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

Messages from 'Having a good day' - Cultural change in services

What research tells us

Strategic managers need to make a mental shift to think first about ordinary community lives and then about what support and services people need to live them. There is a danger that 'day centre culture' may persist into community settings. Change has been greatest in the employment sector, where there is more of an obvious move towards a business culture. It should be expected that some people will react against change, at least initially.

What's happening in practice at the moment

Pointers for development

Do as many things as possible - information, debates, quality action groups, training, conferences, for example - which encourage everyone to reflect on the quality of people's daily lives and what needs to be done locally to achieve ordinary lifestyles.

Actively encourage and support learning. Evaluation is part of this. Make sure that new community day arrangements in your area are evaluated and that there is evidence about the changes that have resulted for people. Try to use an evaluation team that includes people with learning disabilities as paid members. Most important of all, reflect on and use the findings to plan your next steps.

Keep talking about ordinary lives, and challenge accepted ways of doing things. Ask why people are doing things in specially designated buildings or in segregated groups. If the answer is about lack of resources for support or about lack of accessible community facilities then tackle those issues. Don't just accept the status quo!

Make sure that training in person-centred approaches is part of the induction programme for all staff in new community services, including managers. And don't forget individual budgets, direct payments and independent living funding (ILF). Make sure that everyone knows about these routes to increased personal control. Spread the word.

Work with your staff teams to develop clear and deliberate strategies about how you will help people integrate and build up their connections and friendships (see Key task 6: Achieving inclusion in community life).

Make sure that you know the make-up - the diversity - of your local population, and find out if that diversity is reflected in the people accessing community day supports. If not, then identify why not and develop a plan to address it.

Initiate a local discussion about the role of staff in community day services in relation to employment. What specific responsibilities should they take? Mapping the routes to employment and how they are currently offered and supported may help to identify gaps that community day services can fill.

Think very carefully about what people locally may accept as wisdom, especially about what opportunities and supports are right for people with higher support needs. Micheline Mason's poem, for example, challenges us to think carefully about multi-sensory 'snoezelen' rooms.

Beware the Baubles

They stole away our lives Condemned us to a bean-bag existence Alone together with our fellow prisoners Left staring at mobiles, slowly moving round and Just out of reach

Over-controlled teaching In a hush of false protection They pared down our experiences To their diet of force-fed crumbs Of learning

Not broken-down, but shattered Stripped of all meaning and context By their one-step-at-a-time Special Curriculum Practising for the life They would never let begin

Now they are trying to sell our lives back Through their glittering, flashing, bubbling rooms Mechanical, artificial, expensive, Another capitalist cone Feeding off our starvation

Beware the baubles, the disco dream The light of the sun will do, thanks, The brush of the wind, the wet of the rain, The sound of children's laughter In an ordinary, busy classroom The touch of a friend's hand Welcoming us back Into the world

Life is a multi-sensory experience Full of lights, tastes, smells Colours, sounds, textures abounding Emotions, all our birthright Denied to us by misunderstanding And fear

Put away your cheque books Bring us in close to the beating pulse Of shared messy, risky, noisy days Where we all have complex needs We will learn then all that matters And so will you

© Micheline Mason

Practice examples

A group of self-advocates and family carers in Leicestershire have been reviewing the outcomes of day service modernisation. They have focused on 'inclusion outcomes', particularly friendship and involvement, and have used a traffic light approach. The group has been supported by the National Development Team and further information can be found by contacting Steve Easter:

The local authority day services in Essex have a clear role in relation to employment. They directly provide information to people through Job Clubs, helping them to think about the world of work. They then refer people through to the county's supported employment and social enterprise services to pursue actual jobs.

The Wellington Community Enablement Project in Somerset is a national pilot project that has been investigating a new role of community enabler. Focusing on developing support within a local community, two separate cafés have evolved organically and become local community-based facilities. A range of people have used the cafés, including older people, people with learning disabilities, physical disabilities or mental health issues. As a result of word of mouth other members of the public have also joined sessions and enjoyed sharing skills or time with people there. You can read about it in David Waddilove's ' Redesigned and redrawn - developing new roles in social care' (TOPSS, 2004)

Links and resources