The Same As You was a lengthy document which spelt out in great detail what type of change was important. Much emphasis has been placed on the 29 recommendations contained in the report but perhaps more importantly a set of 7 principles was stated at the beginning of the Same As You document. These all remain relevant today.
1. People with learning disabilities should be valued. They should be asked and encouraged to contribute to the community they live in. They should not be picked on or treated differently from others.
2. People with learning disabilities are individual people.
3. People with learning disabilities should be asked about the services they need and be involved in making choices about what they want.
4. People with learning disabilities should be helped and supported to do everything they are able to.
5. People with learning disabilities should be able to use the same local services as everyone else, wherever possible.
6. People with learning disabilities should benefit from specialist social, health and educational services.
7. People with learning disabilities should have services which take account of their age, abilities and other needs.
We think the following parts of the Same As You have been important
• No One Should Live in hospital – This has help to underpin the move into the community and has seen people begin to live real lives in the community. Our earlier comments on the limitations of this recommendation should not take away from the importance we give to what has been achieved here.
• Local Area Coordinators – This has been really important for the people that have used them. There is still significant variation in how this position is understood and the nature of the work that they do. Many of the service users we spoke to particularly valued the service of Local Area Coordinators working in the method of a traditional social worker – both a trouble shooter and a coordinator of local services. People who did not get much support from other sources found that LACS were able to help completing forms, help understand letters and sort out problems. This was as useful to them as being put into contact with advocacy and support organisations.
As a result in Argyll & Bute which has only 2 LACs, the people who use them highly value them because of the flexibility of response that they can give. In many ways this is kind of preventative service that is really helpful at maintaining people in existing low level of support situations.
• The Scottish Consortium for Learning Disability has been an important addition that has come out the of the Same As You. We know some areas of its work well but are not aware of how its work has been evaluated and whether there has been an attempt to see how well SCLD meets the terms of its recommendation 6.
For example, it is clear that SCLD does a very good job in offering training for a range of people. It less clear how it offers advice and support to agencies, professionals and people with learning disabilities and whether it remains a centre for excellence.
At this point, significant resources are spent every year by SCLD and it may be worth considering as we move into a period of Self Directed Support how SCLD continues to fit with the needs of people with learning disabilities and the agencies that support it.
Earlier in this paper we have suggested focussing SCLD on developing work as a good practice agency close to the Scottish Government that can provide information and advice to Health Boards, Local Authorities, voluntary organisations and the private sector would be a good development. In effect SCLD would function as a “Development Agency” for services and support for people with learning disability.
• Local Independent Advocacy has been increasingly important for people with learning disabilities over the last ten years. As the relationship of the individual with statutory agencies has changed, then the ability to get the support from an independent individual to help them make their case has been important. When we carried out research into the people with learning disabilities who were placed in care homes for older people, we were impressed with the stories we heard from advocacy groups about how they had been able to make the case for people remaining in the community. Where people had the help of advocacy groups, they usually stayed in the community, when they didn’t they usually ended up inside.
But we also hear stories about the difficulty of getting access to advocates and how hard it can be to get hold of advocates when they are needed. The limited resources that are available are stretched very widely. Some thought needs to be given to what levels of advocacy support are needed in each area and that it can be a service that is wide enough to maintain the confidence of those that use it.
• Short breaks services again have been changing over the last 12 years. Services like Falkirk’s Short Breaks Bureau which enables people to take holidays with support have made respite much more of a valued service. This is a development that we hope can continue to make a difference with the growth of Self Directed Support.