More needed for people with learning disabilities, autism or both – ARC England response to the Government’s People at the Heart of Care: adult social care reform white paper

Clive Parry, ARC England Director responds;

The Government have published their long-awaited People at the Heart of Care: adult social care reform white paper, setting out a ten-year vision for adult social care and provides information on funded proposals they say will be implemented over the next three years.

With more than 40% of people with a learning disability still not being provided with the annual health checks they were promised years ago (NICE Impact Report on People with a Learning Disability November 2021) and with the Secretary of State engaged in discussions with GPs about suspending preventative measures that monitor the health of vulnerable citizens, we think it is depressing but not surprising that the continuing (and in many respects deepening) health inequalities learning disabled people live with every day are not addressed by the white paper.

In the lead up to its publication, there were many calls for the Government to seize this opportunity to not only fix the adult social care issues as they affect older self-funders of care, but to also address the long-standing and now very serious challenges in some parts of the sector that support people with a learning disability, autism or both, and it would appear that these voices have simply been ignored.

Learning disability is mentioned thirteen times in the white paper but in only one instance is this in relation to a specific measure that will result in a change that people will experience.

News of the supported employment programme that will help 1200 people is of course welcome but, arguably, this is only necessary because of the shift to a Prime Contractor/Multi-tier Sub Contractor model when Workstep was introduced in 2001. This resulted in the loss of large number of the smaller specialist supported employment providers that had previously successfully placed people with a learning disability into paid work.

There are some mentions of additional funding that will enable people to live independently in their own home as part of the housing section in the White Paper, but the plans are vague giving no real detail as to how this will happen for people with a learning disability, autism or both.

Shortly after publishing People at the Heart of Care the department of Health and Social Care (DHSC) promoted a Question and Answer document saying ‘we recognise we are not starting from scratch. The Care Act 2014, particularly its focus on wellbeing, provides a strong foundation for our vision’.

However, I do not believe that the Care Act has been consistently implemented in the way that the legislators imagined it would be. In fact, I would agree with the analysis offered by Caroline Abrahams at the Care and Support Alliance; the fact that some of the measures in the white paper could reasonably be expected to already be in place tells us a great deal about how social care has been neglected in recent years.

One of the most egregious ways in which this has happened has been the failure to fully and consistently implement the Care Act in both letter and spirit.

Whilst I endorse the notion of constructive engagement expressed in the ADASS response to the White Paper, our members would not agree that all learning disabled people need is some kind of temporary bridge to get them over the period of time between now and whenever they are placed at the heart of care reform.

I wonder what it might have meant for people with a learning disability, autism or both if we’d had a one-line white paper in easy read format that simply said: “Every penny of additional funding will be used to ensure that all parts of the Care Act will be implemented in full by every Local Authority”?