This survey has been sponsored by Autism Care UK. The editorial content is independent of the sponsor.
Specialist autism teams are needed to close a skills and training gap that is leading to inadequate support for service users, particularly those with Asperger’s syndrome.
That was the message from a Community Care survey of 182 social care professionals, most of whom (56%) said they were highly experienced in working with adults with autism.
Three years on from the implementation of the national autism strategy for England, many professionals see a lack of progress in achieving its objectives of better diagnosis, assessment and support for adults with the condition.
Mixed views on quality of social work
The survey revealed mixed views on the overall quality of social work and care management for the client group, a need for greater training and guidance, and particular concerns about outcomes for adults with Asperger’s syndrome or high-functioning autism:
- 31% said assessment skills among social care professionals in their area were good or very good, while 24% said they were poor or very poor;
- 30% said support planning skills were good but 28% said they were poor;
- 48% said the availability of training in supporting adults with autism for social care professionals was poor;
- 88% said more guidance was needed for social care professionals about using personal budgets for service users with autism;
- 50% said the quality of care management for adults with Asperger’s or high-functioning autism was poor;
- 61% of respondents said eligibility thresholds in their area denied adults with Asperger’s the support they needed.
Adults with Asperger’s are often excluded from support because they are neither picked up by learning disability nor mental health services, or because they are deemed not to meet adult social care eligibility thresholds because of their intellectual abilities.
Lack of Asperger’s skills
“There is a reasonable service for adults with severe autism but the skills of the worker and the assessment process often means the needs of adults with Asperger’s are not recognised and they are left with inappropriate and inadequate support.”
Social worker, South West England
Concerns about skills levels were reflected in the fact that four in five respondents said all councils needed to set up specialist teams to manage support for adults with autism. These remain relatively rare despite the autism strategy saying that outcomes have improved for adults with the condition in areas which have specialist teams, whether integrated with health or not.
Just 14% of respondents said they had a specialist team in their area; 54% said the social care needs of adults with autism in their area were managed by a learning disability team, either in whole or in part, while 26.5% said they were managed by generic adult social care teams.
“Where we’ve identified good practice it’s tended to involve a specialist autism team,” said National Autistic Society head of policy Sarah Lambert. “The biggest challenge is when people present to a local authority and they have nowhere to go, particularly where they have Asperger’s or high-functioning autism. Where there’s an autism team there’s somewhere for them to go.”
Lambert added that specialist teams were also a good practice resource for other staff working with adults with autism, for instance by helping them develop skills in identifying the needs of adults with Asperger’s during assessment.
Assessment skills crucial
“Unless the assessor has a good understanding of autism and the impact that has on people’s daily lives, particularly where you have someone with high-functioning autism or Asperger’s who may present as very articulate, these issues may be masked,” she said. ”So knowing where to probe or to ask that additional question is very important [during assessment].”
“We see in our work how important early preventative support is for people with high-functioning autism, but eligibility remains a problem as this survey reveals,” said Gary Thompson, operations director at specialist provider Autism Care UK. ”For this group, early intervention can prevent a crisis and thus makes sense in both good practice and economic terms.”
Concerns over providers
“We have very few specialist providers and often people do not get the most appropriate support from providers who truly understand their needs.”
Senior social worker, West Midlands
The survey revealed concerns about the quality of care and support for adults with autism, which 48% of practitioners thought was poor, and a lack of progress against the main objectives of the autism strategy.
Almost two-thirds (64%) said there had been poor progress in improving employment opportunities for adults with autism since the publication of the strategy, while 45% said progress on improving access to care and support had been poor and one-third said the same about progress in access to diagnosis and assessment.
The Department of Health is currently reviewing the impact of the autism strategy, which will involve councils and their partners carrying out a self-assessment of progress against local autism plans. This is due to report next year.
“This should give us a very clear baseline position about what has worked, what hasn’t and what’s yet to be implemented,” said Association of Directors of Adult Social Services learning disabilities lead Andrea Pope-Smith. “[The autism strategy is] work in progress with much more to be done.”
Sharpen up your autism skills
Get practice tips from specialist autism teams at Community Care’s forthcoming conference on supporting adults with the condition, which takes place on 18 September in London. Register now for a discounted place.
Good practice in supporting adults with autism