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Scotland - Know Your Options

Individuals with severe learning disability and challenging behaviour can, with the right support and adaptations, live successfully in a range of housing, including individual self-contained properties, housing networks, group homes, and shared accommodation schemes, and can benefit from the full range of options, from renting to home ownership.

Probably the biggest decision you will need to make is whether a registered care home or supported living is the best option for your son/daughter. A residential care home provides a complete package of accommodation and care, whereas Supported Living is a scheme whereby the accommodation is provided separately from the care support. The main advantages and disadvantages of each are set out below:

Residential Care Homes (see Case Study: Aaron)

Until fairly recently, a residential care home was virtually the only option available to people with severe learning disabilities and challenging behaviour apart from living with their families. A common approach was for the local authority to search for an existing residential home that had a vacancy and was willing to take the individual.

A residential care placement provides a “complete” service, incorporating accommodation and care support. The advantages of this approach include:

A complete, “all in one” package.
The service is usually up and running and can be viewed.
There is a contract with the local authority specifying what is provided.
The home is inspected regularly by the Scottish Commission for the Regulation of Care (SCRC) against a range of standards.

The disadvantages of this type of service include:

If there are any difficulties, the service provider can terminate the contract and the person has to move out.
The individual is unlikely to have any say over who else lives there.
The service provider determines the future direction of the service.
The local authority will require the individual to contribute all of his/her benefit income except £18.50 a week towards the cost of fees. This means that the individual has only £18.50 a week for individual spending.

The culture of “fitting the person into what is available” has gradually been changing, and forward thinking residential care home providers are much more flexible and person-centred than they were in the past.

If you are considering a residential care home placement for your son/daughter, you should obtain a copy of the contract with the local authority to ensure you are aware of what should be provided, and a copy of the most recent SCRC inspection report.

Supported Living (see Case Studies: Andrew, Les, Angela & Colin)

Supporting Living is an individualised approach that enables people to choose where they live, how they live and who supports them. Supported Living means that an individual’s accommodation is separate from their care support.

The advantages of this approach include:

The accommodation and the support required can be tailored to specific individual need.
The accommodation is the individual’s own home, either by tenancy or ownership/shared ownership. (Shared ownership is a scheme whereby people part-buy and part rent the property they live in.)
The individual can claim housing benefit and other benefits.
The individual can choose who provides their care support.
The individual is in greater control of both their accommodation and their care support. As accommodation and care are separate, it means that the person can have security of tenure, cannot be moved against their will, and may be able to change their care provider if they so wish.

The disadvantages of this approach include:

It can be daunting/difficult to make it happen
It can take time and effort to set it up

For more information:

Ownership Options in Scotland: www.oois.org.uk or Tel 0131 661 3400

A new pathway (see Case Study: Daniel)

The Challenging Behaviour Foundation has worked in partnership with others to develop a new pathway for young people with severe learning disabilities and challenging behaviour. This new service model is innovative due to its partnership with the local Further Education College, which the individuals attend on a daily basis. It has a Management Board which has partners from a range of organisations including a parent, voluntary organisations, a Housing Association, a care provider, local authority managers and commissioner and researchers from the University of Kent Tizard Centre. The Management Board oversees the management of the service and its development.

This specialist service is for four students between the ages of 16 and 25 who had previously been placed out of the local area in specialist services, some over 200 miles from their families. It was conceived to enable these four students to return to their home area, complete a further education course and enable planning for long term accommodation to be developed according to individual need. The service is person centred: it was specifically designed around the needs of the individuals that use it. There is specialist input from experienced professionals around the issues of challenging behaviour, with a focus on understanding behaviours and responding appropriately in a person-centred way. The service has two funding streams: from the local authority for the residential care component and from the Learning & Skills Council for the education component, but it is a holistic service, with shared goals, training and learning.

Whilst this specialist service was developed as a transition service and incorporates college provision, the route used to set it up could be applied to any adult service.

A review of the steps taken by the CBF to develop this new service model, written by Steve Easter, National Development Team, contains key learning points and recommendations. A shorter abstract is also available. Copies of the report and a DVD about the service are available from the CBF.

This model may work well for you if you know a small number of individuals locally with similar needs to your own son or daughter. If you think this might be the route for you then the CBF would like to hear from you – please contact us.

Continued education

A person with severe learning disabilities has the same rights as everyone else to continued education. Specialist residential colleges cater for people up to the age of 25. Further and adult education should be available post-25.

There are a number of specialist residential colleges which provide accommodation, support and education for people with learning disabilities under 25 years old, but mostly outside Scotland. Specialist college places may be funded by your local authority if the type of education or support needed is not available at your local Further Education College.

Association of National Specialist Colleges: www.natspec.org.uk or Tel 01509 554357

National Bureau for Students with Disabilities: www.skill.org.uk or Tel 0800 328 5050

Learning and Skills Council: www.lsc.gov.uk or Tel 0870 900 6800

Currently it remains difficult in practice to ensure adults with severe learning disabilities and challenging behaviour are accessing further and adult education. Should it be identified in an individual’s PCP that there is a need for the person to access adult education, a local college or university should be prepared to set up a relevant course if there are none currently running and if it can be shown that there is a demand for such a course. The individual may have to pay to attend the course, and sources of funding for this would have to be identified and possibly incorporated into the individual’s individualised budget.

Employment

Many people with learning disabilities want to have a job and find being part of an organization and contributing to the local community in this way very rewarding. An individual’s strengths, abilities and support requirements should be taken into account when looking for employment, and employers have a responsibility to make ‘reasonable adaptations’ to accommodate people with disabilities, including learning disabilities.

A good place to start may be with the local job centre plus as they have schemes to support people into work and can offer advice about how employment may affect a person’s benefits. See www.jobcentreplus.gov.uk or find details of your nearest office in the phone book. Other organizations such as Enable and SCLD also offer support in finding and maintaining employment.

For individuals with severe learning disabilities an approach known as ‘job carving’ may be helpful. With a ‘job carving’ approach, an individual is assessed and their strengths, abilities and interests are noted and utilised to think about what sort of job the person would enjoy and what support or adaptions might be needed to enable them to perform it. This may be an existing job that the person can do with support or it may be a new role created with that individual in mind. This can be done in conjunction with a particular employer who will then support the individual in performing their role. This approach has been used successfully in America for several years and has seen individuals progress through jobs as they gain confidence and skills.