Learning Disability Wales is extremely concerned about the reduction in day services in recent years. At the recent meeting of our Connections Cymru network we brought people together to explore how provision has changed since the pandemic and what those changes have meant for the people who use them.
Connections Cymru was set up to bring people together to discuss how we can tackle loneliness and social isolation, the issues, share good practice and create change.
Since Covid, and because of increasing pressures on local authority budgets, many day services in Wales have been changed, reduced or removed.
What was discussed at the event?
The Connections Cymru event found many points for improvement in day service provision, but also developed ideas for optimism and opportunity in giving people with a learning disability the provision they want and need.
These included:
- Shifting thinking around day services to ‘life services’ instead.
- Using community assets when establishing services.
- Making co-production central to designing provision.
The challenges in day service provision reflect other systemic issues preventing people with a learning disability from living fulfilling and happy lives where they have choice, voice and control. Among those barriers include a lack of accessibility to public transport, gaps in experience in co-production in the public sector, and a one-size-fits-all approach to solutions for services for people with a learning disability.
While some traditional day services could be restrictive in allowing people to express themselves, learn, develop skills and provide meaningful activities, many offered opportunities to connect and nurture friendships. The loss of such services since Covid has often accelerated a sense of loneliness and social isolation for many people with a learning disability.
What about commissioning?
Guidance says commissioning day services should involve the people who use them, and co-production should be a part of that.
Group discussions found several challenges in this area:
- Time and budget constraints restrict the amount of co-production that is happening.
- More learning is needed to ensure a proper understanding of what co-production really is.
- A lack of information for people to find out what is available.
- Many people do not have a social worker to advocate on their behalf.
- The reduction in day services is impacting on the wellbeing of families.
- Fewer hours in day services for people with a learning disability has meant an increase in people experiencing loneliness and social isolation.
- People are reporting less involvement in meetings. In one case this is because of a lack of transport access, with no option for online meetings instead.
Day service reform founded on genuine co-produced commissioning is needed to give people with a learning disability the resources they need for a good life.
The provision of day services in Wales is a patchwork, with inconsistencies in provision across local authorities The pandemic has made these differences more acute.
It means that the needs of people with a learning disability often go unmet, with the aspiration of co-produced services becoming a victim of diminishing resources.
For some, day services are not appropriate, for others they are. When they are closed, or when changes happen, people said that they were often not consulted. Decisions are therefore being made without talking to the people who use these services.
What good things are happening now?
Despite the pressures on resources and local government finances, there is plenty of good practice happening.
In Flintshire, for example, we heard how day services were outsourced 7 years ago. The new services were designed through involvement with all parties, building on existing provision and activities as well as adding new options such as hairdressing and gardening. These changes have provided opportunities for people to learn new skills and enjoy more variety in the things they do.
There is also a sense that most day services only operate 9-5 rather than offering flexibility in their hours to fit people’s needs and desires to have diverse opportunities, while also providing the things people want, rather than what providers think they need.
One of the main themes to emerge from discussion was that good quality co-production is essential in creating resources and services that will meet the needs of the people who use them.
What are the challenges?
People agreed that there needs to be more thought on intergenerational needs because services are often not designed for different age groups and people with different interests. These challenges reflect the view of day services through a traditional lens of understanding of what these services should comprise, rather than speaking with users and learning what they want.
As well as connecting with other people with a learning disability, day services should also connect with communities, integrating and embedding people into the places they come from so they can contribute to the well-being of those communities, and broadening an understanding of learning disability.
What did local authorities say?
There was an acknowledgement that many day services have changed, are starting to change or, in some cases, need to change. The patchwork of provision means that there are lots of day services that are worthwhile and are giving people good options for how they spend their time.
Sometimes that can be at a day centre, other times it means giving people a broader range of options. The network heard that day centres can be too timetabled and restrictive rather than giving people flexible options that fit with their lives and needs. Councils say they are trying to change things for the better but are having to operate in a difficult financial environment.
The Association of Directors of Social Services in Wales (ADSS Cymru) has identified some key challenges in the provision of day services in the aftermath of the pandemic:
- Day services, respite care and short break services should be reviewed.
- Workforce challenges, pressures and resources need evaluating to understand how skilled staff can enable change but also to identify the barriers that prevent them from doing that.
- What are the opportunities for collaboration with employers to broaden day service provision?
- How can technology and transport assist in the delivery of day services and what resources are lacking?
- Principles of co-production should be embedded at all stages of delivery, making services effective and ensuring they use resources efficiently.
Mencap, along with the Learning Disability Consortium that Learning Disability Wales is a member of, has set out a series of recommendations for Welsh Government to adopt on day services. The purpose of these recommendations is to build a national standard for co-production to ensure consistent design and provision of services. This was discussed at the event.
The recommendations include:
- A national consultation standard.
- National definitions and standards for co-production.
- A duty on local authorities and providers to explain how changes to day services have been co-produced.
- The impact of changes to day services on people, their families and carers should be integral when any changes are made.
Our views on day services
Zoe Richards, Chief Executive of Learning Disability Wales, said: “Our Connections Cymru event was an opportunity to learn about the good things happening in day services in Wales right now, but also the challenges as well.
“What we have seen is that there appears to be differences in the kinds of provision out there, how the system has changed since Covid and what is seen as good practice in co-production.
“There is plenty of work to be done in developing services for people with a learning disability that work for everyone and provide meaningful activities and connections that do not simply operate during office hours.
“Our plan now is to build on this and use the energy from the Connections Cymru event to provide a platform for inspiration and further discussion in Learning Disability Wales’s annual conference later this year.
“We know there are pressures being felt in the public and third sectors in Wales right now, but we also believe in the power of our collective endeavour in creating a better place to live for people with a learning disability.”
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