People with learning disabilities
Introduction
Learning disability is a diagnosis, it comprises; intellectual impairment, social or adaptive dysfunction and early onset of ‘a state of arrested or incomplete development of mind’.
Enabling adults with a learning disability to access the same opportunities within their local community as others remains a continued challenge. One example is employment which remains an ongoing priority as nationally less than 10% of adults with learning disabilities are employed.
Further information is available from the Improving Health and Lives website, which is devoted to the health and wellbeing of those with learning disability.
Facts, figures and trends
The Projecting Adult Needs and Services Information System uses Office for National Statistics population projections and estimates of the number of adults with a learning disability to project how many people aged 18+ will have a learning disability from 2014 to 2030. Around 2,158 adults (aged 18+) in Bracknell Forest are estimated to have a learning disability, with 462 of these having a moderate or severe learning disability. This is projected to increase to 2,451 by 2030, with 511 of these having a moderate or severe learning disability.
There are currently 310 adults (aged 18-64) with a learning disability known to Local Authorities in Bracknell Forest. This equates to a rate of 4.21 per 1000 population and is similar to the national average (Learning Disability Profiles, PHE).
Employment
Currently 17.7% of people with learning disabilities in Bracknell Forest are in employment. This is significantly higher than the national average (Learning Disability Profiles, PHE). Innovative application of the Social Value Act 2012 in commissioning and procurement may also lead to additional opportunities in employment and training to build self-esteem, confidence and resilience in people in this group.
Accomodation
In 2013/14 the proportion of adults living in settled accommodation was significantly higher than the national average at 87.1%.
Direct payments
In 2013/14 the proportion of adults with learning disabilities receiving direct payments was 18.3%. This is significantly worse than the national average.
Health checks
The proportion of eligible adults with a learning disability having a GP health check in 2013/14 was 71.6%. This is significantly better than the England average.
Current activity and services
There are a range of Council and NHS services for people with a learning disability including an integrated team to ensure a holistic approach to meeting people needs:
The Community Team for People with Learning Disability (CTPLD) is an integrated service. It provides specialist health and social services for adults with a learning disability who is a resident in the Bracknell-Forest area under ordinary residency for social services or who are registered with a Bracknell-Forest GP for a health service.
The service will ensure the health and community care needs of Bracknell-Forest people with a learning disability and their carers are met within allocated resources. This involves providing advice, assessing need, providing specialist health assessment and therapeutic intervention, helping a person purchase appropriate services and support with their personal budget establishing and reviewing care plans in a person centred way.
Staff within the team are either employed directly by Bracknell Forest Borough Council or Berkshire Healthcare NHS Foundation Trust.
The Community Team for People with Learning Disability (CTPLD) is managed by the Joint Team Manager who is line managed by the Head of Service who is jointly funded by Bracknell-Forest Social Services and Berkshire Healthcare NHS Foundation Trust.
CTPLD, as well as universal services who are equipped to make reasonable adjustments, are able to signpost people to other types of support within the community. There are also social groups, voluntary and community Sector organisations including access to advocacy, mentoring schemes and many other ways for adults with learning disabilities to access support and services.
Local views
The Bracknell Forest Joint Commissioning Strategy for People with Learning Disabilities has now been published. The strategy covers what is going well and things that need be improved. Key points include:
- People want their support and services to continue
- Having even more flexible support including weekends, evenings and during holiday times was important to people with learning disabilities and their carers
- Finding affordable and suitable accommodation – people feel limited by where houses are available and proximity to local community services
- Economic well being – one of the biggest barriers to this is finding paid employment. People were positive about the work of Breakthrough (employment support services) but were concerned about job availability. People also wanted more control over their money. Finally many people made comments on the affordability of activities.
- Enabling people with complex needs (for example people with communication difficulties, challenging behaviour and physical disabilities to have more choice and control). This included developing the competencies of people supporting individuals with such needs as well working with local services to better respond.
- Ensuring young people approaching adulthood are supported to make their own choices in planning and developing their future. The need for this has been identified previously and the Approaching Adulthood Strategy 2013- 2018 is currently being implemented.
- People who have experienced bullying are mainly being bullied by children and young people.
National & local strategies (current best practices)
There is a wealth of government policy and initiatives that supports adults with learning disability. Details of which can be found on the website for the Department of Health.
Summaries of the most relevant and recent main documents are as follows
Valuing People Now (Department of Health, 2009); sets out the Government’s strategy for people with learning disabilities. It establishes that people with learning disabilities are entitled to the same aspirations and life chances as other citizens and aims to ensure people with learning disabilities have the same opportunities and are treated with the same dignity and respect.
Transforming care: A national response to Winterbourne View Hospital (Department of Health, 2012); Winterbourne View Hospital was an assessment and treatment centre for people with learning disabilities that have challenging behaviour. In May 2011, a Panorama programme was broadcast detailing abuse of people at the centre. Following this, 11 staff at the centre were convicted and sentenced for abuse in the criminal court.
The report identified failings in the development and provision of locally based community services in line with good practice, case management and commissioning. It also identified failings in the monitoring of the centre. The report addressed these issues and recommended 63 actions.
There is a requirement in the report for local authorities and clinical commissioning groups (CCGs) to work together “to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care”. Plans should include children and people approaching adulthood.
Bracknell Forest Learning Disability Joint Commissioning Strategy
The Bracknell Forest Learning Disability strategy supports the recommendations in Valuing People Now and sets out how it intends to implement those and respond to the needs of local people.
What are the unmet needs/service gaps?
The national reports detail a clear message that people with a learning disability are too often receiving sub-standard care that could potentially lead to poor outcomes for the individual and their carers.
Recommendations for consideration by other key organisations
There has been a good local response to Winterbourne and the confidential inquiry. However, further commitment to developing community infrastructure and preventative means of support in order for individuals can remain in and be part of their the community, living safely and without fear, living in their own homes would require further development.