Closing campuses for people with learning difficulties

This article appeared on page 45 of the magazine, under the title Going off campus

By 2010 the several thousand people with learning difficulties in NHS campuses should have moved into the community. Amy Taylor reports on the obstacles en route

Picture this. Over 20 years ago, you were forced to move away from your local area and had no choice about who you moved
in with.

Now, you are legally classified as an NHS in-patient although you are not sick. As a result, you have no right to benefits and all your needs, aside from food and a roof over your head, must be funded from hospital pocket money of less than £20 a week.

It’s Saturday, and you would like to go into town but your accommodation is too far away and you are unable to move closer.

This is the situation faced by some 2,700 people with learning difficulties living in National Health Service residential campuses (see What are NHS campuses) today. As well as having few rights, research has shown that people living in campuses also experience less choice than people living in homes in the community, have fewer things to do during the day and have fewer chances to make new friends.

Until 18 months ago, the government’s main focus was on closing long-stay hospitals, where people with learning difficulties also lived, but since most hospitals have closed it has asked professionals to focus their attention on moving all residents out of campuses and has set a deadline of 2010.

Sue Carmichael, the Valuing People Support Team’s lead on NHS campuses, will not be drawn on whether the deadline will be
met but describes it as a “good challenging target”.

She says that professionals working in campuses are keen to help people to move out and that “the trend is definitely downwards”. “Of the people who I know who manage campuses, some of them are very honest and they just feel it’s not good enough for people and it should be better,” she says.

Jo Kidd, director of The Skillnet Group, a not-for-profit company supporting people with learning difficulties, has been involved in helping people at Lanthorne Court, an NHS Campus in Broadstairs in Kent, to develop their own personcentred plans and become more independent since 2003.

She says that, so far, only one of the 24 residents has moved out into housing in the community while six others have started making plans to do so. Kidd says that moving people out of campuses involves her in helping residents to take small
decisions before building up to larger ones.

“When people say they have supported people to have person-centred plans, and claim everyone has moved out and everyone has got a new life in six months, I would very much doubt that the process had been very person-centred,” she says.

Kidd says that, as with other services, resources and funding are the main obstacles to helping people to move out and that
in her area more supported living options in the community are needed.

Ayesha Janjua, policy and campaigns officer for learning difficulties at charity Turning Point, says that “questions need to be asked” about why community-based housing is not being commissioned for all campus residents now.

She argues that it is “not good enough” that people are still being cared for on campuses when they are known not to be good places to live. Funding complexities are among the obstacles to moving people out of campuses. A government rule stops the
NHS from selling land including campus sites and giving the money as capital to housing associations who could then use it to build alternative community-based accommodation.

But Carmichael says that there is a change in the financial rules from this financial year and this should help to make this situation easier.

She adds that in practice she has never known money from the sale of a campus not going towards housing for its former residents as professionals are usually able to work around the rules.

David Congdon, head of campaigns and policy at learning difficulties charity Mencap, says that a further barrier is campus staff ’s fears about where they will be redeployed as they are protected from losing their jobs by Tupe outsourcing  regulations.

He also argues that it is not always proper for them to follow former residents as community-based housing requires staff with “a different set of values” based on promoting independence rather than control.

However, Yvonne Cox, chief executive of Oxfordshire learning disability NHS Trust, who sits on the government’s learning disability advisory task force, believes that while employing former campus staff in new services “presents a challenge,” it can work.

“It might make it more difficult to ensure you are delivering a supported living service but I don’t think it’s impossible,” she says. “It’s something you would have to actively project manage and would require clear strategic leadership.”

Concerns from families about the suitability of community housing for their relatives can be another barrier.

Carmichael says that this is understandable given the length of time some people have been living in campuses – in some cases between 20-30 years – and says work needs to be done with families to reassure them that the move will be a positive one.

Carmichael says that the Valuing People Support Team is set to come up with a detailed plan on what needs to happen next to help people to move out of campuses.

Janjua says that the 2010 target must be met and that doing so should be made a “national priority” with the closures of
campuses already overdue. “People with a learning difficulty are not ill. No one should be placed in a hospital unless they have health care needs.

A hospital is not a home,” she concludes.

What are NHS campuses
NHS campuses are operated by NHS Trusts and are comprised of housing, some of which is clustered on one site, together with some shared central facilities. They were developed as a direct result of the closure of NHS long-stay hospitals. The people who were moved from hospitals into campuses rather than into the community were usually those who had other conditions aside from their learning difficulty, such as a mental health problem or a physical disability.

The government aimed for all long-stay hospitals to be closed by March 2004. Once this target was missed it extended this to March 2006. Five still remain open housing nearly 150 people. Ministers have set a target for the estimated 2,700 people currently living in NHS campuses to be moved out by 2010.

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