Letters:
Can community residents genuinely choose to leave?
Andrew Plant in ‘Who decides how best to live?’ (winter, 2018-19) argues that Camphill communities should be afforded equal status as valid living choices for people with learning disabilities alongside other forms of support in the community.
His commitment to choice sounds good but I found myself wanting to ask him about a choice he had not mentioned for Camphill community residents: how easy is it to leave?
It may be technically straightforward – but does the environment help people to think about it as a possibility? Do people get a chance to really experience life outside the Camphill community and think about whether they want to join it?
If not, then how easy is it for people to understand what leaving a Camphill community might entail? Or do they tend to choose to move in then stay for life?
With no experience of the outside world who, once settled in, would ever choose to leave?
Personally, I would be happier to see people choosing to opt in if it were clear that the choice remains to opt out later.
My guess is that there are gains and losses when people move into a village or community that is somewhat removed from the rest of the world. The gains, including meaningful relationships and worthwhile activities, may indeed be great, but a genuine choice to leave should not be one of the losses.
Sean Kelly Former chief executive, Elfrida Society
Living in residential care can be a correct, positive decision
The Residential Forum’s 30 years celebration of the Wagner report, Residential Care: a Positive Choice, at the House of Lords was a timely reminder of the positives of good residential care embedded in the community.
The report sought to shift the view of residential care as a last resort to one of valuing its role as a vital part of community care, with an emphasis on the importance of choice and participation.
This type of care should be a positive choice by any prospective resident, who should retain their rights as a citizen with measures to ensure they can exercise them.
Homes should strive for people’s full involvement and ensure quality of life not only in rhetoric but also through resources. Given the squeeze on funding, homes need to be asserting principles that are as relevant today, and ensure that their fees match these needs.
Many adults with learning disabilities are developing inclusive lives in tenancies. The Residential Forum’s celebration reminds us that good, principled, domestic-style residential homes can offer great support and open up life for some of our most vulnerable people.
It is about what is right for different individuals.
Rose Trustam Lancashire
Care Quality Commission courageous to publish guidance on sex and relationships
We know people with a learning disability continue to experience many barriers in being able to develop and maintain safe, intimate relationships.
One of these is a reluctance among some service providers to address this issue, including a failure to offer support staff the necessary guidance and training to respond to people’s sexuality needs in a professional, confident manner.
Furthermore, there has been little incentive to open what can be seen as a can of worms because the key social care overseers, including the Care Quality Commission (CQC), local authority contracts departments and social workers, have rarely asked questions about support for personal relationships as a measure of service quality.
This is not to suggest that wonderful examples of individuals and organisations who have overcome the barriers to finding love do not exist – indeed, your publication has done much to promote these.
Against this background, it is pleasing that the CQC has, at last, had the courage to publish guidance on sexuality in care and support services. This outlines areas relating to sex and relationships that inspectors may explore during a visit, such as policy and information provision, training for both staff and service users, responses to difficult situations and legal implications.
Although generic in nature, the guidance has much to offer service providers and recipients as it provides a new, albeit rudimentary, framework for expectations.
Both Supported Loving and the Lancashire Learning Disability Friends and Relationships Group, which were consulted about it, emphasised the need to focus as much on supporters’ enabling role as on safeguarding.
There is still work to be done, including the introduction of mandatory staff training. Nevertheless, if the fear of opening a can of worms rests on ending up with more trouble than you bargained for, this document should offer some relief in the form of direction, clarity and information.
It is a genuine effort on the part of the CQC to support change. Let’s congratulate them on a brave start and hope the guidance motivates and inspires providers.
Sue Sharples
Director, U-Night Group, Lancashire
Relationships and Sexuality in Adult Social Care Services (including an easy-read version) can be downloaded from http://tinyurl.com/y2ctk6ws
