This inspection took place on 20, 21, 25 and 26 October 2016 and was announced. The last Care Quality Commission (CQC) inspection of the London Borough of Sutton’s Specialist Health Team for People with Learning Disabilities was carried out on 30 and 31 October 2013, where we found the service was meeting all the regulations we looked at.

Sutton’s specialist clinical health team is multi-disciplinary and is made up of staff from a range of health care professionals, including nurses, speech and language, physio and occupational therapists, psychologists, behavioural analysts and music and drama therapists.

The principal aim of the service is to reduce health inequalities for local people with learning disabilities. The provider achieves this by supporting and advising people with learning disabilities and their families about how to access mainstream health care services, reducing hospital admissions and unnecessary GP appointments, empowering people to take greater control over their lives, promoting independence and enabling people to make informed decisions and by reducing social isolation.

The clinical health team also works closely with local care homes for people with learning disabilities, GP practices and NHS Hospital Trusts to raise health and social care providers’ awareness about the specific health care related needs and issues people with learning disabilities face. In addition, the team works in partnership with local mental health and learning disability services through the use of positive behavioural support (A way of supporting people who display behaviours that challenge services) and training to provide effective responses where challenging behaviour arises. At the time of our inspection approximately 270 adults with learning disabilities and their families/informal carers received a service from Sutton’s clinical health team.

The service had a registered manager in post. A new manager was appointed in April 2015 and they were in the process of applying to become the service’s registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Feedback we received from staff about the impact of the new service manager and their leadership style was positive. However, the provider does not have a clear vision for the service and staff still do not know or understand what the clinical health team will look like in the future. Managers advised us that funding for the team from the Clinical Commissioning Group (CCG) has been agreed, although the future role of the service remains uncertain which continues to adversely affect staff morale and the high levels of staff turnover the team has experienced in the last two years. We discussed these issues with the team’s management who were confident a CCG decision about what the new organisational structure of the clinical health team will look like in the future is pending.

People told us overall they were happy with the support they received from Sutton’s clinical health team for people with learning disabilities. People were provided with the support and interventions they required to take greater control of their lives and become more independent, reduce social isolation, make informed decisions and have greater access to health care services. Our discussions with people receiving a service, their relatives and community based health and social care professionals supported this.

The team appropriately safeguarded people from abuse. Managers and staff knew what constituted abuse and who to report it to if they suspected people were at risk. They had all received up to date training in safeguarding adults at risk. Risks to people’s safety were identified and health car

During our inspection we spoke with ten people who attended a weekly 'healthy lifestyle' club that was facilitated by the clinical health team, three members of the 'Speak Up Sutton' group, and a person who sat on the team’s interview panel. They told us they were happy with the health related support and advice they received from the various professionals they had come into contact with. All the people we met at the 'healthy lifestyle' club told us these classes had taught them how to eat and live much healthier lives. One person said “the club is excellent. You can dance and learn what’s good to eat”. Another individual told us “I come here every week; so I must be getting fitter”.

We also talked with the team’s registered manager, three heads of discipline (which included the community nursing, speech and language therapy and quality assurance managers), two community nurses, a speech and language therapist, a drama therapist and three support worker staff.

We found people who accessed the clinical health team’s services received appropriate support and advice from a wide range of suitably experienced and qualified health and social care professionals. The provider also had effective systems in place to routinely monitor the quality of the support and advice people with learning disabilities, their family carers and support workers received.