Agenda Item No. 5

The Vale of Glamorgan Council

Healthy Living and Social Care Scrutiny Committee: 22nd  November, 2016

Report of the Director of Social Services

Autistic Spectrum Disorder: Community Monitoring and Support Project

Purpose of the Report

1. To provide Members with an update on the Autistic Spectrum Disorder (ASD) Community Monitoring and Support Project and to outline future actions.

Recommendations

1. That the work being undertaken by the Autistic Spectrum Disorder (ASD) Community Monitoring and Support Project is noted by Scrutiny Committee.
2. That Scrutiny Committee receives annual updates on the work of the project.

Reason for the Recommendations

1&2. To keep Members appraised of the work done by the ASD Community Monitoring and Support Project and its achievements to date.

Background

2. In 2009, an Adult Task and Finish Group established by the Welsh Government issued a report describing how service provision for adults with ASD was very inconsistent across Wales. As a consequence, Local Authorities were given the opportunity to bid for grant funding. In partnership with Cardiff, the Vale of Glamorgan Council applied for funding to establish a Community Monitoring and Support project across part of the South East Wales Region. This was agreed by Welsh Government in April 2011, initially for three years but then extended until September 2015.
3. Funding previously provided as a grant has now been included in the Revenue Support Grant. The Vale of Glamorgan and Cardiff identified sufficient funding from the ring-fenced amounts to continue providing the service. No funding has been forthcoming from Rhondda Cynon Taff (RCT) or Merthyr and so the service has ceased in those areas.

4. The Welsh Government funding was specifically allocated for creating a service for adults with high functioning autism and Asperger's syndrome at risk of social isolation or vulnerable to mental ill health and who, currently, are not able to access or not eligible to access statutory services. It enabled the Council to employ three part-time Community Project Workers with responsibility for establishing and delivering the service across the Vale of Glamorgan, Cardiff, RCT and Merthyr Tydfil. Following the change in funding in September, the scope of service has decreased and one member of staff has retired. Although staff no longer visit or work directly with RCT and Merthyr residents, if contacted we continue to signpost appropriately.
5. The Adult Autism Advice (AAA) service offers short-term, targeted intervention which promotes the independence and autonomy of adults with High Functioning Autism and Asperger's syndrome by:

• providing them with a clear point of contact for information and advice;
• ensuring that those who are eligible for statutory support are re-directed to existing services.
• signposting those who do not meet the eligibility criteria for statutory social services to appropriate services located in their communities;
• reducing the risk of crisis and helping to prevent enduring mental health problems by encouraging socialisation and directing individuals to social groups, local events and activities; and
• profiling any unmet need and highlighting any gaps in provision which can then be relayed to local steering groups and to the Welsh Government for consideration.

Relevant Issues and Options

6. Access to the service is via telephone, on-line engagements, face-to-face meetings or by referral from partner agencies. To date, the service has been contacted by over 500 different people. Some are simple requests for information while others can result in multiple contacts over extended periods, depending on need.
7. Enquiries cover a wide variety of issues, from people seeking information on obtaining an assessment / diagnosis of ASD, to those wishing to access support groups and social skills training, benefits advice and signposting.
8. The key performance indicator for the service is that individuals feel less isolated and receive support to help them live independent lives. Some clients have advised us that they find comfort in knowing that the service is there should a need arise. Some have used the service to ascertain future steps and to work through problems they are experiencing; such enquiries will typically result in effective signposting to existing services in the community.
9. The service is effective in preventing or delaying the need for more extensive care and support. The service acts to try to minimise the effect on disabled people of their disability, one of the key requirements of the Social Services and Well Being Act, Section 15. For example, a client on the path to homelessness was supported by the service and directed to advocacy services. This resulted in a positive outcome and enabled the client to avoid reaching crisis point, thereby circumventing any urgent need for Council services such as housing or mental health.
10. For this particular client group, the service also meets the Local Authority legal obligation under the above Act to "provide people with information and advice relating to care and support and assistance in accessing care and support". Each and every request to the service results in the provision of information and/or advice. In addition, many enquiries are also followed up with some continued support in accessing services that already exist in the community. For example, the staff may accompany individuals to initial meetings with support groups; volunteer agencies or job centre meetings.
11. In addition, the service continually works to enable clients to live their lives as independently as possible, which is another key aspect of the Act. Rather than creating a dependence on support staff, where possible the Adult Autism Advice service works with the individual to encourage their independence and autonomy. Case work is based on short-term intervention, not long-term support.
12. The service has been successful in reaching out to clients through new media. The Service updates information on a Facebook page where nearly a thousand people have expressed an interest in the page and consult the updates that are posted, (total "likes" currently at 980). Posts can have a wide spread "reach" (defined as the people posts have reached plus likes, comments and shares); the month to 4th of October had a reach of 1,850. The largest "reach", over 31 thousand, was a post on the relaxed pantomime performance, which indicates the potential of social media. The service has also created content on the DEWIS web pages, including the service and activities provided such as adult forums.
13. The service has created innovative opportunities for social contact. They run monthly daytime forums in both Cardiff and Barry. These provide a medium for adults to influence the development of the project and act as a conduit for information to and from the local ASD steering group. A Couples Support Group has also been established, where one or both partners are on the spectrum, to provide an opportunity for couples to share difficulties and experiences and to allow for some group therapy. This group was established as a result of research carried out by and in collaboration with Cardiff University. In addition, our service delivers social skills training to adults on the spectrum through the Socialeyes Programme.
14. Staff also seek opportunities to work with other groups to enable adults with autism to be included in community activities. One example was a short project run jointly with Pedal Power which aims to work with groups of people who would not normally be able to access cycling to achieve the health and well-being goals that matter to them. Adults with autism can often feel socially isolated and struggle to get out and about. Staff have helped some of them to become confident in using public transport to get to Cardiff and then supported them to take part in a Pedal Power project. This was done through free cycle taster sessions, bespoke health and well-being courses and free membership of Pedal Power. In a quite different sphere, the team worked with Welsh National Opera's leader, David Adams, who hosted a supportive environment concert of chamber music as part of the Penarth Chamber Music festival. This very special concert was for people with disabilities and additional needs, in particular autism and for anyone who finds listening in the formal concert environment stressful. The performance allowed people to enjoy the concert without the pressures of staying quiet or remaining in their seats.
15. In addition to creating and signposting to social opportunities, the team frequently work with individuals seeking employment. Having highlighted a gap in provision for employment support, the project was able to access Welsh Government funding to run a specialist employment project from 2013-2014. As a direct outcome of this pioneering work, a national online resource of support materials and training resources has been created with funding from Welsh Government. www.asdinfowales.co.uk/employment.
16. In the past year, staff have concentrated on improving practice (especially around record keeping) and gaining the necessary training and skills to be compliant with the new Social Services and Well-being Act. Staff are being trained to carry out proportionate assessments and they are transferring client data to the E-Swift recording system used by social services. This also means that our information and advice work forms part of the performance indicator reports. Staff have also established co-working practices with health colleagues involved in diagnosis. Adults who are on the diagnostic pathway are referred to the team for a pre-diagnostic meeting and may also elect to have a post-diagnostic meeting. These provide an opportunity for adults to be signposted, where appropriate, and to engage with relevant groups.
17. Over the next year, the team will be involved in developing a Welsh Government funded Integrated Autism Service based on health board footprints. Funding is provided through the Intermediate Care Fund (ICF): £204k for 2016-17 and £368k for each of the subsequent two years. The new Integrated Autism Service will provide the following functions:
    
    Diagnostic assessment of adults without a learning disability or with a mild learning disability who do not have a known moderate to severe mental health difficulty
    
    Liaison, support and consultation in relation to the diagnostic assessment and support of adults with a known moderate to severe mental health difficulty or moderate to severe learning difficulty.
    
    Support for adults with autism without a learning disability or with a mild learning disability without a known moderate to severe mental health difficulty.
    
    Support for parents of children with autism without a learning disability or with a mild learning disability without a known moderate to severe mental health difficulty.
    
    Support for parents, families, partners and carers of individuals with ASD.               
    
    There is no intent at this stage for the team to be completely absorbed in this new service but it will inevitably be an integral part and work very closely with them.

Resource Implications (Financial and Employment)

18. Two part-time ASD Community Support Project Workers currently deliver the service across the two Local Authority areas. The posts are for 20 hours and 13.5 hours a week respectively. Sufficient funding has been identified within the ring-fenced RSG funding across Cardiff and the Vale of Glamorgan to meet the running costs of approximately £24,000 per annum.

Sustainability and Climate Change Implications

19. There are no sustainability or climate change implications as a direct result of this report.

Legal Implications (to Include Human Rights Implications)

20. There are no legal implications as a direct result of this report.

Crime and Disorder Implications

21. As individuals with high functioning autism or Asperger's syndrome may have social communication difficulties, sometimes those who come into contact with the police can be at risk of being misunderstood. The service helps to raise public awareness about how individuals are best supported and also to signpost to existing means of support such as the Emergency Services Card or Autism Alert Card to help overcome these barriers.
22. For the same reason, individuals with high functioning autism or Asperger's syndrome can sometimes be at an increased risk of falling victim to deception or manipulation. By establishing a local source of advice and information, this risk can be reduced.

Equal Opportunities Implications (to include Welsh Language issues)

23. The service has been established in order to ensure that adults with High Functioning Autism or Asperger's syndrome are afforded the same opportunities in carrying out their daily life as adults who do not have such disorders. Marketing materials for the service are available in Welsh.

Corporate/Service Objectives

24. The service helps the Council to fulfil the following Corporate Plan outcomes:

An Active and Healthy Vale - Residents of the Vale of Glamorgan lead healthy lives and vulnerable people are protected and supported; and

An Inclusive and Safe Vale - Citizens of the Vale of Glamorgan have a good quality of life and feel part of the local community.

Policy Framework and Budget

25. The report is in accordance with the Council's policy framework and budget.

Consultation (including Ward Member Consultation)

26. No local ward member consultation has been undertaken as this is a Vale-wide initiative.

Relevant Scrutiny Committee

27. Health Living and Social Care.

Background Papers

28. None.

Contact Officer

Linda Woodley, Operational Manager for Learning Disability Services

Keith Ingram, Autism Project Lead Officer

Officers Consulted

Lance Carver, Head of Adult Services

Responsible Officer

Philip Evans, Director of Social Services