PEOPLE WITH DUAL SENSORY LOSS
ADULT SERVICES DEPARTMENTAL PROCEDURE NO:
13/11
Services for People with Dual Sensory Loss
DATE:
1 April 2011
EFFECTIVE
DATE:
1 April 2011
CATEGORY:
General
KEYWORDS:
Dual Sensory Loss, Deafblind
ISSUED BY:
CONTACT:
PROCEDURES
CANCELLED
OR AMENDED:
35/00 Deafblind Services
REMARKS:
SIGNED:
DESIGNATION:
YOU SHOULD ENSURE THAT:
You read, understand and, where appropriate, act on this information

All people in your workplace who need to know see this procedure

This document is available in a place to which all staff members in your workplace have
access
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PEOPLE WITH DUAL SENSORY LOSS
PURPOSE
It is essential that the department provides good quality, consistent and supporting services to people
who are Deafblind or have a Dual Sensory Loss. This procedure outlines what services should be
provided to people in this client group.
SCOPE
All staff, who are responsible for services supporting people who are Deafblind or those with a Dual
Sensory Loss.
All Adult Services line managers have the responsibility to ensure staff are aware of and following
these departmental procedures.
POLICY
To ensure that specialist services are available to meet the specific needs that arise from being
Deafblind or having a Dual Sensory Loss and that all services must recognise the needs of this client
group and deliver services of an equal standard.
REFERENCES TO LEGAL, CENTRAL GOVERNMENT AND OTHER EXTERNAL DOCUMENTS,
INCLUDING RESEARCH
Local Authorities Social Services Act 1970 section 7 Guidance (re-issued 2009)
National Assistance Act 1948
Chronically Sick and disabled Person Act 1970
National Health Service and Community Care Act 1990
Disability Discrimination Act 1995 & 2005
Equalities Act 2010
HAMPSHIRE COUNTY COUNCIL AND ADULT SERVICES DEPARTMENT REFERENCES
None
DEFINITIONS
Client
A member of the public for whom we are providing
services
Deafblind / Dual
Sensory Loss
These terms can be used interchangeably
SWIFT/ AIS
PARIS
Social care records system
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ROLES
All managers are responsible for supporting their staff to work within this procedure.
AUTHORITY TO VARY THE PROCEDURE
Assistant Director older people/ physical disability HCC
Senior Manager Independent Living Services PCC
SCC to be confirmed
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Contents
1
Introduction
2
Departmental Approach
3
Identification and Contact
4
Referral Pathways and Assessment
5.
Service Provision and One-to One human support
6.
Information access
7.
Senior Management
1. Introduction
1.1. Deafblind people (Db) and people with a Dual Sensory Loss (DSL) have individual needs as
varied as any other in the community. It should be assumed that they will need access to the
full range of available services.
1.2. All the client groups included in this document are covered by Disability Discrimination and
equalities legislation and therefore consideration to their needs must be included in all areas,
e.g. access to buildings, goods and services, information and accommodation, etc.
The Need for this Tri-partite Agreement.
1.3. The number of people who have significant sight and hearing impairment ie Deafblind or
Dual sensory loss is relatively small compared to the national population but require highly
specialised services. It is therefore, a challenge for Departments to recognise and develop
the skills and abilities of these groups of people through education, training, employment and
leisure. This is a small and highly specialised field of work and therefore it seems appropriate
to develop a strategy with neighbouring local authorities to ensure cost effective and dynamic
service delivery. In order to ensure effective implementation of this policy it is beneficial and
cost-effective for Hampshire, Portsmouth and Southampton authorities to jointly agree
service standards, commit to achieving parity and pool specialist resources across the three
authorities from the outset.
1.4. Hampshire County Council, Portsmouth City Council and Southampton City Council have a
duty under Section 7 of the Local Authority Social Services Act 1970 amended by LAC (DH)
(2009)6 to assess and meet the needs of Deafblind people and those with Dual Sensory
Loss living within their catchment areas.
1.5. Please see the Department of Health link below for Local Authority responsibility to
Deafblind people under Section
.http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/LocalAuthorityCircular
s/DH_101114
2. Departmental approach to Deafblind / Dual Sensory Loss
2.1. The deafblind guidance, Section 7 sets out a number of duties which authorities must
consider within their service planning. These duties include the following;
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
To identify, make contact and keep a record of Deafblind people in their catchment areas,
including those with multiple disabilities and a dual sensory impairment.

To ensure that when an assessment is requires or requested, it is carried out by a specifically
trained person or team, equipped to assess the needs of a Deafblind person – in particular to
assess the need for one-to-one human contact, assistive technology and rehabilitation.

To ensure that appropriate services are provided to Deafblind people, who are not necessarily
able to benefit from mainstream services or those services aimed at blind people or deaf
people who are able to rely on their other senses.

To ensure that Deafblind people are able to access a specifically trained one-to-one support
worker for those people assessed as requiring one.

To provide information about services in formats and through methods that are accessible to
Deafblind people and or their families and carers.
2.2. Deafblind people or people with a Dual Sensory Loss have a right to access all services.
They are most at risk of isolation. Adult Services need to be pro-active in identifying,
assessing and meeting their needs.
2.3. Although the onset and degree of loss will vary from individual to individual, four main groups
of Deafblind and Dual Sensory Loss can be identified. See Identification and Contact below.
3. Identification and Contact
3.1. It is recognised by Adult Services that they need to be pro-active in their approach to
identifying and making contact with service users. Therefore, it is important to note that all
Adult Service staff, who assess the needs of vulnerable people, have a duty to identify
Deafblind people or those who have a dual sensory impairment to refer on to specialist
provision. Furthermore, Adult Services will actively seek to work with its’ strategic partners
and colleagues in Health, the Voluntary Sectors including, community groups, other Local
Authorities and private providers to ensure that referral pathways are readily accessible and
will actively seek to raise the awareness of the issues relating to Deafblindness and Dual
Sensory loss.
3.2. To ensure more effective identification and contact with Deafblind people it is useful to
recognise the needs of different groups within this part of our community. Although the onset
and degree of impairment will vary from individual to individual, four main groups of people
experiencing Deafblindness or Dual Sensory Loss can be identified.
3.2.1.

It is recognised that people in this group will have profound communication deficits and
that receiving communication in the conventional sense is very likely not to be possible. It
is therefore, important that family, carers and other professionals both within the local
authority, including the education service, Health professionals and the wider community
have clear access to specialist services.
3.2.2.

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Those who are hearing and sight impaired from birth or early childhood;
Those blind from birth or early childhood who subsequently acquire a hearing loss
that has a significant functional impact.
It recognised that although this population is likely to be relatively small in number, it is
most likely that these individuals have developed language skills. In this instance it is very
important that both strategic and operational relationships with Health partners are
actively established and developed to ensure maximum chance of referral to specialist
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sensory services.
3.2.3.
Those who are deaf from birth or early childhood who subsequently acquire a
significant visual loss;

This population may also include people who are; Deaf, deafened, or hard of hearing
people whose preferred method of communication is speech / lip-reading, British Sign
Language or Sign Supported English and who are now losing their sight.This group will
include people with Ushers Syndrome, a genetic condition which gives rise to the
predominant cause of adolescent deafblindness. This group of individuals are likely to
have sign language skills as their primary communication strategy.

However, it is important to recognise that this group can include people who do not use
sign language, as in the case of those who have had a cochlea implant. With advancing
technology this is more likely to be the case in future years.
3.2.4.

Those who acquire a hearing and sight impairment later in life, that has a significant
functional impact.
It is readily acknowledged that this population will constitute the majority of people
presenting with a Dual sensory loss. In this instance, it is important to ensure that other
presenting issues related to ageing do not eclipse the significance of such sensory
impairments.
3.3. Whilst the above categories are useful for conceptualising the presenting needs of the
majority of people who are Deafblind or a Dual Sensory Loss, it is useful to recognise that
not all people with such sensory needs fall readily into such categories.
3.4. Further acknowledgement needs to be given to the psychological and emotional impact
deafblindness has both in terms of development and well being. This impact must also be
prevented from being overshadowed by other needs.
3.5. Close and effective working partnerships with Learning Disability Teams, Mental Health and
others will make a significant contribution towards mitigating against this occurrence.
Note; People who have Ushers Syndrome often see themselves as a separate group, but for the
purposes of this document are acknowledged within the above groups.
3.6. Staff within Adult Services must be aware of the range of communication needs of Deafblind
people and those with a Dual Sensory Loss including:

Visual i.e. use of large print or other appropriate print, magnifiers for reading, writing, use of
sign language (visual frame)and Lip reading and or the exploration of other possible
channels through which to communicate.

Aural / oral i.e. use of speech, translation of written material into the spoken word.Tactile and
other strategies i.e. Braille, Moon, Hands On and Hands Over Hands Signing, Deafblind
manual, Canaan Barrie, hands on body, Tadoma, Block or Spartan etc.

Guide Communicators/ Intervenors are individuals trained specifically to work with the
communication needs of Deafblind People. Guide Communicators main function is to enable
an individual to effectively move around the built environment and provide tactile or visual
language support. In the case of Intervenours, these people are neither carers or translators,
but conduits enabling the Deafblind individual to communicate and experience their
environment.
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3.7. It is important to note that people’s communication methods are not strictly related to one
identified group. Many people use a variety of communication methods depending on
personal circumstances such as time of day, task at hand, etc. It is however, important to
note that a persons chosen communication method may be different between expressive
and receptive communication.
3.8. it is essential that Deafblind people and those with a Dual Sensory Loss are afforded the
opportunity to be registered appropriately and recorded on the Adult Services database. It is
however, important to appreciate that such registration is voluntary and not mandatory.
3.9. In the case of children who are the responsibility of Hampshire County Council, there are
established eligibility criteria to access services from that department. The link below takes
the reader to that information.
http://www3.hants.gov.uk/childrens-services/specialneeds/aiminghigh/eligibilitycriteria.htm
3.10. In the case of children who are the responsibility of Hampshire County Council and are
approaching the transition from children to adult services, the link below provides further
information.
http://www3.hants.gov.uk/adult-services/aboutas/departmental-proceduresmain/chronological-procedures/transition-young-disabled-people.htm
3.11. Sensory Services and Transitions Team will ensure that cases which have specific sensory
needs are hi-lighted and appropriately managed. Within the context of this policy, it is
expected that those professionals working with children and operating within the scope of
the Local Authority, will be active in making timely transitional referrals to Adult Services.
4. Referral Pathways to Specialist Provision for Assessment.
4.1. The Ophthalmologist (eye consultant with in a health setting) may make a general referral to
Adult Services Sensory Teams, to complete registration, for someone with a sight loss,
which is recorded on a Certificate of Visual Impairment (CVI is the certificate of eligibility for
inclusion on the sight loss register). A CVI can only be issued by a consultant
Ophthalmologist and with the consent of the patient.
4.2. The hearing consultant at hospital (Audiologist) may often make a similar referral to Adult
Services Sensory Teams after a person has had a hearing test.
4.3. Adult Services may have Sensory workers located within Audiology and or Ophthalmology
department with acute hospitals where this is the case, the post holders will be trained to the
(CACDP Signature Level 2) qualifications. Also as a result of increasing numbers of people
presenting with acquired Dual Sensory Loss, Adult Service departments will, through
induction training, raise staff awareness of the full range of sensory impairments. Where
there are no local authority staff in Health settings, partnerships between Adult Services and
the Third sector will need to be developed.
4.4. Referrals can also be made by other Adult Services teams (Care Managers, Deaf services,
Occupational Therapy, Community Innovations, Community Response Teams) or other
Professionals (GPs based at health centres, Rapid Assessment Teams or high street
Optometrists).
4.5. People with a Dual sensory loss may also refer themselves or be referred by family,
neighbours and friends. The starting point for these referrals can be made Hampshire
County Councils’ Hantsdirect, Portsmouth City Councils’ Helpdesk and Southampton City
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Council.
Hantsdirect 0845 603 5630
Portsmouth City Council Helpdesk 02392 680810 dsssensoryimpairmentteamduty@pcc.gov.uk
Southampton City Council 02380 833025
Sensory.services@southampton.gov.uk
4.6. Where referrals are received without a Certificate of Visual Impairment then a screening will
be undertaken in order to prioritise the referral and allocate to a sensory worker. Any
information gathered at this point will be recorded on Adult Services database. In the event
that a referee has not obtained a medical diagnosis, they will be advised to meet with their
General Practitioner
4.7. Using all of the information gathered to date the clients needs will be prioritised using current
departmental criteria . Client casework will then be allocated to a practitioner, who will
undertake an Specialist Assessment of Needs. If the client has specific communication
needs, such as British Sign Language (BSL) , the case can be jointly co-worked with an
appropriately trained practitioner. In the event that this is not possible and where a
practitioner does not have the relevant communication skills, an external specific
communication language support professional may be provided. which can be met from
within Adult Services practitioners, the case can be jointly co-worked. In the case of
Hampshire County Council See policy 24/7.
4.8. The sensory assessment will identify needs arising from issues related to; daily living skills,
access to information, communication and the need to mobilise within the environment.
Details of these assessment outcomes will be shared with and signed by the client and
recorded on the Adult Services database.
4.9. The sensory support and or equipment identified and provided at this time, are recorded in
the assessment framework within Adult Services. Where further re-ablement planning is
required, this will be carried out by an appropriately trained member of staff. In addition and
in collaboration with Care Management expertise, any long term assessed needs will be met
through the Self Directed Support pathway,
4.10. If no further re-ablement needs are required, the Sensory worker will arrange for the
assessed, eligible equipment and its associated demonstration of usage, to be supplied.
Services and or equipment may either be provided directly by Adult Services departments or
indirectly via other providers.
4.11. The Sensory worker will undertake a review by, a face to face visit, phone or letter to the
client and or their representative, to ensure that services and / or equipment have been
delivered, fitted, training given, and have met the assessed needs. When the assessed
needs have been met an evaluation form, in the appropriate format, will be sent to the
Service User. The Service User or their representative will be informed to contact Sensory
Services in the future should their needs change.
5.
Service Provision and one to one human support.
5.1. All aspects of service provision must be undertaken by appropriately qualified people. This
includes SIGNATURE level 2 or equivalent to undertake Deafblind assessment.link to
CACDP qualifications. Level 2
http://www.signature.org.uk/documents/qualifications/qualificationspecs/DBC2QualSpec10-11.pdf
5.2. Where mobility training is required, Deafblind re-ablement will be undertaken by a staff
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member or an external provider, who are ROVI trained, who also has the above training and
has completed further hearing loss rehabilitation training. Joint working with other
professionals and organisations is essential. It is the intention of the authorities to have the
following sensory staff levels trained to the above standard:
Hampshire County Council 100%
Portsmouth City Council 100%
Southampton City Council 100%
5.3. All services for Deafblind people and with a Dual Sensory Loss take into account their
communication, access to information and mobility needs. All assessments are carried out
using the preferred communication mode of the service user. If Care Managers/Specialist
workers do not possess these skills, then appropriately qualified interpreters and or
communication support works may need to be commissioned.
5.4. Staff are supported and encouraged to attend specialist training, within the range provided
by Adult Services departments. Within Hampshire County Council, a training plan to up-skill
all sensory staff to be able to undertake a Deafblind Dual loss assessment is in progress..
This plan, because it needs to meet the special nature of Deafblind and Dual sensory loss
people, has been shared with other neighbouring authorities. Deafblind people their families
and carer are encouraged to participate in any future policy and services developments.
5.5. Deafblind and people and those with a Dual Sensory Loss who are from ethnic minority
groups may also have additional communication language needs. In this instance additional
language support professionals may need to be commissioned. However, it is
acknowledged that even with a highly flexible approach to language and communication
support, there may be instances where such a strategy might not meet the need alone.
5.6. Specifically trained One-to-One support workers can be accessed via the Community Care
budget and Self Directed Support processes. The sensory worker will either support this
themselves or support the service User and the Care Manager through this process.
6. Information Access
6.1. Accessible information will be provided as necessary for Service Users and their
families/carers. Staff will also have access to a range of language professionals as
mentioned above.
7. Senior Management.
7.1. Each authority will have a member of the senior management team who has overall strategic
and operational responsibility for Deafblind and Dual Loss services within their portfolio.
Hampshire County Council: Ruth Dixon
Portsmouth City Council:
Carole Wooding Senior Manager for Independent Living Services
Southampton City Council: TBA
End.
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