Learning disability

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We estimate that over half a million adult social care workers support people who are living with a learning disability and/ or autistic people in England. 

It's vital that these workers have the right values, skills and knowledge to provide high quality, person-centred support, and we have resources to help.  

They explain what skills and knowledge workers need to support people with learning disabilities, their carers and families, and how adult social care employers can develop the skills of their staff when working with people with a learning disability.  

What's new? 

Worked examples to support learning and development

These worked examples are based on real-life scenarios of people with learning disabilities and/ or autistic people, who display or are at risk of displaying behaviours which challenge. They explain what workforce that individual needs, what skills and knowledge the workforce needs, and how much this training would cost. 

They're for adult social care commissioners and providers, to help you identify learning and development needs and plan support.

 

The Learning Disabilities Core Skills Education and Training Framework  sets out the skills and knowledge adult social care workers need to deliver high quality care and support for people with learning disabilities. 

The framework can help you to develop and deliver appropriate and consistent education and training for workers who support people with learning disabilities. 

 

Positive behavioural support (PBS) is a person-centred approach to people with a learning disability who display or at risk of displaying behaviours which challenge. It involves understanding the reasons for behaviour and considering the person as a whole - including their life history, physical health and emotional needs - to implement ways of supporting the person. It focuses on teaching new skills to replace the behaviour which challenges. 

We have resources to help, including a guide to arranging and paying for training in PBS. 

Find out more about how you can support people who display or are at risk of displaying behaviours which challenge. 

 

These worked examples are based on real-life scenarios of people with learning disabilities and/ or autistic people, who display or are at risk of displaying behaviours which challenge. They explain what workforce that individual needs, what skills and knowledge the workforce needs, and how much this training would cost. 

They're for adult social care commissioners and providers, to help you identify learning and development needs and plan support. You can mix and match the examples and draw information from different examples to create your own plan for the person you’re supporting. You can use this template to do this. 

  • If you support someone who has similar care and support needs you can use the examples as a guide or template to plan their workforce and commission learning and development. You could use the worked example to inform specifications or contracts for support services, or make a ‘business case’ for investing in learning and development.

  • If you’re thinking about a population of people in a specific area, you can explore how many people in your area have similar care and support needs to the worked examples, and scale them up to strategically plan and develop the workforce. 

Download our 'How to use the worked examples' overview. 

Download the worked examples 

We've listed the examples in age order. *Please note, we're still testing them with the sector. Please use the online PDF to ensure you have the most up to date version. Email us if you have any feedback.*

  • Joe - Joe's 12 years old. He has a learning disability, autism and sensory challenges. His behaviour can post a risk to himself. He’s currently in a 52 week long school programme which is a long way from his home. Download his worked example here. 

  • Dean - Dean's 15 years old and has a mild learning disability, epilepsy and cerebral palsy. He lives with his parents who are worried and 'can't control him any more'. They're concerned he might be involved in 'mate' or 'petty' crime. Download his worked example here. 

  • Laura - Laura's 21 years old and has type one diabetes, autism and profound, multiple and severe learning disability. She lives in a specialist residential home but is at risk of being admitted to hospital if this breaks down. Download her worked example here

  • Ellie - Ellie's 21 and has Asperger's. She has a mild learning disability and history of familial sexual behaviour and abuse. Soon after starting secondary school she developed anxiety and stopped going to school. Ellie is currently in an inpatient setting following her stabbing her aunt at home and exposing herself in public. Download her worked example here

  • Daniel - Daniel's currently in a secure hospital under section 37-41 (hospital order given by the crown court). He got into trouble with the police for burglary, then this escalated to aggravated burglary and rape. He was identified in prison as vulnerable and moved to a secure hospital. Daniel has gone through the sex offender’s programme and is now ready for discharge. Download his worked example here.

  • Hero and Sweet - They are a couple in their twenties and have two children aged under 6. They both have a mild learning disability and Sweet is experiencing post natal depression. They get some hours of support a week with household tasks, and Sweet’s mum helps them too, but children’s services have concerns about their children’s welfare. Download their worked example here. 

  • Jake - Jake's 28 years old. He has a moderate learning disability and poorly controlled diabetes and epilepsy. He lives in a supported living setting with five other people. His support provider feels he’s at risk of admission to in-patient services as his behaviour can be too challenging. Download his worked example here.  

  • Francois - Francois's 32 years old and has mental ill-health, depression, possible ADHD and a history of alcohol and substance misuse. Currently he gets two hours a week support to help with bills and housework

    He lives in a flat but his landlord has given him notice of impending eviction as “the flat is filthy and other tenants in the building have complained about frequent ‘visitors’" He’s under a M.O.J. restriction as he had been arrested and convicted of assault while under the influence of substances and alcohol. Download his worked example here. 

  • Paul and Doreen - Paul's 50 years old and has autism with no diagnosis of a learning disability, which can sometimes affect his temper and mental health. His Mum, Doreen, supports him at home but her health is deteriorating and she’s worried about how Paul will cope without her. Download their worked example here. 

  • Wilf - Wilf's 72 years old and has a mild learning disability and possible dementia. He has been involved in incidents of arson and has lived in a specialist learning disability inpatient services for six years. His responsible clinician thinks he’s had all the treatment he can benefit from and would like him to move into supported living. However his niece Debbie feels he’s safer in hospital. Download his worked example here. 

  • Carol - Carol's 75 years old and is of Chinese origin. She has a moderate learning disability and people think she may be autistic but she has no formal diagnosis. In the past she’s stayed in various assessment and treatment units and hospitals. She’s been living in a supported living setting for eight years. Recently she’s had health issues and has exhibited behaviour which challenges services. However, she doesn’t like seeing a doctor about it. Download her worked example here. 

Everyone has the right to have meaningful personal relationships, including people with learning disabilities. It’s vital that adult social care workers have the right values, skills and knowledge to support people with personal relationships – and training is a vital part of this.

Our 'Supporting people who need care and support to have meaningful relationships' guide helps employers to think about how they can develop their staff through training. It explains what workers need to know and understand about personal relationships, and how they can create a workforce development programme. 

 

It's vital that people with learning disabilities are supported to access the right eye care and vision services. 

Adults with learning disabilities are 10 times more likely to have serious eye problems, which can seriously undermine quality of life and lead to avoidable sight loss and increased dependency. 

Here are some tips for workers supporting people with learning disabilities.

  • Support people with learning disabilities to have an eye test at least every two years, or more often if needed.
  • Understand how people with learning disabilities use their sight, and the signs that they might be having difficulty seeing. SeeAbility's Functional Vision Assessment Tool is a great starting point in eye care support - but ensure you share the outcomes and any concerns with an eye care professional. 
  • Some optometrists offer additional services to support people with learning disabilities such as picture tests instead of letters, longer appointments, multiple visits including familiarisation visits, easy read information and staff who’ve had training about the specific needs of people with learning disabilities. Use SeeAbility’s optometrist database to find a service in your area.
  • Choose a pair of glasses that the person likes and make sure they’re comfortable to wear.
  • Ensure the person and staff know when the glasses should be worn, for example reading, watching TV or at all times.
  • Record a person’s eye care and vision support in their support plan, communication passport, health action plan and annual reviews.
  • It might be useful to introduce the glasses for short spells of time initially to help the person get used to them.
  • Support the person to clean their glasses regularly.
  • If someone has a visual impairment, organise an assessment by a specialist rehabilitation worker to assess their independence and communication in everyday activities. 

SeeAbility has lots of short factsheets and films about eye tests, wearing glasses and eye conditions for people with learning disabilities and those who support them. 

 

This research report (published in July 2016) explores the adult social care workforce supporting people with learning disabilities and/ or autistic people, using data from the National Minimum Data Set for Social Care. 

Here are some of the key findings. 

  • An estimated two fifths of adult social care workers (621,000) were involved in providing care and support for people with learning disabilities and/ or autistic people in 2014. 
  • 31.8% of workers in these services started their roles within the past 12 months and 26.2% left within the last 12 months. 
  • Almost 80% of senior care workers and 50% of care workers were qualified to a level 2 or above - this is similar to the England average across all care services. 

Download the full report here. 

 

The Transforming Care Programme is designed to improve services for people with learning disabilities and/or autistic people, who display or are at risk of displaying behaviour which challenges services, including those with a mental health condition.

It's all about driving system-wide change so that more people can live in the community, with the right support, and close to home. This means that fewer people will need to go into hospital for their care. 

To do this, there needs to be suitable services available in the community. 

The aims of the programme are outlined in the national plan, Building the Right Support

We're working with other stakeholders to support the ambitions of the Transforming Care programme, by supporting adult social care services to ensure their workforce is confident and capable to support people with a learning disability in the community.

Find out more about the Transforming Care Programme