Quality statement 3: Key worker

Quality statement

People with learning disabilities and a serious mental illness have a key worker to coordinate their care.

Rationale

Appointing a key worker would improve care coordination and help services to communicate clearly with people with learning disabilities and their family members and carers.

Quality measures

Structure

Evidence of local arrangements and written protocols to ensure that people with learning disabilities and a serious mental illness have a key worker to coordinate their care.

Data source: Local data collection.

Process

Proportion of people with learning disabilities and a serious mental illness who have a key worker to coordinate their care.

Numerator – the number in the denominator who have a key worker to coordinate their care.

Denominator – the number of people with learning disabilities and a serious mental illness.

Data source: Local data collection.

Outcomes

Patient and carer satisfaction with their key worker's coordination of care.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (primary, secondary and social care services that provide care for people with learning disabilities and mental health problems) ensure that people with learning disabilities and a serious mental illness have a key worker to coordinate all aspects of care.

Key workers coordinate all aspects of care and communication for the person, their family members and carers, and the services that are involved. They should maintain regular contact with the person and their family members and carers and specify this in the care plan.

Commissioners (clinical commissioning groups, NHS England and local authorities) commission services that provide a key worker for each person with learning disabilities and a serious mental illness. The key worker should coordinate all aspects of care and communication.

People with learning disabilities and a serious mental illness have a key worker who acts as the main contact for them and their family members and carers. The key worker makes sure that all staff involved are working together, and that the care plan is being followed and is helping. They ensure that any assessments, care and treatments are explained clearly to the person with learning disabilities.

Source guidance

Mental health problems in people with learning disabilities: prevention, assessment and management (2016) NICE guideline NG54, recommendation 1.2.8

Definitions of terms used in this quality statement

Serious mental illness

A diagnosis of:

  • severe depression or anxiety that is impacting heavily on the person's functioning

  • psychosis

  • schizophrenia

  • bipolar disorder

  • an eating disorder

  • personality disorder

  • schizoaffective disorder.

[Mental health problems in people with learning disabilities (NICE guideline NG54) and expert consensus]

Key worker

A key worker (also known as a care or case coordinator, or a Care Programme Approach care coordinator) is the central point of contact for the person with learning disabilities, their family members and carers, and the services involved in their care. They are responsible for helping the person and their family members and carers to access services and for coordinating the involvement of different services. They ensure clear communication between all people and services and have an overall view of the person's needs and the requirements of their care plan. They ensure that services communicate regularly with the person and their family members and carers, in a suitable format.

[Adapted from mental health problems in people with learning disabilities (NICE guideline NG54)]

Equality and diversity considerations

Healthcare professionals should take into account the communication needs of people with learning disabilities. They should make reasonable adjustments and provide support if needed for people who have limited or no speech, who have difficulty with English, or who have other communication needs.

Communication with the person and their family members, carers or care workers (as appropriate) needs to be in a clear format and in a language suited to the person's needs and preferences.