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The same as you? A review of services for people with learning disabilities

7 Summary

1 We recognise that services could do more to help people with learning disabilities to achieve a full life. Our main aim is to help them to be included - in community life, in education, in leisure and recreation, in day opportunities and particularly in employment. They should also have far greater access to mainstream services and rely less on specialist services.

2 To achieve these goals means considerable change. We need to improve, reshape and reorganise services, and the public needs to better understand people with learning disabilities and their needs.

3 At the centre of this is a major shift to person-centred and needs-led approaches, which put the individual at the heart of any decisions made. For that to work, people with learning disabilities need better information to make more informed choices, to be supported by an advocate if they want, and to have more control over their lives and services.

4 We want to improve systems. The local area co-ordinators will:

• co-ordinate and arrange support and services;
• act as a voice for people with learning disabilities;
• have a budget to buy new, local and cost-effective services.

These co-ordinators will replace care managers, and care management, which is not performing well enough. And, to plan for the medium and longer terms, every person who wants to have one should have a ‘personal life plan’.

5 The role of services also needs to change. We want them to focus now on including people with learning disabilities in the community, supporting their personal development and their carers. The balance of care needs to shift. People want to have their own homes in the community. Very few people should have hospital as their home, and other forms of shared living should reduce. Day services have to modernise and focus more on education, employment and personal fulfilment. We need more support for carers. This means more flexible and fresh ideas for short breaks.

6 People with learning disabilities, their carers and providers need someone to act for them and promote a better general understanding of learning disabilities. The Scottish Consortium for Learning Disability would do this by being a centre of excellence, providing leadership to agencies in the field and advice in general.

7 To serve people with learning disabilities better, agencies need to be much clearer about their roles and the opportunities for working with others (particularly for people with extra and complex needs). We need effective partnerships between agencies, between professionals, and between users, carers and professionals.

8 We need to add to all these steps by helping the public generally to be more aware and understanding of learning disabilities. We believe our on-going programme of awareness will achieve this.

9 The scale of change we are looking for from the review has never been seen before in learning disability services in Scotland. We cannot achieve this using current resources. But spending on learning disability services is already considerable, and making better use of that is an essential starting point. A ‘change fund’ to help local authorities deliver the new agenda seems essential.

10 Finally, we need to monitor practice and progress to make sure that the changes we have mentioned in this review take place and are developed and maintained. The proposed centre and the new Commission will have important roles in making sure that this happens. The real test will be that the lives of people with learning disabilities and their carers are made richer and fuller as a result of the changes proposed here.

11 Users and carers have waited a long time for this review. They have told us very clearly and consistently what they want and need to lead lives which are as fulfilling as possible. What they are asking for is no more than all of us want for ourselves and our children. We do not think that is asking too much.

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