People with DUAL Sensory LOSS
adult SERVICES DEPARTMENTAL PROCEDURE NO: / 13/11Services for People with Dual Sensory Loss
DATE: / 1 April 2011
EFFECTIVE DATE: / 1 April 2011
CATEGORY: / General
KEYWORDS: / Dual Sensory Loss, Deafblind
ISSUED BY:
CONTACT:
PROCEDURES CANCELLED OR AMENDED: / 35/00 Deafblind Services
REMARKS:
SIGNED:
DESIGNATION:
YOU SHOULD ENSURE THAT:-
§ You read, understand and, where appropriate, act on this information
§ All people in your workplace who need to know see this procedure
§ This document is available in a place to which all staff members in your workplace have access
PURPOSE
It is essential that the department provides good quality, consistent and supporting services to people who are Deafblind or have a Dual Sensory Loss. This procedure outlines what services should be provided to people in this client group.
SCOPE
All staff, who are responsible for services supporting people who are Deafblind or those with a Dual Sensory Loss.
All Adult Services line managers have the responsibility to ensure staff are aware of and following these departmental procedures.
POLICY
To ensure that specialist services are available to meet the specific needs that arise from being Deafblind or having a Dual Sensory Loss and that all services must recognise the needs of this client group and deliver services of an equal standard.
REFERENCES TO LEGAL, CENTRAL GOVERNMENT AND OTHER EXTERNAL DOCUMENTS, INCLUDING RESEARCH
Local Authorities Social Services Act 1970 section 7 Guidance (re-issued 2009)
National Assistance Act 1948
Chronically Sick and disabled Person Act 1970
National Health Service and Community Care Act 1990
Disability Discrimination Act 1995 & 2005
Equalities Act 2010
HAMPSHIRE COUNTY COUNCIL AND ADULT SERVICES DEPARTMENT REFERENCES
None
DEFINITIONS
Client / A member of the public for whom we are providing servicesDeafblind / Dual Sensory Loss / These terms can be used interchangeably
SWIFT/ AIS
PARIS / Social care records system
ROLES
All managers are responsible for supporting their staff to work within this procedure.
AUTHORITY TO VARY THE PROCEDURE
Assistant Director older people/ physical disability HCC
Senior Manager Independent Living Services PCC
SCC to be confirmed
1 April 2011 Page 1 of 9 Procedure 13/11
People with DUAL Sensory LOSS
Contents
1 Introduction
2 Departmental Approach
3 Identification and Contact
4 Referral Pathways and Assessment
5. Service Provision and One-to One human support
6. Information access
7. Senior Management
1. Introduction
1.1. Deafblind people (Db) and people with a Dual Sensory Loss (DSL) have individual needs as varied as any other in the community. It should be assumed that they will need access to the full range of available services.
1.2. All the client groups included in this document are covered by Disability Discrimination and equalities legislation and therefore consideration to their needs must be included in all areas, e.g. access to buildings, goods and services, information and accommodation, etc.
The Need for this Tri-partite Agreement.
1.3. The number of people who have significant sight and hearing impairment ie Deafblind or Dual sensory loss is relatively small compared to the national population but require highly specialised services. It is therefore, a challenge for Departments to recognise and develop the skills and abilities of these groups of people through education, training, employment and leisure. This is a small and highly specialised field of work and therefore it seems appropriate to develop a strategy with neighbouring local authorities to ensure cost effective and dynamic service delivery. In order to ensure effective implementation of this policy it is beneficial and cost-effective for Hampshire, Portsmouth and Southampton authorities to jointly agree service standards, commit to achieving parity and pool specialist resources across the three authorities from the outset.
1.4. Hampshire County Council, Portsmouth City Council and Southampton City Council have a duty under Section 7 of the Local Authority Social Services Act 1970 amended by LAC (DH) (2009)6 to assess and meet the needs of Deafblind people and those with Dual Sensory Loss living within their catchment areas.
1.5. Please see the Department of Health link below for Local Authority responsibility to Deafblind people under Section .http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/LocalAuthorityCirculars/DH_101114
2. Departmental approach to Deafblind / Dual Sensory Loss
2.1. The deafblind guidance, Section 7 sets out a number of duties which authorities must consider within their service planning. These duties include the following;
· To identify, make contact and keep a record of Deafblind people in their catchment areas, including those with multiple disabilities and a dual sensory impairment.
· To ensure that when an assessment is requires or requested, it is carried out by a specifically trained person or team, equipped to assess the needs of a Deafblind person – in particular to assess the need for one-to-one human contact, assistive technology and rehabilitation.
· To ensure that appropriate services are provided to Deafblind people, who are not necessarily able to benefit from mainstream services or those services aimed at blind people or deaf people who are able to rely on their other senses.
· To ensure that Deafblind people are able to access a specifically trained one-to-one support worker for those people assessed as requiring one.
· To provide information about services in formats and through methods that are accessible to Deafblind people and or their families and carers.
2.2. Deafblind people or people with a Dual Sensory Loss have a right to access all services. They are most at risk of isolation. Adult Services need to be pro-active in identifying, assessing and meeting their needs.
2.3. Although the onset and degree of loss will vary from individual to individual, four main groups of Deafblind and Dual Sensory Loss can be identified. See Identification and Contact below.
3. Identification and Contact
3.1. It is recognised by Adult Services that they need to be pro-active in their approach to identifying and making contact with service users. Therefore, it is important to note that all Adult Service staff, who assess the needs of vulnerable people, have a duty to identify Deafblind people or those who have a dual sensory impairment to refer on to specialist provision. Furthermore, Adult Services will actively seek to work with its’ strategic partners and colleagues in Health, the Voluntary Sectors including, community groups, other Local Authorities and private providers to ensure that referral pathways are readily accessible and will actively seek to raise the awareness of the issues relating to Deafblindness and Dual Sensory loss.
3.2. To ensure more effective identification and contact with Deafblind people it is useful to recognise the needs of different groups within this part of our community. Although the onset and degree of impairment will vary from individual to individual, four main groups of people experiencing Deafblindness or Dual Sensory Loss can be identified.
3.2.1. Those who are hearing and sight impaired from birth or early childhood;
· It is recognised that people in this group will have profound communication deficits and that receiving communication in the conventional sense is very likely not to be possible. It is therefore, important that family, carers and other professionals both within the local authority, including the education service, Health professionals and the wider community have clear access to specialist services.
3.2.2. Those blind from birth or early childhood who subsequently acquire a hearing loss that has a significant functional impact.
· It recognised that although this population is likely to be relatively small in number, it is most likely that these individuals have developed language skills. In this instance it is very important that both strategic and operational relationships with Health partners are actively established and developed to ensure maximum chance of referral to specialist sensory services.
3.2.3. Those who are deaf from birth or early childhood who subsequently acquire a significant visual loss;
· This population may also include people who are; Deaf, deafened, or hard of hearing people whose preferred method of communication is speech / lip-reading, British Sign Language or Sign Supported English and who are now losing their sight.This group will include people with Ushers Syndrome, a genetic condition which gives rise to the predominant cause of adolescent deafblindness. This group of individuals are likely to have sign language skills as their primary communication strategy.
· However, it is important to recognise that this group can include people who do not use sign language, as in the case of those who have had a cochlea implant. With advancing technology this is more likely to be the case in future years.
3.2.4. Those who acquire a hearing and sight impairment later in life, that has a significant functional impact.
· It is readily acknowledged that this population will constitute the majority of people presenting with a Dual sensory loss. In this instance, it is important to ensure that other presenting issues related to ageing do not eclipse the significance of such sensory impairments.
3.3. Whilst the above categories are useful for conceptualising the presenting needs of the majority of people who are Deafblind or a Dual Sensory Loss, it is useful to recognise that not all people with such sensory needs fall readily into such categories.
3.4. Further acknowledgement needs to be given to the psychological and emotional impact deafblindness has both in terms of development and well being. This impact must also be prevented from being overshadowed by other needs.
3.5. Close and effective working partnerships with Learning Disability Teams, Mental Health and others will make a significant contribution towards mitigating against this occurrence.
Note; People who have Ushers Syndrome often see themselves as a separate group, but for the purposes of this document are acknowledged within the above groups.
3.6. Staff within Adult Services must be aware of the range of communication needs of Deafblind people and those with a Dual Sensory Loss including:
· Visual i.e. use of large print or other appropriate print, magnifiers for reading, writing, use of sign language (visual frame)and Lip reading and or the exploration of other possible channels through which to communicate.
· Aural / oral i.e. use of speech, translation of written material into the spoken word.Tactile and other strategies i.e. Braille, Moon, Hands On and Hands Over Hands Signing, Deafblind manual, Canaan Barrie, hands on body, Tadoma, Block or Spartan etc.
· Guide Communicators/ Intervenors are individuals trained specifically to work with the communication needs of Deafblind People. Guide Communicators main function is to enable an individual to effectively move around the built environment and provide tactile or visual language support. In the case of Intervenours, these people are neither carers or translators, but conduits enabling the Deafblind individual to communicate and experience their environment.
3.7. It is important to note that people’s communication methods are not strictly related to one identified group. Many people use a variety of communication methods depending on personal circumstances such as time of day, task at hand, etc. It is however, important to note that a persons chosen communication method may be different between expressive and receptive communication.
3.8. it is essential that Deafblind people and those with a Dual Sensory Loss are afforded the opportunity to be registered appropriately and recorded on the Adult Services database. It is however, important to appreciate that such registration is voluntary and not mandatory.
3.9. In the case of children who are the responsibility of Hampshire County Council, there are established eligibility criteria to access services from that department. The link below takes the reader to that information.
http://www3.hants.gov.uk/childrens-services/specialneeds/aiminghigh/eligibility-criteria.htm
3.10. In the case of children who are the responsibility of Hampshire County Council and are approaching the transition from children to adult services, the link below provides further information.
http://www3.hants.gov.uk/adult-services/aboutas/departmental-procedures-main/chronological-procedures/transition-young-disabled-people.htm
3.11. Sensory Services and Transitions Team will ensure that cases which have specific sensory needs are hi-lighted and appropriately managed. Within the context of this policy, it is expected that those professionals working with children and operating within the scope of the Local Authority, will be active in making timely transitional referrals to Adult Services.
4. Referral Pathways to Specialist Provision for Assessment.
4.1. The Ophthalmologist (eye consultant with in a health setting) may make a general referral to Adult Services Sensory Teams, to complete registration, for someone with a sight loss, which is recorded on a Certificate of Visual Impairment (CVI is the certificate of eligibility for inclusion on the sight loss register). A CVI can only be issued by a consultant Ophthalmologist and with the consent of the patient.
4.2. The hearing consultant at hospital (Audiologist) may often make a similar referral to Adult Services Sensory Teams after a person has had a hearing test.
4.3. Adult Services may have Sensory workers located within Audiology and or Ophthalmology department with acute hospitals where this is the case, the post holders will be trained to the (CACDP Signature Level 2) qualifications. Also as a result of increasing numbers of people presenting with acquired Dual Sensory Loss, Adult Service departments will, through induction training, raise staff awareness of the full range of sensory impairments. Where there are no local authority staff in Health settings, partnerships between Adult Services and the Third sector will need to be developed.
4.4. Referrals can also be made by other Adult Services teams (Care Managers, Deaf services, Occupational Therapy, Community Innovations, Community Response Teams) or other Professionals (GPs based at health centres, Rapid Assessment Teams or high street Optometrists).
4.5. People with a Dual sensory loss may also refer themselves or be referred by family, neighbours and friends. The starting point for these referrals can be made Hampshire County Councils’ Hantsdirect, Portsmouth City Councils’ Helpdesk and Southampton City Council.
Hantsdirect 0845 603 5630
Portsmouth City Council Helpdesk 02392 680810
Southampton City Council 02380 833025
4.6. Where referrals are received without a Certificate of Visual Impairment then a screening will be undertaken in order to prioritise the referral and allocate to a sensory worker. Any information gathered at this point will be recorded on Adult Services database. In the event that a referee has not obtained a medical diagnosis, they will be advised to meet with their General Practitioner