Learning disability also commonly referred to as learning difficulty or learning difference, represents problems or sets of problems which impede learning abilities in individuals. Contrary to popular belief, it is not necessarily a clear indicator of lack of intelligence. Skills that are impeded as a result of learning disability include writing, reading, talking, listening and co-relating. Having said that, learning disability (LD) is individual specific, implying that a person with one set of challenges may not be affected by another set of problems plaguing someone else. Learning disability can also be managed efficiently with good care and support.
Coping with learning disabilities can be very distressing not only for the individual, but also for their families. The challenges facing such families are not limited to providing adequate treatment or management of the learning disability. Rehabilitation takes precedence over other issues, since the objective is to enable those struggling with a learning disability to become productive, independent and socially-active citizens. However, one of the major decisions that a person coping with a learning disability and their families must make, involves not simply their care package, but the environment in which they choose to live.
In the past, residential care was the only viable option for those affected by learning disability.
The limitations of the Residential Care system forced authorities to seek a more encompassing and holistic approach, which emerged in the form of Supported Living. Under this approach, care and housing provision are kept separate in legally binding contracts. It provides people with a learning disability with far more rights and a sense of security as they cannot be removed from the home without their consent. Care provided to these service-users must be suited to their specific needs, in the absence of which, the care provider is liable to be replaced.
Since the 1990s, many residential care homes have de-registered as care homes to provide separate housing and care. Some care providers have achieved this by setting up a separate company for housing that bears the same name as the care company. The intention was to give people with a learning disability housing rights, security of tenure, enhanced personal income as well as the opportunity to change care provider - should they wish to do so - without losing their home. The momentum of these changes slowed following the 2004 court judgment which ruled that several changes of the kind outlined above, from residential care to domiciliary care, were illegal because of inadequate consultation with "residents" to verify they wanted such a change. Needless to say, this judgement should have resulted in the creation of a parallel statutory process to ensure that people considering moving into residential care were made aware of, and accepted, their loss of rights, but it did not.
One of the biggest advantages of the Supported Living arrangement is that it empowers people not only to select their care provider, but also to claim housing and other benefits, which translate into significant economic gains for people with learning disabilities. One argument frequently made against this approach is that it is time-consuming and cumbersome. However, recent studies prove otherwise and conclude that Supported Living has greater longevity and is also more economically feasible than the Residential Care system. With residential care provision, the benefits regime makes it all but impossible for those with a learning disability to earn sufficient money so that work does not present a punitive option. Under sweeping new legislation which will radically overhaul the benefit system, it will be interesting to see if the new Conservative-Liberal alliance can achieve their stated aim, namely to make work pay, even for the more vulnerable in our society.
Whilst Supported Living models are gaining prevalence worldwide and providing homes to millions grappling with Learning disability, financial stringencies in these times of global recession, may yet dictate the future for residential care and supported living. The jury is still be out as to which of the two models, namely, residential care or supported living, are more cost-effective, but with a single benefit system pending, it is highly likely that the comparable costs will become more readily identifiable.
Whether residential care or supported living prevail it is clear that there has been a sea-change in the ideology of the care profession: residential care was heavily rooted in the 1948 National Assistance Act and this still informs much social regulation, with its old-fashioned, paternalistic style that does not chime well with today’s vaunted ideals of choice and independent living. As these newer values take hold, what is clear is that the delivery of care is rapidly moving away from the out-moded values of the erstwhile institutional environment.
