Day services for people with learning disabilities have received a lot of interest in recent years. Traditionally, most adults with learning disabilities have been provided with day services – usually centring around a “day centre” to attend along with other people with learning disabilities in the area.
However, in 2001 the government’s Valuing People strategy urged social care commissioners and workers to “modernise” services and support people with learning disabilities to do more day activities in settings such as workplaces colleges sports, leisure and community centres and local towns.(1)
Valuing People policy is based on the evidence that people with learning disabilities generally prefer to do ordinary activities in ordinary places, while still receiving support that meets their individual and specific requirements.
Since the late 1980s a wide range of community-based alternatives to “traditional” day services have emerged in the UK. However, many councils are struggling to make the move to more tailored, flexible services that offer choice and control.
In 2005, a national survey of people with learning disabilities found that 39% of all people with a learning disability were attending a day centre two-fifths of them were attending five days a week.(2) The same survey also found that only one in six had a paid job, compared with two thirds of men and half of women in the general working age population. Two thirds of the people who were unemployed and able to work said that they wanted a job, but the range of jobs available is narrow – with a pattern of low hours and low wages. Mencap has also expressed concern about day services and estimates that 20,000 people with learning disabilities in the UK have no form of support or provision at all for structured activities outside of the home during the day.(3)
There is little evaluative research into day services and supports for adults with learning disabilities.
Employment provision has received more research attention, but the role of adult education and the further education sector, leisure services, and self-help initiatives have been virtually unexplored.
Evidence from Scie’s practice survey and report Having a Good Day? Suggests that people with learning disabilities feel that they “have a good day” when they are:
● Doing things that have a purpose.
● Being in ordinary places, doing things that most of the public would be doing.
● Doing things that are right for them.
● Receiving support that meets their needs.
● Being in touch with local people, meeting people and developing friendships.
There are a number of areas that practitioners, managers, commissioners and people in direct support and community building roles need to focus on if they are to modernise their day services to the desired standards, including: partnerships with people and families, leadership, personalised planning with and for people, individualised funding and direct payments and cultural change in services. There are also specific steps that social care workers can take to create more community-based opportunities and make sure that services are reflecting the priorities of the people using them.
To move towards more community-based services, it helps to:
● Create local solutions.
● Nurture the support of family networks, friends and relations through good involvement and partnership strategies, and evidence of reliable, safe community-based practice.
● Develop deliberate practice strategies to build connections and inclusion, and thereby develop natural supports around people.
● Take things one step at a time and celebrate success so that others can see it’s possible.
● Prioritise people with higher support needs to ensure they have the opportunity for individualised support and can take up opportunities in community settings.
● Work with people from black and minority ethnic communities to create solutions they see as acceptable.
● Develop wide partnerships to build a welcoming community infrastructure.
● Use capital money creatively, and not to create buildings “for the service”.
● Invest in local leaders and champions.
● Create new job roles and responsibilities, and flexible working hours.
● Keep as much money as possible flexible and available for support – not tied up in running buildings.
To ensure that people are doing what they want to do, it helps to:
● Make sure that person-centred approaches are in place.
● Plan with younger people in a person-centred way, encouraging their families to be involved in a natural way to help lead the plan.
● Individualise funding: attach it to each person so that community inclusion happens for them.
● Recruit, develop and support staff to be creative, and to keep finding solutions as people change and develop their aspirations.
● Make sure people get good information about choices, including stories from people who have pursued their own wishes and dreams and succeeded.
● Scie (2007) Having a good day? A study of community-based day activities for people with learning disabilities
● Valuing People online
● In Control project:
(1) Department of Health (2001) Valuing People
(2) Emerson, E, Malam, S, Davies, I and Spencer, K (2005). Adults with learning difficulties in England 2003-4, Health and Social Care Information Centre.
(3) Mencap (2002) A life in the day: The modernisation of day services for people with a learning disability
Research abstracts: Adults with learning disabilities