Rehabilitation Support for Blind and Partially Sighted People

Rehabilitation support for blind and partially sighted people

Briefing for councillors

October 2015

Losing your sight can have a devastating impact upon everyday life, and many people need support and training to adapt to their sight loss.

For many blind and partially sighted people they will need some level of social care support from their local authority. This may include receiving a combination ofinformation, advice, training andsupport.

Blind and partially sighted peopleshould have timely access to rehabilitation services at the point that they require support. People should be able to access the service when they need it, and for many this will be on more than one occasion.For example,a person may need to access support again as they begin to adapt to their sight loss, when they get a new job, if theirsight loss deteriorates, or if someone who provided support moves away.

Setting of budgets

Local authorities are in the process of setting budgets and prioritising spending for 2016/2017 and beyond. We know that tough decisions will need to be madeabout how and where money is allocated. RNIB is calling on local authorities to protect and to continue to invest in vital rehabilitation services.

What is rehabilitation support?

Rehabilitation services provide crucial training and advice to blind and partially sighted people on how to maintain and live in their home safely, and how to negotiate the many obstacles and risks outside of their house. Rehabilitation provides people with the skills they need to be independent and to access and participate in their community.It can also reduce or prevent a person from needing far more costly care and support.

Rehabilitation support can include:

Teaching mobility and confidence skills to negotiate the outside safely, and to get to key identified destinations. This can include how to use a white cane safely and correctly.
Teaching indoor mobility skills, for example how to get upstairs, and minimise the risk of falling or tripping.
Identifying and providing the right walking aids and equipment to support with mobility and daily living.
Teaching skills and helping to build confidence to complete tasks at home safely. For example, safe kitchen skills,and how to clean and maintain the home.
Identifyingand providing appropriate aids and minor adaptations to help achieve assessed outcomes.
Indentifying appropropriate emotional support needs.
Referring onto appropriate internal and external support provision.

Threat to rehabilitation services

RNIB carried out a Freedom of Information (FOI) request of all local authorities in England, and received a 100 per cent response rate. The findings clearly and worryingly show that that there has been an erosion of rehabilitation services across the country.

Local authorities were asked to providetheir total spend on rehabilitation services for blind and partially sighted in 2009/10 and 2014/15. We were able to compare data from 75 local authorities.Shockingly, our findings show that over half of these local authorities have cut their budgets for services for blind and partially sighted people by 15 per cent over a five year period.

More worrying is that this is just part of the story. The information provided by local authorities is incomplete and the actual reduction of budgets is likely to be much higher.

Reduction in the number of rehabilitation officers

Our findings also found that there has been a drop in the number of rehabilitation officers. Worryingly, 28 per cent of local authorities reported that there had been a reduction in the number of rehabilitation officers. When breaking the data down regionally, we found that 43 per cent of local authorities in the West Midlands had reduced the number of rehabilitation officers, 36 per cent in London, and 35 per cent in the North West.

Rehabilitation servicesare stretched

A disturbing picture continues to be built.We identified that 32 per cent of all local authorities in England have less than one full time equivalent rehabilitation officer. An additional 11 per cent said that they didn’t know or provided an ambiguous response, not making it clear on the number of rehabilitation officers employed.

However, some hope is provided, and a very small percentage of local authorities are bucking this trend, eight per cent have increased the number of rehabilitation officers.

Growing demand on services

The shrinking of rehabilitation services does not correlate with the growing number of people living with sight loss. Predictions show that the number of people living with sight loss in England is set to increase by 22 per cent between 2011and 2020.

South West / 22% / North West / 18%
East / 25% / Yorkshire and Humber / 19%
London / 20% / East Midlands / 25%
South East / 24% / West Midlands / 21%

Investing in rehabilitation can save money

The Care Act has elevated the importance of preventative services, and statutory guidance identifies the “clear preventative benefits to the individual and, in many cases, the reduced risk of hospitaladmissions (paragraph 92.61), of rehabilitation support.”

A local authority in the East of England developed a tool to measure the cost benefits of investing in rehabilitation. Theyfound that investing in rehabilitation services has conservatively saved£144,000 each year in care support costs.

The Care Act 2014

The Care Act and associated statutory regulations and guidance, has cemented the importance of investing and providing preventative services. Statutory guidance recognises the role rehabilitation services for blind and partially sighted people.

The Care Act strongly supports the need for specialist rehabilitation services for blind and partially sighted people, and clearly sets out what local authorities should be doing.

Providing rehabilitation services

Provision of tertiary prevention: “Local authorities must provide or arrange services, resources or facilities that maximise independence for those already with such needs, for example, interventions such as rehabilitation/reablement services” (paragraph 2.9).

Rehabilitation services “Rehabilitation services can include provisions that help people attain independence, and remain or return to their home and participate in their community, for example independent living skills and mobility training for people with visual impairment” (paragraph 2.13).

Not charging for rehabilitation services

The local authority’s responsibilities for prevention apply to all adults, including:adults with needs for care and support, whether their needs are eligible and/or met by the local authority or not (see chapter 6) (paragraph 2.3).

Withdrawing services

Guidance sets out thatlocal authorities must consider the impact and consequences of ending preventative services, and that poor exit strategies can have a significant impact on preventing, reducing and delaying needs (paragraph 2.62).

Trained staff

Local authorities should consider securing specialist qualified rehabilitation and assessment provision (whether in-house, or contracted through a third party), to ensure that the needs of people with sight loss are correctly identified and their independence maximised (paragraph22.21).

Timely support

Timely, person-centred assessment, and care and support that is integrated with health care, offer the potential to make improvements in experience and outcomes of people who are sight impaired, as well as improving system efficiency.

Understanding local need

Local authorities should develop a local approach to understand and plan for local needs. They should also ‘consider the different opportunities for coming into contact with those people who may benefit from preventative support, including where the first contact may be with another professional outside the local authority’(paragraph 2.38).

RNIB has produced an externally verified free tool, providing local demographical information on the number of blind and partially sighted people living with sight loss:

Devolution

We know a number of areas have submitted, or are in the process of developing or implementing devolution bids. These bids are varied across the country, but a number of the proposals include the integration of health and social care and pooling of budgets. Whilst these bids are in their early stages and will vary across the country, they could provide an opportunity to ensure thatrehabilitation services for blind and partially sighted meet the needs of the local population. RNIB are calling on local authority to ensure that the devolution plans effectively meet the demands of the Care Act.

Supporting rehabilitation services:what local councillors can do

RNIB is calling on local authorities to protect and continue investing in vital rehabilitation services.

We are asking councillors tofind out more about what local rehabilitation services are provided, and:

to seek assurances that current budgets on rehabilitation support will not be reduced for the next financial year.
to establish whether or not there are any planned changes to rehabilitation services over the next 12 months.

RNIB have produced a template letter for councillors to send to the executive member with responsibility for social care. The letter can be found at the end of this briefing.

Please do share with RNIB any responses or information you find out about local rehabilitation support services.

Further information

For further information and to access a briefing on the Care Act and our position statement on rehabilitation support, please visit

Or please contact

Tara Chattaway, Policy and Campaigns Officer Social Care

020 7391 2123

END

Appendix 1

Template letter/email from ward councillor to exertive member with responsibility for social care:

Dear

I have recently received correspondence from a local resident, highlighting the importance of rehabilitation support for blind and partially sighted people.

Rehabilitation services provide independent living and mobility training to help people adapt to their sight loss. It is delivered by qualified rehabilitation officers and supported by staff that have the skills, knowledge, and experience to understand the unique challenges faced by people with a visual impairment.

My local residentis very concerned to have heard that RNIB (Royal National Institute of Blind People) recent research has shown that;

A quarter of local authorities have cut their budgets for services for blind and partially sighted people by 15 per cent. Though this is likely to be higher, as it is based on data provided by 75 local authorities.

32 per cent of all local authorities in England have less than one full time equivalent rehabilitation officer.
28 per cent of all local authorities reported that there had been a reduction in the number of rehabilitation officers.

I am writing to you ask for further information about whether or not our council provides a structured programme of rehabilitation? If there is such provision, are there plans to reduce the budget for this service in 2016/2017, or to reduce the number of existing rehabilitation officers?

If there is not a structured programme of rehabilitation, then what support do we have in place to meet the rehabilitative needs of blind and partially sighted people?

I welcome any reassurances on this matter.

Yours sincerely

END