By Sue Brown, head of policy at deafblind charity Sense
The most important date in social care this year will be the 1st April. This is when the Care Act comes in to force and it’s vital that local authorities and practitioners are ready for the changes this will bring.
For deafblind people, including the large numbers of older people with sight and hearing loss, the Act will bring welcome changes that will improve their experience of social care. Making sure the Act is implemented correctly however, is key to its success.
Here are some key issues for anyone who is responsible for implementing the Care Act in relation to sensory loss:
How will local authorities manage their first contact with a person with sensory loss? The Care Act guidance is clear that the process of assessment begins “from when the local authorities start to collect information about the person” (see 6.22 of the Care Act Guidance).
There are implications for the training of first contact teams in relation to adults with sensory loss. It is acknowledged that there must be a range of ways to make contact, not just on line or on the phone. For deaf and deafblind people, interpreters may be required.
The Act requires an appropriate level of qualification for people assessing someone who is deafblind. There is also the requirement to ensure that the person being assessed is involved in the assessment as fully as possible.
This will require that the person carrying out the assessment is able to communicate with the adult, and the guidance makes reference to the need for a qualified interpreter, with appropriate training where the adult is deafblind. Information about assessments will also need to be available in accessible formats.
Many of the points in the eligibility criteria are relevant to people with a sensory loss. These might include:
• Managing and maintaining nutrition- because accessing shops and food preparation is difficult and because food identification as well as the ability to read use by dates is compromised.
• Being appropriately clothed – because it is hard to identify clothing (so as to wear matching outfits) and know when clothing is dirty.
• Being able to make use of the home safely – specialist equipment such as vibrating smoke alarms and door bells may need to be fitted, home adjustments such as better lighting may be necessary. Trips and falls are a risk if lighting is not adequate and appropriate.
• Maintaining a habitable home environment- keeping the home clean is often problematic for visually impaired people. Health and safety risks may arise from the inability to see or hear hazards in the home, as well as difficulties accessing information relating to utilities.
• Developing and maintaining family and other personal relationships – both mobility and communication difficulties can be a barrier to developing and maintaining relationships, as they impact on essential activities such as travelling to visit friends, holding a conversation, using the telephone or accessing correspondence.
• Accessing and engaging in work, education, training or volunteering – mobility, access to information and communication all present barriers to this type of involvement.
• Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services.
• Carrying out any caring responsibilities the adult has for a child – for a person with sensory loss many aspects of parenting can be difficult. Older people with sensory loss may wish to provide support to their family by caring for grandchildren.
It will be important for local authorities to have appropriate prevention for people with a sensory loss which might include sufficient rehabilitation officers for the visually impaired. The Care Act guidance says that rehabilitation for sight impaired people is a specific form of reablement.
Information and advice
The Act also requires that a local authority establish a service for providing information and advice to people about care and support for adults and about support to carers. There is a section of the guidance on accessibility of information and advice, and people with sensory impairments are listed as one group whose needs must be considered.
In relation to deafblind people, the deafblind guidance also requires that authorities are able to provide information to people in a range of formats such as braille, large print, electronically. In exceptional circumstances a person may only be able to receive information in deafblind manual. For these small number of people it will be necessary to provide the information in person.
Local authorities must keep a register of people who are sight impaired or severely sight impaired. There is a chapter of the Care Act guidance on this which includes reference to providing excellent services for blind and partially sighted people.
Sue Brown is head of public policy at deafblind charity Sense. Sense has produced a free guide to help local authorities implement the Care Act.