9 December 2014

For a week the publication of  ‘Winterbourne View – Time for Change’, Stephen Bubb’s report on the future of services for people with learning disabilities, was everywhere– it served as a stark reminder of how little has actually changed since 2011 – and once again we were asking the question, when will enough be enough?  

Amid the fleeting flurry of media and political debate and the wrath of reproofs and remonstrations, for me, the most telling, and most important comment amongst all the promotion, was when I read Gary Bourlet’s, (People First England), faultless judgement of the matter:

“The report is full of good words. But there’s not much here that hasn’t been said before.”

Spot on Gary… And that’s what leaves me genuinely troubled, particularly because, after having been with ARC for just under three years now, I’m about to leave to take up my dream job – completely out of the sector – and here I am, left thinking about my initial induction where I had also come from outside the sector. Then, I was given a quick and dirty lesson about long-term hospital and institutional care for people with learning disabilities.  Such care, I was told, had been ‘rapidly’ phased out in the 90’s, in favour of people living locally, closer to home, in community based support settings. Err, sorry but am I missing something when I ask – when did that actually happen? Three years on since Winterbourne, not only are people still in the same or similar hospital setting, but there are more people being admitted to Assessment & Treatment centres (with the very real prospect of getting stuck there too) than are being discharged. The people I have met from ARC’s members and many networks; people who have been working in the sector for years, are more than just frustrated that this is happening, they are scared.

This failure, and it is an abject failure – Norman Lamb admitted as much when he described the affair as the biggest disappointment and regret of his time in office (despite his personal intervention in a number of cases) – would seem to warrant media scrutiny, reports and all manner of soul searching and ‘headline ideas’ but no real solution for the people still stuck in institutions. Where is the innovation, the radical solutions that will not only ‘rock the boat but break it’? (read the blog by Steve Broach).

And so to the report and what do we find? A concordat agreement of some sort (there are too many already aren’t there?); a sign-up to new principles that already exist (are these not called Human Rights?); a commitment to sight an accountable person (can we really not hold people to account now?) and so on… this is surely, just as Gary claims, ‘more of the same’, taking us to the same old place? It seems all too familiar (and easy) that the Westminster Government policy vacuum has been filled once again with reports, agreements, plans, training and guidance documents. In my view this lack of strength of policy making is integral to the strength of government as a whole (check Scotland out as an example if you don’t believe me) and ergo the country at large, and hence the failure. And when policies fail, and the will to really change things fails the costs are manifestly, dearly, significant.

This is, of course, all set in a landscape of a different set of costs and the climate of continuing austerity – one which Osborne’s autumn statement did little to keep the cold realities at bay, and so how can we honestly expect change to occur when the ever present waves of continual cuts and decimated budgets force yet another compromise too far. Increased austerity destroys community low level preventative support – yet the Care Act is insistent on prevention. It will therefore be interesting to see if the ‘Life in the Community Social Fund’, proposed in a ‘Time for Change’, will be the one recommendation that commands a degree of interest for those making decisions.

Real policy, not reports, concordats or agreements

If we take the nine qualities identified by The Institute for Government needed for impactful policy – these are clearly not in place for the Learning Disability sector – it’s a very rare thing indeed to find examples where the government, regulatory bodies, and local authorities create an environment where people with Learning Disabilities and their carers (including providers) can thrive.

A lack of forward-looking policy with clearly defined outcomes; an inability to draw on experience in other countries; a frighteningly leaden approach to innovation and creativity all result in new, well intended reports, plans and commitments, that pretty much end with reports “full of good words. But not much that hasn’t been said before.”

Policy that encourages new and creative ideas, that bases decisions on the best available evidence from a wide range of sources, which involves key stakeholders throughout the process and takes account of the impact on and/or meets the needs of all people affected would take a much more holistic view than any in place or proposed right now. Doing all this work across institutional boundaries would really make inroads to achieving joined-up, evidenced-based, inclusive, and person-centred commissioning, which, directed in partnership with the people who use services, would ensure that the problem of poor quality services are tackled early and head on.

Solutions to a broken system

“They need someone to take charge of making change happen,” Gary argues and, “that person should be working alongside someone with a learning disability.”

So, how can we move forward? The Guardian argues for central government to, “negotiate a plan and knock heads together to make it happen.” Steve Broach advocates for a total system overhaul. The “system is so broken”, he reminds us, “that people are dying.” Gary, voicing the sentiment of hundreds of other people with Learning Disabilities, and their families, speaks of a simpler, less revolutionary but perhaps no less radical a solution… “They need someone to take charge of making change happen,” he argues and, “that person should be working alongside someone with a learning disability.” Gary calls that co-working. TLAP calls it co-production. I’d call it sensible, good old-fashioned real policy making and joint planning.

At ARC we agree with Gary – to making change happen, we need to be working alongside someone with a learning disability. It’s non-negotiable as far as we’re concerned. You have to involve those who will be most affected by what you plan to do.

We restated our values and principles when I first joined ARC. We did that because, every now and again, you need to remind yourself of why you’re here. ARC is here to support anyone who is involved in the planning or delivery of services for people with Learning Disabilities, including people who receive those services – people with Learning Disabilities and their families. We know that providers are part of the team that need to make change happen. Providers, the people they support and their families need to stand united – to raise their voices and to make demands loudly and clearly. This is one place where we really are in it together (and, in my view, for what it’s worth, if you don’t feel like that as a provider, then why are you here?).

We exist to create a force for real change: a locally focused movement of organisations, working together to help people have richer, fuller lives.

We need to work harder to make sure that people with learning disabilities are fully involved in improving support and making sure that it is person-centred and high quality. During my time at ARC we have been working hard to deliver the support that organisations want and need. We’ve listened to what people want and we’ve launched our new ARC England member offer for organisations in England. We exist to create a force for real change: a locally focused movement of organisations, working together to help people have richer, fuller lives. Next year, through the work of our new Membership Officer, Esther Oddy, esther.oddy@arcuk.org.uk,  we intend to develop the networks that will enable organisations to do that – to work together, learn from each other and influence change.

Led by our new Learning & Development Manager, Lisa Lenton lisa.lenton@arcuk.org.uk, the ARC England Learning and Development Team will be improving our offering around practical help and support through a comprehensive learning and development programme. Providing support for your team – your rising stars – through a sensible balance of skills development, sharing practice that works and engagement in strategic debate is going to be key to achieving a committed, valued and supported workforce that works hand-in-hand with the people they support in every part of the planning, delivery, and organisational development – all necessary to realize a well run, well led, good quality service.

And, finally, I can honestly say that I am really chuffed to be able to announce that for the next few months ARC will be in the hands of Anthea Sully, anthea.sully@arcuk.org.uk who has taken over as Interim Chief Executive. Anthea comes to us from Real Life Options where she has been working closely with us as Head of Public Policy – many of you will have encountered her during her previous role as Director of the Learning Disability Coalition. Action is what is needed now and I’m glad that we will keep on keeping on.

So, all that’s left for me to say is, Merry Christmas and Happy New Year!


PS. Some of you, who already know that I’m leaving soon, have asked me where I’m off to – well, having volunteered in animal welfare for a very long time, I’m delighted to be going to the dogs… specifically the Jerry Green Dog Rescue as their new CEO. So, if you’re ever thinking about getting a dog, why not consider a rescue dog, because you now know a woman you can see about a dog…