Taken from LDAS comments on the proposed consultation on new eligibility criteria for all adults services for the City of Edinburgh Council.
The timescale for this consultation is completely inadequate. Two weeks to look at this complicated equality Impact Assessment is not enough. Adults with learning disabilities need to be able to access information in an easily understood way and to have time to digest it. This kind of process cannot take place in this way. Given that this is a decision that need not be hurried and has long term consequences, I believe the consultation should be extended and a report given to a future H, H & S C committee meeting.
Secondly at a consultation meeting which had allegedly 38 invitees to discuss a matter affecting tens of thousands of people in the city, only 5 organisations were represented.
Thirdly a number of the initial invitations were sent to inaccurate email addresses and therefore never reached their intended recipients. For example the suffix for EDG is edg-sco.org and not edg.sco.org The suffix for Partners in Advocacy should finish with a .uk . Such simple errors must lead to a more general questioning of the robustness of the invitation list when so few people attended.
LDAS Comments on New Eligibility Criteria for City of Edinburgh Council
It is our view that the City of Edinburgh Council adopt National Criteria for older people only, and develop bespoke criteria for people with learning disabilities. [3(b)]
We welcome the review of Edinburgh’s Eligibility Criteria For Adult Social Care And Waiting Times For Personal And Nursing Care. This is a much better option than applying the national guideline without thinking what they mean. However we are concerned that the tone of the review seems to be about how to apply rationing fairly and not to address what is the real problem – significant variations in local authority delivery of care for vulnerable groups. 6 years of statistical collection for the “Same As You” has shown that local authorities differ widely in the provision of day care, respite and individual living support. Edinburgh is good in some areas and poor in others.
For most adults with learning disabilities there is little change in the nature of their disability over time. Their disability means that learning and development takes longer and so good support can make a big difference in the long term. Rather than intervention needing to be made to maintain independence, interventions for people with learning disabilities need to be made to promote independence and social inclusion.
The proposed Eligibility Criteria is not applicable to all client groups. These criteria were written specifically for older people and stretched to include other adult community care client groups .
People with learning disabilities along with people with physical disabilities require community support in a range of different ways throughout their lives. We do think that special consideration is required for people with learning disabilities.
Learning disability is a development condition that arises early in life and continues throughout. It affects every aspect of life and requires a range of personal, family and community supports.
People with learning disabilities do not require just one assessment as a condition develops but receive assessments throughout life. The Additional Support for Learning (Scotland) Act suggests that such interventions should begin by at least the age of two.
As a result eligibility criteria for social care services for adults with a learning disability need to start from a different place than those designed for older people facing a loss of independence.
We would recommend that a fifth category of criteria be added titled “Risks Relating to Learning Disability”. This should look at the assessment of risk on the “need to develop independence and to develop inclusion with family, employment, and community”. The focus would be on a positive approach to personal development.
For example:
Critical:
Unable to develop independent living in vital or most aspects of personal care, domestic routines and/or home environment without social scare support and so facing major risks in developing independence.
Substantial:
Unable to develop independent living in many aspects of personal care, domestic routines and/or home environment without social scare support and so facing significant risks in developing independence
Moderate:
Unable to develop independent living in some aspects of personal care, domestic routines and/or home environment without social scare support and so indicating some risk in developing independence
Low:
Difficulty with one or two aspects of personal care, domestic routines and/or home environment without social scare support and so facing significant risks in developing independence
The argument in the EIA that 3(b) be rejected on the grounds on fairness is completely inadequate. The proposed criteria have 4 specifically different type of criteria which already apply to differing groups, one section covers carers, another addresses mental health issues, the main section covers loss of independence but there is no section covering the need to acquire core skills or gain independence. The proposed criteria are clearly unfair for people with learing disabilities and we are surprised that you have not recognised this.
I see as part of your justification that you use service expenditure figures published by CEC through the Scottish Government. I am puzzled how you can supply expenditure figure for the year 2009-10 in November 2010. Surely the financial year has not ended yet!
Secondly the figures you quote to justify the concern with the growth of learning disability services are POBE figures. I am sure that you know that POBE stands for Provisional Outturn and Budget Estimate – in other words these are not final figures but just estimates.
We have looked at the actual financial figures by local authority and noted that expenditure on services for adults with a learning disability as a percentage of social work services was 13.52% in 2006-07 and fell to 13.00% in 2008-08 while net expenditure over the same period rose on service for older people from 43.22% to 43.83%.
Hardly the plain case that the estimated figures in the EIA claims to make that expenditure is rising on services for people with learning disabilities and therefore there is no discrimination. In fact, the opposite may be true from the limited figures we have quoted above. This is another reason why we believe more time is needed for this matter.
The proposal not to recognise that people with learning disabilities have special requirements runs the following risks that need to be addressed in the EIA:
· Personalisation of services will be less likely
· People with learning disabilities will get less services.
· Many people will miss out on valuable life opportunities to grow and develop
· Access to day services, respite and other community support will be restricted
· The 178 people with learning disabilities on the Edinburgh waiting list will be less likely to get the services they are waiting for
· Family carers of people with learning disabilities will spend longer caring for their relatives at the expense of their own health
· There will be a further shift of responsibility of care for people with learning disabilities to families and friends
· More services will be provided on a discretionary basis as “preventative” rather than in response to a real understanding of social need.
