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

Appendix 1 List of recommendations

Recommendation 1  Each local authority or group of authorities and health boards should draw up a ‘partnership in practice’ agreement by 1 June 2001.

Recommendation 2  Health boards and local authorities should agree to appoint local area co-ordinators for learning disabilities from current resources used for managing care and co-ordinating services. Initial training for putting local area co-ordinators in place will begin in Autumn 2001.

Recommendation 3  Everyone with a learning disability who wants to, should be able to have a ‘personal life plan’. (Recommendation 26 builds on this.)

Recommendation 4 The Scottish Executive should set up a ‘change fund’ to help local authorities put in place the recommendations in this review.

Recommendation 5  By 2003, anyone who wants direct payments should be able to have them, and local authorities should be included in the list of possible providers.

Recommendation 6  The Scottish Executive should set up a new Scottish Consortium for Learning Disability. This would offer advice, training and support to agencies, professionals, people with

Recommendation 7  The Scottish Society for Autism by working with the National Autistic Society and health boards and local authorities should develop a national network for people with an autistic spectrum disorder.

Recommendation 8  The Scottish Accessible Information Forum should consult local authorities, health boards and users and carers on how best to provide joint, one-stop, free and accessible local information services for people with learning disabilities, their families and carers. Information must also be available in community languages.

Recommendation 9  The first PIP agreements should set out how local authorities, health boards and primary care trusts will set up and maintain local registers.

Recommendation 10  The Scottish Executive’s review of the effectiveness of funding speech and language therapy for children should also include services for adults.

Recommendation 11  The Scottish Executive should continue to encourage the development of local independent advocacy services.

Recommendation 12  Health boards should make sure they have plans now for closing all remaining long-stay hospitals for people with learning disabilities by 2005.

Recommendation 13  Health boards should aim to reduce their assessment and treatment places specifically for people with learning disabilities to four for every 100,000 population across the country as a whole. Health boards should plan for appropriate community services to avoid in-patient assessments and treatment.

Recommendation 14  Health Boards with sites remaining after 2002 should develop, with their partners, other services in the community as a priority and set aside resources to meet these costs. This will feature in planning guidance and the boards’ performance management arrangements.

Recommendation 15  Local authorities and health boards, should both examine what they provide and develop more modern, flexible and responsive services which support people in the community through employment, lifelong learning and getting them involved socially. Day healthcare services for people with learning disabilities should be mixed with those in the community.

Recommendation 16  Local authorities need to give much greater priority to developing a range of employment opportunities for people with learning disabilities. And, with health boards those authorities should lead by example in employing more people with learning disabilities.

Recommendation 17  The Scottish Executive should consider raising, with the Department of Social Security specific areas of concern related to benefits and support for people with learning disabilities.

Recommendation 18  Local authorities should review their local transport services, to make sure that people with learning disabilities can use public services wherever possible.

Recommendation 19  Health Boards should contribute funding and resources (for example, training for residential and family carers) to developing community based short breaks alongside local authorities. Local authorities will also be able to bid for any ‘change funds’ which may be made available for further developing short breaks for people with learning disabilities.

Recommendation 20  The Scottish Executive and local authorities should review their guidance and procedures to make sure that local authorities and health boards can arrange their short break and shared care arrangements for children and adults flexibly and with as little bureaucracy as possible.

Recommendation 21  There should be a long-term programme to promote public awareness about learning disabilities and including people with disabilities in the community. This should include programmes from the earliest years of education. The new centre for learning disability could be responsible for taking this forward.

Recommendation 22  The Scottish Executive’s National Care Standards Committee is currently developing standards for residential and nursing care homes for all care groups including people with learning disabilities. These standards should look clearly at assessing and managing risk in working with vulnerable people.

Recommendation 23  All local authorities in association with health boards, NHS trusts and other agencies should develop policies and guidelines on protecting vulnerable adults. Social work departments should review their procedures on guardianship to include making a formal assessment of risk a normal part of deciding whether an application should be made. Local authorities and health boards should use the Care Programme Approach for people with learning disabilities who have complex needs whether these needs are caused by disability or vulnerability.

Recommendation 24  The Scottish Executive should consider introducing a new duty on local authorities to identify a responsible person to advise and help the person with learning disabilities and their family put the FNA into practice.

Recommendation 25  Health boards and local authorities should make sure that local professionals are trained to look out for early signs of dementia and so can provide assessment and appropriate responses and services.

Recommendation 26  Life plans for people with learning disabilities who live with their parents should include plans for a time when parents may no longer be able to provide care.

Recommendation 27  Health boards and local authorities should make sure that there is appropriate specialist support such as additional support teams to improve services for people with learning disabilities who have challenging behaviour. The aim of the specialist services should be to support mainstream services and to help people stay in their own homes as far as possible.

Recommendation 28  The Scottish Executive should commission research into the number of people with learning disabilities in prison or in secure accommodation and the arrangements for assessing and providing them with care. Health boards, local authorities, and police forces should make sure that an appropriate adult scheme is in place to meet the needs of people with learning disabilities who come into contact with the police.

Recommendation 29  Local authorities, by working with health boards and the voluntary sector, should make sure that they look at the extra needs of those with profound and multiple disabilities and those of their carers. The centre for learning disability should set up a national network of support to local providers offering advice and training on the extra needs of people with profound and multiple disabilities.

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