Debate contribution: Respite Provision: South Eastern Health and Social Care Trust

Debate contribution by Mr Mike Nesbitt on 8 April 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

8 April 2025

Type

Debate contribution (made as a minister)

Business

Adjournment

Heading

Respite Provision: South Eastern Health and Social Care Trust

Assembly identifier

Official Report component 4920057

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. In the 10 months or so that I have been in post, I have found this issue to be unique in that money is not the primary issue. I have been able to find some money. We have not been able to spend it all, and that is indicative of the fact that the issues are primarily buildings, beds and workforce. I will immediately address the point from Mr McGrath about the numbers. The South Eastern Trust has the worst vacancy rates for social workers in children's disability teams. That speaks to what you addressed. Some of the issues are particular to the South Eastern Trust, but others just reflect broader systemic issues that impact on families across Northern Ireland. It is not confined to one trust or area; it is a regional challenge that I want to see responded to with a regional response. Across all the geographic trusts, overnight short breaks for children with disabilities have been significantly reduced due to the limited availability of residential provision. Much of that provision is now being used for medium- to long-term care placements. The stark impact was laid bare in last year's 'Spotlight' programme, which so many Members have referred to and which featured the lived experience of five families. It also had input from the Children's Law Centre and the National Autistic Society. The accounts were powerful and touching and impossible to ignore. As a former broadcast journalist, I repeat my admiration for Tara Mills for that powerful piece of journalism. It acted as an accelerant rather than a wake-up call for my Department. In October, as Members have said, I committed an additional £13·1 million of recurrent funding to help address the challenges. That has allowed us to start that acceleration work in the Department and across trusts, expanding capacity and trying to reform our delivery models. I take the opportunity to provide an update on the South Eastern Trust and to outline our regional response and share how we are working with the families highlighted in that programme. I will also briefly touch on adult respite services, which remain a key part of the overall strategy. The current position in the South Eastern Trust is deeply concerning. There are just two operational respite beds at Greenhill, and they are available only three nights a week. It is not enough. As of now, 85 children are on the waiting list for short breaks, and families, I understand, are under immense and sustained pressure. Much of the reduction in provision stems from the repurposing of Lindsay House, a dedicated seven-day short-break facility, which has been redirected to care for children entering the care system. That was a decision made out of necessity, but it impacts profoundly on children with disabilities and their families. To address that, £2·4 million in annual recurrent funding has been allocated specifically to the South Eastern Trust to restore and expand respite services for children with disabilities. Several important actions are already under way. Re-mobilising Lindsay House by relocating children currently in care to Redwood Children's Home will free up much-needed short-break capacity. The target date for this is September, though it depends on the successful completion of key interdependent actions. Minor capital works are in progress at Redwood to ensure that it can safely and appropriately accommodate children, and I am encouraged that all posts at Redwood were filled in one day at a recruitment event in March, which reflects a strong commitment from staff. Plans are in place to expand Greenhill's operation from three to five nights a week. That will require further recruitment, and that is scheduled to take place next month. Mr Honeyford asked for a guarantee on the Woodlawn facility: I cannot give a guarantee. The system is so fragile that, if one new child presents, the plans need to be redrawn. Miss McAllister talked about bureaucracy, but it is about safety. Alongside its residential provision, the trust is scaling up the LynC Outreach service.

That provides community-based support during evenings and weekends. Once it is fully implemented, the service will provide day breaks for 80 to 85 children who are on the waiting list. Learning disability nurses will be key to supporting the complex healthcare needs of those children during outreach. I give way briefly.

That is the issue, but I take exception to your use of the term "blocking". That person is a service user who needs help. Last week, I again met the families featured in the 'Spotlight' programme. Also at the meeting were senior officials from the Belfast Trust and the South Eastern Trust. The families have shown immense courage and persistence in advocating change not just for themselves but for other families. I have met them on several occasions, but, in a way, I am meeting them too often: it would be better if we did not need to meet, because that would mean that their needs had been met. The discussion was honest and constructive, because it was about culture and communication. Mr Mathison and Mr McMurray raised the issue of what some people have said and the tone in which they have addressed some of the families. That was discussed and acknowledged by senior figures in the South Eastern Trust, so I expect to see significant positive change in future engagements. Further work, particularly on the pace of change, is needed, however. I am pleased to say that there will be an oversight panel that will be tasked with supporting, monitoring and challenging — the challenge factor will be important — the remobilisation of short-break services. As I said, the issues are not unique to the South Eastern Trust. Across the country, families feel the strain and the pain of inadequate provision. That is why we are progressing a new regional framework for children with disabilities that aligns with the findings of the Ray Jones review and reflects the evolving and increasingly complex needs of children with autism, learning disabilities and additional needs. The aim of the framework is to improve the current offer of early help and community-based support; develop additional effective residential short breaks and short-break fostering; rethink our approach to residential provision and out-of-home placements; and improve transition pathways into adulthood. The £13·1 million of additional funding is helping to stabilise services by creating new beds, restoring lost provision and expanding community supports. Without closing the gap in residential care placements, however, short-break services will continue to be diverted during periods of crisis; that, I am afraid, is inevitable. To deliver sustainable, meaningful change, we must invest in modern, fit-for-purpose buildings, a well-trained, supported and motivated workforce and long-term funding solutions that give trusts the stability that they need to plan and deliver services effectively. Those things cannot be done quickly. I will speak briefly about adults with learning difficulties. While I am assured that most services function as intended, we know that there is room for improvement. Many families continue to rely on that support to manage the demands of caring for adult relatives who have complex needs. Progress on a refreshed service model for adult learning disability has been slower than anticipated due to the impact of other priorities. Officials have now, however, commissioned additional support from the HSC Leadership Centre that will accelerate that work. Our goal is to move towards public consultation as quickly as possible, with a view to implementing a service model that better meets the needs of adults and their families.

There is no doubt that progress has been made, in the trusts and regionally, but I want to be the first to acknowledge that the pace of change is not fast enough. We are constrained by workforce availability, infrastructure limitations and funding pressures: that is not an excuse, but it is the situation that we are in. I repeat my determination to the House and the families that I will do all that I can to make things better.

1,332 words. Text as published by the Northern Ireland Assembly.

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