Agenda item

Karen Fuller, Director of Adult Social Care (Oxfordshire County Council), has been invited to present a report on the Oxfordshire Learning Disability Plan.

 

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

 

Karen Fuller (Director of Adult Social Care, Oxfordshire County Council); Bhavna Taank (Head of Joint Commissioning - Live Well); Clair Taylor (My Life My Choice Project Co-ordinator); Kumudu Perera (My Life My Choice Expert by Experience); Alex Wheeler (Senior Joint Commissioning Officer); and Matthew Tait, (BOB ICB Chief Delivery Officer), were invited to present a report on the Oxfordshire Learning Disability Plan.

 

The Director of Adult Social Care highlighted the strong foundations of co‑production that had shaped the plan and emphasised the positive atmosphere surrounding its development. She noted that the plan had recently been discussed at Cabinet, where its formal signing and subsequent media coverage had been warmly received, reflecting a strong endorsement of the work undertaken.

 

The Head of Joint Commissioning – Live Well and the My Life My Choice Expert by Experience then presented the Oxfordshire Learning Disability Plan in detail. They explained that the plan represented a ten‑year, dynamic strategy that had been co‑produced with people with learning disabilities, their families, carers and professionals across the system. Four central themes shaped the strategy: having a good life, health and wellbeing, a place to live, and homes not hospitals. These themes were supported by cross‑cutting elements including transitions, workforce, technology and inclusion. They emphasised that the plan had been informed by extensive engagement involving more than 200 participants, whose contributions had centred on communication, access to activities and the importance of meaningful relationships.

 

The My Life My Choice Expert by Experience described the empowerment gained through the co‑production process and illustrated how lived experience had helped frame the plan’s priorities. The Officers explained that the plan aligned closely with both local frameworks and wider national policy.

 

The discussion moved into the structure of future reviews, and Officers explained that although the plan had originally been designed for formal reviews at three‑, five‑ and seven‑year points, this structure had been amended following feedback gathered through the World Café engagement event. People with learning disabilities had expressed a preference for an earlier review to ensure timely reflection and the ability to respond more dynamically to changing needs.

 

Officers confirmed that each review would draw on renewed engagement, likely employing a similar World Café‑style format, ensuring that lived experience continued to guide the plan’s evolution. Oversight of progress sat with the Learning Disability Improvement Board, which would assess whether developments in services, new data or emerging concerns required earlier revisions. They stressed that the plan had been deliberately structured as a dynamic document that any subgroup or partner could request to revisit if significant issues, changes in need or new evidence came to light.

 

Attention then turned to risk management, and Officers explained that oversight of risk sat with the Learning Disability Improvement Board, comprising health, social care, voluntary sector representatives and experts by experience. This structure provided continuous scrutiny and challenge. Officers added that the extensive co‑production process itself helped to mitigate risks by ensuring that actions within the plan reflected real need and were grounded in lived experience rather than assumptions. Engagement mechanisms such as World Café events had been intentionally built into the plan’s governance, helping to surface potential difficulties early and ensuring alignment with the priorities of people with learning disabilities. They emphasised that regular monitoring, open communication across partners and the ability to trigger early adjustments formed essential components of long‑term risk mitigation.

 

Consideration was then given to the measures that would be used to assess alignment with wider frameworks, such as the NHS Long Term Plan, the Oxfordshire Way and national learning‑disability guidance. Officers explained that thematic subgroups would develop their own Key Performance Indicators (KPIs) linked to the “what needs to happen” section of the plan, ensuring clear metrics for progress and alignment. These KPIs would be reported to and overseen by the Learning Disability Improvement Board, which included experts by experience and system partners responsible for formal check‑and‑challenge. Officers added that governance and reporting arrangements would be refined further, recognising that various responsibilities sat with system partners beyond the Council and would require continued development and coordination.

 

Discussion then shifted to system‑wide commitments, particularly in relation to the pact signed between Oxfordshire County Council and My Life My Choice. Officers confirmed that the Council took pride in having signed the pact, which contained practical commitments shaped directly through lived experience. These included promoting access to work, supporting good housing and facilitating independence. Some commitments, such as improving recruitment into social care, were already being advanced through joint work with advocacy groups. However, Officers recognised that wider system commitments, including those shared across health, social care and voluntary organisations, required further development. They highlighted the goal of strengthening integration between health and care and ensuring that commissioning decisions, service planning and housing alignment were conducted transparently and in line with the needs of people with learning disabilities.

 

The early priorities for addressing inequalities were then discussed in detail. Officers explained that the initial focus within the first one to three years would be on the most significant and well‑evidenced inequalities disproportionately affecting people with learning disabilities. These included poorer access to healthcare, higher prevalence of co‑existing conditions such as epilepsy and sensory impairments, and persistent barriers experienced by people from ethnic minority communities. They emphasised the importance of improving access to and quality of annual health checks, addressing disparities in life expectancy and tackling negative experiences within NHS settings. Subgroups had already begun examining data relating to dentistry, pain management, health checks and wider health inequalities to establish baseline measures. Officers confirmed that KPIs were being developed and would continue to evolve as new insights and lived‑experience contributions emerged.

 

Plans to expand the number of “safe places” for people with learning disabilities were outlined. Officers clarified that the ambition related to the national Safe Places scheme and that the goal, though challenging, was to ensure that safe places were located within a five‑minute walk for residents by December 2026. Some community support services and libraries already formed part of the scheme, and the “Having a Good Life” subgroup would lead further work to expand it. Although this subgroup was still developing its programme, Officers explained that they intended to work with district councils, community organisations and established networks such as dementia‑friendly schemes to broaden coverage. They welcomed offers from Members to help encourage local organisations to join the scheme, stating that community involvement was essential to its success.

 

Further discussion centred on annual health checks for people aged over 14 with a learning disability. Officers clarified that these checks were an NHS‑commissioned responsibility delivered through GP practices and constituted an essential tool for improving health outcomes and preventing avoidable hospital admissions. It was acknowledged that uptake and quality varied considerably, both locally and nationally, underscoring the need for improvement. The Committee noted the importance of the checks as a bridge between health and social care, particularly given the vital supporting role often played by carers. Officers agreed that stronger integration at neighbourhood level would be required to improve the process and confirmed that they would seek further updates from health partners. They noted that epilepsy, affecting around one in five people with learning disabilities, had already been identified as an area requiring additional attention, and confirmed that updates would be brought into the Health and Wellbeing subgroup and future workplans.

 

System‑wide collaboration was then explored further, with officers emphasising that the Learning Disability Plan had been developed jointly across health, social care and the voluntary sector. This collaborative approach created valuable opportunities to improve pathways such as annual health checks, early intervention and community support. Officers highlighted the role of joint commissioning teams, which operated across organisational boundaries and allowed for better alignment of priorities and monitoring. The Learning Disability Improvement Board would review progress, enabling system partners and experts by experience to challenge inconsistencies and identify any gaps in delivery. Officers reiterated that consistent improvement, particularly in areas such as epilepsy management or the avoidance of unnecessary hospital admissions, depended on strong, integrated governance, shared data and the sustained use of lived experience to inform decisions.

 

The plan’s proposals for an information platform for activities and support groups were discussed next. Officers explained that the platform would be hosted through the Oxfordshire County Council website and the Live Well Oxfordshire portal, with layout, usability and content shaped by subgroup input. They described early findings showing that information across the county was scattered across multiple sources, and a key early task would be consolidating this into a clearer, more accessible system. Accessible design principles would guide the work, with lived‑experience feedback central to refining its structure. A dedicated workstream had begun mapping out how information would be collected, validated and regularly refreshed. Officers mentioned that visual inclusivity indicators such as logos were being considered, although they emphasised the need to avoid unintentionally excluding groups who were not yet using such markers.

 

Employment support for adults with learning disabilities formed another major theme. Officers explained that the Oxfordshire Employment Service already supported many people with additional needs to secure and sustain employment. They also noted the launch of the national Connect to Work programme, which had gone live locally in January and aimed to help people with learning disabilities access employment and training opportunities. The importance of wellbeing and empowerment within employment pathways was highlighted, with advocacy groups such as My Life My Choice providing workplace readiness, confidence‑building and practical peer‑led support. Officers confirmed that benefits advice and guidance formed routine parts of social care and advocacy support, helping individuals make informed decisions without fear of losing essential support.

 

Further emphasis was placed on ensuring that adults with learning disabilities felt genuinely empowered when seeking employment, particularly where employment might affect their benefits. Officers explained that empowerment formed a central principle of the plan and that a wide range of existing support, including workplace coaching, advocacy services and detailed benefits advice, helped to ensure people made informed, confident decisions. They described how advocacy organisations offered travel training, peer support and guidance tailored to individual needs, while social care teams regularly assisted with navigating the benefits system as part of transition planning. This approach was designed to ensure people felt supported and informed throughout their employment journey.

 

Training across the system was then considered, particularly the Oliver McGowan Mandatory Training. Officers explained that the training had become a statutory requirement and that monitoring mechanisms were being established across local organisations. The County Council had already begun delivering the training internally, while broader system‑wide monitoring frameworks, especially those involving NHS and ICB governance, were still being clarified as part of the new operating model. Officers agreed to take away an action to produce a more detailed update and emphasised that robust oversight was essential, given that the training aimed to improve safety, communication and reasonable adjustments for people with learning disabilities.

 

There was also a discussion of supported living and risks relating to choice, continuity and quality. Officers explained that the Council and ICB had already undertaken significant work to strengthen the provider market, including establishing a specialist framework ensuring providers had the right expertise for varying levels of need. While acknowledging risks such as market fragility and the need for stable specialist provision, officers explained that current evidence did not support establishing a fully in‑house service. The council lacked the infrastructure needed to directly deliver care services, and previous scoping had revealed substantial financial and operational barriers. Instead, resilience was being strengthened through mixed approaches, such as the council purchasing properties while external providers delivered care, enabling increased stability without requiring full in‑house provision.

 

Finally, Officers outlined how assistive technology was being used to support adults with learning disabilities. They explained that assistive technology was already widely embedded in practice, forming part of the standard equipment offer. Tools such as movement sensors, bed sensors, medication reminders and devices like Alexa were routinely used to promote safety, support independence and strengthen the quality of assessments. Sufficient resources were available through the council’s equipment budget, and use of technology was expanding across both learning‑disability and dementia services. Officers noted that the technology market continued to evolve quickly and that a dedicated officer monitored developments and collaborated with Innovate Oxfordshire to explore emerging opportunities. Although no standalone strategy existed, assistive technology was considered business as usual and an essential element of future service development.

 

The Committee AGREED to issue the following recommendations subject to minor amendments offline:

 

1. That partners at place consider an anniversary event to share progress and good practice.

 

2. For outcome measures to be developed on all due deliverables, and for this to be prepared for scrutiny by the JHOSC in 2027. It is recommended that there is a statement from all partners at place level on their roles and contributions to LD services, and on what has supported and hindered collaboration.

 

3. That people with Learning Disabilities, paid and unpaid carers, and health staff undertaking annual reviews, are empowered to improve the quality of annual reviews.

 

4. For there to be further engagement with people with Learning Disabilities/autism and epilepsy, and that relevant voluntary sector organisations (with their experts by lived experience) are engaged with in a timely way; with a view to understanding what they can contribute to communities of practice and prevention of avoidable and long admissions to hospital and early deaths.

 

The Committee adjourned for lunch at 12:45, and reconvened at 13:31