---

Learning Disability: Adult Social Care

I thank noble Lords for attending today's debate—we are, I fear, the usual suspects—to discuss how the needs of those with a learning disability will be addressed in the Government's forthcoming paper on future funding for adult social care. You will appreciate that, as president of the Royal Mencap Society, this subject is close to my heart. Mencap is a leading member of the Learning Disability Coalition, which is at the forefront of the campaign to ensure that this Green Paper fully addresses the demographic changes which will necessitate, and already are necessitating, greater social care support for those with a learning disability. Currently, only 120,000 people out of the 1.5 million people with a learning disability receive support from social services. Many of those who receive support have had it reduced because of pressures on social care budgets. That means fewer hours at a day centre and fewer hours of help with washing, shopping and attending social activities. Others have been totally excluded from care as cash-strapped councils tighten their eligibility criteria. For all the people affected, that means that their quality of life has deteriorated. Many languish at home instead of being able, like their non-learning disabled peers, to reach their potential. The Commission for Social Care Inspection has referred to these people as becoming ““lost in the system”” and has confirmed that the tightening of eligibility criteria is set to get worse with 73 per cent of councils stating that next year they will be able to support only learning disabled people with severe or critical needs—means testing by another name. That means that three-quarters of councils' learning disability budgets are under-resourced. Individual stories of hardship, as a result of this tightening of eligibility criteria, are beginning to emerge. The other day I heard from a 70 year-old mother and an 80 year-old stepfather who support their 41 year-old son, Philip, in the family home. Previously, Philip enjoyed a total of nine weeks' residential respite at a local unit three miles away from home. He also had six tea-time visits a year. The family described this respite as a ““life saver””, giving them a chance to relax and carry out their household tasks. They also had access to a 24-hour emergency support service. I believe you will be as shocked as I was to hear that most of this system of support has been withdrawn. In their own words, the family says: "““Philip's respite was reduced to just four weeks, eleven miles away at a unit which we consider unsuitable and which necessitates a difficult journey for us, his elderly parents. There are no tea time visits, no emergency services in place. In reality we had only fifteen nights respite in the last year””." The care services Minister has announced a review of eligibility criteria, and for this we are grateful. However, stories such Philip's show how urgently action is needed and that these alarming reductions in the availability of social care need to be addressed in the forthcoming Green Paper. Another worrying story concerns a 43 year-old man, Andrew, whose father contacted the Learning Disability Coalition. Andrew suffers a range of physical and mental disabilities. His father says that, "““whilst his condition has been deteriorating over the past eight years, this mainly affected his mobility””." The underfunding of adult social care in his area has meant that the vital one-to-one support that Andrew's daycare centre provided has ceased. Andrew used to have the capability to communicate vocally with a few words and short sentences, through which he could indicate his needs. However, Andrew's father says, "““Since the one-to-one facility was abandoned by the centre, he has lost all power of speech. Whilst one cannot be absolutely sure his loss of vocal communication is the result of the lack of stimulation, being shuttered up daily with 50 or so others in a ‘warehousing’ situation, leads our own doctor to strongly believe this is the major cause of his problem””." That widening reduction in services, caused by a lack of adequate resources, will make it near impossible for the Government to deliver the admirable policy promises they have made to people with learning disabilities. Those promises have been set out in Valuing People Now, Improving the Life Chances of Disabled People, Putting People First, the Independent Living Strategy, and others. Those government plans have raised the hopes and expectations of people with a learning disability and their families. However, as the excellent report from the Joint Committee on Human Rights said earlier this month, "““limited resources are undermining attempts to implement the aims of that policy [Valuing People] effectively””." The Commission for Social Care Inspection has also commented that, "““the quality of life for many could be significantly enhanced with relatively minor social care interventions ... support to take part in leisure activities, support to go to a skills class at the local further education college or support to sustain a job””." Indeed, removing day-time activities for people with Down’s syndrome and other forms of learning disability can lead to early onset of dementia and mental health problems. Withdrawing support from people to take exercise endangers their health and encourages obesity. Apart from the impact on people's quality of life, that will cost more in the long run than the cost savings made. This shortfall in funding is making a mockery of the Government's prevention agenda. The Green Paper provides the Government with the perfect opportunity to get to grips with the current failure to resource properly the services they have promised people with learning disabilities. The Government have talked a great deal previously about this Green Paper's agenda to tackle the problems of an ageing population, but they have not talked nearly enough about how they plan to address the social care needs of adults with a learning disability. There are significant differences between the social care needs of people with learning disabilities and older people. Many people with learning disabilities need care packages for life and those packages will need flexibility so that they change as their needs and aspirations change. Co-payment, which is such a pertinent issue in funding the care of older people, is unlikely to be relevant for people with learning disabilities as many of them remain, regrettably, some of the poorest and most socially excluded in the country. I am delighted to say that more people with a learning disability are surviving infancy and are living much longer than ever before. However, improvements in neo-natal care mean that the number of babies surviving with profound and multiple learning disabilities is increasing. Such babies may need costly care packages. This is adding yet further to the pressure on social care services which, as we have seen, are already struggling to meet demand. Another issue is that 60 per cent of people with a learning disability live with their parents. As these sons and daughters live for longer, many elderly and frail parents and families will no longer be around to care for them in the family home. Unfortunately, there is not enough up-to-date information about the trends in demand for services for people with learning disabilities to make accurate projections of how those numbers are increasing and what the likely future costs will be. We need a great deal more evidence if we are to ensure that we allocate sufficient resources to provide the accommodation and support that people with a learning disability need to live independently of their parents. I would be grateful if the Minister could tell me whether the department has, or is considering, carrying out that vital research. My conclusion is very simple. I invite the Government to use the months before the publication of the Green Paper to commission the necessary research so that when they publish they can ensure that services for people with learning disabilities will be adequately resourced in future. The Government have set themselves the aim of achieving equality for disabled people by 2025; if they are truly committed to tackling the complex and sensitive issues that I have outlined today in the forthcoming Green Paper, it has the potential to be a vital tool in the achievement of the 2025 aim. I look forward to hearing the thoughts and comments on these issues from other noble Lords and, in addition to these speeches, eagerly anticipate the Minister’s reply to this discussion.