EQIA of LD Day Service Reform - Final Draft 19 08 2010

LEARNING DISABILITIES DAY SERVICE REFORM EQUALITY IMPACT ASSESSMENT
August 2010
(Final Draft)
For Further Details Please Contact: Planning, Policy and Performance Team Tel: 0141 287 8786 cormac.quinn@glasgow.gov.uk
CONTENTS
Stage One Identification and Scope Stage Two Research and Consultation Stage Three Assessing the Impact Stage Four Taking Action Stage Five Feedback on Proposed Actions Stage Six Monitoring and Evaluation Stage Seven Approval Appendices: Appendix A: Day Service Modernisation Consultation April 2008 Appendix B: Members of the Steering Group Appendix C: References Appendix D: Equality Legislation
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People with Learning Disabilities

People with learning disabilities and their families are entitled to as full a life as possible. They are entitled to feel valued and to be included in society. People with learning disabilities should be able to lead normal lives. We want them to: Be included, better understood and supported by the communities in which they live; Have information about their needs and the services available, so that they can take part, more fully, in decisions about them; Be at the centre of decision-making and have more control over their care; Have the same opportunities as others to get a job, develop as individuals, spend time with family and friends, enjoy life and get the extra support they need to do this; and Be able to use local services wherever possible and special services if they need them.
(Extract from The Same As You? A Review of Services for People with Learning Disabilities - The Scottish Executive.
The Foundations of a Modernised Day Service

Modernised day opportunities should be based on a shared understanding of and commitment to: People with learning disabilities determining for themselves how they spend their days; People with learning disabilities living, working, learning and participating in the community alongside other community members; People with learning disabilities having opportunities to contribute to and benefit from community life and to be seen and valued as equal members; People with learning disabilities having opportunities to build and sustain valued relationships; An equality of access to community life for all people with learning disabilities regardless of their level of learning disability, physical and sensory impairments, ethnic community or health care support needs; Clearly defined eligibility criteria to services which are person-centred, sustainable and that promote dignity, safety and independence.
(Extracts from Valuing People: A New Strategy for Learning Disability for the 21st Century)
Equality Impact Assessment Stage One Identification and Scope

Title of this assessment: EQIA of Proposed Learning Disability Day Service Reform Date assessment completed: March 2010 Responsible Officer: Eric Fiamanya, Senior Officer, Planning Policy & Equality Contact details: Social Work Services, 25 Wheatley House, Glasgow G1 1HL, Tel: 0141
287 8032
This is an assessment of the reform of an existing function/practice. Aims and objectives of the function/practice and the scope of the reform:
Introduction Definition of Learning Disability

Learning Disability is an umbrella term that refers specifically to the presence of a
significant intellectual impairment. The U N (1975) Declaration on the Rights of Disabled Persons states that, Disabled people, whatever the origin, nature and seriousness of their handicaps and disabilities, have the same fundamental rights as their fellow citizens of the same age, which implies first and foremost the right to enjoy a decent life, as normal and as full as possible In the document The same as you (2000) the Scottish Government provided a definition of learning disability as follows: People with learning disabilities have a significant, lifelong condition that started before adulthood that affected their development and which means they need help to: understand information; learn skills; and cope independently. People with learning disabilities should have a range of support and services to meet the following needs: Everyday needs (for example, a place to live, security, social and personal relationships, leisure, recreation and work opportunities). Extra needs because of their learning disability (for example, help to understand information, support to make decisions and plan, learn skills, help with communication, mobility or personal care). Complex needs (for example, needs arising from both learning disability and from other difficulties such as physical and sensory impairment, mental health problems or behavioural difficulties). Understanding the issues 3
For any of these needs the level of support will vary. A person with learning disabilities may need: occasional or short-term support; limited support, for example, only during periods of change or crisis; regular long-term support, perhaps every day; or constant and highly intensive support if they have complex or other needs which are related. So people with learning disabilities have a range of needs which will change during their lifetime. Professionals need to help people plan for the future. For many people with learning disabilities, particularly those with complex needs, organisations need to work together with the individual and their family to plan and support them. People with learning disabilities should have the following: Services that promote and protect their health and welfare, help them lead lives which are as normal as possible and are best suited to their needs, whether at home, in schools, health services or other settings; Information, advice and help to get education, work and leisure that offers personal fulfilment, consistency and security, best meets their needs and personal preferences, and helps them to be included and accepted within local communities; Ordinary homes which are private, secure, comfortable and safe. People with learning disabilities and their families should: have accurate and easily accessible information at the right time about what services and support are available locally and nationally, in a number of different ways; be involved when professionals make decisions about what help to provide, so that they can have a real choice about what happens to them; and get independent advice and advocacy services when they need them. Families and carers should have: a range of help to support them including training and advice to look after a person with a learning disability; access to professionals who take into account and find ways to meet their needs as carers (whether they are parents, brothers and sisters or other family members); and access to short breaks. Communities need to: have greater understanding of people with learning disabilities and how they can contribute to the community; and be involved in supporting people with learning disabilities and their families to achieve their rights. Employers need to: overcome prejudice associated with employing people with learning disabilities, and play their part in helping them to reach their potential.
Aim of the EQIA

To assess the likely impact of the proposed learning disability day service reform on service users, families and carers and staff.
Why do the EQIA?

An equality impact assessment (EQIA) is an analysis of a proposed change to an organisational policy to determine whether it has a disparate impact on gender, ethnic group, those with disabilities or those working part-time. It applies both to external policies, (i.e. those having an impact on the customers - or clients - of the organisation) and to internal policies (that is those affecting the organisations employees). As a public authority, Glasgow City Council has a duty under the equality legislation to ensure that all individuals are able to benefit equally from the services it provides regardless of their race, gender, disability, age, faith or sexual orientation. In the Councils Corporate EQIA programme, Social Work Services made a commitment to carry out an EQIA of the proposed Learning Disability Day Service Reform programme because of the nature and scale of the reform involving significant costs or resources and has the potential to have a differential impact on disadvantaged groups that use the service.
Objectives of the EQIA

To ensure that the proposed new service model does not discriminate on the basis of race, gender, disability, age, faith or sexual orientation; To ensure the views of service users, carers and staff on the proposed changes are taken into account in redesigning the service; To identify any gaps in the proposed service model which are likely to have an adverse impact on service users, carers and staff and make recommendations to improve services based on findings of the impact assessment.
Deliverables/Outcomes
We will produce a written report on the EQIA with an action plan which will be considered by the Social Work Leadership Team, and thereafter it will go to the Corporate Equality Working Group for information. Stage six contains details of the monitoring and evaluation process.
Constraints
The main constraints we are aware of are: Lack of equality data, especially on sexuality and socio-economic data Adequate staff resources to complete the EQIA process Reliance on staff to make time to take part in the exercise
Scope of the Reform Background

Glasgow City Council and Glasgow NHS Board approved the strategic direction for learning disability services in 2001. In essence, this rejected the practice of placing people with Learning Disabilities in long stay hospitals. Lennox Castle was, therefore, closed and clients given the opportunity to live in their own homes. Beside Lennox Castle Hospital, closing of other long stay hospitals like Royal Scottish National Hospital (Larbert) also saw many former residents making the decision to move back to Glasgow. Parallel to this was the development of day services to provide people with learning disabilities with greater opportunities to participate as active citizens within their communities. This approach has delivered many significant changes but in seeking to build on these achievements, the next phase of reform must ensure that people with a learning disability have greater access to education, leisure, health and employment opportunities.
How day care services are currently provided in Glasgow

Currently, day care service provision can be characterised by the following components: Fixed service hours (10am 3pm, Monday to Friday). Activities tend to be service led rather than purely needs led/ person centred (e.g. transport dictates service provision). Segregated service environment. Limited community presence or opportunity to network and build relationships. Limited opportunities for employment/ options in further education. Building based People frequently touch base Limited opportunity for 1:1 Limited transport and flexibility Exclusive service day service staff facilitate
Distribution of Day Service Centres by CHCP (October 2008)

CHCP North West East South West South East Total Number of Centres 3 1 2 2 2 10 Number of Service Users 180 89 230 154 165 818 Current number of Staff 60 23 66 56 46 251
Drivers for Change

The Department of Health has identified three major factors that are creating change in the demand for specialist learning disability services: Significantly increased numbers of people with learning disabilities, partly caused by people living substantially longer as a result of medical and technological advances and thus people needing additional support around illnesses linked to old age, in particular dementia and people with Downs Syndrome. Significant changes in the demographic profile with increased numbers of people with complex needs requiring input from specialist health professionals. This particularly applies to young people with multiple disabilities and, together with the above point, will require commissioners to consider levels of investment in both mainstream and specialist health services. The increasing empowerment of people with learning disabilities and their families, resulting in them expecting and demanding better quality services located nearer to their home and communities. In addition to these major causes, patterns of spending are changing as a result of factors such as an increasing demand to support people with autistic spectrum disorders, better diagnosis and early identification of need. In Glasgow, the key drivers include the workforce pay and benefit review which took place in 2007, the SWIA Report and the Social Work survey (2001) which highlighted the changing expectations of service users and carers. The survey confirmed that service users wanted change. In the survey How is it going? (SCLD 2006) it was highlighted that people with learning disabilities want the same choices and options as everyone else. They want to be able to make decisions about their lives but more importantly they want to have social opportunities, seek employment and develop relationships.
Key Policies
In Scotland the key policies that underpin the drive towards changes in the way learning disability services are delivered are: Same As You (Scottish Executive - 2000) Working for a Change? (Same As You Implementation Group - 2003) Changing Lives 21st Century Social Work Review (Scottish Executive 2004) Make My Day! (Same As You Implementation Group - 2006) How is it going? (SCLD 2006) Whats out there? (SCLD 2009)
Description of the New Service Model

The programme of reform being proposed will involve a service transformation, from traditional building based models defined by time and place, to new approaches tailored to meet individual needs, using personalised budgets as mechanisms for supporting new and/or alternative service models that not only support greater independence, but reflect and respond to individual needs. Equipping the workforce to deliver this new way of working will require effective consultation and communication and a significant investment in new skills and practice.
This proposed modernisation programme is underpinned by a number of key drivers for change. These include:
Demography
Advances in medical science have seen more infants with disabilities surviving into adulthood. People now have increased life expectancy. Scottish Executive figures highlight a year-on-year 1% increase in the number of people with severe and moderate learning disabilities during the period 1965-2010. These demographic changes have resulted in a growing number of older adults with learning disabilities.
Policy Direction
National and devolved governments expect local agencies to place priority on the development of personalised, individually tailored services that promote choice, social integration and independence in order to enable people to lead a full life within their local community. Significantly, the recent Make my day! Report recommended that the role of day centres should change. The vision outlined is of day services transforming to become resource centres, offering limited in-house activities and support and using more community resources to support people with learning disabilities to access education and development, real jobs and sport and leisure activities.
Quality Assurance and Inspection

Whilst highlighting a number of service strengths, the SWIA Report (June 2007) drew attention to the need for services to do more to assist marginalised groups such as people with learning disabilities. An explicit recommendation was made that Glasgow should support more people with Learning Disabilities into employment.
Service User and Carer Expectations

Glasgow City Council has over many years supported and encouraged active service user and carer participation in the development of learning disability services. It is recognised that the active engagement of users and carers in the ongoing reform programme will be critical to ensuring its success. Service users, carers, our partners and staff have been actively encouraged to contribute to and be involved in this reform programme, whilst acknowledging the balance between the needs of carers and the aspirations of service users. Service users in Glasgow have made the following comments on current day services during consultation between January April 2008: More support in the community would be good. Not enough choices outside the Centre. More flexible support not just from 10 am-3 pm. Local Area Co-ordinators are having a positive impact on peoples lives. More thinking on natural support. More employment opportunities. More support to access the community. At the day centre its not always what I want to do and I have to go and do what the group is doing
These comments reflect service users desire for more community-focused day services that promote choice and flexibility. These views are consistent of the ethos of greater personalisation of services; e.g. through the introduction of individual budgeting.
Local Context
Glasgow provides day opportunities for adults with learning disabilities from 10 resource centres across the City, 8 of these provide access to integrated Area Learning Disability Teams. The traditional day service model is ill-equipped to respond to the continuing growth in both the overall population of people with learning disabilities and the proportion of that population presenting with complex needs. However, the aspirations of people with learning disabilities and their carers, whether young people in transition from school, those with complex physical and health needs, or those who are ageing or have older carers, are proving difficult to accommodate within the current service construct and is creating growing pressure for the development of more personalised models of service delivery. Notwithstanding some notable exceptions, Glasgows day services continue to be characterised by a building rather than a community focussed approach, with a large number of learning disabled adults transported daily to services segregated from their communities. This compares unfavourably with national policy and best practice examples from other local authorities.
Future Shape of Services

The new model which has been called the hub and spoke model will be designed to support a transformation from traditional, building-based services, to modern, personalised, community-based services. The core elements of this model would include: A Service Hub focusing on meeting the needs of those individuals with the most profound and complex needs. Initial estimates are that this need can be met from 1 Hub within each CHCP and consultation had been carried out on the basis of this model. There is also a need to review the identified centres within this model to see if they are fit for purpose both in terms of their suitability to accommodate new ways of working and location. An initial review of the estate indicates new builds would be desirable. The Hubs would operate a therapeutic model involving the delivery of integrated care plans, in partnership with health professionals who would be co-located within the buildings. The underpinning philosophy of this element of support would be that of service provision from these building bases, rather than service provision for this group of individuals being based in the buildings at all times. The development of services that are not centre based but focus on enabling individuals with lower support needs to engage with their local communities by facilitating access to mainstream activities. Community outreach services that integrate with key partners and appropriate providers to deliver and support people with a learning disability. Education employment, leisure and health services would be co-located wherever possible.
Building capacity in local communities; e.g. through further development of leisure, further education, employment etc.
This proposed re-design positions the Council and its partners to provide a transformed service supporting choice, independence and personalisation through the use of direct payments, and supporting the move away from a dependency culture. The envisaged modernised service model is a community-focused one, where the emphasis is on supporting people with a learning disability to access greater opportunities in employment, education, training, sport and leisure, volunteering and other opportunities for community inclusion. Individual programmes would be designed in line with individual needs and interests and will provide outcomes, which reflect the aspirations of both service users and carers. As these opportunities develop, fewer people would require access to day centre services. Rather, they would be supported by appropriate staff to access communitybased services and opportunities directly. Access to day services from centres or hubs would continue for those who needed them, particularly those with more complex needs and disabilities and those with a greater requirement for therapeutic interventions. Each CHCP would retain at least one centre or hub in its area. The main features of the new service model can be summarised as follows: Person centred care plans Better community presence More opportunity for employment/further education Needs led and person centred delivery Service level better reflects needs Go direct to activities Flexible transport and hours More involvement of community partners
The key principles underpinning the re-design process are built upon consultation feedback from service users, carers and stakeholders. These are: A phased approach Making sure alternatives are in place before a building is closed. Risk is assessed and managed. Support to maintain relationships and develop new ones. People will generally receive support in their locality. Support arrangements are flexible to enable access to community opportunities in the evenings and weekends.
Workforce Issues
The process of change to the full modernised service envisaged will be complex requiring a building of opportunities and service capacity, redesign of the workforce and close attention to the involvement and impact on service users and carers as the changes move forward.
Proposed staffing for the modernised service is based upon a profiling of service users, living and family situations, information provided by each CHCP and anticipated future demand. Significant numbers of service users live in supported accommodation and residential care and it is felt that a more holistic, individualised and efficient approach to supporting many of these individuals would be achieved by developing plans with the same provider agencies, who currently support them, to extend that support to encompass day support for individuals to access community opportunities (as is the case already for around 800 people supported by provider agencies across the city). This will involve enhancing staffing as appropriate within these services. The proposed workforce for the directly provided service will involve: More focus on management structure Enhanced roles opportunities for Day Services Workers Major increase in Support Workers Increased frontline staffing ratios, particularly for those with complex needs (from 1:2.4 service users to 1:2 service users on average daily attendance at end point). Staff capacity to support a flexible and individual service that can support clients to realise their choices.
Day Service Managers will have a responsibility for both strands of the whole service. CHCPs have also estimated how many other service users they are likely to require in the future as alternative opportunities are developed, service delivery through a centre or hub and how many would require to be supported directly to access community opportunities through a Community Connections team in each area. Therefore, it is envisaged that, at end point, the service requirements will break down as follows: 200 people Community access supported by existing providers or through individual budgets. 350 people Support co-ordinated through hubs but involving community access. 300 people Supported through Community Connections team in each CHCP. In practice the service designed for individuals will be in line with needs which may see some individuals accessing different strands of the service.
Work streams in progress

The main work streams currently being progressed are: Transport Catering Community Access Further Education Employment Culture and Sport/Art Care commission Buildings
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Communication Commissioning Providers Workforce Development o Induction o Recruitment o Staff Training and Development o Staff Restructure phased approach (3 tranches) Trade Union Liaison Flexible Support Staff Learning and Developments Finance Equality Impact Assessment Flexible Support
Challenges
Scale of change Building confidence in change Delivering in current financial framework Partner agencies buying in Complexity of work strands e.g. workforce planning Community infrastructure readiness Ensuring staff have and can apply necessary knowledge and skills required Transport Partnership working
Stakeholder Involvement
It has been recognised that a critical factor in successfully transforming the service is to gain the support of service users and their carers as well as other stakeholders. Therefore a series of events with service users, carers, providers, partners and staff across each of the 5 Community Health and Care Partnerships were organised, some through consultants to get the views of stakeholders and to establish and agree the drivers for change.
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Stage Two Research and Consultation

These are the sources of evidence used and the key facts that informed the assessment of the policy or function: The next section details what research is telling us about the various equality strands.
Estimates of Learning Disabilities

There are no current, definite learning disability prevalence estimates based on studies in the UK and, in particular, Scotland. Furthermore, the reported prevalence of learning disability, including severities, varies across studies and may be the result of different definitions, methodologies, clinical assessment tools, geographical areas, and demographics. The World Health Organisation (WHO) estimates that learning disability prevalence is 3% overall in industrialised countries (Mental Retardation 1989). In England, the Department of Health estimates that there are approximately 210,000 people with a severe/profound learning disability (3.5 per 1,000) and 1.2 million people with a mild/moderate one (25 per 1,000) (Valuing People 2001). The then - Scottish Executives report The same as you? (2000) estimates in Scotland that approximately 20 per 1,000 of the population has a mild/moderate learning disability and 3-4 per 1,000 has a severe/profound one. Roeleveld et al. (1997) estimate that, on average, 3.8 per 1,000 of the population experiences a severe/profound learning disability and 29.8 per 1,000 experience a mild/moderate one. Applying these rates to Glasgow Citys general population, it is estimated that there are 19,553 people with a learning disability (33.6 per 1,000). The majority of them are estimated to experience a mild/moderate one at 17,342, and the remainder a severe/profound one, 2,211. With the above points in mind, the following estimates should therefore be used as a rough guide for the situation in Glasgow City. East CHCP is likelier to have more people experiencing a learning disability at 4,988 (4% of the CHCP population), followed by West and North, each respectively 3,894 (2.8%) and 3,876 (3.9%). Likewise, East is estimated to have more people experiencing a mild/moderate learning disability at 4,518 (3.7% of its population). West is estimated to contain a higher number of people experiencing a severe/profound one, 531 (0.4% of its population). South East is likelier to contain less people experiencing a learning disability at 2,928 (2.9% of its population), as well as a mild/moderate one at 2,542 (2.5%). Research by the Department of Health (1995) suggests that the number of people with learning disabilities will continue to grow by over 1% a year over the next 10 years with more living longer and as a result the needs of people with learning disabilities will change over time. Findings from research published in The same as you (2000) showed that adults with learning disabilities, like any other adults, need learning opportunities throughout their lives. They want to learn skills for work, enjoy leisure activities, improve their skills (especially communication) develop self-confidence and self-advocacy, and learn to use facilities in their local communities. Currently there is evidence that there are barriers preventing people with learning disabilities from getting what they want.
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With regard to equalities, evidence seems to suggest that people with learning disabilities are one of the most excluded groups in our society, and their exclusion from the labour market is exceptionally high. Also people with learning disabilities are reluctant to use public transport because of fears of bullying and harassment. Specifically, there exits significant inequality between people with learning disabilities and other impairment groups and the general population in relation to access to education, employment, health and leisure.
Race/Ethnicity
A review of research on people with learning disabilities and ethnicity reveals considerable amount of data. In this section we provide a summary of the findings of some of the researchers with references detailed at Appendix C. A study by Ghazala Mir et al (2001) found that people with learning difficulties from minority ethnic communities and their carers face considerable problems in accessing relevant services. The main points highlighted in the report were as follows: People with learning difficulties from minority ethnic communities and their carers face considerable problems in accessing relevant services. Minority ethnic communities face substantial inequalities and discrimination in employment, education, health and social services and leisure. The higher prevalence of learning difficulties in South Asian communities has been linked to high levels of material and social deprivation. These may combine with other factors such as poor access to maternal health care, misclassification and higher rates of environmental or genetic risk factors. People with learning difficulties from minority ethnic communities experience simultaneous disadvantage in relation to race, impairment and, for women, gender. In addition, negative stereotypes and attitudes held by service professionals contribute to the disadvantage they face. The study projected that the prevalence of learning disabilities amongst the South Asian communities may be around three times higher than in other communities, and this trend is likely to increase over the next twenty years. Elderly and ill carers and those caring for people with severe disabilities received little support from services. There is a widespread neglect of the needs of people with learning disabilities from black and minority ethnic communities.
Hubert (2006) interviewed 30 family carers of people with learning disabilities from black and minority ethnic communities. The study identified key issues that people with learning disabilities from a minority ethnic background face. The main findings were: BME people with learning disabilities do not receive sufficient or accessible information about available services; there is poor communication between carers and service providers; some BME people have no English and cannot initiate or respond to contact and communications; some are socially isolated from the community in which they live; they are unable to get access to services they need; some services carry a charge which is not within their means to pay; they do not have anyone who visits them on a regular basis; they do not know how to contact service providers for help when they need it; they feel neglected by the service providers; some are suffering from high levels of stress;
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some are frail and/or ill and cannot get the help and support they need to continue caring; they do not have supportive family groups; they have serious anxieties about the future, and need support to start making viable plans.
The lack of social work support was also identified to be an issue in Glasgow. Taylor (2009) held a meeting with nine family carers predominantly from the South Asian communities and found that the most common complaint was that social work passed them to their childs school to address a particular issue and the school pass them back to social work. The school advised the parents to ask social work for assessments or help on behalf of the child as this meant they were more likely to get a social worker allocated to the family, but this was not always the case as not all social work picked up cases due to their workload. There is then a predicted need not only to improve how services are being engaged by people with learning disabilities and how the services themselves are engaging people with learning disabilities but to increase the level of service provision. Karlsen & Nazroo (2002) found that: families from black and minority ethnic communities with a member who has learning disabilities are twice as disadvantaged as those from majority ethnic communities due to racial prejudice and lack of culturally sensitive services; people who have a learning disability and who are from a visible minority ethnic background suffer from added racial discrimination.
Azmi et al (1997) found that Racism and learning difficulty stigma are persistent issues faced in the lives of people with learning disabilities who are from the South Asian community. This is known as double discrimination. A study by Ethnic Enable in Glasgow (http://www.iriss.ac.uk/files/iriss-fc-3-furrah-2008-0617.ppt) found that the main issues affecting people with learning disabilities from ethnic backgrounds are language difficulties, transport issues, social isolation, and more vulnerable to domestic and sexual abuse A report by Kusminder Chahal (2004) which brought together lessons from projects funded by Joseph Rowntree Foundation relating to ethnicity and service provision identified a persistent lack of recognition of the circumstances of groups and individuals that make up minority ethnic communities and the fact that they are often ignored in policy and practice responses. The main findings were:
black and minority ethnic service users felt mainstream services are often inappropriate for their needs and that services make assumptions based on stereotypes and prejudice about what the needs of these users may be or what they may want to access; the experience of racial discrimination and prejudice in mainstream service provision often meant that what minority ethnic users are asking for are specialist, culturally competent services; there are few black and minority ethnic staff in mainstream services and some of the services have made little attempt to change this; there is a general desire for more information about services and entitlements from service providers. For example, very few disabled people have any knowledge of direct payment schemes; religious and cultural identity is very important to many people from minority ethnic communities but it is rarely responded to by mainstream service providers;
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common myths about informal family networks looking after each other cannot be taken for granted. Although informal support is available in certain circumstances, this cannot be relied upon; the differences between the experiences of men and women are often sharper than the differences between different ethnic groups.
Gender
A review of the available literature on gender and learning disabilities reveals the following key findings: Emerson et al (1997) found that severe learning disabilities are most common amongst males, young people and people from South Asian communities. Brenda Ellis (1995) found that transport is a major issue for disabled women. Lack of reliable, accessible transport means they are isolated in their homes, unable to pursue employment, education or leisure activities; Beyer, Goodere and Kilsby (1996) found that 65.8% of the supported employees surveyed are male; and women undertaking supported employment work fewer hours than their male counterparts. A study by Levy et al (1994) found that female supported employees are more likely to have their employment stopped and to have worked a shorter period of time than men; South Asian women are seen as isolated because of traditional customs; the failure to take up services provided by statutory bodies is attributed to black and minority ethnic womens lack of relevant skills, language and understanding of Western lifestyles. gender differences exist with more men receiving supported employment than women, and men working more hours. women and girls with disabilities experience disadvantages and discrimination based on the combination of both disability and gender-based discrimination, known as 'intersectional discrimination'. This means responses targeted to their specific issues and needs must ensure that they enjoy the same rights as all others, including disabled men and/or their non-disabled peers. women, especially BME women face barriers to accessing employment and leisure activities because of lack of reliable transport.
Age
A review of existing literature on age and learning disabilities reveals the following: The Institute for Health Research, Lancaster University (2004) predicted that the number of adults with learning disabilities will increase by 11 per cent and those aged over 60 by 36 per cent by 2021. This increase may be explained by: increased life expectancy, growing numbers of children and young people with complex and multiple disabilities who now survive into adulthood, a sharp rise in the reported numbers of school age children with autistic spectrum disorders, some of whom will have learning disabilities and greater incidence among some minority ethnic populations of South Asian origin. Rimmerman et al (1996) found that women under the age of thirty are less likely to be employed, and males under the age of 35 have higher employment rates than women, but that over the age of 35 the opposite is true.
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Faubion and Andrew (2000) found that the severity of disability and age are negatively correlated to whether somebody is referred to a supported employment agency. A study by the charity Age Concern (2004) found that 28 per cent of adults have experienced age discrimination, most under 25 or the 55-65 age groups; A report by Jane Fitzgerald (1998) for the Joseph Rowntree Foundation found that: people with disabilities, young people moving out of care or gay and lesbian young people often face particular challenges in moving to independent housing. lower rates of housing benefit for people under 18 limit their housing choices; young people experience increased risk and uncertainty as they move into independent housing. there is a marked lack of opportunity for older people with learning difficulties to develop networks with others of similar ages or interests; many older people with learning difficulties would have preferred being cared for by other older people, with similar interests to themselves. age and language can present difficulties in advocating for support and that there exists a population whose needs are being met by families as distinct from the state. older people with learning disabilities are more likely to be excluded from the labour market.
Sexual Orientation
Sexuality and people with learning disabilities is a controversial and sensitive area of research. Because of the specific needs of disabled LGB people and the challenges posed by researching a hidden population, there are no large-scale surveys of disabled LGB peoples health needs. Rather, evidence is provided by a number of small-scale qualitative studies. The National Disability Authority (2005 concluded that the rights of people who are disabled to engage in everyday activities that the rest of society take for granted (for example, taking part in leisure activities, getting a job and falling in love) are severely curtailed; the rights of people who are disabled to sexual relationships are not widely accepted; moreover, the fact that some may wish to have a same-sex relationship is largely unconsidered; same-sex relationships are more likely to be seen as a potential danger and rarely as a source of pleasure or fulfilment;
Abbot and Howarth (2005) concluded current practice in work with people with learning disabilities is more likely to restrict opportunities for sexual relationships rather than support people to have relationships that are satisfying; as with heterosexual relationships, there are issues about consent, mental capacity and risk. Brothers (2003) found that while parents, carers and professionals are concerned about protecting disabled people from exploitation, this often means that disabled people are not empowered to lead the lives they would choose. In Beyond Barriers (2002), one LGB research participant remarked that people with disabilities are unable to explore their sexual orientation and are kept under parental control until they are in their fifties when their parents died.
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Rainbow Ripples and Butler (2006) stated many disabled LGB people have not received relevant sex education in schools; as adults they lack appropriate information about sexual health and do not have access to information about fertility issues; they may also encounter difficulties in accessing mental health services; Brothers (2003) argued that because LGB people with learning disabilities often live at home with their family and rely on them for financial or practical support, they may be more likely to fear rejection from their family than other LGB people. The possibility of disclosure to a social care worker about their sexuality requires that relevant training be provided so that staff are able to offer appropriate support. Shakespeare et al (1996) observed that education for disabled people has often been segregated from mainstream schooling; disabled people say that they received little or no sex education; they lack access to appropriate guidance about safer sex and little support in accessing LGB social spaces; the language of health promotion materials is inappropriate for people with learning disabilities, and targeted materials are likely to be restricted to heterosexual sex.
Valuing People (2001) and Valuing People Now (2007) concluded that there is a need for people with learning disabilities to understand their sexuality, and also to have the opportunity to form relationships; people with learning disabilities should not be left isolated, and that services should provide them with a stimulating environment in which to meet others, and form relationships. education is important to support people with learning disabilities to maintain their relationships; same-sex relationships should be supported if that is what the individual chooses.
An article by Iain Carson and Craig Blyth, Lonely hearts need a helping hand (LD Today, April 2009), concluded that: staff need to do more to support people with learning disabilities when it comes to forming and maintaining relationships; there are many negative attitudes towards the sexuality of people with learning disabilities and that this view needs to be explored and challenged; services need to make small changes in order to improve the experiences of service users when discussing relationships and sexuality with their paid carers.
The implications for policy makers and service providers of the above are: social care staff, in particular, need clear policy guidelines to enable them to offer support for LGB disabled people in relation to relevant sex education; support for their identities as LGB people, including support to help them to socialise in LGB spaces; inclusion of their identities in person-centred plans; and support for developing intimate same-sex relationships; services need to consider whether it is possible to offer private spaces for people with learning disabilities; need to ensure that resources and training are available to support staff; need to view same-sex relationships as being of equal worth and value as heterosexual relationships; support for disabled LGB people to use direct payments to employ a gay-friendly home care assistant.
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According to Abbot and Howarth (2005) the particular issues raised in their study were: difficulties in meeting and knowing other LGB people (there are few groups for disabled LGB people); lack of validation for same-sex relationships; lack of acknowledgement of LGB people (e.g. few images of LGB people displayed in service provision); lack of acceptance in the non-disabled LGB scene; lack of privacy; and few policies, meaning that staff do not feel supported to do proactive work.
Religion or Belief
The Equality Act 2006 defines religion as serious and cohesive belief compatible with human dignity. Belief relates to philosophical beliefs such as humanism or pacifism but not to other sorts of belief such as supporting a political party. The main findings of studies exploring the relationship between religion or belief and people with learning disabilities are as follows: Summers and Jones (2004) stressed that it is important for staff to examine their own beliefs and attitudes as part of training for working with people with learning difficulties from minority ethnic communities; and training should include teaching and discussion around specific cultural beliefs and norms so staff can begin to develop a framework for working cross-culturally.
Having an understanding of religious or other beliefs is important for staff because: religious or other beliefs influence preferences and behaviours, such as negotiating relationships between men and women, washing requirements and facilities, and dietary needs. It is important for health and social care services to be sensitive to these in order to provide culturally appropriate services; disagreements over religious or other beliefs can potentially cause conflict in the community and damage good relations. belief or faith is often cited as a coping mechanism for both the person with a learning disability and for those that care for them; knowledge about religious beliefs and cultural practices can enable services to ensure that people with learning disabilities from black and minority ethnic communities experience a range of relevant cultural events and influences.
Recurrent themes reported by carers include: the need to meet dietary requirements provide culturally appropriate activities same-gender activities or centres increase the number of staff from minority cultures and the number of bilingual workers throughout mainstream services adapt materials in a culturally sensitive way
Mir, G et al (2001) argued that: the assumption that a family wants support only from someone of their own culture is often misplaced, as workers from other cultures may be perceived as less intrusive. The preference for same-gender staff to carry out intimate personal care and support is curiously portrayed as a requirement specific only to certain
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religions and cultures, when, in fact, it exists to a large extent in all communities. This belief is unhelpful as it suggests that the preference is different or special and it gives the impression of an additional burden on resources; not enough consideration is being given to the impact of the religious beliefs of individuals with learning disabilities in an employment context. It would appear that double discrimination exists for people with a learning disability whose religious beliefs may put them at a disadvantage when seeking work or attempting to assimilate into the work place.
Socio-Economic Inequalities
The literature review on socio-economic inequalities reveals the following: Four in ten households in Scotland with at least one member who is disabled live on an income of 10,000 per year or less, compared to only one in four households without anyone who is disabled (Disability in Scotland 2005-2020: a state of the Nation Report, DRC 2005); Nine out of ten families which include a disabled child are likely to experience problems with their housing. Around 28.6 per cent of disabled households live in homes that fall below accepted standards of decency compared to 25.9 per cent of nondisabled households (Prime Minister's Strategy Unit Report, 2005). Mir et al (2001) reported that Black and minority ethnic communities inherently face inequality, discrimination and disadvantage due to a combination of factors - they are more likely to live in inner cities, live in poor housing and suffer discrimination in education, employment, health and social services. Butt and Mirza (1996) concluded that in the U.K., the burden of care, both socially and financially, is greater for carers from black and minority ethnic communities compared with their White peers, due to a number of contributory factors including poverty, poor housing, racism, higher levels of unemployment, low pay, minimum pension rights, reduced benefits because of residence status and inadequate education. For example, spouses of adults with learning disabilities from black and minority ethnic communities are allowed into the U.K. on the proviso that they do not claim on the welfare state for the first 5 years. The Department of Health Report (2005) rightly highlighted that whilst some ethnic minority families may prefer to look after their family members, it is not a general presumption that should be held. Rather, services should account for the fact that many families may not ask for help, but this does not mean they do not need it. Some may not know of services and help available to them; there may be barriers such as language that inhibit families from asking for help and some families may resign themselves to their belief systems, that it is a matter of Gods will and therefore may not seek out help. The report concluded that lack of information often leads to low expectations of the outcome that could be achieved; and knowledge about religious beliefs and cultural practices can enable services to ensure that people with learning disabilities from black and minority ethnic communities experience a range of relevant cultural events and influences.
In The same as you? it was reported that benefits play a big part in the lives of people with learning disabilities. Most are not, or have not been wage earners, and benefits are often their only source of income. So their ability to live a normal and
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fulfilling life is governed by benefits. The report stated that the benefits system is complicated and getting the right advice and help is essential.
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Stage 3 Assessing the Impact

Based on your evidence, outline the positive, negative and neutral impacts the policy/function has, or may have, on the following groups:
People with Learning Disabilities Positive impact:

The reform has the potential to contribute to reducing the inequalities experienced by people with learning disabilities if adequate resources can be made available to support them to access greater opportunities in employment, education, training, sport and leisure, volunteering and other social inclusion opportunities. Potential benefits of the reform are more integration of people with learning disabilities into their local communities, the opportunity for them to increase their expectations and to invite the public into their lives, and the chance to challenge them to leave their comfort zones. In addition, the success of the reform programme will depend on the removal of structural factors (e.g. transport and benefits issues) which hinder the development of community-based day opportunities for people with learning disabilities. Equally, it will depend on effective communications campaign, workforce training and qualifications, and making universal sources of information and guidance accessible to people with learning disabilities. To meet the needs of service users, services should worry less about providing a menu of options and concentrate more on listening to what people say they want and meeting those needs in flexible ways.
Negative impact:
As the focus of the new service model is on people with moderate to severe learning disabilities, one can argue that the proposals are likely to have a differential outcome for disabled people, and potentially, can have an adverse effect on some of them, in particular people with a milder learning disability who may not be eligible for adult social services. It might be interpreted as a policy that treats people with learning disabilities more favourably than other disability groups. In this regard, the Council is at risk of creating a two tier service. Currently, many community facilities do not meet the needs of people with learning disabilities, for example some of the facilities lack adequate changing places. Unless people with learning disabilities have access to adequate facilities their experience of community-based resources may be a negative experience and may end up using the Hubs. There is some perception that the creation of Hubs to accommodate people with complex needs potentially could mean less opportunity for social interaction for them as those with mild learning disabilities will be out using community facilities. It is important to ensure inclusive opportunities are available. It has been suggested that because of prejudice or stigma the community may not be ready to accept or tolerate people with learning disabilities when they go out to access community-based facilities and as a result they may suffer rejection, hence it will be necessary to educate the public.
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Black and Minority Ethnic People Positive impact:

The reform has the potential to contribute to reducing inequalities and tackling the problems of exclusion and harassment experienced by BME people with learning disabilities on the grounds of race, if it creates more opportunities for them to overcome the barriers they face, for example, access to better interpreting services and support from bilingual staff. . Also it is underpinned by values that aim to support people from the most excluded parts of our society towards social inclusion and a better quality of life. In this sense the reform may have a positive impact on BME people who are an excluded group. Other potential benefits include increased awareness of opportunities to develop other interests and mix with people from other cultures, the freedom to nominate a family member of their choice (not necessarily the carer) to look after their budget and employ an advocate from the same cultural background to represent them and articulate on their behalf what they want. Similarly, if BME carers get adequate support to access more employment opportunities they may have a better chance of securing employment. At the moment there are many barriers which prevent them from securing meaningful jobs.
Negative impact:
Evidence tells us that BME people with learning disabilities face many barriers, for example, poor housing, language difficulties, transport problems and lack of information and awareness about services available. Unless these are identified and addressed, the reform may not improve the situation for BME service users. Research tells us that BME service users will need more than encouragement to access community-based services, in particular issues about staff imbalance, low staff morale, transport, communication and language including prejudice and stigma need to improve significantly before the reform can have a positive impact on BME people with learning disabilities. In addition, if services are to improve for BME service users, the reform needs to address the reluctance of older BME carers to ask for help or access Social Work Services. They need help and individual support to come forward to express what they need. In light of the above, the new model should be flexible enough to cater for the needs of all excluded groups. Also it will be necessary to carefully monitor and evaluate how well the reform is working for BME groups. This will ensure that their needs are being met. Furthermore, the reform needs to continue to record information on ethnicity.
Gender Positive impact

As highlighted earlier, women with learning disabilities under the age of thirty are less likely to be employed than men with learning disabilities of the same age. The reform may contribute to reducing this inequality if adequate resources are made available to support these women to access employment opportunities and into meaningful jobs. Measures to promote work need to target women equally to men; also it is
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important to monitor the outcomes for service users by gender to ensure the reform does not only benefit men. The focus on personalisation means that service users should be able to ask for a staff member who is of the same gender to meet their personal needs, assuming there is a better gender balance of staff. Encouraging service users to access community activities may increase their visibility and give them increased opportunity to mix with the general public. Overtime, this can help change the attitude of the public in a positive way and reduce the discrimination experienced by people with learning disabilities. Equally, it can provide them with more opportunities to be involved in gender specific activities. We know from research that the majority of carers are women. The reform may offer them more flexible and responsive services, with better lifestyle choices, better social networks and employment opportunities. In addition, the reform may highlight personal safety issues concerning women and awareness of male issues in caring, in particular, the shortage of male carers and attending to the personal needs of women service users. To meet the shortage of male staff, the Service recently implemented a recruitment policy which resulted in the recruitment of additional male staff. This is a good example of how the Council can increase the numbers of under-represented groups in the workforce.
Negative impact
We know from research that there exists gender imbalance in the workforce which seems to restrict the choices available to service users in terms of staff availability to give personal care. It is important that efforts are made to correct this, otherwise the reform may create the impression that service users have more choice whilst in reality they dont. This can be frustrating for both carers and service users. Over the years, service users have established their own networks and made friends. It is possible that by moving out from day centres to community-based resources they may lose these networks and their friendships. This may leave service users feeling isolated, vulnerable and discriminated against, especially women from the BME background. Efforts need to be made to support existing networks.
Lesbian/Gay/Bisexual/Transgender people: Positive impact

We have highlighted already that the reform aims to promote social inclusion and access to community facilities. This approach is likely to create networking opportunities for people with learning disabilities to meet other people with similar interests and sexual orientation, enabling them to explore their sexuality without fear of being stigmatised. This approach needs to be supported with the appropriate equality and diversity awareness training of staff, carers and stakeholders. Riddrie Centre, in the North East of the City, has been providing relationship and sexual wellbeing education to people with learning disabilities over the last seven years. Around 5 to 10 service users take part in this training at any one time. The group has moved out of the Centre and are now located in Sandyford East in Parkhead. The course is provided at a pace that suits the service users and can last as long as they need to cover all the issues they wish to discuss. The course covers LGBT issues as well as all various forms of abuse, health and safety, and positive
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and negative relationships. Each service user is asked to evaluate the course and their own progress every 6 months. The Service needs to promote this course across the City.
Negative impact
Currently the Council does not have an agreed policy or system of monitoring the sexual orientation of service users. However, within Social Work Services, service usage is recorded by ethnicity and gender. Also equality and diversity training is delivered to all staff, but this does not include LGBT training. As a result, staff we have consulted have expressed a lack of awareness about the sexual needs of people with learning disabilities. The reform should result in a supporting environment for people with learning disabilities where they feel safe discussing their sexuality.
Age Positive impact

The reform has the potential to contribute to tackling the exclusion from the labour market of older people with learning disabilities if appropriate measures are put in place to support them into meaningful employment. The reform also has the potential to help older adults to access age appropriate and specialist activities or services. Older adults with learning disabilities can find it challenging to find common interests among a general group of service users due the inflexible arrangement of existing day services. The provision of individualised support under the reform can lead to better age matching of staff and service users. It can challenge staff to think about age specific and relevant opportunities for individual service users. In addition, the reform may provide younger people the opportunity to try different meaningful activities, for example, going to college, taking on employment and getting involved in leisure activities. Furthermore it may lead to more parental involvement in relation to carers, the chance for older people to retire, and the opportunity for people with learning disabilities to challenge values in the colleges they attend.
Negative impact
Implementing good employment support measures within schools and colleges, with the intention of keeping people out of day services and residential care, may have an adverse effect on older people who are left behind in increasingly under-used day services. If measures are skewed towards young adults, this may arguably lead to older people being less of a focus in the new model. It is important to encourage Services to engage with supported employment agencies to seek work experience opportunities for those furthest from the labour market. Using North Lanarkshire as an example, the new model should ensure that older people using day services have alternatives to traditional day service provision, which includes opportunities for meaningful work.
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Religion or Belief Positive impact

Emphasising needs, promoting social inclusion and choices can create the opportunity for BME service users to arrange care packages that meet their religious and cultural needs. Overall, the reform has the potential to promote the development and delivery of culturally competent services, but as stated previously this requires the pulling down of barriers that prevent BME service users from accessing the service. It has been reported that the Service currently has a bereavement policy. This could be further developed to ensure it meets the needs of service users from a BME background.
Negative impact
It is worth noting that providing individualised services do not always match up with what service users and carers want due to the lack of adequate staff and resources. The lack of resources can prevents the Service from meeting fully the specific religious and cultural needs of BME service users and carers, partly because staff may not get the appropriate cultural awareness training. It also means the Service may not recruit bilingual staff, which in turn creates an imbalance in the number of male and female staff available. Failure to provide adequate resources and build capacity of the organisation can undermine the reform programme and have a negative impact on service users from the black and minority ethnic communities, as they will simply not trust the Council to deliver on its promises.
Socio-Economic Status Positive impact

The new service model may contribute to tackling the socio-economic inequalities experienced by people with learning disabilities, especially BME service users, carers and women, if these excluded groups are targeted and supported to access employment opportunities and into meaningful employment. With regard to benefits, supporting users and carers to claim what they are entitled to may help improve their financial situation. Individual budgets may give service users the opportunity to take more control over their budgets and enable them to purchase a service that is flexible and responsive to their own particular needs. It may give them a greater degree of choice in deciding who, what and how services and delivered. Furthermore, it may give them access to a range of community resources, making them more visible with the opportunity to engage in real social networks of support and ensuring that they are seen as valued members of their local community. This can make significant positive contribution to their mental health and well-being. Overall, the modernised service is likely to give service users and carers more freedom, autonomy and the power to influence the direction and quality of the service they get.
Negative impact
We know from research that carers from black and minority ethnic communities experience greater burden of care, both socially and financially.
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The reform may bring with it additional burden in the form of increased costs to service users and carers. This may create gaps in the welfare benefits received by service users and prevent them from having enough money to meet real needs. In the end it may increase the burden of care. This needs to be recognised and addressed. If service users and carers face additional costs as a result of the reform, they may find it difficult to manage their finances and may be forced to give up control of the them. During consultation with staff, some reported that service users tend not have enough money when they want to access venues or purchase food on outings. One explanation is that they have little control over their budgets and they have to take what they are given. This example shows that service users need to be empowered to have more control over their finances. A key issue in caring for people with learning disabilities is safety of the person being cared for. The reform is likely to raise some issues about safety and it is important that efforts are made to monitor the individuals and organisations that provide the service to ensure the safety of service users is not compromised.
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Stage Four Taking Action

Detail the actions you will take to remove or mitigate any actual or potential negative impacts identified, and to build on positive impacts. Include timescales and responsibilities
SPECIFIC ISSUES within existing Learning Disability Day Service Reform workstreams
The LD Day Reform activity can be separated into 2 phases: The first phase deals with the closure of existing day service buildings which is currently underway. The second phase incorporates the bulk of the reform activity identified in the LD workstreams below.
Workstream 1.Transport
Action Develop alternative transport options which are affordable, accessible and efficient.
Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief
Timescale Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1
Responsibility LD Strategic Group
2. Catering
Action Ensure catering options reflect diversity of service users cultural backgrounds
Equalities theme(s) Race-Ethnicity/ Religion & Belief
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3. Community Access
Action Continuing to support development work on access to employment and performance of ESF employment services and purchased employability services
Responsibility LD Strategic Group ESF Employment Project Glasgow Works
4. Care Commission
Action Effective monitoring of services to establish how service providers and people in contact with service users deal with safety issues with regard to service users and staff
5. Buildings
Action Ensure Building closure takes account of the equality needs of service users when identifying alternative centre locations and services
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6.Communication & Consultation
Action Make service information and guidance accessible to people with learning disabilities
Timescale Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1 Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1
Listening more to what people with learning disabilities say they want when planning services and meeting them in flexible ways
Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief
LD Strategic Group
7.Commissioning Providers
Action Ensure commissioning strategy takes account of the equality needs of service users when identifying providers and potential services.
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8.Workforce Development
Action Providing appropriate equality and diversity awareness training for staff and other service providers in line with Council policy on equality
Timescale Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1 Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1 Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1
Monitoring what demand will be for support outside 9-5 hours
LD Strategic Group
To ensure that the workforce reflects the cultural diversity of Glasgow within the constraints of the current necessary staffing and new recruitment freeze
Race-Ethnicity
Head of Corporate HR
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OTHER ISSUES TO BE CONSIDERED outwith existing Learning Disability Day Service Reform workstreams Workstream Personalisation
Action Increasing the number of people accessing self directed support
Responsibility TBC Personalisation Manager
Ensure the cultural and religious needs of service users are met
Religion and Belief
TBC Personalisation Manager
Implementing good practice in relation to work with young people in transition and in particular with reference to SDS
TBC Personalisation Manager
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Assessment & Care Management
Action Ensure that Care Management delivers effectively through thorough care assessment(particularly around Complex needs) and incorporates new duties around Self Direct Support
Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief/ Socio-Economic Inequalities
Ensuring people with complex needs have a variety of experiences and opportunities to learn skills to be part of the community
LD Strategic Group
Sharing Good practice with Carers and Involving them in a service development and individual planning sessions where appropriate
Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief/ Socio-Economic Inequalities
LD Strategic Group User/Carer Planning partnership
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IT (info systems monitoring)
Action Monitoring and reporting on service usage by ethnicity/age/gender where information available
Timescale Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1 Phase 1: Completion of Building Closure anticipated March 2011. Phase 2: LD Workstreams to be determined pending completion of phase 1
Responsibility LD Strategic Group SWS Information Systems
Developing and implementing initiatives to identify BME people with learning disabilities and their carers who are not accessing the service, especially older BME carers
Race-Ethnicity
CHCP Directors (pending new structure)
LD Teams at local area level
How will we know we have been successful?

More people with learning disabilities are using direct payments/individual budgets Make sure more people with learning disabilities know about direct payments/individual budgets and what support they can have to get it even if they do not want to use them just now. People spending fewer days in the day centres
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More people using mainstream leisure and transport Increase in the number people working towards employment Directory of leisure available to all services and service users
Carers issues
Carers Charter in place Number of carers assessments offered Number of carers involved with individual planning sessions Make sure more carers know about direct payments/individual budgets and what support they can have to get it even if they do not want to use them just now.
Staffing issues
Well trained staff in equality and diversity issues A flexible workforce
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Stage Five Feedback on Proposed Actions

Detail feedback from key stakeholders on the impacts identified and the proposed action plan
To be completed after sending to services and stakeholders Detail changes proposed to your action plan in the light of this feedback To be completed after sending to services and stakeholders
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Stage Six Monitoring and Evaluation

Detail the arrangements put in place to monitor and evaluate the action plan. The Head of Adult Services will be responsible for producing 6 monthly monitoring reports on the Action Plan progress for the Social Work Leadership Team. These will cover: Progress in achieving outcomes outlined in the action plan Recent trends in learning disabilities services based on statutory and locally developed performance indicators Progress in implementing joint working arrangements Summary of any relevant findings of locally or nationally commissioned research in the field and outcomes of any recent user evaluation of service performance
The Head of Adult Services will report on progress in implementing the Action Plan to the Health and Well-being Social Care and Equalities Policy Development Committee on an annual basis. These progress reports will cover the same ground as the above mentioned monitoring reports, and highlight any requirements to review or update the Action Plan. In order to link with other relevant strategies and plans, six-monthly reports, annual reports, reviews and any relevant reports will be submitted to the relevant joint planning structures to note or comment, for example, the CHCP Joint Partnership Board. The Senior Management Team has overall responsibility to ensure the effective implementation of this policy. All managers have a responsibility to ensure that equality issues are core to the planning and delivery of their services. Training will be provided to all employees to support them in their responsibility to promote equality and challenge discrimination in the course of their work.
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Stage Seven Approval

Please indicate who has approved this assessment for publication
To be completed after sending to services
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Appendix A
Consultation Report of the day Service Modernisation Consultation April 2008

Extensive consultation was undertaken from the end of 2007 with Service Users, cares, Glasgow City Council staff working in local authority day centres and providers across the five CHCPs. Approximately ninety events were held across Glasgow between the months of October 2007 and April 2008. In excess of six hundred people in total attended the events with the highest number of attendees, carers and service users respectively. The level of attendance indicates that there is significant interest in the modernisation of Day Services. The events used a number of techniques to gain the views of all stakeholders. The North and East CHCPs utilised focus groups and questionnaires although there was limited return of the questionnaires. Wider engagement with day centre staff and community partner agencies has also recently commenced in the North CHCP. In the South West, Outside the Box was asked to meet with people who use the two day centres in this CHCP, in order to provide an independent route for people to have their say about future services. Outside the Box also consulted with carers of people who use the two day centres in a number of ways ranging from open discussion sessions, surveys and individual telephone discussions. In the South West 90% of activities are no longer building based, however it is still a challenge to develop community presence and build social networks. Clearly there is a need for community capacity building, creating better partnerships and developing infrastructures that welcome people with Learning Disabilities across Glasgow. Fair Deal was commissioned in the South East to gain the views of service users and carers. Information was gathered in two ways, group sessions and questionnaires to people unable to attend the sessions. A total of six carer sessions took place inclusive of one event for members of the BME community. Questionnaires were sent out to carers who could not attend any of the events; however, unfortunately there was a low level of returns received by the deadline of the 15th March 2008. Seven sessions in total took place for people who use Day Centres resulting in significant participation in the process. Fair Deal has produced a report, from the questionnaire responses and information gathered at the events. The West CHCP held 27 events between November 2007 and April 2008 organised into distinct strands: Seven events were held for carers and various CHCP groups.
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A day service staff development day and five focused group meetings were held for day service staff. Two further group meetings were held for fieldwork and clinical staff. Discussions with Working together in the West indicated a strong preference to organising service user consultation via an independent provider. Fair Deal were commissioned to provide this service for which work commenced on the 18th March and is still underway. One event was held with Head Teachers from special schools and separate events were held with staff from Anniesland and Clydebank College.
Summary of Findings
The findings from all of the events gave a wide range of views, however some common themes emerged.
Existing Day Centres

A recurring theme throughout the consultation exercise was concern relating to the closure of day centre buildings where services are currently provided to around 850 people across Glasgow. This was the main concern expressed by carers who perceived that any building closure would result in a lower overall level of service. This would suggest a lack of confidence about alternatives to building based services, as there was no frame of reference for people to imagine how the building could be replaced. There is a measure of familiarity and certainty about existing services that carers fear losing although there was recognition that some existing buildings are poor settings to deliver support. The modernisation of Day Services however hopes to build on the strengths already present in day centre provision by translating this into a community based service that is both reliable and delivers individual outcomes. The buildings that people use rather than being segregated day centres may be replaced for example by workplaces, colleges, sports and leisure centres shared by other community members. Some people who attend day centres did report that they would be happy to attend day centres did report that they would be happy not to attend centres, however, they would like the opportunity to continue meeting with friends with that they have made in the centre. People were also concerned as to the extent that community facilities could replace the existing service and to the cost implications for individuals using outreach services.
Employment and More Opportunities

Lack of information, advice and employment opportunities coupled with links to benefit workers to maximise benefits were highlighted as key barriers for people who would like to work. A constant theme throughout the consultation reports was that people with Learning Disability like the rest of the population want to work. In Glasgow City however, currently only 6% of people with Learning Disability are in employment. Some carers also spoke about employment but in general they were more sceptical about the potential for employment for many people with Learning Disability.
Transport
The current transport system was widely reported by all stakeholders as being inflexible and often unreliable. Individuals felt aggrieved that they were often prevented from participating in individual activities owing to transport arrangements dictating that several people needed to go to the same place. A response in one
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questionnaire highlighted that the current system is not only undesirable but is often stigmatising. There are examples where CHCPs use people carriers instead of Day Centre buses, which is considered as both more responsive to peoples needs and non-stigmatising. Transport was clearly identified as one area that required to be reviewed to ensure it was responsive to meet the needs of a modernised day service.
Flexibility and Choice

It was widely recognised throughout the consultation exercise that there was an increasing need for flexibility to meet the ever changing needs of both service users and carers. People who attend day centres felt that there is a need for individuals from similar age groups to be able to access age appropriate activities. Clearly people acknowledged the need for improved day services that connect people with their local communities and assist them to use a range of community facilities. People who use services also highlighted that they would like more support in the evenings and weekends. Staff also recognised that the ever changing needs of service users and carers required more flexibility in hours, resources and facilities. Staff welcomed the chance to improve services although raised concerns as to how current staffing levels could provide more personalised services.
People with a Higher Level of Need

There was concern raised throughout the consultation process in relation to opportunities for people with a higher level of needs and the ability to link into appropriate community resources. Above all people were concerned as to how the individual needs of people with high support needs could be met in a modernised service. Carers were keen to see physical health given more priority especially for people who require interventions such as postural drainage and rescue medication.
Process of Change and Involvement in Process

Although it was acknowledged throughout the consultation that there is a need for change it was also acknowledged that people who use services and their carers should have a greater say in the shape of services and support. Carers in particular expressed the need for clear plans for services to be in place prior to any closure of buildings. Many carers also aware of redesign of the current workforce raised concern relating to new staff being appropriately trained. Clearly participants desire future involvement and do not wish this consultation to be a one off event. It was also noted that there should be a clear process for change with a phased approach that is open and transparent.
Main Themes
Existing Day Centres Employment and More Opportunities Transport Flexibility and Choice People with a Higher Level of Needs Process of Change and Involvement in Process
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Summary of what users said:

More information about what changes are planned More choice More flexible transport Better co-ordination of health and social care services Better support of the people who have greater needs More opportunities for work A wider range of activities different types of sports, crafts, photography More activities outside the centres More opportunities for learning and help around independent living More social activities, including activities at evenings and weekends Individual people have opportunities to get choices and be listened to Issue about attitudes (stigma) of other people and improvements needed to access mainstream facilities More space Better catering arrangements Better monitoring of medical conditions More advocacy Better access for wheelchair users
Summary of what carers said:

More opportunities for people to take part in a wider range of day time activities and for individuals to have more choice More opportunities for work including access to or preparation for employment Concern about access to other services, especially respite Access for disabled people to ordinary facilities in the community Tackling discrimination towards people with learning disabilities More accessible mainstream services More resources to be made available for services for people with learning disabilities, including day services, respite, housing and support and advocacy Better and consistent risk assessment and prompting choice Concerns about employment opportunities for people with learning disabilities Recognition of issues that affect carers and their contribution to the service Need for an audit of existing services and accessible facilities Anti-stigma campaign Need for budgets and plans to take account of the fact that people with learning disabilities are living longer than before Concern over lower overall level of available day support Concern that people with higher needs will be missed out in the new arrangements Concern that people with learning disabilities aged over 65 may no longer be provided for in the services that they know More flexible transport Concern about safety of service users in taking other forms of transport Need to make ordinary facilities more accessible and welcoming Need for carers to feel secure that they know where the service users are going Need to ensure that all the accessibility infrastructure are in place first Need for lots of alternative activity opportunities in place More use of buildings in the afternoon and evenings Need for staff to be well-trained and continuity with regard to staffing arrangements Need for more staff and services to help people get out and about, outside of the core day centre times Need for more help for older carers to plan for the future, including when they become ill or unable to be an active carer
41
Need for useful contacts where carers can obtain information about services Concerns about unhelpful attitudes of health care staff towards people with learning disability and their carers. More opportunities for people with learning disabilities and their carers to get access to advice around welfare benefits and other money matters Concerns that using Direct Payments and Independent Living Fund as a way of financing services could result in poor quality of care Concerns that the care management and/or key worker system is not working well Carry out audit of accessible facilities Involve carers in raising awareness among staff across the whole range of CHCP services around the needs of people with learning disabilities Involve carers in raising awareness among the public and private sector organisations
Staff Consultation by the EQIA Steering Group

The EQIA Steering Group of the Learning Disability Day Service Reform organised a half-day workshop on 2 November 2009 at the Adelphi Centre for a wide range of staff working at learning disabilities day centres and carers centres. In all over 40 people attended the event, the purpose of which was to encourage discussion amongst staff with regard to the likely equality impacts (positive or negative) of the proposed reform and to come up with possible solutions to mitigate against any negative impacts. During the workshop, participants considered the reform proposals and identified the positive and negative impacts they believed the reform could have on equality groups. These have been incorporated into Stage Three Assessing the Impact, and the Action Plan. Prior to the workshop, staff from the Learning Disabilities Partnership, who are also members of the EQIA Steering Group, organised a series of meetings from 9th 20th October 2009 with staff from 6 Learning Disabilities Day Centres to prepare them for the workshop. Of the 90 staff that were seen only one came from a black and minority ethnic background.
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Appendix B
Members of the Steering Group

Eric Fiamanya Service Modernisation, Social Work Services Sofi Taylor Learning Disability Partnership Angus McDonald - Learning Disability Partnership Jill Murray North CHCP Mary Thomson - Learning Disability Partnership Linda Dunlop - Learning Disability Partnership Eamon McGuire - Learning Disability Partnership Jim McDonald - Learning Disability Partnership
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Appendix C
References Introduction
Declaration on the Rights of Disabled Persons. UN; 1975, Department of Health (1995) The Health of the Nation A Strategy for People with Learning Disabilities, London: HMSO as cited in, The same as you? A review of services for people with learning disabilities, The Scottish Government, May 11th 2000 http://www.scotland.gov.uk/ldsr/docs/tsay-03.asp#b2 SWIA Report and the Social Work Survey (2001 Working for a Change? (Same As You Implementation Group - 2003) Changing Lives 21st Century Social Work Review (Scottish Executive 2004) Make My Day! (Same As You Implementation Group - 2006) How is it going? (SCLD 2006) Whats out there? (SCLD 2009)
Learning Disabilities
CHCP Demographics (2009) Social Work Services Publication Mental Retardation 1989 World Health Organisation Roeleveld et al (1997): The prevalence of mental retardation: a critical review of recent literature Department of Health (1995) The Health of the Nation A Strategy for People with Learning Disabilities, London: HMSO
Race/Ethnicity
Ghazala Mir, Andrew Nocon and Waqar Ahmad, with Lesley Jones (2001) Learning Difficulties and Ethnicity: London: Department of Health Hubert, Jane (May 2006) Family carers' views of services for people with learning disabilities from Black and minority ethnic groups: a qualitative study of 30 families in a south London borough Taylor, S (2009) Administration Meeting at Barnardos, Albert Drive, Glasgow Learning Disability Partnership. NHS Greater Glasgow and Clyde Health Board. Nadirshaw, Z. (1997) Cultural issues. In Adults with Learning Disabilities: A Practical Approach for Health Professionals (eds J. OHara & A. Sperlinger), pp. 139153. Chichester: John Wiley & Sons. Karlsen, S. & Nazroo, J. Y. (2002) Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people. Sociology of Health and Illness, 24, 120.
44
Ghizala Avan and Farkhanda Chaudhry (2009) Whats Out There? Ex Anima Training & Research Consultancy Azmi, S., Hatton, C., Emerson, E., et al (1997) Listening to adolescents and adults with intellectual disability in South Asian communities. Journal of Applied Research in Intellectual Disability, 10, 250263. Ethnic Enable: http://glasgow.radioramadhan.com/files/EthnicEnable.doc. http://www.iriss.ac.uk/files/iriss-fc-3-furrah-2008-06-17.ppt. http://glasgow.radioramadhan.com/files/EthnicEnable.doc. http://www.iriss.ac.uk/files/iriss-fc-3-furrah-2008-06-17.ppt. http://www.nwtdt.com/Events/Raising%20Aw%20of%20Learn%20Dis%20v2.pdf Kusminder Chahal (2004) Experiencing Ethnicity: Discrimination and Service Provision
Gender
Emerson et al, (1997) Is there an increased prevalence of severe learning disabilities among British Asians? Ethnicity and Health 2, 317-21. Brenda Ellis (1995) - The experiences of disabled women Beyer, S. Goodere, L., & Kilsby, M. (1996). The costs and benefits of supported employment agencies: Findings from a national survey. (Employment Service Research Series, No. 37). London: Stationery Office. Shelly Botuck, Joel M Levy, Arie Rimmerman; The Journal of Rehabilitation, vol. 64, 1998 - Post-Placement Outcomes in Competitive Employment: How Do Urban Young Adults with Developmental Disabilities Fare over Time? Levy, J.M., Botuck, S., Levy, P.H., Kramer, M.E., Murphy, B.S. and Rimmerman, A. (1994.) Differences in job placements between men and women with mental retardation. Disability and Rehabilitation, 16, 2, 53 57.
Age
Institute for Health Research, Lancaster University (2004) Valuing People, Department of Health (2001 Department of Health (1995) The Health of the Nation A Strategy for People with Learning Disabilities, London: HMSO as cited in, The same as you? A review of services for people with learning disabilities, The Scottish Government, May 11th 2000 http://www.scotland.gov.uk/ldsr/docs/tsay-03.asp#b2 Rimmerman, A., Botuck, S. and Levy, J.M. (1995a). Job placement of urban youth with developmental disabilities: research and implications. Journal of rehabilitation, 62, 1, 56-64. Faubion, C.W. and Andrew, J. (2000): A systems analysis of the case-coordinator model and an outcome analysis in supported employment.
45
Joseph Rowntree Foundation Services for Older People with Learning Difficulties Jane Fitzgerald -1998 Mencap, Housing Time Bomb (2002)
Sexual Orientation
Department of Health (2007) Valuing People Now: From progress to transformation [online]. Available from: http://www.dh.gov.uk/en/Consultations/ LiveConsultations/DH_081014 (accessed January2010). National Disability Authority (2005) Disability and Sexual Orientation: A discussion paper, National Disability Authority, Dublin. www.nda.ie Abbott, D and Howarth, J (2005) Secret Loves, Hidden Lives: Exploring issues for people with learning diffi culties who are gay, lesbian or bisexual, Policy Press, Bristol. Brothers, M (2003) Not Just Ramps and Braille: Disability and sexual orientation, ReThinking Identity: The challenge of diversity (4964). www.ihrc.ie Beyond Barriers (2002) First Out: Report of the Beyond Barriers survey of lesbian, gay, bisexual and transgender people in Scotland, Beyond Barriers, Glasgow. www.beyondbarriers.org.uk Rainbow Ripples and Butler, R (2006) The Rainbow Ripples Report: Lesbian, gay and bisexual disabled peoples experiences of service provision in Leeds, Rainbow Ripples, Leeds. www.rainbowripples.org.uk/the_rainbow_ ripples_report.pdf Shakespeare, T, Gillespie-Sells, K and Davies, D (1996) The Sexual Politics of Disability: Untold desires, Cassell, London. Valuing People, Department of Health (2001) Valuing People Now, Department of Health (2007) Carson I & Blyth C (2009) Lonely hearts need a helping hand. Learning Disability Today April 2009 1821.
Religion or Belief
Summers, S.J. and Jones, J. (2004) Cross-cultural working in community learning disabilities services: clinical issues, dilemmas and tensions, Journal of Intellectual Disability Research, vol 48, no 7, pp 687694. Hatton, c et al (2004) Religious Expression: A fundamental human right OHara, Jean (Royal College of Psychiatrists 2003) Learning Disabilities and Ethnicity: achieving cultural competence
Socio-Economic Inequalities
Department of Health (1995) The Health of the Nation A Strategy for People with Learning Disabilities, London: HMSO as cited in, The same as you? A review of services for people with learning disabilities, The Scottish Government, May 11th 2000 http://www.scotland.gov.uk/ldsr/docs/tsay-03.asp#b2
46
Prime Minister's Strategy Unit Report to Transform the Life Chances of Disabled People. 19 January 2005. CAB 002/05. www.cabinetoffice.gov.uk/.../2005/050119_disabled.aspx English House Condition Survey Technical Report (2005 Edition). Published: 4 September 2007; Site: Housing Ghazala Mir, Andrew Nocon and Waqar Ahmad, with Lesley Jones (2001) Learning Difficulties and Ethnicity: London: Department of Health Butt, J. & Mirza, K. (1996) Social Care and Black Communities. London: HMSO. Advances in Psychiatric Treatment (2003), vol 9 (Disability in Scotland 2005-2020: a state of the Nation Report, DRC 2005
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Appendix D
Equality Legislation
Below is a list of KEY legislation in terms of Equality. The list is not exhaustive and will change as new Acts are introduced or existing Acts are amended.
Data Protection Act (1998)

This has an impact on equality. Organisations processing (i.e. collecting, holding, using, disclosing and destroying) personal or sensitive data must comply with the relevant data collection principles: collecting data fairly, and for lawful and specified purposes and should not be processed beyond those purposes, ensuring data is accurate and kept up to date, and keeping data only as long as necessary. Special measures have been included to allow processing of sensitive data such as ethnic monitoring information (i.e. that it is being processed to meet a legal duty and/or it is being used to review equal opportunities by race.
Sex Discrimination Act 1975

Makes it unlawful to discriminate on grounds of sex or marital status in areas such as employment, education and the provision of goods and services.
Race Relations Act 1976

Makes it unlawful to discriminate on grounds of colour, race, nationality, ethnic or national origin.
Equal Pay Act 1970 (amended 1983)

Makes it unlawful for employers to discriminate between men and women in terms of their pay and conditions (including pay, holiday entitlement, pension etc) where they are doing the same or similar work; work rated as equivalent; or work of equal value.
Disability Discrimination Act 1995

Makes it unlawful to discriminate on grounds of disability in the areas of employment, the provision of goods and services and education.
Human Rights Act 1998

Gives effect to rights and freedoms guaranteed under the European Convention on Human Rights. The legislation makes it unlawful for a public authority to breach convention rights, unless an Act of Parliament prevents it from acting differently. The Act came into force in the United Kingdom in October 2000. Article 8 gives the right to respect for a private life (including the right to sexual expression).
Race Relations (Amendment) Act 2000

Outlaws discrimination in all public authority functions, and places a general duty on public authorities to promote race equality and good race relations. There is also a specific duty on public bodies to produce a Race Equality Policy and undertake race equality impact assessments.
48
Employment Act 2002

Makes provision for rights to paternity and adoption leave and pay; amends the law relating to statutory maternity leave and pay; makes provision for the use of statutory procedures in relation to employment disputes; and covers the right to request flexible working.
Employment Equality (Religion or Belief) Regulations 2003

Makes it unlawful to discriminate on grounds of religion or religious belief in employment and vocational training.
Employment Equality (Sexual Orientation) Regulations 2003

Makes it unlawful to discriminate on grounds of sexual orientation in employment and vocational training.
Gender Recognition Act (2005)

Enables people who have undergone gender reassignment to have their birth certificates amended to reflect their new gender.
Disability Discrimination Act 2005

Makes substantial amendments to the 1995 Act. It introduces a duty on all public bodies to promote equality of opportunity for disabled people. In particular, public bodies have to produce a Disability Equality Scheme to promote disability and to explain how they intend to fulfil the duty to promote equality. It also extends the definition of disability.
Civil Partnerships Act (2005)

Enables people of the same sex to register their partnerships and thus have rights of inheritance and other rights currently shared by married couples.
Employment Equality (Age) Regulations 2006

Makes it unlawful to discriminate against employees, job seekers or trainees on grounds of age in employment and vocational training. They introduce a minimum retirement age of 65; a duty on employers to respond to requests to work beyond retirement age; and remove the upper age limit for claiming a redundancy payment or unfair dismissal.
Disability Equality Duty 2006

Section 49A of the Act says that public authorities (including NHS trusts and local authorities) must have due regard to the need to: promote equality of opportunity between disabled people and other people; eliminate discrimination; eliminate harassment of disabled people that is related to their disability; promote positive attitudes towards disabled people; encourage participation by disabled people in public life; and take steps to meet disabled peoples needs, even if this requires more favourable treatment.
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Equality Act 2006

Makes provision for the establishment of the Equality and Human Rights Commission (EHRC) by merging the Equal opportunities Commission, the Commission for Racial Equality and the Disability Rights Commission. In addition to legislation relating to these three strands it specifically mentions removing discrimination on the grounds of religion or belief and sexual orientation. It also creates a duty on public authorities to eliminate unlawful discrimination and harassment and to promote equality of opportunity between women and men by requiring them to produce a Gender Equality Scheme.
Equality Bill 2008

There is a vast array of legislation in relation to equality and tackling discrimination, some of which is outlined above. However there is a recognition that the law is becoming complex and cumbersome to implement. Therefore, in order to streamline the law and build on developing work in the area of equality, a new Equality Bill is currently progressing through Parliament. The Bill intends to strengthen existing legislation and will include additional public sector duties. It is expected to achieve Royal Assent in 2010 and be implemented in 2011.
Crime and Disorder Act 1998 (Section 96)

This allows for an aggravation on the grounds of racial prejudice to be added to any offence against the person or property ranging from graffiti, vandalism, harassment etc. to the most serious physical assaults. The aggravation can be added by the Procurator Fiscal to the original charge.
Offences Aggravated by Prejudice (Scotland) Act 2009

This Act will allow the police and PF to add the existing aggravation (as it applies to race and religion) to the social groupings defined by sexual orientation/transgender and disability. This is, to date, the most far reaching legislation of its kind in Europe due to the inclusion of the transgender definition.
Codes of practice
Race Equality Duty, Statutory Code of Practice, Scotland, 2002 Disability Equality Duty, Statutory Code of Practice, Scotland, 2006 Gender Equality Duty, Statutory Code of Practice, Scotland, 2007 The above Codes of Practice give practical guidance to public authorities on how to meet the duties imposed on them to promote equality in terms of Race, Disability and Gender. The Codes do not impose legal obligations. They are statutory Codes which means that they have been approved by Parliament and are admissible as evidence in legal proceedings under any of the Acts in relation to Race, Disability and Gender equality.
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EQIA of LD Day Service Reform - Final Draft 19 08 2010

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LEARNING DISABILITIES DAY SERVICE REFORM EQUALITY IMPACT ASSESSMENT

People with Learning Disabilities

The Foundations of a Modernised Day Service

Equality Impact Assessment Stage One Identification and Scope

Introduction Definition of Learning Disability

Aim of the EQIA

Why do the EQIA?

Objectives of the EQIA

Scope of the Reform Background

How day care services are currently provided in Glasgow

Distribution of Day Service Centres by CHCP (October 2008)

Drivers for Change

Description of the New Service Model

Quality Assurance and Inspection

Service User and Carer Expectations

Future Shape of Services

Work streams in progress

Stage Two Research and Consultation

Estimates of Learning Disabilities

Stage 3 Assessing the Impact

People with Learning Disabilities Positive impact:

Black and Minority Ethnic People Positive impact:

Gender Positive impact

Lesbian/Gay/Bisexual/Transgender people: Positive impact

Age Positive impact

Religion or Belief Positive impact

Socio-Economic Status Positive impact

Stage Four Taking Action

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

Equalities theme(s) Race-Ethnicity/ Religion & Belief

Responsibility LD Strategic Group

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group ESF Employment Project Glasgow Works

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

6.Communication & Consultation

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group

Monitoring what demand will be for support outside 9-5 hours

Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Action Increasing the number of people accessing self directed support

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility TBC Personalisation Manager

Religion and Belief

TBC Personalisation Manager

Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

TBC Personalisation Manager

Assessment & Care Management

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief/ Socio-Economic Inequalities

Responsibility LD Strategic Group

Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief/ Socio-Economic Inequalities

LD Strategic Group User/Carer Planning partnership

IT (info systems monitoring)

Equalities theme(s) Gender/Disability/ Race-Ethnicity/Age/ Religion & Belief

Responsibility LD Strategic Group SWS Information Systems