Equality Impact Assessment - Physical Disability, Sensory Impairment and HIV Services Strategy

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The Royal Borough of Kingston upon Thames

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BROWSE

Function being assessed:

Draft Strategy for people who are

• Physically disabled

• Live with a long term medical condition

• Have a sensory impairment and/or

• Live with HIV

This strategy is valid from 2008 to 2013, which is supported by other Strategic plans and in particular the Promoting Independence and Wellbeing 2008-2011 and The Carer’s Strategy 2008 to 2013.

Is this a new function or a review of an existing function?

The strategy builds on “Towards full Inclusion 2004-2009” which was a five year plan for developing services for and with disabled people.

What are the aims/purpose of the function?

The aim of the strategy is to identify key personalised outcomes for health and social care services for physically disabled and sensory impaired people and their carers. Priorities have been identified looking at the needs analysis of the population of the borough and consultation with stakeholders. Ensuring that the key commissioning outcomes are that we do not plan services per se but instigate activities that will achieve key desirable outcomes for local disabled people.

The specific aims of the strategy are as follows:

Ability to make informed decisions – accessible information, to ensure that disabled people know what they are entitled to and what services are available to them

Ability to live in their own homes in the community – access to appropriate housing and support service services to prevent the needs for people to be placed in care homes

Ability to Choose from a range of options and to control their own lives – access to Direct Payments and Individualised budgets

Ability to define their own needs and to “help themselves” to services, where appropriate - access to self assessment

Ability to fulfil parenting roles - Support for disabled parents

Ability to sustain and increase their level of independence and to access local work, education and recreational opportunities - Access to flexible daytime support.
Equal Access to Services - Ensure that service users from all communities can access resources that appropriately meet their needs taking also into account BME communities and all disability groups.

Is the function designed to meet specific needs such as the needs of minority ethnic groups, older people, disabled people etc?

The Strategy has focused on the needs and desired outcomes of people with a physical/sensory impairment across our communities.

Whilst the document is not focused primarily upon older people (there being a separate commissioning plan for older people), it must be emphasised that many disabled people are also older people.

The strategy has identified some specific actions to meet the needs of BME communities after consultation with the community and this has been included in the strategy. Including vulnerable people and disabled groups.

What information has been gathered on this function? (Indicate the type of information gathered e.g. statistics, consultation, other monitoring information)? Attach a summary or refer to where the evidence can be found.

Specific needs and priorities were identified in the Strategy, through the needs analysis (population data, prevalence of illness and disability, inequalities) and consultation with specific groups. The needs analysis mentioned can be found on pages 5 to 8 of the strategy.

For example

We can estimate that between 12,000 and 16,000 of local adult residents are disabled. The Census figures do not capture disability data accurately and there is no comprehensive data on disabled people therefore this puts commissioning strategies at a disadvantage not only locally but nationally.

Our projected figures are that the numbers of older people will increase, definitely amongst the group of people who are over 85 and, therefore, will be most likely to require community care services.

RBK has some wards with significant levels of deprivation and due to their likelihood of having to rely on state benefits, local disabled people are likely to be amongst the most deprived.
The level of unemployment amongst disabled people is very high with associated consequences in terms of poverty and social exclusion.

Consultation has and continues to take place with a number of established networks where CCS engages in dialogue with local disabled people and other stakeholders about the development of service for disabled people. These include the Partnership Board for Disabled People; the Kingston and Richmond Low Vision Services Committee, Deaf BSL Users consultation events, Hard of Hearing consultation, the Day Service Modernisation Group and the council wide Disabled and Older People’s Forum consultation events. In addition, disabled people and other stakeholders are routinely, directly involved in service developments. The participants of these consultation groups are as far as we are able to influence are a representative of different disabled groups.

Does your analysis of the information show different outcomes for different groups (higher or lower uptake/failure to access/receive a poorer or inferior service)? If yes, indicate which groups and which aspects of the policy or function contribute to inequality?

SWIFT data collected on our services users gives us an analysis/ profile of the disabled groups using services. Included in this is gender, ethnicity, age and disabled grouping. We understand that there is further guidance coming out on sexual orientation and religion and this will be incorporated into the action plan.

There is currently limited data on people with HIV/Aids in the borough. We are aware due to recent collation of data, using data from Kingston Hospital that there are 183 people with a diagnosis of HIV/Aids living within the borough, 22 people are currently being care managed by the HIV care management team. Working with the South London Partnership a new data base will better inform the strategy in months to come.

So far evidenced in this strategy shows no higher or lower uptake of services from any particular group however, it does identify deprivation and unemployment as significant disadvantages that disabled people in this borough face. It may be assumed that poverty and lack of employment opportunities will impact on the need for Community Care services and may also cause barriers to accessing services. The action plan sets out how CCS is responding to this through Workstart and Community Outreach Support programmes from the welfare benefits section.

Although the strategy does not set out actions to reduce deprivation levels/ increase uptake of welfare benefits, it is supported by the Independence and Wellbeing Strategy which clearly sets out its aims to improve access to welfare benefits and outreach to vulnerable groups, of which Disabled people are included.

When services are delivered to meet individual needs there will be differences based solely on ones need. There should be no negative impact on any of the equality target groups in how they receive services.

We currently do not collect data on sexual orientation and therefore unable to provide any appropriate information on service users or for service users. We are looking into how best to collect this data in a meaningful and balanced way. The data collection needs to be constantly improved and checked to ensure that the service is making informed decisions based on qualitative and quantitative data.

RBK has for a number of years supported via direct payments a substantial number of disabled people to live independently in their own homes. This is in line with the current personalisation agenda and over recent years, there has been a decrease in numbers of disabled people moving into care homes. In some service areas there a greater take up of direct payment services by BME communities. Reasoning behind this maybe that individuals can have a more bespoke personalised support service. Alternatively this could be that services are not meeting cultural needs. However, during consultation this has not been raised as a concern with BME communities. Further investigation of this data needs to take place to inform the action plan.

There is a lack of appropriate accessible housing within the borough and appropriate support for some disabled people. This result in people being moved into general care homes outside of the Borough. Given sufficient resources and appropriate services most if not all disabled people could be supported to live in the community, if necessary, with 24 hour per day support packages. There will inevitably always be a minority of people whose needs will be best met in a care home.

Once particular example is that of people with acquired brain injuries. Service users from this group often have a multitude of needs, frequently associated with substance misuse, mental health problems and challenging behaviour. In many cases, they have lifestyles and need a substantial level of daily (and sometimes night time) support to enable them to structure their lives, maintain their tenancies, remain safe and look after their health.

At present due to the lack of specialist support and accessible housing we are not able to meet, in the majority of cases the same outcomes for this particular group of disabled individuals as compared with other disabled groups.

Are these differences justified (e.g. are there legislative or other constraints)? If they are, explain in what way.

As discussed throughout the strategy, these issues are also reflected nationally. Differences identified in needs analysis have been incorporated into the action plan set out at the end of the strategy. Any differences would be on meeting individual’s specific needs rather than the way in which service is delivered.

What action needs to be taken as a result of this Equality Impact Assessment to address any detrimental impacts or meet previously unidentified need? Include here any reasonable adjustments for access by disabled people. Include dates by which action will be taken. Attach an action plan if necessary.

Action plan in this strategy, the Independence and Wellbeing Strategy, The Older People’s Strategy and that of the service aims and objectives incorporates actions to address need.

On Strategic Commissioning priorities information and signposting is a key priority. Whilst there is a focus on “online” information. Consultation on the draft strategy has shown that there needs to be a balance regarding alternative ways of information provision and sign posting. This is being addressed via the action plan and team objectives.

When will you evaluate the impact of action taken? Give review dates.

A review of achievements against the objectives and outcomes identified in the strategy action plan will be reported on a quarterly basis to the People with Physical Disability Partnership Board and a progress report will be submitted annually, which will include a revised action plan. Service and Team plans will also be reviewed to assess outcomes. There will also be a specific equality reporting on data and analysis this will inform and build on the work.

Assessment completed by:

Lesley Dodd

Principal Manager for Health & Disability and occupational Therapy Services

26 March 2008

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