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Learning disability cost savings plan sparks ‘institutionalisation’ fears

Posted on 3/10/2016 by Aminul Hoque


Council looks to save by cutting number of supported living tenancies and moving people to alternative settings, including residential care

A council has defended a set of controversial cost saving plans for learning disability services after campaigners claimed the measures promoted a “shocking” return to institutionalised care.

Rochdale council has tabled proposals to save £1.4m by ‘remodelling’ its supported living offer and moving some people who currently have their own tenancies into alternative settings, including residential care units.

The council said it will consult on the proposals, which would come into effect from next April. A pre-consultation paper said care teams had already considered “possible future living options”, including care homes, for all 263 people potentially affected. The potential reduction in the number of supported living tenancies formed the basis of the savings claims.

‘Value for money’

The council said their supported living arrangements normally involved two to four people sharing one home, with staff on site round-the-clock to support them.

“The model of care therefore does not provide value for money as the same staffing numbers could support a greater number of people in larger premises. In addition not everyone’s needs are the same in a supported living home but the staffing level needs to based on the person with the highest needs,” the council report said.

Supported living worked “very well for some people” but may not be the best option for others, the report added. It gave the example that some older people with learning disabilities may find a specialist residential care home “a more suitable setting”. Shared lives placements and extra care housing were also listed as potential alternatives.

The council rejected “any suggestion” the proposals amounted to ‘re-institutionalisation’ and said service users would only be moving if the new options were assessed as meeting their needs and after “detailed conversations with them and their families”.

‘Institutionalisation’ concerns

The proposals drew fierce criticism from learning disability organisations and campaigners.
Learning Disability England, a membership organisation for people with learning disabilities, described the plans as “shocking” and “a proposal to return to institutionalised services”, adding “we should never return to warehousing people with learning disabilities”.

Rob Greig, chief executive of the National Development Team for Inclusion and a former national director for learning disabilities, told Community Care the proposals should be scrapped.

“This epitomises everything that’s gone wrong with adult social care commissioning. The council is claiming residential care can offer better value for money. What they actually mean is, this is cheaper. It’s not value for money because value for money is about the outcomes you get for what you spend…we know that poorer staff support ratios in large group settings means people have lower quality of lives and they will thus end up being more dependent upon services in the future.

“The other big problem with this proposal is the rights agenda. They are proposing changes that could see people have to move from a situation where they have housing rights which give them the ability to determine where they live, who supports them, who comes in and out of the house and, crucially, allows them go out to paid work. Instead they’ll move to a residential unit. In my view it is legally questionable.”

‘No compulsion’

Sheila Downey, Rochdale’s director of adult social care, said: “Any suggestion that this is ‘reinstitutionalisation’ or ‘warehousing’ people against their wishes to save money is irresponsible and wrong.

“We are trying to improve the service we offer to users and their families because we are over-reliant on one service model, the group home model which doesn’t meet everyone’s needs, particularly in old age.

“Our proposals will improve, enhance and extend the supported living options we offer and we are consulting widely with service users, providers, carers and families on the new models of care. There will be no compulsion, with service users only moving if the new options meet their needs following an assessment and detailed conversations with them and their families.

“I would like to emphasise that no decisions have been made. The interests, care needs and wellbeing of individual service users will always be our main priority.”



Source: Community Care