It is not expected that residents with Learning Disabilities come under both the Care Homes DES and the Learning Disability DES. Practices/clusters should decide which applies, depending on what is most appropriate for the resident.
This does not alter the principle regarding private hospitals; their patients do not fall under the Care Homes DES.
(a) A learning disability residential unit / home registered with HIW
If a learning disability residential unit / home is registered with Healthcare Inspectorate Wales as an independent hospital, the learning disability home is not classed as a care home.
Health Boards will need to clarify with Healthcare Inspectorate Wales whether the learning disability unit / home is registered as an independent hospital. The HIW website indicates the inspections they have undertaken in relation to learning disability residential units.
If the GP practice needs to undertake an annual health check, this will be covered through the Learning Disability DES.
(b) Residents with a learning disability living in a care home registered with CSSIW
For residents with a learning disability who are elderly, less mobile with an expectation for home input, and living in a care home where the higher percentage of residents are elderly and less mobile, it would be appropriate for their care to be covered through the Care Homes DES. If required, the practice / LMC can agree with the health board.
For residents with a learning disability living in a care home who are younger and more mobile with an expectation they would usually be expected to attend the surgery, it would be appropriate for their additional care to be covered through the Learning Disability DES. If required, the practice / LMC can agree with the health board.