How do we do it better?

It seemed apt that the title of a conference on implementing the
Department of Health guidance on services for deafblind
people¹ should be called “How do we do it?” because many
of the local authority social services representatives attending
were desperately short of answers.

And some answers are sorely needed because the threat of judicial
review hangs over those local authorities that fail to provide
these services.

But a survey by deafblind charity Sense at the end of last year
showed that the majority still have a long way to go before they
can claim to be implementing the guidance effectively. More than
half said they had neither financial resources nor staff to provide
a communicator guide to a person who needed one and more than
one-third had no system for identifying deafblind people in their
area.

The guidance was hailed as a breakthrough. For the first time there
was a statutory recognition that deafblind people cannot
necessarily benefit from services for deaf or blind people and need
specific services of their own.

The guidance puts a duty on local authorities to:

• Identify, make contact with and keep a record of deafblind
  people in their catchment area.
• Ensure that assessments are carried out by a person or team
  specifically trained to assess needs of deafblind people.
• Ensure they are able to access specifically trained one-to-one
  support workers for those people they assess as needing one.
• Ensure that services provided are appropriate.
• Provide information about services in formats and methods that
  are accessible to deafblind people.
• Ensure that one member of senior management includes within
  their remit overall responsibility for deafblind services.

Bradford Council had been implementing many of these measures
for 10 years before the guidance came in. Head of adult services
Peter Kay emphasises the importance of a “champion” to put
deafblind people on the agenda, and of having policies and
strategies in place to underpin services. A senior deafblind
champion can ensure that the entire social services department is
aware of their responsibilities under the guidance.

Given that deafblindness is a specialist area, those authorities
newly committed to working in the field are likely to need to train
staff. Those providing support, such as communicator guides,
interveners and interpreters, and those assessing a deafblind
person need specialist training. The Council for the Advancement of
Communication with Deaf People (CACDP) has developed a series of
courses at different levels which will be essential to any
authority implementing the guidance.

Sense’s head of acquired deafblindness, Liz Duncan, who delivers
the CACDP training says: “Although it is called a support worker
course, the level 2 CACDP course is also suitable for senior
managers. I often find that this can give a senior manager the
confidence to become the ‘deafblind champion’ for an authority. The
level 3 course is suitable for specialist staff. One sensory
impairment team who recently took the course said that, although
they already had a lot of experience of sensory impairment, they
found the course very useful in looking at how their service could
be accessible for deafblind people.”

Complying with the guidance can seem a bewildering prospect. A
child born deafblind, a teenager born deaf who uses British Sign
Language and is now progressively losing their sight and an 80 year
old who has been hearing and sighted for most of their life are all
covered by the guidance.

This is not an area where a one-size-fits-all approach is possible.
Deafblind services need a person-centred approach. And they must be
run by staff who understand the unique challenges facing people who
can no longer use the two senses by which we gain 95 per cent of
our information about the world around us.

As well as using the DoH website for reference, local authorities
trying to implement the guidance are supported by voluntary
organisations. Sense chief executive Tony Best says: “Sense was
delighted when the guidance was introduced as we knew it could make
a real difference to the lives of deafblind people. We are happy to
help any local authority that is trying to implement the guidance.
However, this is a statutory responsibility and local authorities
have to take the initiative in developing strategies, and approach
us for support as needed.”

The DoH will also monitor local authorities’ progress. Pamela Marsh
is responsible for sensory impairment and environmental support for
the DoH. She told the conference, which was organised by Sense and
publisher Pavilion: “This year’s delivery and improvement
statements will ask for more specific information about the way
data are collected, who is carrying out assessments and what
services are being offered. We know that practical help is what is
needed and we continue to update the DoH website² which
provides information on training, links to other sites, summaries
of reports on initiatives and contact points for those and other
relevant information.”

At the moment organisations representing deafblind people are happy
to advise and help those local authorities struggling with the
guidance. But it will not be long before deafblind people lose
their patience with authorities which are not making significant
progress and those councils will be subjected to a more critical
campaigning strategy. CC

Council’s response    

In April 2002 Walsall Council recruited a deafblind development
officer and a deafblind service co-ordinator.  

The team takes initial referrals and works with the client for
up to eight hours a week for four to eight weeks. Since March 2001
more than 250 deafblind people have been identified and assessed in
Walsall, most of whom are elderly who have acquired a dual sensory
loss.  

After the report is made, services, including communicator
guides, are then arranged. Ten people currently receive a
communicator guide service.  

Staff training in deafblindness has been initiated and rolled
out across the social services team, in liaison with a specialist
agency.

Client’s response 

Dianne Walker receives a communicator guide service run by Kent
Association for the Blind.  

“Having a communicator guide has brought back happiness into my
life. Shopping had become a daunting, unpleasant experience because
I couldn’t see items or prices, ‘buy one get one free’ offers and
if my food store had a change around, I wouldn’t have a clue.  

“I lost all confidence and could no longer go there. My guide
changes shopping trips into happy events. Every week we have a good
laugh about something that happened while we were out. She has even
taken me to Bluewater shopping centre and the local garden centre,
places I could never have gone on my own.”   

Sue Brown is head of campaigns and public policy, Sense.
Tel: 020 7272 7774, fax: 020 7272 6012. 

References  

¹ Local Authority Circular
LAC(2001) 8, Social Care for Deafblind Children and
Adults, April 2001. Further information about the guidance can
be found on Sense’s website
www.sense.org.uk/socialservices 

²
www.doh.gov.uk/scg/deafblind