People with Physical Disabilities - Adults

This section deals with adults with physical disabilities.  Issues for young people are in many ways similar, and are dealt with here.

Key messages:

Priorities for this group of people include

• better information and advice about services and facilities

• increasing the use of assistive technology to support people in the community

• recognising the role of carers

• developing services to maximise independent living, inlcuding making the best use of housing-related support

• increasing personal control over resources and developing self-directed support

• involving people with a disability in the planning and delivery of services

• using a new phone service to signpost people who are not emergencies

• working with children's services for a seamless transition to adulthood

What we know:

Using census based information it is estimated that between 21,000 and 24,000 adults in Northumberland aged 18-64 have a moderate or severe physical disability.

• Of those who need care management support, and whose diagnosis is recorded, around one in five have arthritis, one in eight have multiple sclerosis, and one in eleven are stroke survivors.

• Around 500 adults aged 16 to 60 may have severe to profound deafness, and 12,000 may have mild to moderate deafness

• At the time of the 2001 census, 32,680 people aged 16-64 in Northumberland said that they had a limiting long-term illness or disability (LTLI) – one in six of the population. This included 11% of all 16-49 year-olds, and 29% of 50-64 year-olds, 16.8% of people who identified themselves as white, 15.6% of women and 17.9% of men.

Analysis of the social care budget at the end of March 2012, shows that 539 people were receiving services

• 121 were arranging some or all of their support themselves using a direct payment

• 270 were supported by home carers, for an average of 13.3 hours per week

• 38 were attending day care services, on average for two days per week

• 48 were living in care homes, of whom 15 were in care homes providing nursing care

• 37 people had short breaks in care homes arranged by the Adult Care Directorate in 2011-12

• An estimated 2,540 people took delivery of items of disability equipment supplied by the joint equipment store (JELS).

What people have told us:

People with a disability or long-term illness and their carers

The views of people with a disability or long-term illness and their carers are drawn from a wide variety of sources, including user forums for people with a long-term condition, and for people who receive direct payments, carers’ forums organised by Carers Northumberland, surveys of service users and carer, and specific consultations about key developments such as the personalisation of social care.  The key messages coming out of these consultations include:

• People want services that fit into their lives and do not want to change their lives to fit the service delivery schedules and capacity of care agencies that sometimes cannot for a variety of reasons provide support when they want it
• The current care management service is valued as a way of having needs assessed and support services arranged, but is also felt to be bureaucratic, with many forms having to be completed to access these services
• People want to feel that they are listened to and want to be in control of the care planning and care arrangement processes.

People receiving social care services

People receiving social care services in Northumberland were surveyed as part of the Adult Social Care User Survey in England 2010-11. Overall views were very positive: overall satisfaction with the care and support people were receiving was 93% - either extremely (31%) satisfied, very satisfied (32%) or quite (30%) satisfied.

This is reflected in the view that some key aspects of quality of life were mostly in place:

• People described their personal care positively: 53% feeling able to present themselves in the way that they liked; 41% feeling adequately clean and presentable.
• 64% of people felt they got all the food and drink they liked when they wanted it; 30% felt their food and drink adequate.
• 60% felt their home was as clean and comfortable as they wanted; 35% felt it was adequate.
• 62% of people felt as safe as they wanted; 30% felt adequately safe.

However, views on overall quality of life suggested that people would like to see improvement: 47% of people felt extremely, very or quite satisfied. Possible issues include:

• 72% of people felt they had as much control as they wanted over daily life and 47% felt they had adequate control.
• 39% felt they had as much social contact as they would like, and 36% had adequate social contact.
• 61% of people thought information and advice very easy or fairly easy to find, 20% found it fairly difficult or very difficult to find.
• Perhaps understandably in a county such as Northumberland, satisfaction with getting around outside the home was an issue: with 30% of people feeling able to get to all the places in their area that they want; 27% acknowledging that at times this was a challenge; 24% unable to get to the places they want and 19% unable to leave their home.

Short Term Support Service

People with many different needs use this service, which provides initial assessment and support with a view to quickly restoring people’s independence and maintaining their ability to live in their own homes. Their views were sought in summer 2012.

Overall views were very positive

• High levels of overall satisfaction: 97% rating the service either excellent (73%) or very good (24%).
• Most people felt the service offered helped them to do things for themselves (93% either agreed with this or agreed strongly)
• Most people the treatment they received was polite and friendly (99% agreed or agreed strongly); and respected their dignity and privacy (99% agreed or agreed strongly).
• Information about the service was understood fully (57%) or partially (28%); and timing of visits was convenient always (65%) or most of the time (32%).

There were some areas where comment was negative or suggested improvement was possible – 24% of people felt their ability to do housework or laundry had reduced after receiving the service; 25% of people felt the same in respect of shopping.

In-house services (mostly for people with learning disability)

The users of these services made the following points.

People liked going to the day services, felt safe there; were happy with the staff; had friends there; but views about meals and information provided by the service were mixed.

People using the horticultural services also liked going there; felt safe there; were happy with the staff; and had friends there. They reported that they got the chance to learn about new things; they knew how to use tools and equipment safely; but some people felt they were not consulted about how the service was run and others also wanted to see better information.

People from residential care services liked living there; were happy with the building; felt safe there; were happy with the staff; and felt able to keep in touch with family and friends. Some people said they wanted more things to do and to go out more: some people did not feel able easily to make their own drinks and snacks.

Copies of surveys from previous years are available below:

What customers have said about our services (Northumberland Care Trust 2009)

Annual Survey of People Accessing Care Management (Northumberland Care Trust 2008)

Home Care Survey Summary 2009 (Northumberland Care Trust 2009)

Summary report on outcomes for service users and carers 2008 (Northumberland Care Trust 2008)

Policy and research:

Disability Discrimination Act (2005) makes it unlawful to discriminate against a disabled person in relation to employment, the provision of goods, facilities and services, and the disposal and management of premises. Some provisions also relate to education, taxis, public service vehicles and rail vehicles..

National Service Framework on long term (neurological) conditions (2005) sets out 11 quality requirements to improve treatment, care and support from diagnosis to the end of life for people with long-term conditions.  It Includes issues for providers of transport, housing, employment, education, benefits and pensions. The NSF focuses on people with long-term neurological conditions, but much of the guidance it offers applies to anyone living with a long-term condition.

Improving the Life Chances of Disabled People (ODPM, 2005) - a Joint report making recommendations for independent living; early years and family support; transition to adulthood; and employment.

Aiming High for disabled children (2007) - a Government review of services for disabled children and their families focusing on three priority areas:

• access and empowerment
• responsive services and timely support
• improving quality and capacity.

Equity and excellence: Liberating the NHS (HMG , 2010)
This White Paper proposed a major restructuring of health services and of councils’ responsibilities:
• GP commissioning consortia, working in partnership with councils and health services
• An NHS commissioning Board to oversee commissioning and promote service improvement and patient involvement
• Abolition of Strategic Health Authorities and primary care trusts n 2013
• new roles for councils in public health, including new statutory Health and Wellbeing Boards to oversee coordination between social care , public health and health improvement
• A new national voice for patients Health Watch, whilst existing local involvement networks became local Health Watch Branches
• new roles in relation to health and social care providers for Monitor (economic regulation) and the Care Quality Commission (quality inspectorate)
 
A vision for adult social care: Capable communities and active citizens (DH, 2010)
Set out the government’s vision for social care based around seven principles:
1. Prevention: empowering people and strong communities to maintain independence.
2. Personalisation: individuals taking take control of their care.
3. Partnership: delivering care and support in a partnership between individuals, communities, the voluntary and private sectors, the NHS and councils
4. Plurality: Encouraging diverse service provision to match the variety of people’s needs
5. Protection: safeguarding people against the risk of abuse or neglect.
6. Productivity: increasing local accountability to drive improvements and innovation.
7. People: drawing on a skilled compassionate and imaginative workforce.
 
Caring for our future: reforming care and support (HMG, 2012)
This White Paper bult on the 2010 vision for social care with proposals for a reformed care and support system, structured around outcomes for the people who use services and their carers:
• “I am supported to maintain my independence for as long as possible”
• “I understand how care and support works, and what my entitlements and responsibilities are”
• “I am happy with the quality of my care and support”
• “I know that the person giving me care and support will treat me with dignity and respect”
• “I am in control of my care and support”.
 
Draft Care and Support Bill (HMG, 2012)

The draft Care and Support Bill was published alongside the White Paper above consolidating the existing legislation into a single law for adult care and support and providing the legal framework for some of the main proposals in the White Paper.
 
The Adult Social Care Outcomes Framework 2013/4 (DH, 2012)
This framework set out new measures for adult social care under four domains:
1. Enhancing quality of life for people with care and support needs
2. delaying and reducing the need for care and support
3. Ensuring that people have a positive experience of care
4. Safeguarding adults whose circumstances make them vulnerable and protecting from avoidable harm
The framework is a key mechanism allowing government to set priorities for adult social care and measure progress against them.  It is intended to link with similar frameworks for NHS outcomes and public health outcomes.

Our Plans for the future:

Joint Social Care and Health Commissioning Plan 2012 -15

Sets out our shared commissioning intentions for working-age adults with a physical disability or illness.

Contact Adult Social Care

Telephone: 01670 536 400

Email address: Socialcare@northumbria.nhs.uk