Dear Western Health and Social Care Trust (Northern Ireland),

I refer to the (far below) text from Nigel Chambers July 2022 who explains the cuts to respite/ day care for the learning disabled (LD) WHSCT uses this same rationale.

1.In June , WHSCT LD services stated that the Enniskillen day care centre was running at approx 92% capacity.

How many , exactly were NOT attending because of that limited capacity

2.when does the day centre intend to return to 100% capacity?

3.The guidance being used, the PHA pathway, commissioned by DOH, implemented in June 2022, states day care should be limited by how much and why?

4.is the PHA guidance only a guide (optional, open to interpretation) or is it mandatory and must be followed,

5.The persons with learning disabilities who moved into a care home in 2022 and had their day care taken away from them, is that a permanent removal, and if so, why would it be permanent if covid restrictions are not life long bans? (and the rest of society have moved on from such drastic restrictions)?

6The people with LD who live in a care home and had their day care taken from them, since covid, is that permanent, and if so, why would it be permanent if covid restrictions are not life long bans?

7If a person had a place in May 2022 in a day centre, and then moved to a care home and lost her day care place, and the day care then went back to 100% capacity (as it was before covid), then why would that person who has an assessed need for day care, lose her/his place if there is no one else needing that place as day care is at 100% again.

8.Why, if someone has assessed need for daycare, would someone "living a family home" take priority if their needs are the same and the places could be shared 2 or 3 days each.

9.Nigel Chambers, head of LD services at DOH writes:

"I am also aware that due to limited capacity in adult day care, services have been prioritised
for those living in the family home to minimise the risk of placement breakdown. "

a)what does WHSCT understand the phrase 'placement breakdown " to mean and is that concept what WHSCT uses to withhold day care from certain people ?

b)why exactly does WHSCT prioritize giving places to a LD service user from a "family home"

10.Mr Chambers states:
"those living in residential care and supported living have been unable to access
day care, potentially increasing the risk of isolation and impacting mental health and wellbeing."

what does WHSCT plan to do about that, given that care homes do not offer 6 hours a day day care and can only take a few people out on a bus if they have the staff which they often don't.

11.How can the WHSCT see that the care home can allow access to the community in an appropriate way? and how can they see that as NOT a deprivation of liberty, when the care home CANNOT offer what is needed and the WHSCT are the body with the duty of care/ ultimate responsibility for the welfare of the LD adult?

12. N . Chambers sates:
"Trusts are currently identifying placement in day opportunities for this cohort of service users to ensure that they have a meaningful range of day activities aligned to their assessed needs."

what is WHSCT doing to identify placement in day opportunities for those in care homes who have no day care?

13.If one hundred and ten people in WHSCT with LDs are currently living in care homes and accessing day care, why are some people being refused this same service? (if WHSCT claim the priority goes to those living " in the community"
b) why allow some people both services and not others?

TEXT ; MR CHAMBERS

​Remobilisation of adult day care, short breaks and transport

Community services for people with learning disabilities remain subject to infection prevention
and control (IPC) guidance to minimise the risks associated with Covid-19 and respiratory
illness. Throughout the pandemic, an increased emphasis was placed on IPC considerations,
specifically physical distancing guidelines and isolation of close contacts. In practice, this has
limited capacity across Health and Social Care services, which has been acutely observed in
adult day care and transport. In addition, short breaks/respite is dependent on access to beds
in care homes, which have been subject to tightly defined admissions criteria and enhanced
mitigations to minimise the spread of Covid-19. I am acutely aware of the significant impact
that this has had on service users, families and carers. While Trusts have endeavoured to
provide alternative supports, families have been clear that they seek full restoration of these
services.
The Minister commissioned the Public Health Agency (PHA) to undertake a review of IPC
guidelines and their implementation in learning disability services. The PHA developed a
Pathway to remobilise services, which better enabled Trusts to balance Covid-19 risks with the
wider risks to mental health and wellbeing associated with reduced community services.
Subsequently the PHA provided further clarification and updated guidelines in June 2022.
Further details on the Pathway, associated IPC guidelines and current provision levels can be
found on the Department’s website:
https://www.health-ni.gov.uk/articles/re...
I am also aware that due to limited capacity in adult day care, services have been prioritised
for those living in the family home to minimise the risk of placement breakdown. As a
consequence, those living in residential care and supported living have been unable to access
day care, potentially increasing the risk of isolation and impacting mental health and wellbeing.
Trusts are currently identifying placement in day opportunities for this cohort of service users to ensure that they have a meaningful range of day activities aligned to their assessed needs. The Department will continue to monitor remobilisation efforts very closely and provide the Minister with fortnightly reports. Regular updates will be made available on the Department’s website

Yours faithfully,

Joan Corrigan