Its learning disabilities week and what better way to raise awareness of the barriers and challenges people with learning disabilities face in such unprecedented circumstances. These last weeks have really got me thinking about all the things we take for granted. This includes freedom, relationships, employment or meaningful activity and structure to our days and having access to lot of different things that add colour to our lives. The list is endless.
For some people with a learning disability life is at a standstill and whilst it might be slowly creeping back to some kind of normality, others are facing more uncertainty and are having to come to terms with an new normal that is unrecognisable from what went before. Friendship groups that may have been forged over many years have been placed on hold and for many people the prospect of seeing loving family and friends, relationships which may sometimes already be difficult to maintain, becomes almost impossible if based on staffing levels, rotas and the unavailability of support due to the pandemic.
So bearing this in mind its vitally important that we continue to think of the impact of the pandemic on people who are already faced with inequalities and discrimination. This further compounded by their gender, geography, social location, societal priorities and attitudes which intersect with disability type to create inequities in health and social care access. None of this is new but is highlighted and hugely compounded during a crisis like COVID-19.
So the challenge is set. If we know the health inequalities and social disadvantage that people with learning disabilities already face and we accept these risks are highly inflated by the risks of further isolation and lack of opportunity due to the pandemic, how are we going to respond? How can we ensure that the human rights of people with learning disabilities are upheld, especially when and where it matters most? How do we ensure in this midst of global crisis we ensure people with learning disabilities remained connected with others who provide friendship, love and opportunities as this may be the only thing that may prevent them going in to crisis.
I think we have a range of answers and although legislation on its own is not the solution, it does help us provide a framework for ensuring that our approach is consistent, strengths based and enables people to take risks and experience opportunities on a personal level. As health and social care practitioners we have legal frameworks that ensure that people remain connected. It’s a human right that does not diminish due to the presence of a disability, these rights are universal and apply and matter to me as much as they do to you and to all of us. Understanding the important of Article 8, the right to a private and family life and working to provide people with access to their loved ones (whilst working with restrictions due to COVID-19) is fundamentally important. Health and social care is at its best when it is used to enable people to access their own networks, families and supporters not provide them.
Much of this approach is also enshrined in The Mental Capacity Act 2005. Anyone who supports people with learning disabilities should be regularly reflecting whether their approach is consistent with the five principles of the Act. Essentially this means supporting adults to make their own decisions wherever possible and going the extra mile to ensure we have done all we can to enable the person to make their own decision wherever possible. Only if there is evidence a person is unable to make a particular decision can staff act in their ‘best interests’ and even then the Act tells us it must always be the least restrictive option available and be genuinely in the persons (not our!) best interest. That’s quite a challenge but really gets to the essence of why health and social care at its best is a remarkable place to work.
Finally, the answers are also in The Care Act 2014. This vital legislation clearly articulates the local authority’s responsibilities to assess and provide services to adults with learning disabilities and their family carers. It also sets out how the potential abuse of adults with learning disabilities needs to be responded to by organisations. I think that crucially at its heart, the Care Act understands that assessment, services and statutory support to safeguard someone’s rights can only be achieved if we truly take on board the Wellbeing Principle which runs throughout it. Understanding, respecting, upholding and enabling people to remain in control of their daily lives is at the very core of the Care Act and must be reflected in all our actions at all times.
This pandemic has given us a little insight to some of the issues people with learning disabilities by the mere fact that the things we have taken for granted have been curtailed. If one good outcome of this could be that across the sector there is an understanding that we be increasingly legally literate in our approach, recognising that a joined up health and social care system that draws on and includes wider elements of the community to ensure that we support people with learning disabilities overcome the barriers that are faced by them through inequalities, then there is hope. Respect for human rights across the spectrum, including economic and social rights, and civil and political rights, will be fundamental to the success of the health and social care response.