Working with lesbian, gay, bisexual and transgender people: people with physical disabilities: Doug's story

In this film we meet Doug, a gay man with physical disabilities who is in residential accommodation eight miles away from his friends and family. Doug carefully considered when to ‘come out’ within residential care and explains that this is a continual process because of the high turnover of residential care staff.

Discrimination and insensitivity about Doug’s being ‘out’ to other residents and suggestions by his providers to ‘keep quiet’ around other residents are highlighted in the film. Doug feels he has little opportunity to meet other gay people, so he feels isolated and cut off from the gay community.

Doug believes that a cultural shift and change in attitudes in social care is vital in order to provide relevant care for LGBT people. He also feels that direct payments are only one part of a solution to offer more choice and control to the user of services.

Messages for practice

• People with physical disabilities have sexual desires and different sexual orientations just like anyone else.
• Discrimination can exist in what we say, what we do and the way we do it.
• It is illegal under the Equality Act (sexual orientation) 2007 in the provision of goods to discriminate against someone on the grounds of their sexual orientation.
• Personalisation and direct budgets offer the user of services greater choice and control. However these choices may challenge and test the service provider in providing for LGBT people.
• Discrimination still exists in social care and within wider society. Training needs to question personal assumptions around sex and sexuality whilst balancing issues of privacy, safety and respect toward the LGBT individual receiving support.

Who will find this useful?

Commissioners; directors of adult social services; social workers; social care workers; service users, their carers and families; social care and social work students; the general public.

• Video transcript Open

  There are at least 600,000 Lesbian, Gay, Bisexual and Transgendered people living with a disability in the UK today.

  Doug Pauley: The home is paid around a £1,000 a week for me to live here which is about what it would cost if you struck a deal with a four star hotel in London and the staff there are trained that the customer is king. That always doesn’t seem to be the way that I’m treated in residential care.

  Narrator: Doug Pauley lives in residential care outside Leeds and relies heavily on medical and social care support.

  Doug Pauley: I’ve got problems with my autonomic nervous system and it affects my ability to maintain a normal blood pressure. I’ve got a tendency to pass out quite a lot and also I’ve had a stroke.

  Narrator: Doug wasn’t always disabled. He was an opinionated teenager and as a young man a self-confessed anarchic squatter. He enjoyed his alternative lifestyle.

  Doug Pauley: I was very much part of the green anarchist scene in Leeds. I’d been squatting off and on living in shared houses, an environmentalist hippy I suppose.

  Narrator: But when he was hospitalised in 2001 he realised life as he knew it was about to change.

  Doug Pauley: The hospital decided that I was no longer allowed to stand up because of health and safety considerations in case I fell over and hurt myself or hurt somebody else.

  Narrator: Doug was moved to a care home in Weatherby eight miles from his home and his friends.

  Doug Pauley: I was forced to move to a town where I knew nobody and into a situation where I was reliant on other people fully for many aspects of my daily life which was new to me. I had to consider very carefully how and when to come out when I moved into residential care. Constantly throughout your life you’re meeting new people and you have to make a continual assessment as to how and when to tell people. There’s a high turnover of staff within the home so it’s not a coming out once in residential care and then it’s done with if you like. These people are responsible for so many of your everyday kind of tasks and for so much of your life the potential impact of getting a negative reaction can be huge. Most of the staff haven’t had any form of issue with it. I’ve had the occasional member of staff who’ve objected on fundamentalist Christian policies … well, not really objected but have made it clear that they feel that it’s wrong to be gay. There was one point where management raise an issue. They were concerned about the ability of other residents to be able to cope with the fact that I might be gay and asked me to keep quiet around other residents which felt a little wrong really. When I was living more independently than I am now I was able to have other relationships and meet other gay people. When I moved to residential care that all had to stop because in this small town in which I live there isn’t really a gay scene or a gay community. It felt like I became quite cut off really from my existing links and that included the gay community such as it was. I’m supposed to have support with me, people with me whenever I go out and if you don’t have your own carer, if you live in residential care, then finding and organising that support can be very difficult. Also the home made a judgement that some of the places that I wanted to go it wasn’t appropriate to send staff with me. There was one occasion in particular where I wanted to go to a techno rave in Leeds and we took the staff but they said that they weren’t prepared to take me again. So there’s some assumptions about what is acceptable to ask for support to go to if you like.

  Narrator: Doug believes that a cultural shift in attitude towards LGBT people in care is vital.

  Doug Pauley: One key way of making that change happen is through social care service users being seen as a high paying customer.

  Narrator: Dough thinks he and other LGBT people like him could benefit from direct payments.

  Doug Pauley: If you have your own budget you can choose who provides your support, then you can make sure you choose somebody who is alright with gay issues if you like or you can be certain that they’re okay with gay people.

  Narrator: Doug’s case for a budget is currently under review.

  Doug Pauley: Direct payments and individualised budgets are one part of the answer in looking at driving change towards more person centres appropriate care but they are only one part of it. There has to be a ground change in the culture in the way that support is provided. It’s a case of forcing the organisations to make the cultural changes such that they actually conform to them. There is a huge inbuilt existing momentum of institutionalisation and low expectations of people’s life and the one size fits all approach to care and poor assumptions as to what’s acceptable quality of life for social care service users and that people are burdens, that they’ve got no benefit to give, which has to change but it’s a slow and difficult process. It’s quite depressing really. I’ve depressed myself now.