LD Intensive Support Team

About our service

The Intensive Support Team (IST) adopts a multi-disciplinary team approach to assessing and supporting people who are referred to us. The team consists of psychiatry, psychology, occupational therapy (OT), speech and language (SLT), nursing and nursing associates, therapy assistants and healthcare assistants. These professional groups are supported by assistants. The team also supports trainee nurse associates and offers placements to student nurses.

 

IST operates Monday to Friday (9.00 a.m. to 5.00 p.m.) and can undertake work outside of these hours based on clinical need.

 

IST provides support to people on a person-centred basis, meaning that we work with people for as long as they need support from us alongside input from the Community Learning Disability Team or the Community Forensic Team, where appropriate.

 

 

Aim of the service

The aim of the Intensive Support Team is to reduce and or manage behaviours that challenge, working with people in their own residences and or day provision, reducing and or preventing the need for the use of restrictive practices, inpatient services, out-of-area residential placements. Support will be provided via integration at a local level across all relevant services such as; Community Learning Disability Services (CLDT), General Practitioners (GPs), Acute Trusts, mainstream mental health services, third sector organisations, as well as care and support providers. All patients under the IST will be offered a variety of interventions according to their individual needs.

 

These aims are in line with the national service model for 'Supporting people with a learning disability and / or autism who display behaviour that challenges, including those with a mental health condition' (Department of Health, 2015) and including the golden threads as identified within it:

• Quality of life.
• Keeping people safe .
• Choice and control.
• Support and intervention.
• Equitable outcomes.

 

Assessment, treatment, and support for individuals with intellectual disabilities who display behaviours of concern that are of high risk and needing intensive support, avoiding admission to hospital or supporting admission with the aim of smooth transition back into the community:

• Provision of support and person specific training for other agencies supporting those individuals.
• Coordination of transitions from inpatient and other settings.

Crisis response.

 

 

Referral and eligibility criteria

The triage scale consists of 2 levels:

• Category 1: immediate or urgent, requiring 4-hour response by the Intensive Support Team (IST). The referrer informs Single Point of Access (SPA) either on the form or verbally that a referral is urgent. SPoA will verbally inform the duty clinicians who will complete a Community Critical Risk Screening Tool which will support decision making for the request of a 4-hour time frame response. If a 4-hour response is required, the Clinical Team Leader or / and Duty Matron to be informed and, if required, to liaise with IST duty to arrange a response.
• Category 2: non-urgent (for information: not IST). Non urgent referrals upon RiO registration are emailed to duty clinicians via the LD generic duty inbox to advise of the non-urgent referral. Duty will complete SBAR and a Community Critical Risk Screening Tool and write on RiO progress notes and transfer to the appropriate locality caseload.

 

Eligibility criteria

• Must be 19 years or older (or within six weeks of their 19th birthday).
• Anyone with a diagnosed significant learning disability who needs specialist health support that cannot be met through mainstream services even with the use of reasonable adjustments.
• Must be registered with a Birmingham GP.
• People moving into the Birmingham area who have a Birmingham residential postcode and an identified Birmingham GP, but are unable to register with the GP until they have actually moved into their property (for example, a service user discharged from hospital or a complex case moving into the area and going through the transfer or handover of the care process). Confirmation will be required for service users eligible for Section 117 that the transferring Learning Disability Service have had a conversation with the local Integrated Care Board (ICB).

 

In addition, all referrals to IST must meet:

• Either: shows severely challenging behaviour: 'Behaviour of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to and use of ordinary community facilities; or behaviour that is likely to impair a person's personal development and family life and which presents a challenge to services, to families and to the person themselves, however caused' (Mental Health Foundation, 1997).
• Or: has an additional mental health need (for example, psychosis, severe depression, significant self-harm within the context of a mental illness) which requires urgent attention, and which jeopardises the community placement, or presents risks to themselves or others. Without intensive support intervention, the person would require inpatient treatment.

 

You can make a referral by calling the Learning Disability's Single Point of Access:

• Phone:  0121 466 4980
• Email:  BCHNT.ldreferrals@nhs.net

 

This will require completion of a referral form that needs to be sent through.