SUPPORTING LOCAL IMPROVEMENTS?

Pathways Associates CIC Ltd was established in 2008 as a partner to facilitate delivery of the North West Training and Development Team Programme of work.

NWTDT was established in 1984 to support health and social care organisations work collaboratively with people with a learning disability and their families in the North West.

We run several subgroups each of which focus on coproduction and co-delivery in relation to a particular topic as identified by stakeholders from across the NW.

They are:

• NWTDT Board
• Staying Healthy;
• Living Well;
• Being Safe;
• The Regional Forum; and
• Regional Families Forum.

A copy of our NWTDT Annual Report covering 2023/24 can be found here

Pages 4-15 provide more information about how these groups work to support coproduction across the North West and wider.

We also co-chair the NWADASS LD Network and facilitate the National Expert Hub group

Pathways NW Expert Hub

The NW Expert Hub was established to support the work of Experts by Experience and be a place where people with lived experience of having a learning disability, autism or both or family members can develop skills and confidence to help with developing services in the North West, and wider, to improve the lives of local people.

The Hub has 5 key areas of work and supports experts with paid work:

• Training
• Care Education and Treatment reviews
• Research
• Accessible Information
• Quality

VOICES

Coproduction and consultation/ engagement are very different; historically public services have not done well when relying on consultation or engagement. Coproduction is a long-term relationship; we have the foundations to support that in the NW because of the infrastructure available which is unique and celebrated outside the North West.

Coproduction involves working in partnership to share power and achieve great outcomes for people, services and communities.

It means working together with colleagues and community members to design, deliver and evaluate solutions in our work.

Future Coproduction support

In addition to the existing coproduction structures referred to above the Expert Hub is developing the work it can do to more widely support, we acknowledge that coproduction is not happening properly in many areas.

Coproduction is dependent on excellent relationships.

• We nurture our long-established networks to help us coproduce our work.
• We invest in our relationships and the skills within our communities.
• We are always searching for new opportunities and relationships that can strengthen our network and understanding.
• We enable safe spaces for conversations and different routes for people to be involved. These can include face-to-face, online meetings and digital solutions.
• We create accessible information in different formats to support people’s involvement.
• We continually reflect and build on our values, our practices and our skills in supporting effective coproduction.
• We can assist partner organisations to think through coproduction solutions using our infrastructure and skills.

System Improvement

All our work is aimed at gradual system improvement which we believe, together, we are achieving. The following projects influence general strategy or policy development locally, regionally, or nationally:

• Our co-produced graphics and films are shared across the North West and nationally to share knowledge and improve understanding of relevant matters;
• Our training is delivered across the North West and nationally;
• We have delivered presentations across the region via the North West Regional Forum focusing on the major problems relating to transport and isolation;
• We have worked to support the development and implementation of national policy which supports our community;
• We have worked closely with NWADASS and have presented to DASS colleagues to remind them of our shared commitments;
• We attend, and co-chair, NWADASS LD Network meetings;
• We have been asked to support NWADASS Regional Leaders Coproduction group.
• We represent NWADASS LD Network at the National ADASS Learning Disability and Autistic People Policy Network.

Furthermore, our monthly policy briefing bulletin is developed and delivered at the beginning of every month and covers the following topics:

• NWTDT/Pathways News and Updates;
• Health and Social Care News;
• Court of Protection Update;
• Resources and Research; and
• Events and Training.

Back copies of the monthly Policy Briefing can be found here

Our detailed Court of Protection update draws attention to the most recent publicised cases and highlights key points explaining law and obiter that are meaningful to overall practice. We integrate this into our training.

The policy briefing is shared, free to NWTDT Subscriber areas who request to be added to the distribution list.

EXAMPLES OF WORK DELIVERED TO INDIVIDUAL SUBSCRIBERS

There are occasions when the needs of a subscriber are unique and require specific input.

More information about recent work to support the North West can be found by clicking the links below:

• Greater Manchester
• Pan Lancashire/ South Cumbria
• Cheshire/ Merseyside

We are happy to discuss any individual requirements that you may have.

Some other examples include:

• Development of Quality Audits using Welcome Values. Reviews are coproduced locally with teams of Experts by Experience, Commissioners and Providers and create an action plan for improvement embedding a continuous cycle of quality reviews through building local capacity.
• Development of person centred skills, person centred teams
• Support planning in complex situations in partnership with individuals, families, friends, allies, partners etc.
• Turning person centred plans into specifications that can be tendered and embed a culture of change. This has been particularly helpful for areas moving people back to localities from Assessment and Treatment or other hospital settings

Partnership Working

Pathways sits within the Third Sector which means we are in the fortunate position of having being available to support collaborations of organisations in partnership to further develop local capacity and available funding.

We have supported a number of areas to apply for funds available through the Third Sector or other funding/commissioning organisations and have used existing subscription as match funding where necessary. We are able to search for appropriate funding opportunities for specific projects that may be useful to you and to act as a third sector partner in developing bids that you may already be considering. Feel free to approach us with any ideas that you are considering.

Some examples

• We have successfully brought in additional funds to further support our work through Awards for All, Lottery etc. and have used this to develop a wide range of workshops and events for families and people with LD living in the North West
• We worked with UCLAN to develop a bid and a business case for funding to increase participation of people with LD in the national cancer screening programmes.
• We supported MMU submit various research bids to further support the GM agenda.
• A successful bid to the Heritage Lottery Fund has enabled us to establish a research project to record the “People’s Story of Institutional Life in Calderstones and Brockhall Hospitals”
• We have been funded by Health Education England to coordinate a Leadership Programme for Systems Leaders in the Transforming Care Partnerships during 2017

EVENTS Planning and Management

Our team are skilled at organising and facilitating events and training in partnership with other organisations and our community.

Pathways events team can work with you to plan and deliver all aspects of your events including:

• Accessible venues
• Accessible materials/ agendas and presentations
• Coproduced and co-delivered workshops and keynotes etc.

WE ARE ABLE TO RUN EVENTS ACROSS THE NW WHICH FEED INTO LOCAL OR NATIONAL CONSULTATION/ENGAGEMENT. A FEW OF THESE INCLUDE:

• HOLD – (Home Ownership for People with Long Term Disabilities) we hosted 3 events in Preston, Oldham and Liverpool to share learning about HOLD.
• We have hosted many events and training sessions  to share learning and good practise in relation to Care Education and Treatment Reviews.
• The North West Regional Forum Conference in Blackpool is an event which is coproduced and co-delivered by the Regional Forum and provides opportunities for more people to get involved coproducing local and sub-regional plans form a key part of the agenda.
• All our training is coproduced and co-delivered and mapped against the skills frameworks for learning disability and autism.

Training

Pathways Associates are an approved provider via Crown Commercial Services Learning and Training Dynamic Purchasing System (RM6219).

In addition to leading the refresh and coproduction and codelivery of the NWTDT Training programme outlined on pages 16-21 of this report the Self-Advocates Training Partnership has developed and delivered a range of coproduced training including:

• Being a Trainer
• Staying safe online workshops;
• Introduction to Pathways
• Care Act
• Relationships
• Home
• Confidence Building
• Pass-It-On
• CETR awareness
• Race equality training (delivered with the Race Equality Foundation);

Work is also being undertaken to ensure that we deliver training that supports the development of the children’s workforce, namely:

Keyworker

Our Experts delivered keynotes at 2 Pneumonia workshops for NHS England.

A Shield not a Sword – MCA Conference in partnership with University of Manchester.

In November 2023, we hosted the Mental Capacity Act 2005 Conference in Manchester. It was titled “A Shield Not A Sword” and consisted of a number of workshops and key notes about the Mental Capacity Act. We worked in partnership with colleagues from the University of Manchester where our experts present on the Best Interest Training delivered in order to support and embed learning and understanding. Over 100 delegates took part in this event, which was free to NWTDT subscribers.

A copy of the agenda and details about the workshops delivered are here

We have developed our work in relation to Anti Racist and Intersectionality. Pathways, as an organisation supporting all team members, took part with the Equal Treatment project. This project was organised by Learning Disability England and the Race Equality Foundation. The project was about understanding and tackling racism through supporting self-advocacy groups to speak up about racism and become anti-racist in their work.

With our team, Pathways explored what racism is; what it does and heard people’s stories. We also talked about how Pathways can be anti-racist and used the work to continue to develop our work on intersectionality.

In addition to our training offer the NW Expert Hub has been a leader in the North West in relation to the roll out of the Oliver McGowan Mandatory Training

From 1 July 2022 Health and Social Care providers registered with the CQC must ensure that their staff receive training on learning disabilities and autism appropriate to their role. The Governments preferred training is the Oliver McGowan Mandatory Training, although at the time of writing the Governments Code of Practice has yet to be published.

We have been committed to utilising Pathways reserves in order to support the training and support of Experts.

Pathways Associates CIC are an approved training provider.

We now have in place –

Tier 1

• 4 approved Facilitating Trainers who can train the workforce and also train other trios (with a trio)
• 6 approved experts with a learning disability who can train the workforce and also train other trios (with a trio), 2 of whom are also Autistic and approved to deliver either as part of the trio.
• 5 approved Autistic experts who can train the workforce and also train other trios (with a trio)

All our team are approved to deliver

• Tier 1 1-hour webinar to train the workforce
• Tier 1 Part 1 train the trainer – training more trios who can then train the workforce
• Tier 1 Part 2 train approved trios to be able to deliver the train the trainer part 1 and part 2.
• Train the Trainer training at Tier 1 must be completed as a trio (facilitating trainer, expert with lived experience of a learning disability and an autistic expert).

Tier 2

• 2 Lead Trainers who are approved to deliver the Tier 2 Training Day to train the workforce AND also approved to train Facilitating Trainers, Experts with lived experience of a learning disability and autistic experts.
• 7 Approved Experts with lived experience of a learning disability who can deliver the tier 2 one day training to the workforce.
• 7 Approved Autistic Experts who can deliver the tier 2 one day training to the workforce.
• 7 Facilitating Trainers who can deliver the tier 2 one day training to the workforce.

Training More Trainers at Tier 2 involves separate:

• 2-day training for Facilitating Trainers
• 3-day training for Experts with lived experience of a learning disability
• 3-day training for Autistic Experts

Pathways have invested resources to support the roll out of the training.

In preparing for rollout, we have:

• Developed evaluation surveys for the training;
• Liaised with organisations about delivery of tier 2 and train the trainers;
• Developed a FAQ briefing note for interested organisations; and
• Delivered several ‘practice runs’ of the training internally where we engaged in reflective practice and feedback.

We have already successfully delivered Tier 1 Webinar sessions and Tier 2 face-to face delivery in the North West and wider.

We have developed are two sets of commercial rates:

1. North West Training and Development Team Subscribers: offering reduced rates due to the NW Expert Hub being built on the foundation that NWTDT Subscriptions enable; and
2. None North West where the cost will be higher.

CTR WORK

Our skilled team of Independent Chairs, Clinical Advisers and Experts by Experience have worked to support the delivery of CTRs since 2014 when they were introduced.

We currently support 3 large ICBs from the North West and wider to deliver this agenda to support people from our communities.

Please follow this link to find out more about our team

We have continued to develop the North West Experts Hub. In relation to C(e)TRs we have continued to support the NW ICBs with independent panel members.

Pathways independent panel members have coproduced a survey which promotes reflection on issues raised following every CETR. Copies of these surveys have been used to help identify strategic themes and are available to the areas we support including supporting the work of Oversight Panels.

Pathways Expert Hub have led and contributed to CTR and CETR training and webinars, including facilitation of the National Expert Hub group.

Pathways hosted CTR Webinars for CTR panel members from across the North West supporting to develop and roll out the new KLOE in line with national policy.

We have also delivered extensive training to experts, clinical advisers and independent chairs, including:

• CTR and CeTR training and webinars;
• In depth training in relation to Mental Capacity Act
• Supporting good physical health
• Supporting good Mental Health

Research

Pathways has led the development of a collaboration between a range of NW (and wider) academic institutions this includes work with universities:

• Manchester Metropolitan University
• Edge Hill
• University of Manchester
• Liverpool University
• University of Central Lancashire; and
• University of Sheffield

Our work with MMU has led to us securing funding to support co-production work and an additional resouces via UCLAN.

This funding is facilitating the development of coproduced training to support the development of research skills for research assistants with a learning disability.

Representatives from the Universities above attended the NWRF Conference in Blackpool and hosted a ‘Fancy a Chat’ zone where they were able to discuss a range of research themes currently being worked on, gather important data from delegates and also spend time with people in workshops and informally to assist planning of potential research options.

Accessible Information

Pathways secured funds via Awards for All and have been delivering capacity training to experts across the North West to develop a consortium of organisations with the skills to support the production of accessible information.

We have continued to support NW and wider organisations in translating materials they require to be more accessible using a variety of formats including easy read and video/ recorded options.

Quality

Pathways have:

• Established an Independent Voices Group, initially at Mersey Care Whalley and now for the same inpatients who have moved to Maghull LSU. The group utilises fortnightly Peer Advocacy visits and support to report on what is working and what needs improvement.
• Worked alongside NHSE in relation to safeguarding issues as part of the NHSE quality assurance oversight work;
• Updated Peer Led Quality Checking Process to help make sure there is a framework and independent Expert by Experience eyes on services;
• Supported in the production of a training video for Community Forensic Services in Cheshire and Wirral to increase understanding of the needs of people with a learning disability and Autistic people.
• Worked with Choice Support to develop links offering potential employment opportunities and support to CQC inspections in the North West

Environmental Responsbility:

Modern slavery: