This chapter was last reviewed and/or updated April 2021.

Most Adult Care procedures are generic; however, some procedures for the Learning Disability Service differ from other areas of Adult Care. This section concentrates on areas of work which are specific to learning disabilities.

1. Section 75 Agreement

There is a Section 75 agreement in place (Health and Social Care Act 2006) between Lincolnshire County Council and the Health Authority, under which the Learning Disability Service teams carry out certain health related functions on behalf of the Health Authority. The Health Authority contributes to the Adult Care Learning Disability budget, specifically to fund this.

2. Therapy Services

Lincolnshire Partnership NHS Foundation Trust (LPFT) offers a range of services to support people with learning disabilities in the community.

The service works with service users, families, social care, and health partners to enable adults with a learning disability living in Lincolnshire to receive the right care, in the right place, at the right time.

They provide specialist health support to people with learning disabilities who require assessment and/or treatment for their physical or mental health, including support with behaviours of concern.

The service includes:

  • a single point of access (SPA) for all referrals;
  • four community hubs – a multi-disciplinary team which provides the whole range of specialist learning disability professions;
  • countywide community home assessment and treatment team.

2.1 Referrals

The service works with adults over the age of 18 who have a diagnosis of learning disability and associated physical and / or mental health needs who are registered with a Lincolnshire GP. Learning Disability Community Team practitioners can make referrals by completing the Learning Disability Service Referral Form in conjunction with reading the Learning Disability Service Referral Guidance.

All referrals are made through the Single Point of Access (SPA) (see Local Contacts).

2.2 Community learning disability hubs

The service is provided in four community hubs across Lincolnshire. These hubs are based at:

  • Beech House, Boston;
  • Beaconfield Centre, Grantham;
  • Units 1 and 2, St George’s Site, Lincoln;
  • Johnson Community Hospital, Spalding.

There are also a number of satellite clinics which are used to enable choice and care close to home, when required.

The four community hubs provide an integrated multi-disciplinary approach to supporting people with a learning disability. Each hub has specialist nurses, psychology, physical and mental health liaison nurses, psychiatry, occupational therapy, physiotherapy, speech and language therapy, and specialist liaison nurses for people with autism.

2.3 Liaison with health services

In each hub there are liaison nurses for physical health, mental health and autism. They work with local health services and service users and carers to ensure equal access to mainstream services, helping to develop reasonable adjustments and provide appropriate training for professionals.

2.4 Community Home Assessment and Treatment

Working closely with the community hubs, the Community Home Assessment and Treatment (CHAT) Team provides home assessment, intervention and treatment anywhere in Lincolnshire to service users in their home environment, whether that be a family home, supported living or a care home.

The CHAT team works to a Positive Behaviour Support model to provide intensive support to people who are experiencing a deterioration in their mental health, or an increase in behaviours of concern and associated risk to self and others. The service will respond quickly and positively to assess the level of risk and put in place a plan of care to address the immediate concerns, initially for 72 hours, with additional support for a further two weeks.

Once the immediate risks have been addressed and a clear plan is in place, the CHAT Team will liaise with the community hubs who will continue with the ongoing care plan as needed.

See the LPFT Learning Disabilities website for further information.

3. NHS Continuing Healthcare

All services for NHS Continuing Healthcare apart from Funded Nursing Care (FNC) are completed in-house by Learning Disability Practitioners who hold a Registered Nurse qualification.  The Practitioners follow the procedures included in the NHS Continuing Healthcare chapter. The Practitioners are the lead in this process and are responsible for collecting the evidence that is required.

The CHC Review Flow Chart (Lincolnshire County Council intranet) can help to clarify the process for practitioners.

This process only applies to service users who are over the age of 18, who have a diagnosis of Learning Disability and associated physical and / or mental health needs who are registered with a Lincolnshire GP. Once the NHS Continuing Healthcare assessment has taken place, this information is forwarded to Lincolnshire Clinical Commissioning Group, whereby they ratify the decision and send confirmation letters. All further reviews are also undertaken by the LD practitioners and forwarded to the Clinical Commissioning Group. If any of the service users are eligible for Funded Nursing Care, these assessments are carried out by Continuing Healthcare on behalf of the Clinical Commissioning Group.

4. Lincolnshire Learning Disability Partnership Board

‘The Lincolnshire Learning Disability Partnership Board is working towards making things better for people with learning disabilities and their families in Lincolnshire.’ (LLDPB). For more information, refer to the Lincolnshire Learning Disability Partnership Board website.