage answer “positively” | Local data |
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Changes in care and support packages following reviews. Consider the percentage of individual:
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Increasing percentage | Local data |
| Financial/Value for Money Indicators | To improve aim for | National/Local |
|---|---|---|
| The Skills for Care Adult Social Care Workforce Data on the social care workforce in each council area gives data on the costs, capacity, and capability of the local workforce. Therefore, monitor and analyse data on: | Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
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Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
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Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
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Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
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Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
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Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications | National data |
6.5 Self-evaluation questions
How to rate yourselves against the self-evaluation questions
For each chosen section the director of adult social services should consider each statement about good practice that follows and work with their senior management team, representatives of key partner organisations and local experts by experience to rate how close the councils approach to supporting adults with a learning disability is to the best practice described using the following five-point scale, where one means it is far away from best practice and five means it is already using best practice.
The scale to be used is as follows:
| Developing the local care and support workforce | Score 1 - 5 | Basis of score |
|---|---|---|
| 1. The council ensures their own staff use strengths-based approaches consistently when working with adults with a learning disability for example: at first point of contact, throughout the assessment, care management and review processes, and they check/re-enforce the use of strengths-based approaches and use of direct payments through the supervision and appraisal processes. Where possible staff will encourage and facilitate use of a person’s personal and community assets as the first choice, rather specialist care | ||
| 2. The council monitor/analyse Skills for Care adult social care workforce data on the learning disability social care workforce in their area and benchmark themselves against others to get indications about staff satisfaction, motivation, capabilities and the attractiveness of a career in care and support. | ||
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3. The council works in partnership with local care and support providers and other stakeholders to: develop a shared value set, understand the local learning disability workforce market, monitor the local workforce capacity/ capability and work jointly to:
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4. Council commissioning arrangements require care and support providers (internal and external) to use human resources processes that help to recruit, retain and motivate staff with the values and skills needed to use a flexible, personalised and strengths based approach to support people with a learning disability and autism. For example:
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| 5 The council regularly undertakes research to understand how satisfied council and provider staff are with their work and their working environment AND to understand the satisfaction of the people who are supported (and their carers) with the council and provider staff. These findings are used to inform improvement actions plans. | ||
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6 Council procurement/contract management processes ensure provider fees are sustainable so they can afford to pay staff a living wage and invest in skills development so they can meet requirements to:
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| 7 The council supports adults with a learning disability and their carers to find, recruit, manage and retain personal assistants (PAs) so support can be personalised | ||
| 8 The council supports adults with a learning disability and their carers to apply for and manage direct payments so they can manage and personalise care and support. | ||
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9 The council supports adults with a learning disability to find and keep employment. It:
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| 10 The council works in partnership with local care and support providers and other stakeholders to understand the value of the care and support sector to the local economy so the local narrative is about the positive value the sector adds; rather seeing it as a cost/burden. |
Guidance
- To understand what adults with a learning disability and carers want from the support workforce view Making it Real: TLAP (2018)
- To learn about best recruitment/retention practice download Recruitment and retention in adult social care: Skills for Care (2017)
- To develop the capability to support more complex needs in the community view: Specialist Staff: understanding the challenges in supporting people in their communities: NDTi (2016)
- To understand what capabilities the social work workforce needs to have/develop, view two capability statements for social workers by the Department of Health and Social Care/British Association of Social Workers on working with:
- To understand the capabilities the social care workforce needs in relation to transitions, visit Learning Disability Transition Pathway Competency Framework: Health Education England (2016)
- Department of Health & Social Care Autism Training resources
- Specialist autism training resources provided by Skills for Care
- Guide to training the workforce to support people with profound and multiple learning disabilities: Raising our Sights -Training the workforce: Mencap (2010)
When asked what a good support worker does, an expert by experience told us:
They put themselves in our shoes and have had learning disabilities awareness training."
Who is good at this?
In Darlington a 15-week training programme developed by the Life Stage Service, the PICKS (Process, Information, Competency, Knowledge and Skills) aims to develop the skills of the workforce to enable them to implement the “Progression” model across the service. The model supports the team to embed a positive enablement approach, supports capacity building for individuals and in turn leads to cost efficiency and future planned efficiencies for the organisation.
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