Community-based day activities and supports for people with learning disabilities

Messages from 'Having a good day' - Smart commissioning

What research tells us

There are three key tasks: planning the transition from centre-based to community services; reconfiguring and using resources in specialist and mainstream community services to meet existing and unmet needs; developing supports that respond to the needs of individuals. Poor strategic leadership, poor partnerships, lack of emphasis on employment, and shortage of properly trained care managers are all issues of concern.

What's happening in practice at the moment

Pointers for development

The work of local commissioners, policy makers and managers should be informed by people with learning disabilities, support workers and families. Think beyond partnership board meetings to reference groups, citizen juries, coffee mornings, open door days and more.

Make sure that everyone is clear about the ends being pursued: what is meant by community inclusion and connections, self-directed supports and so on. Talk about things in ways that everyone can understand. Make it real by unpicking terms like 'community builder', 'independent living', 'all means all', 'self-determination'... Have monitoring systems for community day services that are focused on those ends. The effectiveness of strategic commissioning and purchasing is part of local authority annual performance assessment from 2007. How will you show the effectiveness of day service modernisation and community services locally?

Think about the whole-system and the future, not just about services run by social care agencies and not just about the next year or two. Aim to develop a comprehensive and coherent network of options and support that will meet projected demand while also enabling people to have greater control over their daily lives.

Find ways of empowering providers to achieve excellence, but make expectations clear too. Use the Disability Equality Duty as leverage with mainstream services. Ultimately, if the local authority simply has too many constraints and red tape for community provision to thrive, consider the benefits of 'externalising' services. See the development of Pure Innovations in Stockport as an example.

Use the Checklist for community developments (17kb PDF file), which is based on ordinary life principles, as a starting point to assess every proposed development. The aim is to be able to answer 'yes, we do' on all counts.

Give priority to safeguarding the financial standing of services that are really making progress in helping people achieve ordinary lives. Plan well ahead so that they are not left to end or decline. Give others that aren't doing so well some targets and a timeframe to improve results, but make sure they get support too. Ultimately, d ecommission things that don't work and reinvest in things that do.

Keep focused on routes to employment. Work is a significant feature of ordinary life. Make sure there is a clear role for community day services, and that staff are developed to fulfill it.

Read the rest of this guide!

Some don'ts!

Practice examples

North Lanarkshire is a good example of a whole local authority strategy in action, with a strong leadership and values base. The five day centres in the area have now become 'locality bases', and are rapidly moving into providing community support instead of centre-based provision. At the same time, some 300 people have recently left long-stay institutions and are now receiving individualised services for supported living, and have their own tenancies or homes. North Lanarkshire works with a large number of providers, who work together and share their experience rather than competing with each other. They have broken down the division between support for living and support for day activities. Because of this, people with learning disabilities are having true individualised support, with supporters they know and trust.

North Lanarkshire also provides supported employment services, both through the council (former day centre staff have moved over successfully into supported employment) and also within its provider services. Currently 110 people with learning difficulties have real paid jobs, and all of these are over 16 hours a week. Others are starting up micro-enterprises. One person, for example, has a business in car washing, and another is planning to start up a café. Everything is based on a person-centred model and there is emphasis on accessible information and use of multi-media at every level.

One parent of a young man with high support needs describes how she had initially been very concerned about day centre closure. With other parents, she had taken part in active protests. Now, however, her son has one-to-one community-based support from a service that is supporting six young men with complex needs. Support starts from their own homes, and they go out to different places with their supporters, who work closely with parents and family members in a person-centred way. This parent has been totally won over to the new model.

A new community sport centre in Southampton is being created with money released from sale of a day centre combined with a grant from Sport England to refurbish and expand a community centre. The new centre will be managed by local residents, including people with learning disabilities. It is part of a day service modernisation strategy that will re-invest capital money from day centre sales into the development of three community facilities for the benefit of all members of the community.

Pedal Power in Cardiff arose from the work of physiotherapists and has developed into a separate charity. It is run by volunteers with advice from a sessional cycling coach, and has its own adapted bicycles. It's currently based in a caravan park with access to traffic-free parkland and the Taff Trail. People cycle for up to an hour, for exercise, to try cycling out, or just for fun.

Links and resources