Tuesday, 3 October 2017

A real return on investment - investing in people with learning disabilities

I’ve been following @garybourletLDE , @AliciaWood___ , @hillsideliz , @SScown , @LearningDisEng and others who have been subjecting themselves to the UK (English?) party political conference season, asking the questions that need to be asked and trying to direct politicians’ attention to the realities of the lives of people with learning disabilities.

When local authorities are considering where to put the money they are entrusted with, what are they looking for? Among other things, I think they’d be wanting: 1) improvements to the health and wellbeing of people in their local communities; 2) relatively stable, connected communities with good levels of employment in good jobs; 3) good, sustainable and affordable housing that matches the needs of local communities; 4) their investment to be recirculated within local businesses and enterprises; and 5) for their investment to be efficient and cost-effective.

I think a local authority investing in really good support for people with learning disabilities in their area will achieve everything I’ve listed above, in a maximally efficient and cost-effective virtuous circle. What do I mean by really good support? Something like the following:

  1.  First of all, use the resources that are available in your local area. Invest properly in vibrant self-advocacy organisations and family-led organisations. They will bring you expertise, creativity, and local knowledge of life’s realities. If you let them, they will generate cost-effective solutions rooted in local communities, at a far more reasonable rate than management consultants. And by investing properly in them, you will be helping to establish entrepreneurial local organisations that can offer vital support to a wide range of local organisations, such as training, consultancy and the production of accessible information for local health and social care services, leisure services, the police, transport and businesses.
  2. Invest in local communities to help people live connected, fulfilling lives locally – Community Circles being one example that also encourages local community cohesion. Shared Lives is another example of a living option that some people may choose which does not require additional housing, matching people with learning disabilities with others in their local community who have space and a willingness to share that space. These are really cost-effective, with the social care investment being kept and shared within local communities.
  3. With the support of self-advocacy, families and local enterprise, focus the commissioning of support for people with learning disabilities on small, local enterprises, developed through collaborative ideas generated from and by people with learning disabilities and families. This will develop efficient, cost-effective local enterprises with a genuine commitment to people with learning disabilities and the locality. Investment at a council level in supporting these small enterprises with pooled functions like HR, payroll, legal support etc will ensure they stay efficient and focused. Work to promote ‘scaling across’ rather than ‘scaling up’ – local small enterprises can encourage others to develop, rather than forcing them into expanding hugely into large enterprises that become sclerotic, remote and less efficient, with profits from local investment becoming siphoned out of the locality. Co-operatives, community interest companies and similar social enterprises are relevant here. Radically change bureaucratic procurement and tendering processes that stack the deck against small, innovative local entrepreneurs, and use the money saved to invest in ways to keep developing and maintaining local organisations.
  4. Ensure that you invest properly in these local support organisations, such that support workers can be decently paid. This will encourage a stable, skilled and committed workforce that will stay in the area and have money in their pockets to spend in local businesses, rather than ending up with a transient, unstable workforce.
  5. Support local businesses and organisations of all sorts to be hospitable to people with learning disabilities. They’re missing out on potential customers and contributors if they’re not.
  6. Invest heavily in good quality supported employment support with people with learning disabilities, developed and delivered locally. Many, many more people with learning disabilities want paid work than currently have the opportunity to do so, and on-the-job support and support to keep people working well in jobs is a highly cost-effective investment. Local employers gain a stable workforce with bespoke on-the-job training to do specific tasks they need doing, and ongoing support to keep people working well. Ensure that the paid work is good work at levels and with numbers of hours that pay people a decent wage. This will ensure that people with learning disabilities have disposable income, which they will spend overwhelmingly locally, recirculating the investment straight back into the locality. All sorts of other good things for people with learning disabilities and local communities follow from good work. Also encourage entrepreneurship and the development of enterprise amongst individuals and groups of people with learning disabilities.
  7. Invest in local, attractive, affordable housing that is accessible to everyone, including people with learning disabilities. Put the investment into supporting people with learning disabilities within local homes in local neighbourhoods to lead active lives as part of their local communities – belonging, contributing. This investment will again put money back into local businesses (as people maintain their homes, buy food and clothes, and enjoy themselves in local leisure facilities that help keep communities vibrant places to be). For many people, you will also be helping their families too, among other things in terms of their potential for paid employment themselves.
  8. Provide guaranteed minimum personal budgets (and personal health budgets, and integrated personalised commissioning) for people over long periods of time (5 years? 10 years? longer?). Strip away needless bureaucracy in assessing/reviewing/monitoring, and use the money saved to invest in supporting people and families with PBs in legal/HR/payroll issues, and in supporting people to really plan for their futures, individually and collectively. People are in the best position to invest their personal budget wisely and efficiently, without waste, and again will invest locally.
  9. Invest in social workers who have the time to get to know people properly, and who respect people in the decisions they make about their lives.

I’m sure there is much more to be said and I’ve ignored many vital things. My point is that from a local authority point of view these forms of investment are highly cost-effective and likely to form a virtuous circle, and help to achieve the vibrant, inclusive local communities local authorities are aiming for while supporting local business and supporting people with learning disabilities to live more active, fulfilled and healthier lives.

Which is why I find it weird that so many local authorities are throwing public money at large, quasi-institutional residential services for people with learning disabilities. Local authorities are paying for layers of bureaucracy, profits that are not transparent and are siphoned out of the locality as part of big companies’ profits, and buildings that do not improve or contribute to general housing or amenities in the locality. They are paying for a low waged, transient workforce. They are paying for people to be shut away, such that local businesses and enterprises see very little of the public money sunk into these places and don’t see the benefit of people with learning disabilities as employees and customers. Over time, local communities become less vibrant, less connected, less cohesive. And inactive, isolated people with learning disabilities are more likely to become seriously ill and experience abuse and neglect. A vicious and self-defeating cycle.

What are local authorities waiting for? Be smart – invest in people with learning disabilities.

With thanks/apologies to @neilmcrowther for unwittingly triggering this line of thought.