Report for Information

Manchester City Council Item 7 Health Scrutiny Committee 12 November 2012

15

Manchester City Council Report for Information

Report to: Health Scrutiny Committee – 12 November 2012 Subject: Sensory Provision in Manchester Report of: Liz Bruce, Strategic Director, Adults Health and Wellbeing Summary This report provides Members of the Committee with an overview of services for customers who are Visually impaired in Manchester. Recommendations The Health Scrutiny Committee is asked to note the contents of this report Wards Affected: All - Citywide Contact Officers: Name: Joe Kelly Name: Mags Doherty Position: Sensory Team Manager Position: District Manager - Central East Telephone: 0161 219 2658 Telephone: 0161 227 3952 E-mail: [email protected] E-mail: [email protected] Background documents (available for public inspection): The following documents have been produced by the Manchester Sensory Service and can be made available to Members for further information.

1. Kelly, J (2009) Good Practice in Sight Review 2. Kelly, J (2011) Sensory Provision in Manchester - Team Plan 3. UK Vision Strategy (2012) Seeing it my way 4. RNIB (2012) Providing excellent services for blind and partially sighted people

– A guide for local authorities.


16

1. Introduction 1.1 The following paper provides an overview of health and social care services

for the visually impaired in Manchester 2. Background 2.1 Almost 2 million people in the UK are living with sight loss (vision less than

6/12). By 2020 this number is predicted to increase by 22% and it is expected to double to nearly 4 million people by the year 2050. These increases mainly due to the demographics of the population in which eye health will be affected as over 80% of sight loss occurs in people of the age of 60.

2.2 There are currently 2140 registered as severely visually impaired and 1927

registered as visually impaired in Manchester. It is estimated that there are approximately 13,500 people living in Manchester who have a visual impairment.

3. Identification of people with Sight Loss 3.1 Traditionally referral to social care services has been either via self referral or

when a customer is registered as visually impaired or severely visually impaired. An individual may be identified as having sight loss by the community optometrist or GP they would then be referred to a consultant ophthalmologist whom would certify eligibility to be registered.

Certificate of Visual Impairment (CVI) formally certifies someone as visually

impaired (partially sighted) or severely visually impaired (blind) so that the local authority can register him or her.

Customers are entitled to access services they are assessed as needing

without registration but will not be placed on the formal register without completion of the CVI and the signature of the consultant ophthalmologist.

The register for customers with a visual impairment is managed within the

Sensory Team, and is also recorded on Micare. An exercise is currently being undertaken to monitor the time taken for the

certificate of visual impairment being signed by the consultant ophthalmologist to the time it is received to complete registration at the Sensory Team.

3.2 The Low Vision Leaflet (LVL) is a self referral leaflet which a customer can

who encounters difficulties can send to the Sensory Team if they wish to be contacted for help.

The LVL has not been used in Manchester previously, through working with

Manchester Local Optical Committee and the Low Vision Committee we have developed a Manchester LVL and aim to implement this by December 2012.


17

It is intended for the LVL to be accessible from the Manchester City Council website and NHS staff will also be able to download this, print a copy and provide this to the customer.

Social care presence in the hospital is maintained by partners Henshaws

Society for Blind People whom run a patient support service. The service provides key support and information services to those that have newly lost their sight.

4. NHS services for visually impaired people There are a range of NHS services available for people with sight problems; both to support those living with visual impairment, and to treat patients presenting with eye problems. These are found both in the community and in hospital. 4.1 Low vision clinic Based at the Manchester Royal Eye Hospital, the low vision clinic provides support to patients with a visual impairment who have restrictions in activities that might be ameliorated through the use of low vision aids. Patients are referred to the service via the following routes: Current Eye Hospital patients referred from medical staff or other staff groups,

e.g. optometrists, orthoptists. Referral requests from social services, qualified teachers of the visually

impaired, employment services and other agencies can be accepted provided the patient is registered with an Eye Hospital consultant and has had a recent ophthalmological assessment (i.e. within 12 months).

Self-referrals back to the low vision clinic from patients who have been

assessed within the past 12 months. Tertiary referrals from other ophthalmic units without ‘low vision’ Referrals from General Practitioners for patients who have an established

diagnosis will be accepted provided the GP provides evidence of recent ophthalmological assessment (i.e. within 12 months).

Low vision aids (magnifiers) are provided on a 'free' on loan basis to patients who may use them for reading, watching TV, occupational requirements, school work etc. After an initial visit, the patient is reviewed by telephone, or in clinic, to see how the patient is getting on. The clinic works closely with the patient support service, provided by Henshaws, which helps facilitate the social/rehabilitation services delivered in the community. 4.2 Community Orthoptic Service: The Orthoptic Service provides eye care for children across Manchester. Orthoptists detect and treat eye problems such as reduced vision, squints and lazy eyes.


18

Most children seen by the Service are aged from birth to 7 years. Children with Special Needs are seen up to the age of 18-19. The Service has close links with the Ophthalmologist (eye doctor) through the Manchester Eye Hospital. There are 21 Community Orthoptic Clinics and 8 Community Refraction clinics available across the city The service operates an open access referral policy and accepts referrals for all children from Manchester GPs, Health Visitors, School Nurses, Hospital Consultants, Paediatricians, Education, other Health Professionals, parents and carers. 4.3 Community Optometry Community optometry practices are found in high streets and supermarkets, at the heart of many local communities. In Manchester there are 50 such practices staffed by optometrists, dispensing opticians and their staff. Optometrists - also called ophthalmic opticians - examine eyes, test sight and

prescribe spectacles or contact lenses for those who need them. They also fit spectacles or contact lenses, give advice on visual problems and detect any ocular disease or abnormality, referring the patient to a medical practitioner if necessary.

Dispensing opticians - advise on, fit and supply the most appropriate spectacles after taking account of each patient’s visual, lifestyle and vocational needs. Dispensing opticians also play an important role in advising and dispensing low vision aids to those who are partially sighted and in advising on and dispensing to children where appropriate. After undergoing further specialist training, they are also able to fit and provide aftercare for contact lenses.

In some circumstances, Community Optometrists will carry out home visits to carry out sight tests. The person must be eligible for an NHS (free) sight test and must be housebound. 4.4 Enhanced Services Community optometrists can also provide a number of other services called enhanced services. These have been certified by NHS Manchester and optometrists undergo additional training in order to be approved to provide these services. Red Eye Scheme – This is a relatively new service for patients presenting

with a “red eye” condition. It is for patients, over the age of 12 who are registered with an NHS Manchester GP. Patients can self refer into participating practices or be referred by a GP or other healthcare professional.

Diabetic Retinal Screening - Patients who have diabetes and are over 12

years old will be invited every year to take part in the National Screening Programme for Diabetic Retinopathy. This screening programme aims to reduce the risk of sight loss in people with diabetes. The screening process helps to identify diabetic retinopathy early and ensure patients are offered


19

effective treatment where necessary.

Systematic screening involves digital photography of the retina followed by a two or three stage image grading process to identify the changes of sight-threatening diabetic retinopathy in the retina. Cataract Referral Refinement scheme – Delivered by optometrists, the aim

of this service is to identify patients with a cataract that requires surgery

Ocular Hypertension (OHT) – This service measures Intraocular Pressure (IOP) for patients to identify patients with an IOP >21mmHg who will then require further treatment. The service aims to reduce the number of inappropriate referrals to secondary care.

Glaucoma Referral Refinement - Services to patients with suspected Glaucoma.

Details of which Community Optometrist practices offer each of these schemes can be found on the NHS Manchester website 4.5 Hospital Care The Manchester Royal Eye Hospital is a specialist hospital providing an extensive range of eye services for both adults and children from its large outpatient department, in-patient wards and 5 operating theatres. These are supported by the following on site services: Emergency Eye Centre - a nurse-led service specialising in eye

emergencies. Highly experienced Opthalmic Nurse Practitioners assess, diagnose and treat patients presenting with urgent care needs

Ultrasound Unit – an ophthalmic diagnostic service using ultrasonography.

Used to diagnose cataracts, glaucoma and other abnormalities Electrodiagnosis - diagnostic service measuring electrical signals to identify

the cause of sight problems Manchester Eye Bank - processes donated eyes from across the country

preparing corneas for graft surgery, which helps to restore sight Ocular Prosthetics - the prescribing, design, fabricate and fitting of custom

made ocular and facial prostheses. Not all services are provided from the hospital site. For example, cataract surgery takes place at Withington hospital, with up to sixty patients being seen there every week. Opthalmology services at Wythenshawe Hospital and North Manchester General Hospital are limited with the vast majority of Manchester patients being seen at the Royal Eye Hospital or its off-site clinics.


20

MREH is also proactive in low vision research and conduct trials on service models and technology, including one just started which is backed by the National Institute of Health Research. 5. Services for Visually Impaired People in Manchester Libraries 5.1 The aim of the Service is to enable visually impaired people to access library

services as closely as possible to their neighbourhood. 5.2 Some specialist services will be provided in Central Library which will be fully

accessible and is located at the heart of an excellent transport hub. 5.3 Services are detailed further in are detailed in Appendix 1, and will be free of

charge to visually impaired customers 6. Manchester City Council’s Sensory Team 6.1 The Sensory Team is a specialist city wide service, working with customers

who are Manchester residents, and are over the age of 18 have a visual impairment or are Deaf/deafened, hard of hearing, or have a combined sensory loss. In the year 2011/2012 the Sensory Team received 1570 referrals including both visual and hearing difficulties.

6.2 The Sensory Team was redesigned in 2007 following an independent

consultation by Contact Consultation. This has further developed with consultation with the Visually Impaired steering group.

6.3 The Sensory Team subscribes to the Manchester City Council Mission

Statement 'Manchester citizens aspire to be the best they can be' and that all adults can be healthy, in work, safe parents, active citizens, lifelong learners and can contribute fully to the city and to their own lives. The work of the Sensory team is to make these objectives a reality in the lives of people with sensory disabilities.

6.4 The Statutory duty and function of the Sensory Team is identified in Appendix

2 6.5 The Sensory Team is a multidisciplinary service, consisting of assessment

and provision of services to individuals. A brief overview of the roles can be found in Appendix 3.

The Customer Pathway for accessing the Sensory Team can be found in

Appendix 4. 6.6 The services for Manchester's sensory impaired population are assisted by 2

consultation groups which meet bi-monthly and are chaired by the Sensory Team manager:

Visual Impaired Steering Group(VISG); The VISG is made up of visually impaired persons who live in Manchester. There are approximately 14


21

members and is also attended by Commissioning, and 3rd Sector organisations such as Henshaws.

The groups have been involved in the following consultations and projects: Redesign of Sensory services for Manchester. Transport for Greater Manchester, consultation re: services for the future in

Manchester, and accessibility for people with a visual loss. Consultation re: Shared Spaces in Manchester Consultation re: Improved crossing for visually impaired persons Consultation re: Blue Badge Consultation Consultation re: Redefined Social Care Offer Currently involved in the Town Hall Transformation Project Currently involved in procurement exercise in regards to provision of

equipment to people with a sensory loss in Manchester. In addition, the Sensory Team, works with Henshaws, Manchester Royal Eye Hospital Ophthalmologists, Manchester commissioning and other key parties involved in the provision of low vision services in Manchester to form the Low Vision Services Committee (LVSC). The aim of the LVSC is to work together to enable people with low vision living in the area to meet their full visual potential. enables customers to be informed of services available from Manchester Sensory Team and Henshaws Society for the Blind, and how the customer can obtain appropriate support. 6.7 The Sensory team provides support in key areas to ensure that a customer is

supported to remain independent in the community in the following areas; Provision of Equipment; The equipment is to provide support to customers

to maintain their independence in their home. There is a range of equipment provided which covers areas such as communications, daily living skills, mobility and orientation, telling the time etc.

The equipment provided is currently undergoing a procurement review

exercise with a view to a reduction in costs to £72,000 per year or 21.7%. A full list of equipment can be found in the Sensory Equipment catalogue

Visual Impairment Rehabilitation; The rehabilitation service is a key aspect

of enabling customers with a visual impairment to regain their independence and build confidence. The service provides:

Emotional Support; addresses the complex emotional needs as the

person adjusts to losing their sight and having to rethink their life in different ways

Daily Living Skills; supporting the customer to adjust to independent

living without sight, for example, making a cup of tea, or preparing a meal.


22

Mobility Training; provides customers with new ways to move around their environment, this may include learning long cane training, developing auditory and tactile skills. This is very intense training and can take up to 12 months for a person to learn the skills competently.

Communication; learning new ways to assimilate information, such as

computer software, braille etc. Customers are often referred to other organisations or given learning packs to learn independently to meet this need.

Rehabilitation and Reablement; The Sensory team is currently looking

at working more closely with reablement services, but it needs to be recognised that the short term nature of reablement can be a major barrier to independent living. The support package provided by reablement services needs to be closely co-ordinated with the rehabilitation officers.

Access to Services; The Linkworkers play a key role in ensuring accessibility

to mainstream services for customers with a sensory loss. The key aspects of the support that the Sensory Team service provides are as follows:

A major issue for our customers is accessibility to information. The Sensory

Team will work with the customer and other organisations to support their ongoing independence. This may include ensuring that organisations communicate with the customer using the appropriate format or method, for example, using email for a person who is visually impaired, or SMS text message for a Deaf person. This promotes a confidence to make informed decisions independently.

Customers are also supported to access services existing in Manchester

City Council, this providing further information and support to teams in regards to working with people with a Sensory loss.

An important aspect of the work of the Sensory team is partnership

working with 3rd Sector organisations to develop services in a cost effective and innovative way.

6.8 The Sensory Team is very well regarded by its customers. It has received 108

compliments in regards to the service provided in the last 12 months. Appendix 5 identifies a testimony on how the Sensory Team strives to support customers with a sensory loss.

7 Partnership working to Improve Services for Customers with a Sensory loss 7.1 The Sensory Team strives to develop and improve services for customers who

live in Manchester, to enable this we work closely with other services and organisations to ensure that we all work together to Manchester’s Mission Statement.


23

7.2 Person Centred Counselling for Visually Impaired Persons; This service provided by Face to Face Counselling and is in partnership with RNIB is provided once a week for visually impaired people to have a specialist person centred counselling for people with sight loss. The service enables customers to adjust positively to their changed circumstances recognising that confidence and emotional stability are key to supporting a blind or visually impaired person to live independently. The service is held at the Sensory Team offices, every week, and referral is through Face to Face Counselling. The beneficial effect of person centred counselling and emotional support has been evidenced by the UK Vision Strategy ‘Seeing it my way’ (2012) document. The funding by DoH is currently due to cease in March 2013 and further funding streams are currently being sought.

7.3 Henshaws Skill Step Program; The Sensory Team refers to Henshaws

Society for the Blind to their skill step program which runs for 12 weeks and has 3 sessions a week. It includes modules on information technology, route training to Henshaws, personal and social development, vocational skills and a 2 week work placement.

7.4 Information and Sight loss group; This is run by Henshaws based at the

Sensory Team offices, funded by Manchester City Council Wellbeing fund. It is a short term course, running 7 weeks. The group was developed in partnership with the Sensory team, where it was identified that people whom had been newly diagnosed with sight loss were not provided with information about their sight loss, or the services available to them. This group enables attendees to gain skills and experience to determine the best approach to enable their independence in the future. It also provides peer support and discussion about their sight loss and the barriers that they may face. The course is currently funded until March 2013, and will run a further two times in this period.

7.5 Transition; Working with the Inclusion Service and other partnership

organisations to hold a coffee morning, where young people with a sensory loss and their family/carers can attend to receive information regarding adult services and enabling them to become independent and make informed choices.

8 Future Service Plans 8.1 Group Advocacy/Peer Support Network; To develop a Peer support

network recognising the importance to support people with sight loss and the knowledge and experience that a visually impaired person has.

Members of the Visually Impaired Steering group are committed to providing peer support to customers who have a visual impairment; they will often have a more in-depth knowledge of what it is like to be visually impaired and the issues that they have faced in the past.


24

It is anticipated that as the new sight loss group runs, this will attract more individuals to develop the network and provide support via telephone and social events.

8.2 Henshaws Blind Social Group; A social group will take place at Manchester

Deaf Centre, a central location in Manchester for visually impaired persons to meet up and socialise. The group is led by visually impaired people, supported by Henshaws and meets on a weekly basis.

Reference: 2 Access Economics (2009), Future Sight Loss UK:1 Economic Impact of Partial

Sight and Blindness in the UK adult population. RNIB 3 Age UK http://www.ageuk.org.uk/health-wellbeing /conditions-illnesses/age-

related-macular-degeneration/?ito=1944&itc=0 4 Bosanquet, N and Mehta, (2008) , Evidence base to support the UK Vision

Strategy. UK Vision Strategy 5 Department of Health (2007), The identification, referral and registration of sight

loss: Action for social services department and optometrists, and explanatory notes.

6 Directorate for Adults, Health and Wellbeing (2012) Business Plan. Manchester City Council

7 Hospital Episode Statistics: Outpatient, treatment by speciality by attendance type: England 2010/2011, Health & Social Care Information Centre (http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/HospitalEpisodeStatistics/index.htm)

8 http://www.rnib.org.uk/eyehealth/lookingafteryoureyes /pages/smoking/asp.x 9 http://www.stroke.org.uk/media_centre/press_releases/stroke_survivors.html 10 RNIB (1999) Low Vision Services: Recommendations for future service delivery

in the UK 11 RNIB,2008 Good Practice in Sight Guide 12 Visionary, (2011) Transforming Adult Social Care – Implications for Blind or

Partially Sighted People.

Manchester City Council Appendix 1 - Item 7 Health Scrutiny Committee 12 November 2012

25

Appendix 1: Services for Visually Impaired People in Manchester Libraries DRAFT Proposal for services going forward in April 2012 The aim of the service is to enable visually impaired people to access library services as closely as possible to their neighbourhood. Some specialist services will be provided in Central Library which will be fully accessible and is located at the heart of an excellent transport hub. All services detailed here will be free of charge to visually impaired customers Access to books, information, DVDS and CDs Audio, Large Print, E-books and other E-documents, DVDs and CDs available to

visually impaired users with reservation service to enable copies from any Manchester library to be borrowed

Daily newspapers and other publications available online in a format suitable for reading with assistive technology reading aids

Staff can find stock on the catalogue for VI users and recommend specialist libraries such as CALIBRE and the RNIB Libraries

Information produced by libraries will be available in accessible formats on request

Children Large print, audio and tactile books for children available and reservation service

as above Bookstart packs for babies and preschool children - Booktouch packs - available

in tactile format Accessible bounce and rhyme sessions for babies and toddlers delivered in

libraries Home Visits Books to Go service will deliver books including audio and large print to

customers unable to get to a library Books to Go service will deliver and support Wireless for the Blind equipment in

collaboration with the City Council’s Sensory Team Access to computers with free internet access, word processing packages and online library services Computers with assistive technology and with large monitors, adapted keyboards,

headphones and scanners in certain areas. VI users able to book computers in the library at no charge for unlimited time Currently the Library Service installs Supernova software (to magnify text or

convert it to speech) on some computers to give access to standard Microsoft packages and the internet


26

Staff and volunteers All staff will have awareness training in the needs of VI users and will be able to

welcome VI users and assist with any queries Staff will be trained to be aware of the varying issues technology can cause

visually impaired people and will be able to assist where possible, or arrange for further support if required, possibly through volunteers or other agencies

Staff will be trained to use the RNIB Reading Sight website especially the Your Reading Choices section to enable visually impaired customers to find the right material for them in the library

Six Steps pledge The Library Service is signed up to the pledge to deliver the Six Steps to Making

Libraries Accessible with a senior member of staff taking on the role of designated champion for the reading needs of blind and partially sighted people

Proposal for new Central Library opening in Spring 2014 Information and Business section on 2nd floor Specialist equipment for VI users to be provided in the Information and Business

Service on the second floor Area with tables and computers located near to lift Propose the following equipment or similar to be located in this section to enable

printed material to be converted to speech and to enable printed material to be magnified and manipulated: ClearReader, ClearView and scanner.

computers with assistive technology and with large monitors, headphones and adapted keyboards located in this area

VI users able to book these computers at no charge for unlimited time Propose the 3 computers have Supernova software (to magnify text or convert it

to speech) installed to give access to standard Microsoft packages and the internet

Staff in the Information and Business section will be trained to be aware of the varying issues technology can cause visually impaired people and will be able to assist where possible, or arrange for further support if required

New VI users will be shown how to use text to speech and video magnification technology. If support is needed in using equipment and software this will also be provided. These services will be available at certain times, possibly by appointment and may be delivered by volunteers or other agencies.

Provision across Central Library Audio, Large Print, E-books and other E-documents available in various locations

across the library for children and adults, all free of charge to visually impaired users

Accessible bounce and rhyme sessions for babies and toddlers with tactile books for babies

Information produced by libraries available in agreed accessible formats on request


27

Staff can find stock on the catalogue for VI users and recommend specialist libraries such as CALIBRE and the RNIB Libraries

Booklists of new stock such as audio stock available online Daily newspapers and other publications available online in a format suitable for

reading with assistive technology reading aids All staff will have awareness training in the needs of VI users and will be able to

welcome VI users and assist with any queries Staff will be trained to use the RNIB Reading Sight website especially the Your

Reading Choices section to enable visually impaired customers to find the right material for them in the library

Other computers in the library have assistive technology installed – numbers and locations to be agreed


28

Appendix 2: Statutory Duty and Function underpinning the Sensory Team Assessments are carried out under the powers enabled by the National Assistance Act 1948 (Part 3) and the Chronically Sick and Disabled Persons Act (1970, Section 2) gave the Local Authority a duty to assist disabled people as defined by the Section 29 of the National Assistance Act 1948). In the Chronically Sick and Disabled Persons Act, it identifies that there is a duty to arrange adaptations or provision of additional facilities to promote “safety, comfort or convenience” a major part of the role includes assessing for communication aids and equipment. The NHS and Community Care Act (1990) Section 47 also provides a duty for the Local Authority to carry out an assessment if it appears there is a need for such services and the provision of services is as identified in the National Assistance Act 1948, Part 3 (welfare and accommodation services) and Health Services and Public Health Act 1968, Section 45. The Equality Act (2010) places a duty on the Local Authority to provide additional support above what is provided to a non-disabled person to enable them to access services. This duty underpins as does the provision of support as outlined in the previously mentioned Acts; the Linkworker service in its present form. Further Government White papers such as Our Care, Our Health, Our Say (2006) and Putting People First (2007) underpin the team role and function, as well good practice guidance such as the Good Practice in Sight (RNIB, 2008) which is supported by ADASS.


29

Appendix 3: A brief overview of the roles of the Sensory Team A more detailed explanation of the roles can be found in the document 'Provision of Sensory Services: Team Plan 2011' (Kelly, J) Visual Impairment Rehabilitation Officers; provide assessment and provision for persons who have a visual impairment and need support in regards to enabling independence in the home, and developing mobility and orientation skills in the local community. This may include developing routes to key areas in their community, for example, college, university, workplace, key community areas or skills in regards to meal preparation and cooking safely. Sensory Assessment Officers; provide an assessment for equipment and minor adaptations in the home in relation to a person's sensory loss. They will often be the first customer’s first contact with statutory services. There are 3 assessment officers, The assessment officers carry out approximately 42 assessments a week, and will also carry out training for specific items of equipment. Linkworkers; provide support and advice in regards to welfare rights, benefits, housing issues and access to services. The Linkworker service was traditionally set up to support profoundly Deaf British Sign Language customers; however since the inception of the Sensory team, it has broadened its scope to cover persons who are hard of hearing and visually impaired. The Linkworkers are also actively involved working with 3rd Sector organisations to develop and encourage the provision of services such as Job clubs, befriending services etc. Business Support; provide information and support to customers, carers, family members and other professionals over the telephone and face to face visitors to the Sensory offices. They manage the bookings of appointments for assessment staff, and also manage the Visual Impairment Register and Transport for Manchester Travel Permits for people who have a sensory loss. Sensory Social Worker is a new position based within the Sensory Team. The criteria for referral to the social worker are as follows; Customer lives in Manchester and is between the age of 18-64 years old, except

where the customer is profoundly Deaf and uses British Sign Language as their preferred method of communication.

The Customer is profoundly Deaf or visually impaired and this is their main

presenting need. Where the customer has a sensory loss and other disabilities the social worker

will work in partnership with the other team providing advice and support to the lead service.

The social worker will take the lead on all safeguarding investigations for

customers whom are visually impaired, Deaf or hard of hearing and this is the main presenting need.


30

For customers over the age of 65 their needs would be met by the Primary Assessment team based within the area hub. The PAT team would be offered support and advice to be able to provide low-level advice and equipment to persons with a sensory loss.

Carer’s assessments will be carried out by the Sensory Social Worker for the

carers of sensory impaired customers, or where the customers use British Sign Language as their preferred means of communication.

Where the Sensory Social worker is at capacity or is absent from work, the

customer with sensory loss will supported by the local primary assessment team or social work team. This decision will be made by the Sensory Team manager, and PAT/SWT Team manager/Senior for the customer to be assessed.

Where a customer with a Sensory Loss has an eligible need under the revised

social care offer it will be presented at the Central panel, following agreement by panel the locality Team manager will be informed by email confirming the award for the customer by the Sensory Team manager or Social Worker.


31


32


33

Appendix 6: My Safety Net – A testimony by a Visually Impaired customer For me, the Sensory Provision Team have been like a safety net; they have given me the skills and confidence to live my life despite progressive sight loss. As I emerged from the progress of diagnosis and certification, shocked beyond belief, bewildered and very frightened, the ‘Team’, along with my G.P. practice moved calmly but firmly to support me. My Safety Net has never been prescriptive or told me what to do but at the same time have been gently clear ‘But Joy you are a registered blind person’, said kindly in the face of my denial. From the first assessment, shortly after registration, things began to change. It wasn’t just the equipment issued. Which has been so helpful, it was the FACT of a REAL person being there, in my house, asking me questions and filling out forms. So I began a process of acknowledging and recognising my sight loss and it’s, until now, detrimental effects on my life – the unnoticed adjustments, the excuses and the tiredness. Along the way there seems to have been a mountain of paperwork, most of it simple enough and some most definitely not! Here, again the Team stepped in. When a particular organisation denied receiving my forms a lady from safety net called them on my behalf and miraculously the documents in question were found and processed. I simply could not begin to understand or ‘face’ the D.L.A forms. Support came and used post-it notes. She broke it down into bits that I could manage and together we made a successful application. I have Asperger Syndrome and my overwhelm and fear of being lost in unfamiliar or busy places and my general fear of loss of control was becoming increasingly difficult to manage and so more often than not I was ‘choosing’ to stay home! I asked for a referral to a Mobility Officer, not really sure if this is what I needed. An assessment was carried out – I was still a bit dubious, but it’s very hard, or just arrogant, to argue with 20+ years of experience! It’s not just the cane training, which has already saved me from a couple of minor accidents, but because this training takes over several months, I’ve learned lots of ways to manage – things that are really common sense but because I didn’t really know what was happening I didn’t know what simple things to do to help. Far from my life narrowing into an increasingly limited context, the team enabled me to begin to see that I could continue in my work and in making a real contribution to the wider community. The registration process and Sensory Team have helped me to recognise my sight loss. I have been given the skills to better manage the vision I have, and, also, to continue that management process as my vision continues to deteriorate. I now have a greatly increased confidence, that whilst life may continue to be frustrating and challenging, if I take a breath and think about what I’ve learned then I can deal with it; knowing also, that if at any point I find I cant, then my Safety Net will be there to help me find solutions.


34

Appendix 7: Asian Young Mum group report by Catherine Tynan During the last eighteen months, I received a number of Rehabilitation referrals involving young Asian/Muslim Mums who were finding difficulties in various aspects of baby care. Due to the effects of their visual impairment, and language barriers. These issues ranged from, changing and bathing, measuring baby milk, administering medication, preparing baby meals. The other issues were in relation to choosing a pram system a visually impaired person could manage. Outdoor mobility was a big issue, road safety, whilst managing a pram, crossing a busy road, and route training. Mums need to attend GPs, chemists, clinics etc. Unfortunately there are still problems and stigmas within the Asian community of women going out alone or using some kind of vital mobility aid. These difficult issues are experiences by all young visually impaired Mums, I felt in these cases they could give each other so much support, physically emotionally and culturally. So with their agreement I set a phone support network up. This was purely to get them to contact each other in times of difficulty or isolation which most of them were experiencing. From then on it would be themselves who generated the group. My role would purely be the referrer of other new Mums. The network has been going just about a year. The feedback has been really positive, during phone calls to each other they have been able to arrange socially, accompany one another to clinics/hospital appointments. One Mum said "It's a great support knowing that we are all struggling in one way or another, I have other Mums out there who really understand my difficulties" Another Mum said "I was feeling so cut off from the world, it was just me and my baby all day long, I had no one to talk to, my family are supportive but don't really understand how hard it is to be a Mum with a visual problem" " Now I have people I can turn to and meet up with, I can just be Me!" The Sensory Team have supported each individual Mum by way of an Equipment assessment, information, and financial advice. From a Rehabilitation I personally have trained them through their individual support programme of daily living skills and Mobility. I am sure this group will self generate for future Asian Mums.

Report for Information

Documents