Adult social care review implementation
Implementation of the Compton report should mean more personalised services for adults with physical and learning disabilities. Stephen Dineen reports.
At the heart of the Compton review, ‘Transforming Your Care’, published last December, is a new health and social care model within five years, based on the individual. The Chief Executive of the Health and Social Care Board and his colleagues recommended more direct control over care by patients and carers. They also advocated greater choice using the independent sector.
On services for people with disabilities, the review recommended:
• that health and social care organisations shift from being enablers to information providers for people with physical disabilities;
• more control for service users over budgets and continued promotion of direct payments;
• joint planning of services by statutory, voluntary and community providers;
• more recognition and support of carers, including respite and short breaks;
• support from integrated care partnerships to improve clinicians’ awareness of the needs of individuals with a learning disability; and
• closure of long-stay institutions for people with learning disabilities, with complete resettlement by 2015.
For people with physical disabilities, the new model of enablement “may include some of the traditional residential and daycare services, but will increasingly reflect a wider range of needs.”
Compton stated that care could be provided “closer to home with intensive treatment and rehabilitation and when needed” rather than in long-term care settings.
A growing number of young disabled people are surviving into adulthood because of medical improvements, it found, but called for reduced waiting times for equipment.
Independent living, balanced with “the increasing complexity” of needs and the requirement for significant nursing and personal care support is “essential to promoting the rights of people with disabilities.”
While much respite and short break care is currently provided through traditional residential and daycare settings, home-based respite services are being developed and should be developed further, it recommended.
Compton found that implementation of the 2007 Bamford recommendations on mental health and learning disability was too slow. Bamford called for independent living, advice and advocacy services to be embedded in services and for assessments to include examination of physical health needs.
Programmes to help people with a disability access primary healthcare (e.g. annual health checks) need to be consistent. The review discovered particular problems in accessing dentistry.
Clinicians must also be helped to respond “more appropriately” to people with learning disabilities’ needs as integrated care partnerships are planned, it stated. Minister Poots has said that these will be formed during 2012-2013.
To ensure independence and personalisation, Compton advocated a focus on more community-based options, reform of the day centre-based model and a broader range of age-appropriate day services.
Service users and carers should get more information, it stated, while peer and independent advocacy is needed to help people make decisions and protect their rights.
Following its publication, Health Minister Edwin Poots told the Assembly that the recommendations represented “a sustainable model which will deliver a different, improved, citizen-focused and safe service for us all.”
During the review, Mencap recommended better services, advocacy support and improved short breaks.
“We welcome the proposals outlined in the report and believe that this confirms the direction outlined in the Bamford Review,” spokeswoman Paschal McKeown said.
Three-year population plans for each trust area, which will deal with population needs, quality improvement and the impact of reform, were to be published in June. A DHSSPS spokesman said that these will inform an overall strategic implementation plan, which will be published for public consultation in September.
