Preparing for adulthood
View more detail on the 4 areas in the sections below.
Growing up and becoming an adult is known as Preparing for Adulthood or PfA for short. There are 4 areas of PfA which are important for everyone growing up. These are:
- Education, training and employment
- Independent living
- Having friends and being part of your community
- Keeping healthy
The Local Offer has more information on Preparing for Adulthood and what to expect.
When a young person moves to adulthood it is important to ensure that they have an understanding of their basic health and wellbeing needs, as well as any additional knowledge around their individual health conditions or medical needs.
Annual health checks
Annual Health Checks are designed to promote the early detection and treatment of physical and mental health problems. If you are over 14 and on the GP Learning Disabilities register, then your GP will invite you for an Annual Health Check. You can find out more about the Annual Health Checks on the Mencap website. It is easy to be added to the Learning Disabilities Register, an individual can request this at the reception desk during a routine visit to the GP.
Gloucestershire Carers Hub
Once your child turns 18 then you will become a “carer” rather than a “parent carer”. Gloucestershire Carers Hub provides information and support for Gloucestershire’s unpaid carers.
Mental Capacity Act 2005
The Mental Capacity Act is relevant to people aged 16+ and is the legislation around how people make decisions about their life. The law says that we must help people to make their own decisions wherever possible and support them to understand what the decision they are making means.
When a person cannot make their own decision other people have to decide what is in their best interests. Often the person’s family will make these decisions, but sometimes other people must do this, for example a doctor if it is a medical decision. This is very different to how decisions are made regarding children where relatives can make all the decisions.
Learning Disabilities Hospital Liaison Nurses
Going into hospital is a daunting time for anyone, but for a young person with learning disabilities it can be even more challenging. The purpose of the Learning Disabilities Hospital Liaison Nurses is to help make sure that any hospital visits or admissions are as easy as possible for the individual. The Nurses can help to make sure that ‘reasonable adjustments’ are put in place for the hospital visit, for example: visiting the young person at home before admission so they recognise the Nurses, talking to ward staff about the patient’s needs and reducing wait times for the individual to reduce stress and anxiety. The service can be referred to by an individual, their family or a professional working with the individual.
For more details on the Learning Disabilities Hospital Liaison Nurses and how to get in touch with them please take a look at the learning disabilities liaison team leaflet.
Community Learning Disabilities Team (CLDT)
The Community Learning Disabilities Team sits in the Gloucestershire Health and Care NHS Foundation Trust. They are a specialist service for people with learning disabilities and health needs which may include:
- postural management (OT)
- sensory (OT)
- managing and maintaining nutrition
- mental health
- behaviours of distress
The team includes Community Nurses, Occupational Therapists, Physiotherapists, Psychiatrists, Psychologist and Speech and Language Therapists.
An individuals GP can refer them to the CLDT and/or if they are known to Children’s health services, they may refer them and conduct transition planning.
Intensive Health Outreach Team (IHOT)
IHOT provides a specialist service for people with learning disabilities and other vulnerable adults with physical health needs who require medical assessment.
The Team offer support such as desensitising basic health checks by gentle introduction of equipment and staff, in the person’s own home or taking bloods for people who struggle with this and where reasonable adjustments have still not made it possible.
Learning Disabilities Intensive Support Service (LDISS)
LDISS is a highly specialist service for individuals with learning disabilities who have behaviours that challenge and/or mental health needs. They work with individuals which may be at high risk of mental health hospital admission, to prevent unnecessary admissions to these units the Team also facilitate discharge where individuals have been admitted.
In addition, where an individual has complex needs LDISS helps people to move back into Gloucestershire from out of county, including inpatient services, educational services or residential care.
Adult Continuing Healthcare
Young people with complex health needs which may have been as a result of congenital conditions, long-term or life-limiting or life-threatening conditions, disability, or the after-effects of serious illness or injury may be eligible for Adult Continuing Healthcare (CHC)
Often the young people who are referred for an Adult CHC assessment will have been supported through Children’s Continuing Care during their childhood, however this is not always the case.
Below is an overview of the process for accessing Adult Continuing Healthcare:
An Adult CHC ‘Checklist’ can be submitted to the Team when the young person is aged 17.5, a checklist is the screening stage to establish the likelihood of eligibility and whether a full assessment is needed. CHC Checklists can be completed by services such as: Children’s Continuing Care, the Adult Social Care Transition Team and Children’s Social Care. The completion of a checklist should be undertaken in a community setting with the young person and their family. The professional completing the checklist will also talk to other services working with the young person to gather a full picture of the individual’s needs. For a checklist to be submitted informed consent must be given by the young person. If the young person is not able to give consent, then someone else will need to undertake this decision for example a relative, this decision must be made in the individuals’ best interests. Once the screening stage has been completed it will be reviewed by the CHC Team, and they will agree whether the young person will move onto the full assessment stage, to decide CHC eligibility. If the screening stage shows that the young person does not meet eligibility, then they will be informed by NHS Gloucestershire Clinical Commissioning Group (CCG).
The full CHC assessment will be coordinated by the CHC Team. There are 2 parts to the assessment these are:
- An assessment of needs – this provides up to date information from the young person, their family and their multi-disciplinary team (health, social care and educational professionals supporting the young person)
- Decision support tool –there are 12 elements of a decision support tool, known as domains, these help to understand the young person’s level of need in each area. The young person’s multi-disciplinary team will write about their care needs for each domain.
The multi-disciplinary team develop their recommendation of eligibility based on the above, which the young person and their family are able to look at. The CCG then reviews the recommendations and agrees an outcome, which will be provided to the young person in writing.
If the young person is eligible then the CHC team will work with them to develop a support plan for their health and wellbeing, in day-to-day life, the plan will also consider where the young person will receive their care and who will complete this. These decisions should be made jointly between professionals and the young person with their family.
NHS England have developed a video to provide more details to families on how the CHC process works.