The first review into how councils and primary care trusts commission services for people with a learning disability has called for better planning to ensure care is accessible, personalised and allows service users to lead as full and independent lives as possible.
The review was jointly conducted by the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission, and follows a series of reports over the past decade documenting poor service availability, particularly for those with complex needs.
The review found that while improvements were being made, the pace of change was ‘too slow’ and ‘uneven’.
Issues included a lack of person-centred plans which involve people in decisions about their future, insufficient progress towards direct payments schemes which allow users to make their own decisions about which care to buy, and a lack of training for staff, who fail to take into account the views of users and families or to recognise safeguarding issues for vulnerable adults.
The review focused on nine local authority areas in England, which were chosen fore their representative characteristics. Its commissioners believe the findings are relevant to all organisations that commission or provide care for people with learning disabilities and complex needs.
The review found positive evidence that councils and PCTs are moving away from large-scale care and support, toward more flexible services, where the needs of individuals were taken more into account.
Another positive finding is that many of the councils and PCTs involved in the review are adding new obligations to contracts, requiring service providers to provide evidence of the quality of their services.
The review also found progress in giving people more choice in where they live and progress in closing the last few examples of NHS ‘campus’ accommodation, which the government says is unsuitable.