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CHAPTER SEVEN: DISCUSSION & CONCLUSIONS

DISCUSSION

7.1 National policy in The same as you? and Working for a change? is unequivocal in stating that people with learning disabilities and/or ASD want to work and need support to get and keep real paid jobs. At the start of the research however, the extent to which employment for people with learning disabilities and/or ASD was 'on the agenda' for local authorities and practitioners, as well as the extent to which 'supported employment' was becoming established in Scotland, were unclear. The Scottish Executive commissioned this research to map current support for employment and to better inform the National Implementation Group's work to promote employment.

7.2 The commissioned study was about employment support in its widest sense and not 'supported employment' specifically. This distinction is not just about semantics. The broad approach resulted in information being gathered about a plethora of approaches, a small proportion of which would pass for what is internationally recognised as 'supported employment', that is, real work in integrated settings with ongoing support. Employment support providers varied considerably in terms of the size of the staff team, sector, type of provider they were and, critically, in respect of the model and approach they took to providing employment support.

7.3 The Scotland-wide survey of employment support found just over 3,000 people being supported in both paid and unpaid jobs by 69 separate employment support providers. This came from questionnaire returns from 41% of identified relevant employment support providers and was therefore likely to be an underestimate of the real situation. Additionally, some services did not use disability labels, believing this to contradict 'supported employment' and its emphasis on capacity, further compounding the task of gathering comprehensive mapping information about employment support for these groups of people.

7.4 While the figures undoubtedly demonstrate progress in terms of an increase in numbers of people with learning disabilities in employment compared to the picture 20 years ago (Beyer et al, 1996), it was plain that 'supported employment' as defined by the research was still rare. Only a third of the supported jobs were full-time as defined by the Department of Employment ( i.e. 16 hours or more), and which would have met the definition of 'supported employment' used in the research. The majority were part-time jobs, jobs paid under permitted work rules, unpaid jobs or voluntary work. In establishing 'what works' in promoting employment, the model of 'supported employment' was consistently identified as the most effective.

7.5 Although 'supported employment' was evidently present on the current landscape, it did not appear to be firmly embedded as a primary strategy for improving quality of life and providing opportunities for social inclusion. As the Policy Consortium on Supported Employment (2000) argued, 'supported employment' needs to be "much more widely available, with services of consistent quality". To achieve this would require a more strategic and coordinated approach to be adopted nationally.

7.6 A lack of consensus around the definition of 'supported employment' was a key finding of the research. Alongside an increase in employment opportunities, has grown a confusion around the use of terminology especially in relation to 'supported employment'. This lack of conceptual discipline has led to a watering down of the model in some cases. Both the survey and literature review provided clear evidence that in the absence of a national lead on this issue, all manner of services consider themselves to be providing 'supported employment' even when they are supporting unpaid jobs or jobs in segregated settings. While there is nothing inherently wrong with for instance, part-time work and work experience, they are not the same as, and therefore should not be called, 'supported employment'. Without further clarity of definition however, it is unlikely that 'supported employment' will develop and flourish.

7.7 The research found evidence of quality outcomes when services adopt a principled and values-led approach to implementing 'supported employment'. The positive examples found further confirmed the existence of employers who recognised the value of the contribution that disabled employees make to their business. Employers who had experienced the successes, resolution of problems, and the wide range of outcomes for their business, staff, organisational learning and employees themselves, were enthusiasts and champions of 'supported employment'.

7.8 Fifteen individuals with learning disabilities and/or ASD were interviewed for this research and all were highly satisfied with 'supported employment'. They experienced positive outcomes such as increased self-esteem, self-confidence, vocational integration, an increase in disposable income and they felt their lives to be significantly improved. Families agreed with this and also felt they had benefited from their relative being in employment. They expressed less worry about the individual, and family relationships had improved.

7.9 There was only a limited sense that individual aspirations and choices were being explored through person centred career-planning methods. There was some evidence that effective 'supported employment' services were placing people in interesting jobs that closely matched their individual preferences, but the predominance of jobs in certain sectors suggested stereotyping of people with learning disabilities and/or ASD. Having now accepted that people with learning disabilities and/or ASD should have opportunities for employment, the restricted notion that they will be satisfied in certain types of jobs needs to be challenged, particularly as the research suggests that the main reason why community jobs fail is through poor job match.

7.10 The option of supported self-employment or employment in what the Americans call 'micro-enterprises' seemed rare in Scotland. We found some examples of self-employment and 2 people who were interviewed, both living in rural parts of Scotland, were self-employed. The potential of this option to provide the choice and flexibility sought by some individuals seems ripe for development. That self-employment for some people has advantages including a closer match between individual preferences and contribution with the job, and fitting employment around individuals' values and lifestyle preferences, have led some to argue that self employment is "the next logical step in the evolution of supported employment technology". This will of course necessitate putting in place personal and business support systems, and expanding the knowledge base of employment specialists.

7.11 The survey discovered major inequalities in terms of who was able to access employment support not least of which the group that served as the original inspiration for the 'supported employment' concept, i.e. people with more severe or profound disabilities. People with ASD and those from minority ethnic communities were poorly served. Fewer women were being supported in paid work. Ensuring that employment is routinely considered for young school leavers was only happening through the efforts of a few services. As one of the key stakeholders remarked, targeted work with young people is vital to ensuring that they "do not enter the cycle of the benefits trap in the first place".

7.12 The short-life working group which produced Working for a change? argued that helping people with learning disabilities choose, get and keep jobs should be a mainstream coordinated service. A strong counter argument is that while there is a clear logic for locating 'supported employment' within the business and employment world, its weakness might be that the focus on the disability agenda might be lost. There are alternative models as evidenced by the Glasgow Partnership. Translated into a national agenda, this would mean adopting cross-departmental collaborative models rather than locating all responsibility in one place.

7.13 A drawback of perceiving 'supported employment' as a general technological fix to the problems of unemployment, is that its' outcomes might be compromised and it might not reach the people for whom it was originally designed, i.e. people with severe disabilities. 'Supported employment' grew out of principled and ideological stance concerned with inclusion and citizenship for all. The philosophical basis of 'supported employment' was about getting people on the margins to be included in the world of work. Where this has been most successful as demonstrated by this and other research, has been when a strong values based approach is adopted. In order to retain this, it will be critical to resolve the issues around definition, principles and establishing quality standards.

7.14 The traditional view that the biggest barrier to employment is the existing welfare benefits system was alluded to in this research. However, this was challenged by the positive stories of individuals who were financially better off in employment and by the practice of a few 'supported employment' services who had demonstrated that with sufficient determination and targeted information it is possible to support people into full-time work and for them to be better off in work, sometimes considerably so. This suggests a two pronged approach is necessary: 1) to advocate systemic change in relation to parts of the system that operate as disincentives to employment and 2) in the meantime, build on existing expertise which proves conclusively that with skilled understanding of benefits, tax credits and so on, it is possible to help more people to be better off financially as a result of being in work.

7.15 Negative attitudes or the low expectations of others were identified as a major barrier to employment. This included the attitudes of a range of professionals such as care managers, support workers and some families/parents. It was suggested by the research participants that SVQ and other professional training did not include an awareness of 'supported employment', and that employment was not routinely considered as an option during community care assessments, or by parents. The literature review confirmed the importance of investing in staff training in for example, person centred planning to enhance both the practices and values necessary for successful implementation. Employment support providers perceived that employers sometimes had negative attitudes towards people with learning disabilities, although the sample of employers we interviewed was overwhelmingly positive and had valuable things to say to other employers from a business perspective.

7.16 People with learning disabilities and/or ASD, families and employers participating in the research identified a number of recommendations or key messages they felt were important for promoting employment. These were addressed at people with learning disabilities and/or ASD, families, employers, and lastly at government and other agencies. The key messages were highlighted in chapter 6 and are repeated below:

For people with learning disabilities and/or ASD

• You can get your dream job
• Just ask - you can get difficulties at work sorted out
• You can run your own business: there are people and organisations who will help
• Jobs need to be stretching but not so challenging you give up
• Having a job is an awful lot better than sitting around all day
• Don't think if you'll get a job, think when you'll get a job
• You get to meet and be with people
• You gain confidence, more independence, more skills, more money and self esteem
• If things are going wrong in a job, hang on in there and get support to find a better job
• Positive relationships with colleagues really help; you can have a laugh too
• Job coaches and some jobs open up new opportunities- things you might never have thought of before
• Having a job can allow you to contribute to your household's income - and in other ways to your family's life

For families

• Family support, encouragement and backing really helps
• Supported employment can benefit the whole family - financially, worry/anxiety levels, relationships, individuality and independence
• Good job coaches will take you and your needs into account as well
• Your hopes could be surpassed, your concerns might not materialise

For employers

• If you run a good business - good pay and conditions, a good atmosphere in the workplace and good working relationships - it will be a good place for 'supported employment'
• You need to be aware of people's individual differences and requirements
• People with learning disabilities and/or ASD can do a wide range of jobs and contribute to your workplace if the support is right
• Your other staff can help
• You've got to watch out that other staff treat the person in 'supported employment' reasonably
• Supported employment can be good for your business -customers will tell you so
• Advertise that you provide 'supported employment'
• Make sure you and your staff have the training you need to get the support right
• Difficulties can be sorted out - work it out together, the answer can come from a wide range of sources
• Experience has shown that people with learning disabilities are reliable and hard working employees
• Employers need to hear more about success stories from other employers
• Good 'supported employment' has a lot to offer employers - job profiling, job coaching and on-going support for the disabled employee are also of benefit to employers
• Flexibility of working arrangements is helpful not only with employees with disabilities but other employees too

For the government and other agencies

• Promote equality - by promoting the value of 'supported employment' and ensuring it becomes the norm
• Make sure 'supported employment' becomes more widely available
• Ensure that 'supported employment' agencies can work with people with high support needs
• Good 'supported employment' agencies have an impact not just on people's employment but on their whole lives
• Government should look into the situation of people trapped by the benefits system, e.g. those in supported accommodation/care homes
• Promote direct payments as one of the supports for employment
• Education, awareness raising and training are all vital - in schools, colleges, for employers and for the public
• Ensure that gateways to employment, like college courses are better tailored to individuals and that support is not only available in segregated courses and facilities
• Government could do more to change attitudes and to sell 'supported employment' to businesses as many employers are unaware of the benefits
• Those promoting 'supported employment' need to adopt a business-like approach, and put the business case for employing disabled people
• In promoting employment, government should recognise that employers don't respond to charity but need to see the benefits to their company
• Government should provide more information about different disabilities to raise awareness, for example, about Aspergers Syndrome
• Government should set targets about the numbers of disabled people that should be employed within companies
• Government should make more use of senior managers in business who can act as 'champions' to speak out at conferences and to professional bodies

IMPLICATIONS FOR POLICY AND PRACTICE

7.17 The findings from this study point to the need to build on the well-developed practice, skills and expertise of the 'supported employment' services in Scotland who are already achieving quality outcomes. In addition, there is a need to further develop practice through initiatives in certain priority areas. In particular, the research suggests practical developments or initiatives in the following areas would be helpful:

• The strategic development of a national definition, framework and standards for 'supported employment' in Scotland
• Drawing upon person centred planning approaches (including personal life plans) that show how to achieve a more consumer-driven and career planning approach
• Targeting school leavers to expand expectations and options for the future directly linking career assistance and 'supported employment' providers with schools
• Equipping employment specialists to facilitate self employment for people who want supported self-directed employment
• Implementing ways of delivering 'supported employment' for people with more severe disabilities
• Ensuring 'supported employment' is offered to people with ASD, in particular to adults with autism

7.18 Because there is little known about some of these, participatory development and action research models would seem to be appropriate both in terms of their development and evaluation. Such an approach would also be in keeping with the values and philosophy of The same as you? and recommendation 9 of Working for a change? which called for an employment-related participatory action research programme run by, and for, people with learning disabilities.

7.19 In addition, it will be important to continue to promote and publicise good practice and innovative services such as North Lanarkshire's Supported Employment Service, that have found ways to tackle the benefits issues and place people in full time jobs. Engaging employers and people with learning disabilities and/or ASD as champions for 'supported employment' would also be beneficial strategies.

CONCLUSION

7.20 In conclusion, while there are grounds for optimism, there is some way to go before the aspirations of people with learning disabilities and/or ASD for real paid jobs are met, especially for people with ASD. The positive experiences related in this report illustrate what can be achieved when best practice in 'supported employment' is implemented. Good practice was identified and while the results were life changing for the individuals involved and their families, 'supported employment' as originally intended was not being put into practice. It would seem that securing jobs with higher rates of pay and for more hours remains a key issue. There is a pressing need for central and local government to adopt a more strategic and coordinated approach to developing and funding 'supported employment' in Scotland so that its implementation can be more widespread.

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