What are they key inequalities?

Compared with non-disabled people, disabled people are:

• more likely to live in poverty - the income of disabled people is, on average, less than half of that earned by non disabled people.
• less likely to have educational qualifications - disabled people are more likely to have no educational qualifications.
• more likely to be economically inactive - only one in two disabled people of working age are currently in employment, compared with four out of five non-disabled people.
• more likely to experience problems with hate crime or harassment - a quarter of all disabled people say that they have experienced hate crime or harassment, and this number rises to 47% of people with mental health conditions;
• more likely to experience problems with housing - nine out of ten families with disabled children have problems with their housing;
• more likely to experience problems with transport - the issue given most often by disabled people as their biggest challenge.

(Improving the life chances of disabled people, Prime Minister's Strategy Unit, 2005)

What are they key gaps in knowledge/services?

It is unclear where Newcastle measures up to with regards to national indicators.  Further data collection work is required to bench-mark services against these indicators.

What are the risks of not delivering our targets?

The National Service Framework for People with Long-Term Conditions (2005) identifies some of the economic impacts associated with disability.

Table 2.2: Costs of high rates of economic inactivity amongst disabled people

Is what we are doing working?

The Adult Social Care Performance for Newcastle upon Tyne for the period 2006/07from the 2007 annual performance assessment (APA) by the CSCI identified a number of areas where social care services are performing to a good standard.  The following were identified as the key strengths of the service:

• Joint working between the council and health partners to promote healthy lifestyles.
• Effective and wide range of programmes that engage people and their carers.
• The provision and support for advocacy services for most people who use services.
• The number of people in receipt of direct payments.
• Disability Equality Scheme published on council's website.
• Arrangements in place to make decisions and agree continuing care and shared care funding arrangements.
• Comprehensive arrangements in place to maximise uptake of benefits.
• Independent provider commissioned to deliver independent mental health capacity advocacy.
• The number of council staff trained in addressing work with vulnerable adults.
• The availability of single rooms.
• Multi agency safeguarding arrangements in place and are embedded.
• Relaunch of adult safeguarding policies.
• The council has set out key challenges for all service user groups which reflects both the national and local agendas and priorities.
• The percentage of staff where ethnicity not stated.
• Appointment of a Director of Adult Social Care.
• Working with key partner agencies and the Acting Director of Public Health to develop strategic commission.
• Joint commissioning arrangements involve the PCT, housing, people who use services and their carers.
• Priorities are linked to the councils Regeneration Strategy and the Local Area Agreement and drawn up in consultation with service user groups.
• More robust and frequent financial monitoring meetings and systems.

The following areas have been identified as requiring improvement:

• The development of self assessments.
• The full implementation of the Single Assessment Process (SAP and eSAP).
• Full implementation of the 5 equality standards for local government.
• Continue to improve recording of adult safeguarding referral patterns and completion rates.
• Appointment of permanent senior management team.
• Ongoing planning with the residential sector to introduce new methodologies to monitor physical environment and quality outcomes in registered provision.

The feedback from various service user consultations has been generally positive.  However certain aspects regarding obtaining information and contacting social services have been less positive:

• Social Services provides me with all the information I need? A quarter (27%; 55) either disagreed (21%; 43) or strongly disagreed (6%; 12) with the statement.
• I can always contact Social Services easily if I need to. 14% (28) either disagreed (7%; 19) or strongly disagreed (4%; 9) with the statement.
• Do you know how to make a complaint about Social Services? 7% (15) of these respondents said that although they knew they felt they could not complain if they wanted to. Another third (32%; 68) said they did not know how to complain.

Further negative feedback has been noted with regards to equipment:

• Social Services have provided me with the adaptations and equipment that I need. 19% (34) either disagreed (12%; 22) or strongly disagreed (7% 12) with the statement
• The majority (83%) of respondents said that they had not had problems whilst they were waiting for their equipment. However, some respondents commented that they had faced serious problems because of the waiting period. In particular, difficulties in bathing and severely limited mobility whilst waiting were mentioned, for example:
• Follow-up after equipment has been received: A relatively high percentage of respondents, 30%, said that they had not been contacted after they received their equipment to see if everything was okay.
• Several respondents did not seem to be clear about who had provided their equipment - whether it was Newcastle Adult Services or Newcastle PCT - and about how to contact them.

However:

• 94% were satisfied with the overall service they had received.
• 95% said that the equipment / minor adaptation they had received had made the quality  their life either much better or a little better (PAF indicator D83).
• 95% of people surveyed in 2004 felt that their lives would be a lot worse without help from Social Services.

What is coming on the horizon?

The Action Plan for Physical Disabilities 2008-2009 is in the process of being implemented.  Within this programme are the following three main work-streams:

• Implement 3 new training programmes to increase uptake of Direct Payments and sustain existing packages.
• Devise and implement robust infrastructure to increase uptake of Independent Living Fund (ILF) monies and sustain existing funding agreements.
• Implement new outcome of independence in travel for service users with long-term conditions as part of assessment and care-planning process.

What should we be doing next?

• There is the need for a programme of data collection to ensure that Newcastle is achieving national targets regarding a range of services for people with physical disabilities.
• In consultation with service users the problem of communication arose. There should be a dedicated work programme to rectify any issues around communication. Further work is required to ensure all service users are appropriately informed.