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[]
[null,"Improvement Tool"]
[null,"Reducing deaths of people with a learning disability in NHS acute (hospital) trusts in England"]
[null,"Contents"]
[null,"Instructions"]
[null,"Questions for managers"]
[null,"Questions for staff"]
[null,"Improvement summary"]
[null,"Action plan"]
[]
[null,"Name of trust"]
[null,"hospitals, wards and departments included"]
[null,"Name of trust LD lead"]
[null,"Date of completion"]
[null,"Facilitator"]
[null,"Contributors"]

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[]
[null,"Managers responses:",null,null,{"$f":"IF(TrustName<>\"\",TrustName,\"\")&\",\"&IF(CompletionDate<>\"\",TEXT(CompletionDate,\" dd-mmm-yy\"),\"\")","v":","}]
[null,"Respecting and protecting peoples' rights"]
[null,"All NHS trusts must ensure that they meet their Equality Act Duties to people with a learning disability; and ensure that their wider human rights are respected and protected, as required by the Human Rights Act."]
[null,"Improvement measures",null,"Mgr Rating Code","Questions for managers","Manager rating","mgrs scores"]
[null,"Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","Question 1","MR1a","Does your trust have systems in place to ensure that senior managers hear about the experiences of patients with learning disabilities and their families, who use your services; and if so, can these be disaggregated, so that the views of patients with learning disabilities can be considered separately, and compared to other patients.",null,{"$f":"IF(F6=\"Currently achieving.\",5,IF(F6=\"Confident we will  achieve within 6 months.\",3,IF(F6=\"Not fully achieved, but will in the next 12 months.\",1,IF(F6=\"Not achieving and unlikely to do so in next 12 months.\",0))))","v":false}]
[null,null,"Question 2","MR1b","Does your trust monitor the 'clinical outcomes' of services delivered to patients with learning disabilities in a way that allows data about service use to be disaggregated for patients with learning disabilities, so that any inequalities in service use can be identified and addressed?",null,{"$f":"IF(F7=\"Currently achieving.\",5,IF(F7=\"Confident we will  achieve within 6 months.\",3,IF(F7=\"Not fully achieved, but will in the next 12 months.\",1,IF(F7=\"Not achieving and unlikely to do so in next 12 months.\",0))))","v":false}]
[null,null,"Question 3","MR1c","Does your trust monitor numbers of patients with learning disabilities on waiting lists and the lengths of their waits, so that comparisons can be made with other groups? And, if there are concerns, do you proactively report these to service commissioners?",null,false]
[null,null,"Question 4","MR1d","Does your trust have a robust Mental Capacity Act policy which requires staff do everything possible to support patients to make their own decisions about their care and treatment. And, if a patient has been assessed as lacking capacity to make a particular decision, does the policy outline how the decision is to be made in accordance with a lawful 'best interests' process?",null,false]
[null,null,"Question 5","MR1e","Does your trust undertake at least annual audits of compliance with its Mental Capacity Act Policy so that you can understand how effectively it is being followed; and make improvements where needed?",null,false]
[null,null,"Question 6","MR1f","Does your trust have a clear policy (based on the principles of the Mental Capacity Act), which guides and supports staff when making decisions about withdrawing life sustaining treatments, or not to attempt cardio-pulmonary resuscitation?",null,false]
[null,null,"Question 7","MR1g","Does your trust audit clinical records and communications to ensure that information about a patient's learning disability and the reasonable adjustments they need is shared both within the trust and wherever appropriate, with external agencies?",null,false]
[null,"trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","Question 8","MR2a","When working with patients with learning disabilities, does your policies require staff to make use of Health / Hospital Passports (or equivalent); and to pay due regard to their contents - especially with regard to making those reasonable adjustments that are noted to be required?",null,false]
[null,null,"Question 9","MR2b","Are trust staff required to specifically determine, record and share, the communication and information needs of patients with learning disabilities. And; to provide the right support on the basis of this?",null,false]
[null,null,"Question 10","MR2c","Do you ensure staff in the trust's services have access to a wide range of accessible information resources that can be used to help patients with learning disabilities understand services and make decisions about their health?",null,false]
[null,null,"Question 11","MR2d","Are trust staff required to promote and support the use of adapted pain assessment appoaches and tools?",null,false]
[null,null,"Question 12","MR2e","Where patients with learning disabilities have multiple long term health conditions, that mean they regularly and predictably access a range of departments, does the trust require that they have an identified practitioner to lead / coordinate service delivery, either from within the trust; or possibly from another NHS provider, as agreed in a Service Level Agreement?",null,false]
[null,null,"Question 13","MR2f","Do your trust's clinical areas meet those environmental needs of patients with disabilities that can reasonably be predicted? This includes the provision of physically accessible premises, low stimulus waiting areas, ‘Changing Places’ toilets, facilities for families to stay with them overnight etc.",null,false]
[null,null,"Question 14","MR2g","If for some exceptional reason, a decision is being considered not to support a patient with a learning disability to follow the same care pathway as other patients, do the trust's policies require staff to fully record the compelling reasons for the proposal and the processes by which such an agreement has been reached? ",null,false]
[null,"Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","Question 15","MR3a","Are trust staff trained to recognise when a patient's liberty is being restricted; under what circumstances this can lawfully be done; and what to do if they feel the restriction is not appropriate?",null,false]
[null,null,"Question 16","MR3b","Does the trust have a policy that guides staff with regard to the application of 'restrictive practices' and 'deprivations of liberty'; and which ensures that if used, there is clear evidence that they are necessary, proportionate and applied in accordance with a procedure prescribed by law?",null,false]
[null,null,"Question 17","MR3c","If patients are 'deprived of their liberty', or have it restricted, does the trust have a policy that requires staff to tell patients (and their families, or others who advocate on their behalf) why and what to do if they unhappy about it?",null,false]
[null,null,"Question 18","MR3d","Does the trust routinely collect, analyse and monitor data regarding restrictions and deprivations of patients' liberty within services, or as a result of advice given by trust staff provide to others; and can this data be disaggregated so that patients with learning disabilities can be identified?",null,false]
[null,"Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","Question 19","MR5a","Does your trust have systems to ensure that if a patient with a learning disability dies whilst using services (or if you learn that they has died within 6 months of discharge), notifications are made to the Learning Disabilities Mortality Review Programme (LeDeR); and do your  policies / procedures ensure full information sharing; and where appropriate, that your staff are supported to contribute to mortality reviews?",null,false]
[null,null,"Question 20","MR5b","Does the trust have governance processes that ensures senior managers consider implications of local Learning from Death Reviews, LeDeR reviews and prominent national reports concerning deaths of patients with a learning disability, in order to better understand amenable causes of death; and to introduce actions to reduce potentially avoidable deaths within your services.",null,false]
[null,null,"Question 21","MR5c","Do the trust collate data on numbers of deaths of patients with learning disabilities known to your services; and specifically as a result of seizures, choking incidents, sepsis, gastrointestinal obstructions and pneumonia? If so, is this data is shared with your commissioners, along with local plans to reduce these causes of death?",null,false]
[]
[null,"Including and engaging people and families"]
[null,"All NHS trusts must ensure people with a learning disability, their families and carers, are all empowered to be partners in the care they receive."]
[null,"Improvement Measures",null,"Mgr Rating Code","Questions for Managers","Manager Rating"]
[null,"Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS Constitution.","Question 22","MI1a","Are trust staff required to involve all patients with a learning disability (and where appropriate family carers and / or advocates) in discussions about planning their care; and are they able to provide a record, in an accessible format, of what has been agreed, if the patient or their family want one?",null,{"$f":"IF(F31=\"Currently achieving.\",5,IF(F31=\"Confident we will  achieve within 6 months.\",3,IF(F31=\"Not fully achieved, but will in the next 12 months.\",1,IF(F31=\"Not achieving and unlikely to do so in next 12 months.\",0))))","v":false}]
[null,null,"Question 23","MI1b","Are patients with a learning disability and their families required to be told about any safety incident relating to their care which has caused, or could still cause, significant harm or death? Are they are given the facts and an apology, in the most helpful format possible; and also any other reasonable support they need?",null,false]
[null,"Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","Question 24","MI4a","Do the trust policies and staff training, ensure that staff receiving complaints and concerns have the right knowledge, skills and autonomy to make immediate safeguarding referrals, without delay, where they believe there is an ongoing risk of harm?",null,false]
[null,null,"Question 25","MI4b","Is the trust able to demonstrate openness and transparency in dealing with complaints / investigations, including making reasonable adjustments to complaints processes, such as having accessible information about how to make complaints and flexible processes for gathering evidence from patients with learning disabilities; and are complainants provided with updates at regular intervals?",null,false]
[null,null,"Question 26","MI4c","Are patients and their families told the outcomes of complaints investigations (including what has been learned and what will be done differently in future) in an appropriately reasonably adjusted manner, in an appropriate place, and by an appropriate person?",null,false]
[]
[null,"Workforce issues"]
[null,"All NHS trusts should have the skills and capacity to meet the needs of people with a learning disability; by providing safe and sustainable staffing, with effective leadership at all levels."]
[null,"Improvement Measures",null,"Mgr Rating Code","Questions for Managers","Manager Rating"]
[null,"On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them.","Question 27","MW1a","Does the trust have a workforce plan (updated in the last 12 months) which clearly identifies the range of specialist learning disability knowledge and skills that are required to ensure effective services to patients?",null,{"$f":"IF(F40=\"Currently achieving.\",5,IF(F40=\"Confident we will  achieve within 6 months.\",3,IF(F40=\"Not fully achieved, but will in the next 12 months.\",1,IF(F40=\"Not achieving and unlikely to do so in next 12 months.\",0))))","v":false}]
[null,null,"Question 28","MW1b","Is the trust workforce plan concerning the needs of patients with learning disabilities informed by a comprehensive, evidence based understanding of local population needs (e.g. a Joint Strategic Needs Assessment)?",null,false]
[null,null,"Question 29","MW1c","Where it can reasonably be predicted that trust staff require access to specialist practitioners (including on a liaison basis) from other health or social care providers, does the trust have clear service level agreements, or joint working protocols, with them which include referral mechanisms and response times?",null,false]
[null,"Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.","Question 30","MW2a","As a minimum, do all trust staff receive up to date training, appropriate to their roles, covering: learning disability awareness; health issues associated with learning disability (e.g. dysphagia, epilepsy, respiratory conditions, bowel care, postural care needs etc.); human rights, mental capacity and best interests; supporting patients with challenging needs; and safeguarding?",null,false]
[null,null,"Question 31","MW2b","Have trust staff received training on their responsibilities to make, record, report and share information about reasonable adjustments when working with patients with learning disabilities?",null,false]
[null,null,"Question 32","MW2c","Have trust staff have been trained to help patients and those who routinely provide day to day care and support, to understand how to recognise and respond to any future signs of emerging health problems / relapse which may arise subsequent to discharge?",null,false]
[null,"Trusts must have workforce plans which include provision to manage and mitigate the impact of the growing, cross-system shortage of qualified practitioners with a professional specialism in learning disabilities.","Question 33","MW3a","Does the trust have a clearly identified senior management lead(s) for improving service delivery to patients with learning disabilities?",null,false]
[null,null,"Question 34","MW3b","Does the trust workforce plan include data on current and future pressures arising from retention / recruitment difficulties relating to key disciplines (especially concerning reduced numbers of learning disability nurses); and projected retirement figures for your workforce. Does it also include workforce planning / recruitment strategies to mitigate these pressures?",null,false]

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[]
[null,"Staff responses:",{"$f":"IF(TrustName<>\"\",TrustName,\"\")&\",\"&IF(CompletionDate<>\"\",TEXT(CompletionDate,\" dd-mmm-yy\"),\"\")","v":","}]
[null,"Respecting and protecting peoples' rights"]
[null,"All NHS trusts must ensure that they meet their Equality Act Duties to people with a learning disability; and ensure that their wider human rights are respected and protected, as required by the Human Rights Act."]
[null,"Improvement measures",null,"Mgr Rating Code","Questions for staff","Staff rating"]
[null,"Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","Question 1","SR1a","As far as you know, does your trust use systems and measures to check whether the experiences of patients with learning disabilities who use your services, are the same as anyone else's?",null,{"$f":"IF(F6=\"Yes, definitely\",5,IF(F6=\"To some extent\",3,IF(F6=\"Not certain but I expect so\",1,IF(F6=\"I doubt it\",0))))","v":false}]
[null,null,"Question 2","SR1b","Within your team, do you ever get to see and reflect on data that shows how clinically effective your trust/service is at supporting patients with learning disabilities?",null,{"$f":"IF(F7=\"Yes, routinely\",5,IF(F7=\"Now and again\",3,IF(F7=\"Not often\",1,IF(F7=\"Not really\",0))))","v":false}]
[null,null,"Question 3","SR1c","When offering learning disabled patients choices about their care and treatment, if staff think a patient might lack the ability to make a decision, are they able to either formally assess the person’s capacity themselves; or arrange for a specialist to come quickly and do it?",null,{"$f":"IF(F8=\"Yes, routinely\",5,IF(F8=\"More often than not\",3,IF(F8=\"Sometimes / partially\",1,IF(F8=\"Not really\",0))))","v":false}]
[null,null,"Question 4","SR1d","If a learning disabled patient has been found to lack the capacity to make an important decision, do staff: routinely consult the person’s family; or, if there is no-one appropriate to consult, do they know how to arrange a referral for an Independent Mental Capacity Advocate instead?",null,{"$f":"IF(F9=\"Yes, routinely\",5,IF(F9=\"More often than not\",3,IF(F9=\"Sometimes / partially\",1,IF(F9=\"Not really\",0))))","v":false}]
[null,null,"Question 5","SR1f","Have staff been trained to understand their duty to respect and protect learning disabled patients' right to life; and importantly, to follow processes that are consistent with the Mental Capacity Act,  if contributing to decisions about withholding life sustaining treatments or resuscitation?",null,{"$f":"IF(F10=\"Yes, in detail\",5,IF(F10=\"Mostly\",3,IF(F10=\"Partially\",1,IF(F10=\"Not really\",0))))","v":false}]
[null,null,"Question 6","SR1g","If staff make referrals to other departments within the trust, or other external agencies, are they always explicit if a patient has a learning disability, and about any reasonable adjustments they are known to require?",null,{"$f":"IF(F11=\"Yes, routinely\",5,IF(F11=\"More often than not\",3,IF(F11=\"Sometimes / partially\",1,IF(F11=\"Not really\",0))))","v":false}]
[null,"Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","Question 7","SR2a","Do trust staff always ask about, read and pay attention to the contents of ‘Health/ Hospital Passports’ (or equivalent) in the way they provide services and make reasonable adjustments; and, if learning disabled patients do not have already have one, do staff either support them to develop one, or know how to direct them to someone who can?",null,false]
[null,null,"Question 8","SR2b","Do trust staff routinely check and record the 'communication and infromation' needs of patients with learning disbailities; and then modify their communication including verbal and written materials, in ways that make it easier for patients to understand what is going on and make sense of their health needs?",null,false]
[null,null,"Question 9","SR2c","Where required, do trust staff have access to and make use of accessible literature and information, to help learning disabled patients understand their health and the trust's services; and to help them make their own choices?",null,false]
[null,null,"Question 10","SR2d","Are trust staff familiar with and do they use, tools and modified appraoches to help assess whether learning disabled patients, who may struggle to communicate verbally, are in pain or discomfort e.g. the DISDAT, the Abbey pain scale, or bespoke visual pain profiles.",null,false]
[null,null,"Question 11","SR2e","If a learning disabled patient sees a number of teams / specialists on a regular basis because they have more than one long term health condition, does a single practitioner either from your trust or another service, act as a coordinator?",null,false]
[null,null,"Question 12","SR2f","Are clinical areas that patients with disabilities might access, including waiting areas, adapted or modified to take account of their potential environmental needs? (This includes things like accessible premises, low stimulus waiting areas, ‘Changing Places’ toilets and facilities for relatives to stay with patients overnight during hospital stays).",null,{"$f":"IF(F17=\"Yes, definitely\",5,IF(F17=\"To a fair extent\",3,IF(F17=\"A bit / partially\",1,IF(F17=\"Not really\",0))))","v":false}]
[null,null,"Question 13","SR2g","Are patients with learning disabilities routinely supported, using reasonable adjustments, to follow the same treatment pathways for health conditions as anybody else - unless or until there is a fully documented agreement that an alternate pathway is more appropriate?",null,{"$f":"IF(F18=\"Yes, routinely\",5,IF(F18=\"More often than not\",3,IF(F18=\"Sometimes / partially\",1,IF(F18=\"Not really\",0))))","v":false}]
[null,"Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","Question 14","SR3a","Have trust staff been trained to recognise that under human rights law everybody has a right to liberty and freedom - but that under a few exceptional circumstances, it may be appropriate, necessary and lawful to restrict someone's freedom?",null,{"$f":"IF(F19=\"Yes, in detail\",5,IF(F19=\"Mostly\",3,IF(F19=\"Partially\",1,IF(F19=\"Not really\",0))))","v":false}]
[null,null,"Question 15","SR3b","If restrictions placed on a patient's freedom are more significant and amount to a 'deprivation of liberty', do trust staff follow a policy that ensures that it is lawfully authorised and that patients have safeguards against their misuse?",null,{"$f":"IF(F20=\"Yes, routinely\",5,IF(F20=\"More often than not\",3,IF(F20=\"Sometimes / partially\",1,IF(F20=\"Not really\",0))))","v":false}]
[null,null,"Question 16","SR3c","If patients are deprived of their liberty or have it restricted, do trust staff provide them and their families with accessible information about why it has been done, their rights and what to do if they are unhappy?",null,{"$f":"IF(F21=\"Yes, routinely\",5,IF(F21=\"More often than not\",3,IF(F21=\"Sometimes / partially\",1,IF(F21=\"Not really\",0))))","v":false}]
[null,null,"Question 17","SR3d","Do staff get to see audit reports about the use of deprivations and restrictions of liberty within the trust and discuss these within teams?",null,{"$f":"IF(F22=\"Yes, routinely\",5,IF(F22=\"Now and again\",3,IF(F22=\"Not often\",1,IF(F22=\"Not really\",0))))","v":false}]
[null,"Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","Question 18","SR5a","If and when trust staff become aware that a patient with a learning disability has died, do they know that the reporting processes are different than for other patients and if so, who to contact, so that the national Learning Disabilities Mortality Review Programme can be informed? Also, are staff supported to contribute to reviews of deaths.",null,{"$f":"IF(F23=\"Yes, definitely\",5,IF(F23=\"To some extent\",3,IF(F23=\"Not sure / partially\",1,IF(F23=\"I don't think so\",0))))","v":false}]
[null,null,"Question 19","SR5b(i)","Do trust staff get to discuss and reflect on key learning from reviews of the deaths of patients with learning disabilities, within their teams?",null,{"$f":"IF(F24=\"Yes, definitely\",5,IF(F24=\"To some extent\",3,IF(F24=\"Not sure / partially\",1,IF(F24=\"Not really\",0))))","v":false}]
[null,null,"Question 20","SR5b(ii)","Are trust action plans for reducing preventable deaths of patients with learning disabilities, shared, discussed and acted on within your team?",null,{"$f":"IF(F25=\"Yes, definitely\",5,IF(F25=\"To some extent\",3,IF(F25=\"Not sure / partially\",1,IF(F25=\"Not really\",0))))","v":false}]
[]
[null,"Including and engaging people and families"]
[null,"All NHS trusts must ensure people with a learning disability, their families and carers, are all empowered to be partners in the care they receive."]
[null,"Improvement Measures",null,"Mgr Rating Code","Questions for Managers","Staff Rating"]
[null,"Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS Constitution.","Question 21","SI1a(i)","Where they want to, are patients routinely included in meetings that relate to their care, treatment and discharge (unless exceptionally, there is a recorded legal basis not to do so)?",null,{"$f":"IF(F30=\"Yes, routinely\",5,IF(F30=\"More often than not\",3,IF(F30=\"Sometimes / partially\",1,IF(F30=\"Not really\",0))))","v":false}]
[null,null,"Question 22","SI1a(ii)","Where patients with learning disabilities or their families want, do trust staff provide them with records of meetings in an accessible format?",null,false]
[null,null,"Question 23","SI1a(iii)","Are learning disabled patients offered support to prepare, in advance, of meetings about their care and treatment? This includes support to make written representation, and involving advocates to ensure their voices are heard?",null,false]
[null,null,"Question 24","SI1b","If there is a serious incident that affects a learning disabled patient's safety, do staff follow a trust policy that requires them to promptly tell patients and their families, to apologise and to provide any extra support they need to help them understand what has happened?",null,false]
[null,"Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","Question 25","SI4a(i)","If a learning disabled patient, or their family or carers, makes a complaint or raises a concern with trust staff, do they have the discretion to act immediately if they feel there are ongoing safeguarding issues?",null,{"$f":"IF(F34=\"Yes, routinely\",5,IF(F34=\"To some extent\",3,IF(F34=\"Not sure but I think so / partially\",1,IF(F34=\"Not really\",0))))","v":false}]
[null,null,"Question 26","SI4a(ii)","If trust staff make a safeguarding referral, do they tell the patient as soon as possible and where appropriate, their family; and do they explain what this means and what will happen next as a result of the referral?",null,{"$f":"IF(F35=\"Yes, routinely\",5,IF(F35=\"More often than not\",3,IF(F35=\"Sometimes / partially\",1,IF(F35=\"Not really\",0))))","v":false}]
[]
[null,"Workforce issues"]
[null,"All NHS trusts should have the skills and capacity to meet the needs of people with a learning disability; by providing safe and sustainable staffing, with effective leadership at all levels."]
[null,"Improvement Measures",null,"Mgr Rating Code","Questions for Managers","Staff Rating"]
[null,"On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them.","Question 27","SW1a","Do staff on your ward / department have the right knowledge and skills to ensure they feel confident and are able deliver the service in a way that fully recognises and meets the needs of patients with learning disabilities?",null,{"$f":"IF(F40=\"Yes, routinely\",5,IF(F40=\"More often than not\",3,IF(F40=\"Sometimes / partially\",1,IF(F40=\"Not really\",0))))","v":false}]
[null,null,"Question 28","SW1c","Where in order to meet patients' needs, trust staff need to work with staff from another health or social care provider, are there clear referral mechanisms and arrangements for joint working?",null,{"$f":"IF(F41=\"Yes, definitely\",5,IF(F41=\"To some extent\",3,IF(F41=\"Not sure but I think so\",1,IF(F41=\"Not really\",0))))","v":false}]
[null,"Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.","Question 29","SW2a","Do trust staff receive up to date and relevant training on: learning disability / autism awareness including: the health issues associated with learning disabilities; accessible communication needs; supporting patients with challenging needs; safeguarding; and mental capacity and best interests?",null,{"$f":"IF(F42=\"Yes, in depth\",5,IF(F42=\"Mostly\",3,IF(F42=\"Partially\",1,IF(F42=\"Not really\",0))))","v":false}]
[null,null,"Question 30","SW2b","Have trust staff received training about the legal requirement to make, report, record and share reasonable adjustments to learning disabled patients' care and support, in order to ensure that they are not disadvantaged?",null,{"$f":"IF(F43=\"Yes, in depth\",5,IF(F43=\"Mostly\",3,IF(F43=\"Partially\",1,IF(F43=\"Not really\",0))))","v":false}]
[null,null,"Question 31","SW2c","As a result of training, do trust staff routinely provide advice to learning disabled patients and those who provide day to day care and support, to help them recognise emerging health problems or future signs of relapse, and to know how to respond?",null,{"$f":"IF(F44=\"Yes, definitely\",5,IF(F44=\"More often than not\",3,IF(F44=\"Sometimes / partially\",1,IF(F44=\"Not really\",0))))","v":false}]
[null,"Trusts must have workforce plans which include provision to manage and mitigate the impact of the growing, cross-system shortage of qualified practitioners with a professional specialism in learning disabilities.","Question 32","SW3a","Where trust staff need specialist advice on the care and support of patients with learning disabilities, do they have access to clearly identified people in lead roles (which may include specialist liaison nurses)?",null,{"$f":"IF(F45=\"Yes, routinely\",5,IF(F45=\"More often than not\",3,IF(F45=\"Sometimes / partially\",1,IF(F45=\"Not really\",0))))","v":false}]
[null,null,"Question 33","SW3b","Where regular trust staff have to work with bank / agency staff, are there clear protocols which they follow in order to maximise consistency, by making sure that the bank and agency workers are alerted to the specific care and support needs of any learning disabled patients’ in the ward / department.",null,{"$f":"IF(F46=\"Yes, routinely\",5,IF(F46=\"More often than not\",3,IF(F46=\"Sometimes / partially\",1,IF(F46=\"Not really\",0))))","v":false}]

{"sheet":"PID","index":3,"n_rows":71,"n_cols":12,"rows_kept":71,"cut":false,"hidden":true,"merged":[]}
["Currently achieving."]
["Confident we will  achieve within 6 months."]
["Not fully achieved, but will in the next 12 months."]
["Not achieving and unlikely to do so in next 12 months."]
["N/A"]
["Q1"]
["Yes, definitely"]
["To some extent",null,null,null,"VLOOKUP table"]
["Not certain but I expect so",null,null,null,"mean greater than","value to return"]
["I doubt it",null,null,null,0,0,"Not achieving and unlikely to do so in next 12 months."]
["N/A",null,null,null,0.5,1,"Not fully achieved, but will in the next 12 months."]
["Q2; Q17",null,null,null,2,3,"Confident we will  achieve within 6 months."]
["Yes, routinely",null,null,null,4,5,"Currently achieving."]
["Now and again"]
["Not often"]
["Not really"]
["N/A",null,null,null,null,null,null,null,null,null,"Reverse lookup"]
["Q3; Q4; Q6; Q7; Q8; Q9; Q10; Q11; Q13; Q15; Q16; Q21; Q22; Q23; Q24; Q26; Q27; Q32; Q33",null,null,null,null,null,null,null,null,null,"mean greater than"]
["Yes, routinely",null,null,null,null,null,null,null,null,null,0,"Not achieving and unlikely to do so in next 12 months."]
["More often than not",null,null,null,null,null,null,null,null,null,0.5,"Not fully achieved, but will in the next 12 months."]
["Sometimes / partially",null,null,null,null,null,null,null,null,null,2,"Confident we will  achieve within 6 months."]
["Not really",null,null,null,null,null,null,null,null,null,4,"Currently achieving."]
["N/A"]
["Q5; Q14; "]
["Yes, in detail"]
["Mostly"]
["Partially"]
["Not really"]
["N/A"]
["Q12"]
["Yes, definitely"]
["To a fair extent"]
["A bit / partially"]
["Not really"]
["N/A"]
["Q18"]
["Yes, definitely"]
["To some extent"]
["Not sure / partially"]
["I don’t think so"]
["N/A"]
["Q19; Q20"]
["Yes, definitely"]
["To some extent"]
["Not sure / partially"]
["Not really"]
["N/A"]
["Q25"]
["Yes, definitely"]
["To some extent"]
["Not sure but I think so / partially"]
["Not really"]
["N/A"]
["Q28"]
["Yes, definitely"]
["To some extent"]
["Not sure but I think so"]
["Not really"]
["N/A"]
["Q29; Q30"]
["Yes, in depth"]
["Mostly"]
["Partially"]
["Not really"]
["N/A"]
["Q31"]
["Yes, definitely"]
["More often than not"]
["Sometimes / partially"]
["Not really"]
["N/A"]

{"sheet":"Standards and targets","index":4,"n_rows":54,"n_cols":12,"rows_kept":54,"cut":false,"hidden":true,"merged":[]}
["Domain","Improvement Code","Improvement Measure","Manager Indicator Codes","Mgr Supp raw scores","Managers scores","Manager indicators","Staff Indicator Codes","Staff supp raw scors","Staff score","Staff indicators"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1a",null,{"$f":"'Questions for Managers'!G6","v":false},{"$f":"'Questions for Managers'!E6","v":"Does your trust have systems in place to ensure that senior managers hear about the experiences of patients with learning disabilities and their families, who use your services; and if so, can these be disaggregated, so that the views of patients with learning disabilities can be considered separately, and compared to other patients."},"SR1a",null,{"$f":"'Questions for Staff'!G6","v":false},{"$f":"'Questions for Staff'!E6","v":"As far as you know, does your trust use systems and measures to check whether the experiences of patients with learning disabilities who use your services, are the same as anyone else's?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1b",null,{"$f":"'Questions for Managers'!G7","v":false},{"$f":"'Questions for Managers'!E7","v":"Does your trust monitor the 'clinical outcomes' of services delivered to patients with learning disabilities in a way that allows data about service use to be disaggregated for patients with learning disabilities, so that any inequalities in service use can be identified and addressed?"},"SR1b",null,{"$f":"'Questions for Staff'!G7","v":false},{"$f":"'Questions for Staff'!E7","v":"Within your team, do you ever get to see and reflect on data that shows how clinically effective your trust/service is at supporting patients with learning disabilities?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1c",null,{"$f":"'Questions for Managers'!G8","v":false},{"$f":"'Questions for Managers'!E8","v":"Does your trust monitor numbers of patients with learning disabilities on waiting lists and the lengths of their waits, so that comparisons can be made with other groups? And, if there are concerns, do you proactively report these to service commissioners?"},"SR1c",null,{"$f":"'Questions for Staff'!G8","v":false},{"$f":"'Questions for Staff'!E8","v":"When offering learning disabled patients choices about their care and treatment, if staff think a patient might lack the ability to make a decision, are they able to either formally assess the person’s capacity themselves; or arrange for a specialist to come quickly and do it?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1d",null,{"$f":"'Questions for Managers'!G9","v":false},{"$f":"'Questions for Managers'!E9","v":"Does your trust have a robust Mental Capacity Act policy which requires staff do everything possible to support patients to make their own decisions about their care and treatment. And, if a patient has been assessed as lacking capacity to make a particular decision, does the policy outline how the decision is to be made in accordance with a lawful 'best interests' process?"},"SR1d",null,{"$f":"'Questions for Staff'!G9","v":false},{"$f":"'Questions for Staff'!E9","v":"If a learning disabled patient has been found to lack the capacity to make an important decision, do staff: routinely consult the person’s family; or, if there is no-one appropriate to consult, do they know how to arrange a referral for an Independent Mental Capacity Advocate instead?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1e",null,{"$f":"'Questions for Managers'!G10","v":false},{"$f":"'Questions for Managers'!E10","v":"Does your trust undertake at least annual audits of compliance with its Mental Capacity Act Policy so that you can understand how effectively it is being followed; and make improvements where needed?"},"SR1e",null,null,null,"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1f",null,{"$f":"'Questions for Managers'!G11","v":false},{"$f":"'Questions for Managers'!E11","v":"Does your trust have a clear policy (based on the principles of the Mental Capacity Act), which guides and supports staff when making decisions about withdrawing life sustaining treatments, or not to attempt cardio-pulmonary resuscitation?"},"SR1f",null,{"$f":"'Questions for Staff'!G10","v":false},{"$f":"'Questions for Staff'!E10","v":"Have staff been trained to understand their duty to respect and protect learning disabled patients' right to life; and importantly, to follow processes that are consistent with the Mental Capacity Act,  if contributing to decisions about withholding life sustaining treatments or resuscitation?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1g",null,{"$f":"'Questions for Managers'!G12","v":false},{"$f":"'Questions for Managers'!E12","v":"Does your trust audit clinical records and communications to ensure that information about a patient's learning disability and the reasonable adjustments they need is shared both within the trust and wherever appropriate, with external agencies?"},"SR1g",null,{"$f":"'Questions for Staff'!G11","v":false},{"$f":"'Questions for Staff'!E11","v":"If staff make referrals to other departments within the trust, or other external agencies, are they always explicit if a patient has a learning disability, and about any reasonable adjustments they are known to require?"}]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1supp1",{"$f":"AVERAGE('Questions for Managers'!G13:G19)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(MR1supp1raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of MR2a-g","SR1supp1",{"$f":"AVERAGE('Questions for Staff'!G12:G18)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(SR1supp1raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of SR2a-g","x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1supp2",null,{"$f":"MW1c","v":false},{"$f":"'Questions for Managers'!E42","v":"Where it can reasonably be predicted that trust staff require access to specialist practitioners (including on a liaison basis) from other health or social care providers, does the trust have clear service level agreements, or joint working protocols, with them which include referral mechanisms and response times?"},"SR1supp2",null,{"$f":"SW1c","v":false},{"$f":"K47","v":"Where in order to meet patients' needs, trust staff need to work with staff from another health or social care provider, are there clear referral mechanisms and arrangements for joint working?"},"x"]
["Rights","R1","Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities.","MR1supp3",{"$f":"AVERAGE('Questions for Managers'!G43:G44)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(MR1supp3raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of MW2a-b","SR1supp3",null,{"$f":"SR3a","v":false},{"$f":"K24","v":"Have trust staff been trained to recognise that under human rights law everybody has a right to liberty and freedom - but that under a few exceptional circumstances, it may be appropriate, necessary and lawful to restrict someone's freedom?"},"x"]
["Rights","R1",null,null,null,null,null,"SR1supp4",{"$f":"AVERAGE('Questions for Staff'!G42:G43)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(SR1supp4raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of SW21-b","x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2a",null,{"$f":"'Questions for Managers'!G13","v":false},{"$f":"'Questions for Managers'!E13","v":"When working with patients with learning disabilities, does your policies require staff to make use of Health / Hospital Passports (or equivalent); and to pay due regard to their contents - especially with regard to making those reasonable adjustments that are noted to be required?"},"SR2a",null,{"$f":"'Questions for Staff'!G12","v":false},{"$f":"'Questions for Staff'!E12","v":"Do trust staff always ask about, read and pay attention to the contents of ‘Health/ Hospital Passports’ (or equivalent) in the way they provide services and make reasonable adjustments; and, if learning disabled patients do not have already have one, do staff either support them to develop one, or know how to direct them to someone who can?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2b",null,{"$f":"'Questions for Managers'!G14","v":false},{"$f":"'Questions for Managers'!E14","v":"Are trust staff required to specifically determine, record and share, the communication and information needs of patients with learning disabilities. And; to provide the right support on the basis of this?"},"SR2b",null,{"$f":"'Questions for Staff'!G13","v":false},{"$f":"'Questions for Staff'!E13","v":"Do trust staff routinely check and record the 'communication and infromation' needs of patients with learning disbailities; and then modify their communication including verbal and written materials, in ways that make it easier for patients to understand what is going on and make sense of their health needs?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2c",null,{"$f":"'Questions for Managers'!G15","v":false},{"$f":"'Questions for Managers'!E15","v":"Do you ensure staff in the trust's services have access to a wide range of accessible information resources that can be used to help patients with learning disabilities understand services and make decisions about their health?"},"SR2c",null,{"$f":"'Questions for Staff'!G14","v":false},{"$f":"'Questions for Staff'!E14","v":"Where required, do trust staff have access to and make use of accessible literature and information, to help learning disabled patients understand their health and the trust's services; and to help them make their own choices?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2d",null,{"$f":"'Questions for Managers'!G16","v":false},{"$f":"'Questions for Managers'!E16","v":"Are trust staff required to promote and support the use of adapted pain assessment appoaches and tools?"},"SR2d",null,{"$f":"'Questions for Staff'!G15","v":false},{"$f":"'Questions for Staff'!E15","v":"Are trust staff familiar with and do they use, tools and modified appraoches to help assess whether learning disabled patients, who may struggle to communicate verbally, are in pain or discomfort e.g. the DISDAT, the Abbey pain scale, or bespoke visual pain profiles."},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2e",null,{"$f":"'Questions for Managers'!G17","v":false},{"$f":"'Questions for Managers'!E17","v":"Where patients with learning disabilities have multiple long term health conditions, that mean they regularly and predictably access a range of departments, does the trust require that they have an identified practitioner to lead / coordinate service delivery, either from within the trust; or possibly from another NHS provider, as agreed in a Service Level Agreement?"},"SR2e",null,{"$f":"'Questions for Staff'!G16","v":false},{"$f":"'Questions for Staff'!E16","v":"If a learning disabled patient sees a number of teams / specialists on a regular basis because they have more than one long term health condition, does a single practitioner either from your trust or another service, act as a coordinator?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2f",null,{"$f":"'Questions for Managers'!G18","v":false},{"$f":"'Questions for Managers'!E18","v":"Do your trust's clinical areas meet those environmental needs of patients with disabilities that can reasonably be predicted? This includes the provision of physically accessible premises, low stimulus waiting areas, ‘Changing Places’ toilets, facilities for families to stay with them overnight etc."},"SR2f",null,{"$f":"'Questions for Staff'!G17","v":false},{"$f":"'Questions for Staff'!E17","v":"Are clinical areas that patients with disabilities might access, including waiting areas, adapted or modified to take account of their potential environmental needs? (This includes things like accessible premises, low stimulus waiting areas, ‘Changing Places’ toilets and facilities for relatives to stay with patients overnight during hospital stays)."},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2g",null,{"$f":"'Questions for Managers'!G19","v":false},{"$f":"'Questions for Managers'!E19","v":"If for some exceptional reason, a decision is being considered not to support a patient with a learning disability to follow the same care pathway as other patients, do the trust's policies require staff to fully record the compelling reasons for the proposal and the processes by which such an agreement has been reached? "},"SR2g",null,{"$f":"'Questions for Staff'!G18","v":false},{"$f":"'Questions for Staff'!E18","v":"Are patients with learning disabilities routinely supported, using reasonable adjustments, to follow the same treatment pathways for health conditions as anybody else - unless or until there is a fully documented agreement that an alternate pathway is more appropriate?"}]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2supp1",null,{"$f":"MR1b","v":false},{"$f":"'Questions for Managers'!E7","v":"Does your trust monitor the 'clinical outcomes' of services delivered to patients with learning disabilities in a way that allows data about service use to be disaggregated for patients with learning disabilities, so that any inequalities in service use can be identified and addressed?"},"SR2supp1",null,null,{"$f":"K7","v":"Have staff been trained to understand their duty to respect and protect learning disabled patients' right to life; and importantly, to follow processes that are consistent with the Mental Capacity Act,  if contributing to decisions about withholding life sustaining treatments or resuscitation?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2supp2",null,{"$f":"MI1a","v":false},{"$f":"'Questions for Managers'!E31","v":"Are trust staff required to involve all patients with a learning disability (and where appropriate family carers and / or advocates) in discussions about planning their care; and are they able to provide a record, in an accessible format, of what has been agreed, if the patient or their family want one?"},"SR2supp2",{"$f":"AVERAGE('Questions for Staff'!G30:G32)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(SR2supp2raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of SIa1(i)-(iii)","x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2supp3",null,{"$f":"MW1c","v":false},{"$f":"'Questions for Managers'!E42","v":"Where it can reasonably be predicted that trust staff require access to specialist practitioners (including on a liaison basis) from other health or social care providers, does the trust have clear service level agreements, or joint working protocols, with them which include referral mechanisms and response times?"},"SR2supp3",null,{"$f":"SW1c","v":false},{"$f":"K47","v":"Where in order to meet patients' needs, trust staff need to work with staff from another health or social care provider, are there clear referral mechanisms and arrangements for joint working?"},"x"]
["Rights","R2","Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes.","MR2supp4",{"$f":"AVERAGE('Questions for Managers'!G43:G44)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(MR2supp4raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of MW2a-b","SR2supp4",{"$f":"AVERAGE('Questions for Staff'!G42:G43)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(SR2supp4raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of SW2a-b","x"]
["Rights","R3","Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","MR3a",null,{"$f":"'Questions for Managers'!G20","v":false},{"$f":"'Questions for Managers'!E20","v":"Are trust staff trained to recognise when a patient's liberty is being restricted; under what circumstances this can lawfully be done; and what to do if they feel the restriction is not appropriate?"},"SR3a",null,{"$f":"'Questions for Staff'!G19","v":false},{"$f":"'Questions for Staff'!E19","v":"Have trust staff been trained to recognise that under human rights law everybody has a right to liberty and freedom - but that under a few exceptional circumstances, it may be appropriate, necessary and lawful to restrict someone's freedom?"},"x"]
["Rights","R3","Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","MR3b",null,{"$f":"'Questions for Managers'!G21","v":false},{"$f":"'Questions for Managers'!E21","v":"Does the trust have a policy that guides staff with regard to the application of 'restrictive practices' and 'deprivations of liberty'; and which ensures that if used, there is clear evidence that they are necessary, proportionate and applied in accordance with a procedure prescribed by law?"},"SR3b",null,{"$f":"'Questions for Staff'!G20","v":false},{"$f":"'Questions for Staff'!E20","v":"If restrictions placed on a patient's freedom are more significant and amount to a 'deprivation of liberty', do trust staff follow a policy that ensures that it is lawfully authorised and that patients have safeguards against their misuse?"},"x"]
["Rights","R3","Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","MR3c",null,{"$f":"'Questions for Managers'!G22","v":false},{"$f":"'Questions for Managers'!E22","v":"If patients are 'deprived of their liberty', or have it restricted, does the trust have a policy that requires staff to tell patients (and their families, or others who advocate on their behalf) why and what to do if they unhappy about it?"},"SR3c",null,{"$f":"'Questions for Staff'!G21","v":false},{"$f":"'Questions for Staff'!E21","v":"If patients are deprived of their liberty or have it restricted, do trust staff provide them and their families with accessible information about why it has been done, their rights and what to do if they are unhappy?"},"x"]
["Rights","R3","Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment.","MR3d",null,{"$f":"'Questions for Managers'!G23","v":false},{"$f":"'Questions for Managers'!E23","v":"Does the trust routinely collect, analyse and monitor data regarding restrictions and deprivations of patients' liberty within services, or as a result of advice given by trust staff provide to others; and can this data be disaggregated so that patients with learning disabilities can be identified?"},"SR3d",null,{"$f":"'Questions for Staff'!G22","v":false},{"$f":"'Questions for Staff'!E22","v":"Do staff get to see audit reports about the use of deprivations and restrictions of liberty within the trust and discuss these within teams?"},"x"]
["Rights","R3",null,null,null,null,null,"SR3supp1",null,{"$f":"SR3a","v":false},{"$f":"K24","v":"Have trust staff been trained to recognise that under human rights law everybody has a right to liberty and freedom - but that under a few exceptional circumstances, it may be appropriate, necessary and lawful to restrict someone's freedom?"},"x"]
["Rights","R5","Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","MR5a",null,{"$f":"'Questions for Managers'!G24","v":false},{"$f":"'Questions for Managers'!E24","v":"Does your trust have systems to ensure that if a patient with a learning disability dies whilst using services (or if you learn that they has died within 6 months of discharge), notifications are made to the Learning Disabilities Mortality Review Programme (LeDeR); and do your  policies / procedures ensure full information sharing; and where appropriate, that your staff are supported to contribute to mortality reviews?"},"SR5a",null,{"$f":"'Questions for Staff'!G23","v":false},{"$f":"'Questions for Staff'!E23","v":"If and when trust staff become aware that a patient with a learning disability has died, do they know that the reporting processes are different than for other patients and if so, who to contact, so that the national Learning Disabilities Mortality Review Programme can be informed? Also, are staff supported to contribute to reviews of deaths."},"x"]
["Rights","R5","Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","MR5b",null,{"$f":"'Questions for Managers'!G25","v":false},{"$f":"'Questions for Managers'!E25","v":"Does the trust have governance processes that ensures senior managers consider implications of local Learning from Death Reviews, LeDeR reviews and prominent national reports concerning deaths of patients with a learning disability, in order to better understand amenable causes of death; and to introduce actions to reduce potentially avoidable deaths within your services."},"SR5b(i)",null,{"$f":"'Questions for Staff'!G24","v":false},{"$f":"'Questions for Staff'!E24","v":"Do trust staff get to discuss and reflect on key learning from reviews of the deaths of patients with learning disabilities, within their teams?"},"x"]
["Rights","R5","Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.",null,null,null,null,"SR5b(ii)",null,{"$f":"'Questions for Staff'!G25","v":false},{"$f":"'Questions for Staff'!E25","v":"Are trust action plans for reducing preventable deaths of patients with learning disabilities, shared, discussed and acted on within your team?"},"x"]
["Rights","R5","Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","MR5c",null,{"$f":"'Questions for Managers'!G26","v":false},{"$f":"'Questions for Managers'!E26","v":"Do the trust collate data on numbers of deaths of patients with learning disabilities known to your services; and specifically as a result of seizures, choking incidents, sepsis, gastrointestinal obstructions and pneumonia? If so, is this data is shared with your commissioners, along with local plans to reduce these causes of death?"},"SR5supp1",null,{"$f":"SI1b","v":false},{"$f":"K37","v":"If there is a serious incident that affects a learning disabled patient's safety, do staff follow a trust policy that requires them to promptly tell patients and their families, to apologise and to provide any extra support they need to help them understand what has happened?"},"x"]
["Rights","R5","Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services.","MR5supp1",{"$f":"AVERAGE('Questions for Managers'!G34:G35)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(MR5supp1raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Average of MI4b-c"]
["Inclusion","I1","Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution.","MI1a",null,{"$f":"'Questions for Managers'!G31","v":false},{"$f":"'Questions for Managers'!E31","v":"Are trust staff required to involve all patients with a learning disability (and where appropriate family carers and / or advocates) in discussions about planning their care; and are they able to provide a record, in an accessible format, of what has been agreed, if the patient or their family want one?"},"SI1a(i)",null,{"$f":"'Questions for Staff'!G30","v":false},{"$f":"'Questions for Staff'!E30","v":"Where they want to, are patients routinely included in meetings that relate to their care, treatment and discharge (unless exceptionally, there is a recorded legal basis not to do so)?"},"x"]
["Inclusion","I1","Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution.",null,null,null,null,"SI1a(ii)",null,{"$f":"'Questions for Staff'!G31","v":false},{"$f":"'Questions for Staff'!E31","v":"Where patients with learning disabilities or their families want, do trust staff provide them with records of meetings in an accessible format?"},"x"]
["Inclusion","I1","Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution.",null,null,null,null,"SI1a(iii)",null,{"$f":"'Questions for Staff'!G32","v":false},{"$f":"'Questions for Staff'!E32","v":"Are learning disabled patients offered support to prepare, in advance, of meetings about their care and treatment? This includes support to make written representation, and involving advocates to ensure their voices are heard?"},"x"]
["Inclusion","I1","Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution.","MI1b",null,{"$f":"'Questions for Managers'!G32","v":false},{"$f":"'Questions for Managers'!E32","v":"Are patients with a learning disability and their families required to be told about any safety incident relating to their care which has caused, or could still cause, significant harm or death? Are they are given the facts and an apology, in the most helpful format possible; and also any other reasonable support they need?"},"SI1b",null,{"$f":"'Questions for Staff'!G33","v":false},{"$f":"'Questions for Staff'!E33","v":"If there is a serious incident that affects a learning disabled patient's safety, do staff follow a trust policy that requires them to promptly tell patients and their families, to apologise and to provide any extra support they need to help them understand what has happened?"},"x"]
["Inclusion","I1","Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution.","MI1supp1",{"$f":"MR5supp1raw","v":{"$error":"#DIV/0!"}},{"$f":"MR5Supp1","v":{"$error":"#DIV/0!"}},"Average of MI4b-c",null,null,null,null,"x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","MI4a",null,{"$f":"'Questions for Managers'!G33","v":false},{"$f":"'Questions for Managers'!E33","v":"Do the trust policies and staff training, ensure that staff receiving complaints and concerns have the right knowledge, skills and autonomy to make immediate safeguarding referrals, without delay, where they believe there is an ongoing risk of harm?"},"SI4a(i)",null,{"$f":"'Questions for Staff'!G34","v":false},{"$f":"'Questions for Staff'!E34","v":"If a learning disabled patient, or their family or carers, makes a complaint or raises a concern with trust staff, do they have the discretion to act immediately if they feel there are ongoing safeguarding issues?"},"x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.",null,null,null,null,"SI4a(ii)",null,{"$f":"'Questions for Staff'!G35","v":false},{"$f":"'Questions for Staff'!E35","v":"If trust staff make a safeguarding referral, do they tell the patient as soon as possible and where appropriate, their family; and do they explain what this means and what will happen next as a result of the referral?"},"x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","MI4b",null,{"$f":"'Questions for Managers'!G34","v":false},{"$f":"'Questions for Managers'!E34","v":"Is the trust able to demonstrate openness and transparency in dealing with complaints / investigations, including making reasonable adjustments to complaints processes, such as having accessible information about how to make complaints and flexible processes for gathering evidence from patients with learning disabilities; and are complainants provided with updates at regular intervals?"},"SI4supp1",null,{"$f":"SR5a","v":false},{"$f":"K29","v":"If and when trust staff become aware that a patient with a learning disability has died, do they know that the reporting processes are different than for other patients and if so, who to contact, so that the national Learning Disabilities Mortality Review Programme can be informed? Also, are staff supported to contribute to reviews of deaths."},"x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","MI4c",null,{"$f":"'Questions for Managers'!G35","v":false},{"$f":"'Questions for Managers'!E35","v":"Are patients and their families told the outcomes of complaints investigations (including what has been learned and what will be done differently in future) in an appropriately reasonably adjusted manner, in an appropriate place, and by an appropriate person?"},"SI4supp2",{"$f":"AVERAGE('Questions for Staff'!G24:G25)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(SI4supp2raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Mean of SR5b(i)-(ii)","x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","MI4supp1",{"$f":"AVERAGE('Questions for Managers'!G24:G26)","v":{"$error":"#DIV/0!"}},{"$f":"VLOOKUP(MI4supp1raw,PID!$E$10:$F$13,2,TRUE)","v":{"$error":"#DIV/0!"}},"Average of MR5a-c","SI4supp3",null,{"$f":"SI1b","v":false},{"$f":"K37","v":"If there is a serious incident that affects a learning disabled patient's safety, do staff follow a trust policy that requires them to promptly tell patients and their families, to apologise and to provide any extra support they need to help them understand what has happened?"},"x"]
["Inclusion","I4","Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes.","MI4supp2",null,{"$f":"MI1b","v":false},{"$f":"'Questions for Managers'!E32","v":"Are patients with a learning disability and their families required to be told about any safety incident relating to their care which has caused, or could still cause, significant harm or death? Are they are given the facts and an apology, in the most helpful format possible; and also any other reasonable support they need?"},null,null,null,null,"x"]
["Workforce","W1","On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them.","MW1a",null,{"$f":"'Questions for Managers'!G40","v":false},{"$f":"'Questions for Managers'!E40","v":"Does the trust have a workforce plan (updated in the last 12 months) which clearly identifies the range of specialist learning disability knowledge and skills that are required to ensure effective services to patients?"},"SW1a",null,{"$f":"'Questions for Staff'!G40","v":false},{"$f":"'Questions for Staff'!E40","v":"Do staff on your ward / department have the right knowledge and skills to ensure they feel confident and are able deliver the service in a way that fully recognises and meets the needs of patients with learning disabilities?"},"x"]
["Workforce","W1","On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them.","MW1b",null,{"$f":"'Questions for Managers'!G41","v":false},{"$f":"'Questions for Managers'!E41","v":"Is the trust workforce plan concerning the needs of patients with learning disabilities informed by a comprehensive, evidence based understanding of local population needs (e.g. a Joint Strategic Needs Assessment)?"},null,null,null,null,"x"]
["Workforce","W1","On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them.","MW1c",null,{"$f":"'Questions for Managers'!G42","v":false},{"$f":"'Questions for Managers'!E42","v":"Where it can reasonably be predicted that trust staff require access to specialist practitioners (including on a liaison basis) from other health or social care providers, does the trust have clear service level agreements, or joint working protocols, with them which include referral mechanisms and response times?"},"SW1c",null,{"$f":"'Questions for Staff'!G41","v":false},{"$f":"'Questions for Staff'!E41","v":"Where in order to meet patients' needs, trust staff need to work with staff from another health or social care provider, are there clear referral mechanisms and arrangements for joint working?"},"x"]
["Workforce","W2","Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.","MW2a",null,{"$f":"'Questions for Managers'!G43","v":false},{"$f":"'Questions for Managers'!E43","v":"As a minimum, do all trust staff receive up to date training, appropriate to their roles, covering: learning disability awareness; health issues associated with learning disability (e.g. dysphagia, epilepsy, respiratory conditions, bowel care, postural care needs etc.); human rights, mental capacity and best interests; supporting patients with challenging needs; and safeguarding?"},"SW2a",null,{"$f":"'Questions for Staff'!G42","v":false},{"$f":"'Questions for Staff'!E42","v":"Do trust staff receive up to date and relevant training on: learning disability / autism awareness including: the health issues associated with learning disabilities; accessible communication needs; supporting patients with challenging needs; safeguarding; and mental capacity and best interests?"},"x"]
["Workforce","W2","Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.","MW2b",null,{"$f":"'Questions for Managers'!G44","v":false},{"$f":"'Questions for Managers'!E44","v":"Have trust staff received training on their responsibilities to make, record, report and share information about reasonable adjustments when working with patients with learning disabilities?"},"SW2b",null,{"$f":"'Questions for Staff'!G43","v":false},{"$f":"'Questions for Staff'!E43","v":"Have trust staff received training about the legal requirement to make, report, record and share reasonable adjustments to learning disabled patients' care and support, in order to ensure that they are not disadvantaged?"},"x"]
["Workforce","W2","Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.","MW2c",null,{"$f":"'Questions for Managers'!G45","v":false},{"$f":"'Questions for Managers'!E45","v":"Have trust staff have been trained to help patients and those who routinely provide day to day care and support, to understand how to recognise and respond to any future signs of emerging health problems / relapse which may arise subsequent to discharge?"},"SW2c",null,{"$f":"'Questions for Staff'!G44","v":false},{"$f":"'Questions for Staff'!E44","v":"As a result of training, do trust staff routinely provide advice to learning disabled patients and those who provide day to day care and support, to help them recognise emerging health problems or future signs of relapse, and to know how to respond?"},"x"]
["Workforce","W2","Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them.",null,null,null,null,null,null,null,null,"x"]
["Workforce","W3","Trusts must have workforce plans which include provision to manage and mitigate the impact of the growing, cross-system shortage of qualified practitioners with a professional specialism in learning disabilities.","MW3a",null,{"$f":"'Questions for Managers'!G46","v":false},{"$f":"'Questions for Managers'!E46","v":"Does the trust have a clearly identified senior management lead(s) for improving service delivery to patients with learning disabilities?"},"SW3a",null,{"$f":"'Questions for Staff'!G45","v":false},{"$f":"'Questions for Staff'!E45","v":"Where trust staff need specialist advice on the care and support of patients with learning disabilities, do they have access to clearly identified people in lead roles (which may include specialist liaison nurses)?"},"x"]
["Workforce","W3","Trusts must have workforce plans which include provision to manage and mitigate the impact of the growing, cross-system shortage of qualified practitioners with a professional specialism in learning disabilities.","MW3b",null,{"$f":"'Questions for Managers'!G47","v":false},{"$f":"'Questions for Managers'!E47","v":"Does the trust workforce plan include data on current and future pressures arising from retention / recruitment difficulties relating to key disciplines (especially concerning reduced numbers of learning disability nurses); and projected retirement figures for your workforce. Does it also include workforce planning / recruitment strategies to mitigate these pressures?"},"SW3b",null,{"$f":"'Questions for Staff'!G46","v":false},{"$f":"'Questions for Staff'!E46","v":"Where regular trust staff have to work with bank / agency staff, are there clear protocols which they follow in order to maximise consistency, by making sure that the bank and agency workers are alerted to the specific care and support needs of any learning disabled patients’ in the ward / department."},"x"]
[null,null,null,null,null,null,null,null,null,null,null,"x"]

{"sheet":"Scores","index":5,"n_rows":74,"n_cols":19,"rows_kept":74,"cut":false,"hidden":true,"merged":[]}
["Standard","Improvement Measure","Manager Total","Manager max","Manager % max","Staff Total","Staff Max","Staff % max",null,null,null,"Mean managers score","Mean staff score","Overall mean score"]
["Rights","R1",{"$f":"SUM(MR1a,MR1b,MR1c,MR1d,MR1e,MR1f,MR1g,MR1supp1,MR1supp2,MR1supp3)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(MR1a,MR1b,MR1c,MR1d,MR1e,MR1f,MR1g,MR1supp1,MR1supp2,MR1supp3))*5","v":0},{"$f":"IFERROR(C2/D2,\"\")","v":""},{"$f":"SUM(SR1a,SR1b,SR1c,SR1d,SR1f,SR1g,SR1supp1,SR1supp2,SR1supp3,SR1supp4)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(SR1a,SR1b,SR1c,SR1d,SR1f,SR1g,SR1supp1,SR1supp2,SR1supp3,SR1supp4))*5","v":0},{"$f":"IFERROR(F2/G2,\"\")","v":""},"R1 Mean",{"$f":"AVERAGE(E2,H2)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MR1a,MR1b,MR1c,MR1d,MR1e,MR1f,MR1g,MR1supp1,MR1supp2,MR1supp3),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SR1a,SR1b,SR1c,SR1d,SR1f,SR1g,SR1supp1,SR1supp2,SR1supp3,SR1supp4),\"\")","v":""},{"$f":"AVERAGE(L2,M2)","v":{"$error":"#DIV/0!"}}]
["Rights","R2",{"$f":"SUM(MR2a,MR2b,MR2c,MR2d,MR2e,MR2f,MR2g,MR2Supp1,MR2Supp2,MR2Supp3,MR2Supp4)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(MR2a,MR2b,MR2c,MR2d,MR2e,MR2f,MR2g,MR2Supp1,MR2Supp2,MR2Supp3,MR2Supp4))*5","v":0},{"$f":"IFERROR(C3/D3,\"\")","v":""},{"$f":"SUM(SR2a,SR2b,SR2c,SR2d,SR2e,SR2f,SR2g,SR2supp2,SR2supp3,SR2supp4)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(SR2a,SR2b,SR2c,SR2d,SR2e,SR2f,SR2g,SR2supp2,SR2supp3,SR2supp4))*5","v":0},{"$f":"IFERROR(F3/G3,\"\")","v":""},"R2 Mean",{"$f":"AVERAGE(E3,H3)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MR2a,MR2b,MR2c,MR2d,MR2e,MR2f,MR2g,MR2Supp1,MR2Supp2,MR2Supp3,MR2Supp4),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SR2a,SR2b,SR2c,SR2d,SR2e,SR2f,SR2g,SR2supp2,SR2supp3,SR2supp4),\"\")","v":""},{"$f":"AVERAGE(L3,M3)","v":{"$error":"#DIV/0!"}}]
["Rights","R3",{"$f":"SUM(MR3a,MR3b,MR3c,MR3d)","v":0},{"$f":"(COUNT(MR3a,MR3b,MR3c,MR3d))*5","v":0},"",{"$f":"SUM(SR3a,SR3b,SR3c,SR3d,SR3supp1)","v":0},{"$f":"(COUNT(SR3a,SR3b,SR3c,SR3d,SR3supp1))*5","v":0},"","R3 Mean",{"$error":"#DIV/0!"},null,{"$f":"IFERROR(AVERAGE(MR3a,MR3b,MR3c,MR3d),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SR3a,SR3b,SR3c,SR3d,SR3supp1),\"\")","v":""},{"$error":"#DIV/0!"}]
["Rights","R5",{"$f":"SUM(MR5a,MR5b,MR5c,MR5Supp1)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(MR5a,MR5b,MR5c,MR5Supp1))*5","v":0},"",{"$f":"SUM(SR5a,SR5bi,SR5bii,SR5supp1)","v":0},{"$f":"(COUNT(SR5a,SR5bi,SR5bii,SR5supp1))*5","v":0},"","R5 Mean",{"$error":"#DIV/0!"},null,{"$f":"IFERROR(AVERAGE(MR5a,MR5b,MR5c,MR5Supp1),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SR5a,SR5bi,SR5bii,SR5supp1),\"\")","v":""},{"$error":"#DIV/0!"}]
["Rights","TOTALS",{"$f":"SUM(C2:C5)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(D2:D5)","v":0},"",{"$f":"SUM(F2:F5)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(G2:G5)","v":0},"","Overall Mean","Rights",{"$f":"AVERAGE(H6,E6)","v":{"$error":"#DIV/0!"}}]
["Inclusion","I1",{"$f":"SUM(MI1a,MI1b,MISupp1)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(MI1a,MI1b,MISupp1))*5","v":0},"",{"$f":"SUM(SI1ai,SI1aii,SI1aiii,SI1b)","v":0},{"$f":"(COUNT(SI1ai,SI1aii,SI1aiii,SI1b))*5","v":0},"","I1 mean",{"$f":"AVERAGE(E7,H7)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MI1a,MI1b,MISupp1),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SI1ai,SI1aii,SI1aiii,SI1b,SI1supp1),\"\")","v":""},{"$error":"#DIV/0!"}]
["Inclusion","I4",{"$f":"SUM(MI4a,MI4b,MI4c,MI4supp1,MI4supp2)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(MI4a,MI4b,MI4c,MI4supp1,MI4supp2))*5","v":0},"",{"$f":"SUM(SI4ai,SI4aii,SI4supp1,SI4supp2,SI4supp3)","v":{"$error":"#DIV/0!"}},{"$f":"(COUNT(SI4ai,SI4aii,SI4supp1,SI4supp2,SI4supp3))*5","v":0},"","I4 mean",{"$f":"AVERAGE(E8,H8)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MI4a,MI4b,MI4c,MI4supp1,MI4supp2),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SI4ai,SI4aii,SI4supp1,SI4supp2,SI4supp3),\"\")","v":""},{"$error":"#DIV/0!"}]
["Inclusion","TOTALS",{"$f":"SUM(C7:C8)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(D7:D8)","v":0},"",{"$f":"SUM(F7:F8)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(G7:G8)","v":0},"","Overall Mean","Inclusion & Engagement",{"$f":"AVERAGE(E9,H9)","v":{"$error":"#DIV/0!"}}]
["Workforce","W1",{"$f":"SUM(MW1a,MW1b,MW1c)","v":0},{"$f":"(COUNT(MW1a,MW1b,MW1c))*5","v":0},"",{"$f":"SUM(S1a,SW1c)","v":0},{"$f":"(COUNT(S1a,SW1c))*5","v":0},"","W1 mean",{"$f":"AVERAGE(E10,H10)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MW1a,MW1b,MW1c),\"\")","v":""},{"$f":"IFERROR(AVERAGE(S1a,SW1c),\"\")","v":""},{"$error":"#DIV/0!"}]
["Workforce","W2",{"$f":"SUM(MW2a,MW2b,MW2c)","v":0},{"$f":"(COUNT(MW2a,MW2b,MW1c))*5","v":0},"",{"$f":"SUM(SW2a,SW2b,SW2c)","v":0},{"$f":"(COUNT(SW2a,SW2b,SW2c))*5","v":0},"","W2 Mean",{"$f":"AVERAGE(E11,H11)","v":{"$error":"#DIV/0!"}},null,{"$f":"IFERROR(AVERAGE(MW2a,MW2b,MW2c),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SW2a,SW2b,SW2c),\"\")","v":""},{"$error":"#DIV/0!"}]
["Workforce","W3",{"$f":"SUM(MW3a,MW3b)","v":0},{"$f":"(COUNT(MW3a,MW3b))*5","v":0},"",{"$f":"SUM(SW3a,SW3b)","v":0},{"$f":"(COUNT(SW3a,SW3b))*5","v":0},"","W3 mean",{"$error":"#DIV/0!"},null,{"$f":"IFERROR(AVERAGE(MW3a,MW3b),\"\")","v":""},{"$f":"IFERROR(AVERAGE(SW3a,SW3b),\"\")","v":""},{"$error":"#DIV/0!"}]
[null,"TOTALS",{"$f":"SUM(C10:C12)","v":0},{"$f":"SUM(D10:D12)","v":0},"",{"$f":"SUM(F10:F12)","v":0},{"$f":"SUM(G10:G12)","v":0},"","Overall Mean","Workforce",{"$f":"AVERAGE(E13,H13)","v":{"$error":"#DIV/0!"}}]
[]
[null,"Manager Rights","Staff rights","Manager inclusion","Staff inclusion","Manager workforce","Staff workforce"," "]
[null,{"$f":"T('Questions for Managers'!F6)","v":""},{"$f":"T('Questions for Staff'!F6)","v":""},{"$f":"T('Questions for Managers'!F31)","v":""},{"$f":"T('Questions for Staff'!F30)","v":""},{"$f":"T('Questions for Managers'!F40)","v":""},{"$f":"T('Questions for Staff'!F40)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F7)","v":""},{"$f":"T('Questions for Staff'!F7)","v":""},{"$f":"T('Questions for Managers'!F32)","v":""},{"$f":"T('Questions for Staff'!F31)","v":""},{"$f":"T('Questions for Managers'!F41)","v":""},{"$f":"T('Questions for Staff'!F41)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F8)","v":""},{"$f":"T('Questions for Staff'!F8)","v":""},{"$f":"T('Questions for Managers'!F33)","v":""},{"$f":"T('Questions for Staff'!F32)","v":""},{"$f":"T('Questions for Managers'!F42)","v":""},{"$f":"T('Questions for Staff'!F42)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F9)","v":""},{"$f":"T('Questions for Staff'!F9)","v":""},{"$f":"T('Questions for Managers'!F34)","v":""},{"$f":"T('Questions for Staff'!F33)","v":""},{"$f":"T('Questions for Managers'!F43)","v":""},{"$f":"T('Questions for Staff'!F43)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F10)","v":""},{"$f":"T('Questions for Staff'!F10)","v":""},{"$f":"T('Questions for Managers'!F35)","v":""},{"$f":"T('Questions for Staff'!F34)","v":""},{"$f":"T('Questions for Managers'!F44)","v":""},{"$f":"T('Questions for Staff'!F44)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F11)","v":""},{"$f":"T('Questions for Staff'!F11)","v":""}," ",{"$f":"T('Questions for Staff'!F35)","v":""},{"$f":"T('Questions for Managers'!F45)","v":""},{"$f":"T('Questions for Staff'!F45)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F12)","v":""},{"$f":"T('Questions for Staff'!F12)","v":""}," ",null,{"$f":"T('Questions for Managers'!F46)","v":""},{"$f":"T('Questions for Staff'!F46)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F13)","v":""},{"$f":"T('Questions for Staff'!F13)","v":""}," ",null,{"$f":"T('Questions for Managers'!F47)","v":""}," "," "]
[null,{"$f":"T('Questions for Managers'!F14)","v":""},{"$f":"T('Questions for Staff'!F14)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F15)","v":""},{"$f":"T('Questions for Staff'!F15)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F16)","v":""},{"$f":"T('Questions for Staff'!F16)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F17)","v":""},{"$f":"T('Questions for Staff'!F17)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F18)","v":""},{"$f":"T('Questions for Staff'!F18)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F19)","v":""},{"$f":"T('Questions for Staff'!F19)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F20)","v":""},{"$f":"T('Questions for Staff'!F20)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F21)","v":""},{"$f":"T('Questions for Staff'!F21)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F22)","v":""},{"$f":"T('Questions for Staff'!F22)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F23)","v":""},{"$f":"T('Questions for Staff'!F23)","v":""}," "]
[null,{"$f":"T('Questions for Managers'!F24)","v":""},{"$f":"T('Questions for Staff'!F24)","v":""}]
[null,{"$f":"T('Questions for Managers'!F25)","v":""},{"$f":"T('Questions for Staff'!F25)","v":""}]
[null,{"$f":"T('Questions for Managers'!F26)","v":""},{"$f":"T('Questions for Staff'!F26)","v":""}]
[]
["Count"]
["Count Achieving",{"$f":"COUNTIF(B16:B36,\"Currently achieving.\")","v":0},{"$f":"COUNTIF(C16:C35,\"Yes,*\")","v":0},{"$f":"COUNTIF(D16:D20,\"Currently achieving.\")","v":0},{"$f":"COUNTIF(E16:E21,\"Yes,*\")","v":0},{"$f":"COUNTIF(F16:F23,\"Currently achieving.\")","v":0},{"$f":"COUNTIF(G16:G22,\"Yes,*\")","v":0},null,null,"Currently achieving."]
["Count 6 Months",{"$f":"COUNTIF(B16:B36,\"Confident we will  achieve within 6 months.\")","v":0},{"$f":"SUM(COUNTIFS(C16:C35,{\"To some extent\",\"Now and again\",\"More often than not\",\"Mostly\",\"To a fair extent\"}))","v":0},{"$f":"COUNTIF(D16:D20,\"Confident we will  achieve within 6 months.\")","v":0},{"$f":"SUM(COUNTIFS(E16:E21,{\"To some extent\",\"Now and again\",\"More often than not\",\"Mostly\",\"To a fair extent\"}))","v":0},{"$f":"COUNTIF(F16:F23,\"Confident we will  achieve within 6 months.\")","v":0},{"$f":"SUM(COUNTIFS(G16:G22,{\"To some extent\",\"Now and again\",\"More often than not\",\"Mostly\",\"To a fair extent\"}))","v":0},null,null,"Confident we will  achieve within 6 months."]
["Count 12 Months",{"$f":"COUNTIF(B16:B36,\"Not fully achieved, but will in the next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(C16:C35,{\"Not certain but I expect so\",\"Not often\",\"Sometimes / partially\",\" Partially\",\"Not sure / partially\",\"Not sure but I think so / partially\",\"Not sure but I think so\"}))","v":0},{"$f":"COUNTIF(D16:D20,\"Not fully achieved, but will in the next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(E16:E21,{\"Not certain but I expect so\",\"Not often\",\"Sometimes / partially\",\" Partially\",\"Not sure / partially\",\"Not sure but I think so / partially\",\"Not sure but I think so\"}))","v":0},{"$f":"COUNTIF(F16:F23,\"Not fully achieved, but will in the next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(G16:G22,{\"Not certain but I expect so\",\"Not often\",\"Sometimes / partially\",\" Partially\",\"Not sure / partially\",\"Not sure but I think so / partially\",\"Not sure but I think so\"}))","v":0},null,null,"Not fully achieved, but will in the next 12 months."]
["NO",{"$f":"COUNTIF(B16:B36,\"Not achieving and unlikely to do so in next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(C16:C35,{\"I doubt it\",\"Not really\",\"I think so\"}))","v":0},{"$f":"COUNTIF(D16:D20,\"Not achieving and unlikely to do so in next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(E16:E21,{\"I doubt it\",\"Not really\",\"I think so\"}))","v":0},{"$f":"COUNTIF(F16:F23,\"Not achieving and unlikely to do so in next 12 months.\")","v":0},{"$f":"SUM(COUNTIFS(G16:G22,{\"I doubt it\",\"Not really\",\"I think so\"}))","v":0},null,null,"Not achieving and unlikely to do so in next 12 months."]
["Count N/A",{"$f":"COUNTIF(B16:B36,\"N/A\")","v":0},{"$f":"COUNTIF(C16:C35,\"N/A\")","v":0},{"$f":"COUNTIF(D16:D20,\"N/A\")","v":0},{"$f":"COUNTIF(E16:E21,\"N/A\")","v":0},{"$f":"COUNTIF(F16:F23,\"N/A\")","v":0},{"$f":"COUNTIF(G16:G22,\"N/A\")","v":0}]
[]
["No action required",{"$f":"SUM(B39:G39)+SUM(B43:G43)","v":0}]
["Some action required",{"$f":"SUM(B40:G40)","v":0}]
["Considerable action required",{"$f":"SUM(B41:G42)","v":0},null,{"$f":"SUM(B45:B47)","v":0}]
[]
[null,"Summary scores by indicator"]
[null,"Rights",null,"Inclusion",null,"Workforce"]
[null,"R1",{"$f":"VLOOKUP(N2,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}},"I1",{"$f":"VLOOKUP(N7,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}},"W1",{"$f":"VLOOKUP(N10,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}}]
[null,"R2",{"$f":"VLOOKUP(N3,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}},"I4",{"$f":"VLOOKUP(N8,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}},"W2",{"$f":"VLOOKUP(N11,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}}]
[null,"R3",{"$f":"VLOOKUP(N4,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}},null,null,"W3",{"$f":"VLOOKUP(N12,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}}]
[null,"R5",{"$f":"VLOOKUP(N5,PID!$K$19:$L$22,2,TRUE)","v":{"$error":"#DIV/0!"}}]
[]
[null,null,"Rights","Inclusion and engagement","Workforce"]
[null,"Managers % max",{"$f":"E6","v":""},{"$f":"E9","v":""},{"$f":"E13","v":""}]
[null,"Staff % max",{"$f":"H6","v":""},{"$f":"H9","v":""},{"$f":"H13","v":""}]
[]
[]
[null,null,null,null,null,"Managers trajectory","Current","6 months","12 months","Not in foreseeable future","TOTAL","6 months hence","12 months hence"]
[null,null,null,null,null,"Rights",{"$f":"COUNTIF(MR,5)","v":0},{"$f":"COUNTIF(MR,3)","v":0},{"$f":"COUNTIF(MR,1)","v":0},{"$f":"COUNTIF(MR,0)","v":0},{"$f":"SUM(G62:J62)","v":0},null,null,null,"Standard","Now","6 months hence","12 months hence"]
[null,null,null,null,null,"Rights",{"$f":"G62/$K$62","v":{"$error":"#DIV/0!"}},{"$f":"H62/$K$62","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"SUM(G63:J63)","v":{"$error":"#DIV/0!"}},{"$f":"G63+H63","v":{"$error":"#DIV/0!"}},{"$f":"G63+H63+I63","v":{"$error":"#DIV/0!"}},null,"Managers' view",{"$f":"G63","v":{"$error":"#DIV/0!"}},{"$f":"L63","v":{"$error":"#DIV/0!"}},{"$f":"M63","v":{"$error":"#DIV/0!"}},"Manager rights"]
[null,null,null,null,null,"Inclusion & engagement",{"$f":"COUNTIF(MI,5)","v":0},{"$f":"COUNTIF(MI,3)","v":0},{"$f":"COUNTIF(MI,1)","v":0},{"$f":"COUNTIF(MI,0)","v":0},{"$f":"SUM(G64:J64)","v":0},null,null,null,"Managers' view",{"$f":"G65","v":{"$error":"#DIV/0!"}},{"$f":"L65","v":{"$error":"#DIV/0!"}},{"$f":"M65","v":{"$error":"#DIV/0!"}},"Inclusion"]
[null,null,null,null,null,"Inclusion & engagement",{"$f":"G64/$K$64","v":{"$error":"#DIV/0!"}},{"$f":"H64/$K$64","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},null,{"$f":"G65+H65","v":{"$error":"#DIV/0!"}},{"$f":"G65+H65+I65","v":{"$error":"#DIV/0!"}},null,"Managers' view",{"$f":"G67","v":{"$error":"#DIV/0!"}},{"$f":"L67","v":{"$error":"#DIV/0!"}},{"$f":"M67","v":{"$error":"#DIV/0!"}},"Workforce"]
[null,null,null,null,null,"Workforce",{"$f":"COUNTIF(MW,5)","v":0},{"$f":"COUNTIF(MW,3)","v":0},{"$f":"COUNTIF(MW,1)","v":0},{"$f":"COUNTIF(MW,0)","v":0},{"$f":"SUM(G66:J66)","v":0}]
[null,null,null,null,null,"Workforce",{"$f":"G66/$K$66","v":{"$error":"#DIV/0!"}},{"$f":"H66/$K$66","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"SUM(G67:J67)","v":{"$error":"#DIV/0!"}},{"$f":"G67+H67","v":{"$error":"#DIV/0!"}},{"$f":"G67+H67+I67","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,"Staff trajectories"]
[null,null,null,null,null,"Rights",{"$f":"COUNTIF(SR,5)","v":0},{"$f":"COUNTIF(SR,3)","v":0},{"$f":"COUNTIF(SR,1)","v":0},{"$f":"COUNTIF(SR,0)","v":0},{"$f":"SUM(G69:J69)","v":0}]
[null,null,null,null,null,"Rights",{"$f":"G69/$K$69","v":{"$error":"#DIV/0!"}},{"$f":"H69/$K$69","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"G70+H70","v":{"$error":"#DIV/0!"}},{"$f":"G70+H70+I70","v":{"$error":"#DIV/0!"}},null,"Standard","Now","6 months hence","12 months hence"]
[null,null,null,null,null,"Inclusion & engagement",{"$f":"COUNTIF(SI,5)","v":0},{"$f":"COUNTIF(SI,3)","v":0},{"$f":"COUNTIF(SI,1)","v":0},{"$f":"COUNTIF(SI,0)","v":0},0,null,null,null,"Staff starting point",{"$f":"G70","v":{"$error":"#DIV/0!"}},{"$f":"L70","v":{"$error":"#DIV/0!"}},{"$f":"M70","v":{"$error":"#DIV/0!"}},"Staff rights"]
[null,null,null,null,null,"Inclusion & engagement",{"$f":"G71/$K$71","v":{"$error":"#DIV/0!"}},{"$f":"H71/$K$71","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"G72+H72","v":{"$error":"#DIV/0!"}},{"$f":"G72+H72+I72","v":{"$error":"#DIV/0!"}},null,"Staff starting point",{"$f":"G72","v":{"$error":"#DIV/0!"}},{"$f":"L72","v":{"$error":"#DIV/0!"}},{"$f":"M72","v":{"$error":"#DIV/0!"}},"Inclusion"]
[null,null,null,null,null,"Workforce",{"$f":"COUNTIF(SW,5)","v":0},{"$f":"COUNTIF(SW,3)","v":0},{"$f":"COUNTIF(SW,1)","v":0},{"$f":"COUNTIF(SW,0)","v":0},0,null,null,null,"Staff starting point",{"$f":"G74","v":{"$error":"#DIV/0!"}},{"$f":"L74","v":{"$error":"#DIV/0!"}},{"$f":"M74","v":{"$error":"#DIV/0!"}},"Workforce"]
[null,null,null,null,null,"Workforce",{"$f":"G73/$K$73","v":{"$error":"#DIV/0!"}},{"$f":"H73/$K$73","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"G74+H74","v":{"$error":"#DIV/0!"}},{"$f":"G74+H74+I74","v":{"$error":"#DIV/0!"}}]

{"sheet":"action recomendations","index":6,"n_rows":29,"n_cols":6,"rows_kept":29,"cut":false,"hidden":true,"merged":[]}
[{"$f":"AVERAGE(MR1a:SR1a)","v":{"$error":"#DIV/0!"}},1,{"$f":"IF(A1=5,5,A1*(1/B1))","v":{"$error":"#DIV/0!"}},"Ensuring staff and managers across the trust routinely hear and reflect on the subjective experiences of individual patients with learning disabilities.",{"$f":"RANK(C1,$C$1:$C$26,1)+COUNTIF(C$1:C1,C1)-1","v":{"$error":"#DIV/0!"}},{"$f":"IFERROR(INDEX(D:D,MATCH(SMALL(E:E,ROW(D1)),E:E,0)),\"\")","v":""}]
[{"$f":"AVERAGE(MR1b:SR2a)","v":{"$error":"#DIV/0!"}},1.0449999999999999,{"$error":"#DIV/0!"},"Ensuring staff and managers see and reflect on data about the clinical outcomes that patients with learning disabilities experience.",{"$f":"RANK(C2,$C$1:$C$26,1)+COUNTIF(C$1:C2,C2)-1","v":{"$error":"#DIV/0!"}},{"$f":"IFERROR(INDEX(D:D,MATCH(SMALL(E:E,ROW(D2)),E:E,0)),\"\")","v":""}]
[{"$f":"MR1c","v":false},1,0,"Providing additional checks and support to patient with learning disabilities on waiting lists.",{"$f":"RANK(C3,$C$1:$C$26,1)+COUNTIF(C$1:C3,C3)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR1d:MR1e:MR1f:SR1c:SR1d:SR1f)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Checking that practice reflects MCA policies and that staff have the skills and time to implement them.",{"$f":"RANK(C4,$C$1:$C$26,1)+COUNTIF(C$1:C4,C4)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR1g:SR1g)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Making sure information about reasonable adjustments is being shared both within the trust and, where appropriate, externally.",{"$f":"RANK(C5,$C$1:$C$26,1)+COUNTIF(C$1:C5,C5)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR2a:SR2a)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Making sure due regard is paid to the content of hospital passports, across all wards / departments.",{"$f":"RANK(C6,$C$1:$C$26,1)+COUNTIF(C$1:C6,C6)-1","v":{"$error":"#DIV/0!"}},{"$f":"IFERROR(INDEX(D:D,MATCH(SMALL(E:E,ROW(D6)),E:E,0)),\"\")","v":""}]
[{"$f":"AVERAGE(MR2b:SR2b)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Making sure people’s communication / information needs are considered and taken account of.",{"$f":"RANK(C7,$C$1:$C$26,1)+COUNTIF(C$1:C7,C7)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR2c:SR2c)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Making sure staff know how to access and use accessible information.",{"$f":"RANK(C8,$C$1:$C$26,1)+COUNTIF(C$1:C8,C8)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR2d:SR2d)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Supporting the use of adapted pain recognition / assessment approaches.",{"$f":"RANK(C9,$C$1:$C$26,1)+COUNTIF(C$1:C9,C9)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR2e:SR2e)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Making proper arrangements for care coordination where people have multiple long term needs which mean they are frequent users of Trust services.",{"$f":"RANK(C10,$C$1:$C$26,1)+COUNTIF(C$1:C10,C10)-1","v":{"$error":"#DIV/0!"}},""]
[{"$f":"AVERAGE(MR2f:SR2f)","v":{"$error":"#DIV/0!"}},1.17,{"$error":"#DIV/0!"},"Looking at how patient areas can be further adapted to meet the predictable needs of patients with learning disabilities - or how better use can be made of what is available.",{"$f":"RANK(C11,$C$1:$C$26,1)+COUNTIF(C$1:C11,C11)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MR3a:MR3b:SR3a:SR3b)","v":{"$error":"#DIV/0!"}},1.2250000000000001,{"$error":"#DIV/0!"},"Reviewing and enhancing arrangements for ensuring that 'restrictions' and/or 'deprivations of liberty' are used as a proportionate last resort and are lawfully authorised.",{"$f":"RANK(C12,$C$1:$C$26,1)+COUNTIF(C$1:C12,C12)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MR3c:SR3c)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Ensuring that patients and their families know what to do if they are not happy about having their freedoms restricted in any way.",{"$f":"RANK(C13,$C$1:$C$26,1)+COUNTIF(C$1:C13,C13)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MR3d:SR3d)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Ensuring managers and front line staff contribute to plans and programmes to reduce the use of restrictive practices",{"$f":"RANK(C14,$C$1:$C$26,1)+COUNTIF(C$1:C14,C14)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MR5a:SR5a)","v":{"$error":"#DIV/0!"}},1.5,{"$error":"#DIV/0!"},"Ensuring that all clinical staff are aware of their responsibilities to support the national LD mortality review.",{"$f":"RANK(C15,$C$1:$C$26,1)+COUNTIF(C$1:C15,C15)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MR5b:SR5bi:SR5bii)","v":{"$error":"#DIV/0!"}},1.5,{"$error":"#DIV/0!"},"Ensuring that staff and managers reflect and consider actions needed in response to both local mortality reviews; and those from similar services elsewhere in the country.",{"$f":"RANK(C16,$C$1:$C$26,1)+COUNTIF(C$1:C16,C16)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"MR5c","v":false},1.4,0,"Making sure that governance and data systems mean that the trust is sighted on trends regarding key causes of preventable deaths; and taking action to address amenable causes.",{"$f":"RANK(C17,$C$1:$C$26,1)+COUNTIF(C$1:C17,C17)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MI1a:SI1ai:SI1aii:SI1aiii)","v":{"$error":"#DIV/0!"}},1.0900000000000001,{"$error":"#DIV/0!"},"Ensuring learning disabled patients, their families and advocates are fully involved in all aspects of planning their care and treatment.",{"$f":"RANK(C18,$C$1:$C$26,1)+COUNTIF(C$1:C18,C18)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MI1b:SI1b)","v":{"$error":"#DIV/0!"}},1.125,{"$error":"#DIV/0!"},"Making sure that reasonable adjustments are made with regard to the Trust’s duty of candour responsibilities.",{"$f":"RANK(C19,$C$1:$C$26,1)+COUNTIF(C$1:C19,C19)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MI4a:SI4ai:SI4aii)","v":{"$error":"#DIV/0!"}},1.2250000000000001,{"$error":"#DIV/0!"},"Ensuring staff are confident responding promptly to concerns about actual or potential abuse; and ensuing patients are fully aware of any safeguarding proceedings.",{"$f":"RANK(C20,$C$1:$C$26,1)+COUNTIF(C$1:C20,C20)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MI4b:MI4c)","v":{"$error":"#DIV/0!"}},1.26,{"$error":"#DIV/0!"},"Making reasonable adjustments to all complaints handling processes.",{"$f":"RANK(C21,$C$1:$C$26,1)+COUNTIF(C$1:C21,C21)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MW1a:MW1b:SW1a)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Identifying the knowledge and skills required to meet the needs of the local learning disabled population and ensuring there are plans to deliver them.",{"$f":"RANK(C22,$C$1:$C$26,1)+COUNTIF(C$1:C22,C22)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"MW1b","v":false},0.14499999999999999,0,"Ensuring that there is good provision for working in partnership with other health and social care providers who support people with learning disabilities locally.",{"$f":"RANK(C23,$C$1:$C$26,1)+COUNTIF(C$1:C23,C23)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MW2a:MW2b:MW2c:SW2a:SW2b:SW2c)","v":{"$error":"#DIV/0!"}},1.2,{"$error":"#DIV/0!"},"Making sure all staff have access to learning disabilities awareness training; and that this includes how to support regular carers and the need to provide reasonable adjustments.",{"$f":"RANK(C24,$C$1:$C$26,1)+COUNTIF(C$1:C24,C24)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MW3a:SW3a)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Ensuring that there is clarity about who leads on learning disabilities for the Trust and who can provide specialist advice.",{"$f":"RANK(C25,$C$1:$C$26,1)+COUNTIF(C$1:C25,C25)-1","v":{"$error":"#DIV/0!"}}]
[{"$f":"AVERAGE(MW3b:SW3b)","v":{"$error":"#DIV/0!"}},1,{"$error":"#DIV/0!"},"Developing plans to mitigate the impact of short and longer term shortages of key groups of staff.",{"$f":"RANK(C26,$C$1:$C$26,1)+COUNTIF(C$1:C26,C26)-1","v":{"$error":"#DIV/0!"}}]
["         "]
["Raw score","Potency of recommendation","Weighted score","Recommendation (lower scores more potent actions) ","Rank"]
[null,null,null,"Totp 10 areas for action… Think about:"]

{"sheet":"Improvement Summary","index":7,"n_rows":39,"n_cols":7,"rows_kept":39,"cut":false,"hidden":false,"merged":[[9,1,9,3],[0,1,0,2],[1,1,1,6]]}
[null,"Performance and areas for improvement"]
[null,{"$f":"IF(TrustName<>\"\",TrustName,\"\")&\",\"&IF(CompletionDate<>\"\",TEXT(CompletionDate,\" dd-mmm-yy\"),\"\")&\": \"&IF(Wards<>\"\",Wards,\"\")","v":",: "}]
[]
[]
[]
[]
[]
[]
[]
[null,"Improvement measures: current position\n(Informed by combined staff & manager ratings)"]
[]
[null,"Respecting & Protecting People's Rights","Inclusion & Engagement","Workforce"]
[null,"Anti-discriminatory practice","Partnerships with people and families","Enough of the right staff"]
[null,"Reasonable adjustments","Learning from investigations","The right training"]
[null,"Monitoring & reducing restrictions of liberty",null,"Effective workforce planning"]
[null,"Learning when people die in services"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,"Top five areas to meet NHS improvement standards:"]
[null,null,null,null,null,null,{"$f":"\"1. \"&'action recomendations'!F1","v":"1. "}]
[null,null,null,null,null,null,{"$f":"\"2. \"&'action recomendations'!F2","v":"2. "}]
[null,null,null,null,null,null,{"$f":"\"3. \"&'action recomendations'!F3","v":"3. "}]
[null,null,null,null,null,null,{"$f":"\"4.\"&'action recomendations'!F4","v":"4."}]
[null,null,null,null,null,null,{"$f":"\"5. \"&'action recomendations'!F5","v":"5. "}]

{"sheet":"Action Plan","index":8,"n_rows":14,"n_cols":8,"rows_kept":14,"cut":false,"hidden":false,"merged":[[2,1,2,7],[3,1,3,7],[1,1,1,7]]}
[]
[null,{"$f":"IF(TrustName<>\"\",TrustName,\"\")&\",\"&IF(CompletionDate<>\"\",TEXT(CompletionDate,\" dd-mmm-yy\"),\"\")&\": \"&IF(Wards<>\"\",Wards,\"\")","v":",: "}]
[null,"NHSI learning disability improvement standards: action plan"]
[null,"Complete the columns below by inserting relevant information concerning your action plan. "]
[null,null,"Improvement Measure","Type of plan needed","Think about things like","What needs to be done to achieve the standard / sustain adherence?","Who will be responsible for making sure it happens?","When does it need to be done by?"]
[null,"R1",{"$f":"'Standards and targets'!C2","v":"Trusts must have measures in place to promote anti discriminatory practice in relation to people with learning disabilities."},{"$f":"IF(Scores!N2>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"How the Mental Capacity Act is applied; outcomes monitoring; waiting list management; reasonable adjustments; and access to learning disability specialists."]
[null,"R2",{"$f":"'Standards and targets'!C13","v":"Trusts must demonstrate that reasonable adjustments are made to care pathways, to allow people with learning disabilities to access highly personalised care, and to achieve equality of outcomes."},{"$f":"IF(Scores!N3>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"The use of health passports; meeting information and communication needs; adapted assessments; care coordination; environmental modifications; outcomes monitoring; access to specialists; training."]
[null,"R3",{"$f":"'Standards and targets'!C24","v":"Trusts must demonstrate that they vigilantly monitor any restrictions or deprivations of liberty associated with the delivery of care and treatment."},{"$f":"IF(Scores!N4>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"Policies; training; user involvement; governance; and data driven practice."]
[null,"R5",{"$f":"'Standards and targets'!C29","v":"Trusts must have processes to investigate and learn lessons if people with learning disabilities die whilst using their services."},{"$f":"IF(Scores!N5>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"Engagement with LeDeR programme; governance structures; data analysis; and engagement with families."]
[null,"I1",{"$f":"'Standards and targets'!C34","v":"Trusts must demonstrate processes that ensure they work and engage with people receiving care, their families and carers, as set out in the NHS constitution."},{"$f":"IF(Scores!N7>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"How are people included in meetings and care planning; responses to safety incidents; and governance arrangements for driving improvements in response to investigations."]
[null,"I4",{"$f":"'Standards and targets'!C39","v":"Trusts must demonstrate that they learn from complaints, investigations and mortality reviews, and that they engage with and involve families and carers throughout these processes."},{"$f":"IF(Scores!N8>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"Consider staff training; responding to safeguarding concerns and safety incidents; complaints handling; and how investigation processes avoid causing undue distress."]
[null,"W1",{"$f":"'Standards and targets'!C45","v":"On the basis of a robust analysis of the needs of the local population, trusts must have enough staff, with the necessary specialist knowledge and skills to meet the unique needs of people with learning disabilities who access and use their services; as well as those who support them."},{"$f":"IF(Scores!N10>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"Are workforce plans aligned to population need; and are there effective arrangements for cross agency working."]
[null,"W2",{"$f":"'Standards and targets'!C48","v":"Staff must be trained and routinely refreshed, in the delivery of care and support to people with learning disabilities who use their services, in a way that takes account of their unique needs and health vulnerabilities; and the need to make individualised adjustments to how services are delivered to them."},{"$f":"IF(Scores!N11>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"Breadth and depth of key training in relation to rights, needs, health issues and reasonable adjustments."]
[null,"W3",{"$f":"'Standards and targets'!C52","v":"Trusts must have workforce plans which include provision to manage and mitigate the impact of the growing, cross-system shortage of qualified practitioners with a professional specialism in learning disabilities."},{"$f":"IF(Scores!N12>4,\"Sustainability plan\",\"Improvement plan\")","v":{"$error":"#DIV/0!"}},"How is safe staffing maintained; clinical and practice leadership; how workforce data informs planning; and how you mitigate the impact of reliance on agency / bank staff and workforce shortages."]