Who is our service for?
The Intensive Support Team is a Black Country wide service serving all four CCG localities.
The Intensive Support Team offers specialist advice/consultation to others where their patients are in need of additional and more intensive support. Their patients will be people over 18 years of age who have a diagnosed learning disability, are unable to access to main stream services and/or require a specialist intervention team.
This includes provision of advice and consultation to other NHS health and social care professionals which incorporates statutory and non-statutory bodies. A core element of this specialist provision is enabling mainstream services, and other partners, to support people with learning disabilities directly.
How do we help?
In summary the service enables:
- The highest level of independence possible, in the most least restrictive way.
- Prevent and avoid unnecessary hospitalisation.
- Facilitate timely discharge from hospital inpatient care.
- Develop early detection systems alongside community teams and respond with timely early interventions at referral.
- Respond to crisis intensively.
- Input alongside MDT to assess and develop formulation especially in relation to behaviours that challenge.
- Plan strategies, alongside the community teams, to prevent future crisis.
- Signpost and navigate assessment of need for family carers to help support them with the demands of caring during periods of crisis.
- Provide timely and accessible intervention to patients experiencing psychiatric, psycho-social, behavioural and/or pharmacological problems.
The service aims:
- To provide a stepped-care comprehensive and integrated service.
- To provide a range of therapeutic and practical interventions, including using creative and innovative solutions.
- To provide targeted, time-limited “hands on" support for patients.
- To ensure collaborative development of Positive Behaviour Support plans.
- To ensure joint working between provider staff and team members in order to model skills, engagement, provide advice and share good practice.
- To acknowledge historic, current and future risks and to support the patient to maximise their potential for independence.
- To support patients (their carers and providers) to manage risks effectively.
- To support effective, safe discharge from hospital settings into the community.
- To support transfer of care, from out of area placements, to the Black Country team localities.
- To offer opportunities/access to the wider local community/mainstream services where this safe and relevant to do so.
- To support, advise and consult the Community Learning Disability Teams/ Forensic team to work with individuals who are displaying challenging behaviours and/or relapse signatures, which haven’t yet met the threshold for the Intensive Support Team.
- To develop and maintain key links and working partnerships with statutory and non-statutory agencies.
Where meeting health and/or care needs are particularly complex, the teams intensive specialist multi-disciplinary support or bespoke training may be needed in order to ensure equity of outcomes for people with learning disabilities.
The Intensive Support Team aims to work closely with statutory and non-statutory care services to ensure those eligible for the service have the appropriate level of support at the point of their greatest need.
The service is provided in the most appropriate setting. For example the patient’s residential setting, own home or other place of their choosing.
The team includes Psychologists, Occupational Therapists, Speech and Language Therapists, Learning Disability Nurses, Specialist Behaviour Support Therapists, a range of support worker roles and access to Consultant Psychiatrists.
There is one referral system for our Tier 2 and Tier 3 teams (Community Learning Disability Teams, Intensive Support Team and Forensic Community Team) known as the ‘single point of referral’ (SPOR).
Most patients who may need Intensive Support will already be known to our locality Community Learning Disability Teams.
If you believe someone requires Intensive Support please refer by telephoning the persons local Community Learning Disability Team on the relevant number listed below:
Sandwell Community Learning Disability Team - 0121 543 4063
Walsall Community Learning Disability Team - 01922 658 800
Wolverhampton Community Learning Disability Team - 01902 444447
Dudley Community Learning Disability Team - 01384 323047
SPOR sits within each multi-disciplinary community learning disability team located in the four geographical areas. SPOR meet once a week for clinical allocation. Referrals are checked and screened daily. Urgent referrals will be considered in line with the professional guidelines, the multi-disciplinary community team criteria and/or prioritisation screening (dependent on the nature of referral) and passed directly on to the Intensive Support Community Team where relevant.
Where are we located?
The Intensive Support Team is located in The Cabin at Heath Lane Hospital.
Heath Lane Hospital
The team operates flexibly Monday to Friday (excluding bank holidays) within the core hours of 8am to 8pm based on the needs of the patient and/or service. Pre-planned support will be delivered in the evenings and/or at weekends and bank holidays where clinically appropriate and agreed as part of the patient care plan.