LeDeR Briefing for Care Providers – April 2026

This briefing outlines positive practice and improvement areas identified for care providers who care for people with a learning disability, from LeDeR reviews completed by Staffordshire and Stoke-on-Trent Integrated Care Board in Quarter 4. It highlights the importance of improvements required by care providers and provides useful resources to support with these improvements. Themes of positive practice and learning identified this quarter are consistent with those identified in the Quarter 3.

Positive practice identified:

• Care and treatment in the majority of reviews was described as good including concerns escalated to relevant healthcare teams for support.
• Good communication and collaboration between care staff and the various community professionals involved in the person’s care.
• Ongoing support to families and individuals following a person’s death.
• Very thorough and detailed care plans produced for all the person’s needs and conditions.
• Recognition of person-centred care

Communication/Documentation learnings and improvements:

• Ensure discussions with GP’s/other healthcare professionals are recorded and any risk triggers are clearly recorded in the individuals notes.
• If there are changes in a person’s care needs, the care provider needs to communicate any additional support required to commissioners as soon as possible and updated forms i.e. ReSPECT/health passport
• Improve communication pathways to ensure a multi-agency approach.
• Ensure Best Interest meetings and Mental Capacity Assessments are undertaken.

Useful resources:

• NHS England » Providing proactive care for people living in care homes – Enhanced health in care homes framework

Screening, vaccinations and medication reviews learning and improvements:

• Importance of ensuring that individuals are provided with an annual check by their registered GP practice.
• Importance of raising with the GP Practice, LD Nurse or screening services if an individual has not received their age-appropriate screening, vaccinations, long term condition reviews and medication reviews.
• Ensuring that reasonable adjustments are made for people to understand the reason and benefits of receiving vaccinations and screening.
• Ensuring samples taken in a timely manner

Useful resources:

• Flu vaccination supporting people with LD
• Easy read resources Cancer Screening and Immunisations including Covid
• Easy read guide to the pneumococcal vaccine (practice365.co.uk)
• Easy read guide to Cervical Screening
• Video for people with LD to support their understanding of cervical screening
• ICS video – what happens at breast screening appointments
• Pneumonia Prevention Leaflet
• Staffs and Stoke on Trent ICS Pneumonia video
• Community collaboration: Local people with learning disabilities star in new NHS vaccine films

Deterioration learning and improvements:

• Ensure DISDAT tool in place if required, used to identify’ an individual’s pain by looking for non-verbal communication.
• Consider staff training and education in the use of validated tools to help recognise and respond to signs of deterioration and escalate concerns.

Useful resources:

• How social care staff can recognise and manage pain in people with learning disabilities
• Microsoft Word – DisDAT-15.doc
• Instructions for Use – Wong-Baker FACES Foundation

Useful training:

• Social Care Academy for Staffordshire and Stoke-on-Trent | Sepsis Training

End of Life Care learning and improvements:

• People to be supported to remain in their home in older age, especially when their health needs deteriorate.
• Consideration to be given for End-of-Life Care Planning to take place sooner for individuals.

 Useful resources:

• NHS England End of Life Care Plan Easy Read
• ReSPECT Guidance
• Palliative Care Co-Ordination Centre

Learning Disability (LD) Register learning and improvements:

• Not all individuals were registered on the GP Practice LD register.
• Importance of ensuring that care providers register individuals on the GP practice LD register.

 Useful resources:

• NHS England » Find out about the Learning Disability Register

Annual Health Checks (AHC):

It is important for individuals to attend their AHC. The AHC is a chance for the doctor, the person with a learning disability and those who support them (if relevant) to review the individual’s physical and mental health.

Health Action Plan:

As part of an individual’s AHC, practices will be required to produce a health action plan. A health action plan identifies the individual’s health needs, what will happen about them (including what the individual or care providers needs to do), who will help and when this will be reviewed.

Useful resources:

• Annual health checks Easy Read (mencap.org.uk)
• NHS England » Annual health checks
• Annual Health Checks | Mencap | Easy Read

Staff training/escalation learning and improvements:

• Training for nursing and care staff on communication, reasonable adjustments, health checks and health passports.
• Consider staff training and education in the use of validated tools to help recognise and respond to signs of deterioration and escalate concerns.
• Importance of escalating to specialist LD services for support for individuals.

Useful resources:

• Better Health for people with Learning Difficulties
• Important advice for staff who support people with a learning disability or autistic people.
• Improving healthcare access for people with learning disabilities – GOV.UK
• Reasonable adjustments for people with Learning Difficulties

Additional useful resources

The resource bank is of use to healthcare professionals supporting people with a learning disability or people who are autistic with their health or care.

Useful webpages for more information about the LeDeR programme:

• LeDeR – Staffordshire and Stoke-on-Trent, ICS
• NHS England LeDeR webpage
• Keele careLeD tool

You can report a death at: Report the death of someone with a learning disability or an autistic person