Learning Disability Pages within the Joint
Strategic Needs Assessment (JSNA)
JSNA
A JSNA is a report with information about the people
of Devon. The JSNA will improve the way
information on people’s needs is used to inform
service planning.
A person with a learning disability is usually defined
as having
 Difficulty in understanding new or complex
information
 have difficulty learning new skills
 have difficulty in being able to cope
independently
 these difficulties would have started before
someone becomes an adult and effect a
persons development.
All these things may be correct but they focus on the
things people with learning disabilities can not do,
and the support they need.
This had led to adults with learning disabilities not
being recognised for what they can do and are now
an undervalued and disadvantaged group of people
within our society.
People with learning disabilities are People First,
and have the same rights and responsibilities in
society as everyone else.
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This change has been led by the government
through the white paper Valuing People (2001)i and
the refresh Valuing People Now (2009).
The Government White Paper, Valuing People
(2001) and Valuing People Now (2009) is a strategy
to improve the lives of people with learning
disabilities and their families.
The other big change universal services need to be
mindful of is the Mental Capacity Act (2005).
The Mental Capacity Act (MCA) is the law which
gives protection and support for people aged 16
years and over, who can not make decisions for
themselves.
There are 5 key points.
 A person must be assumed to have capacity
unless it is established that they lack capacity
 a person is not to be treated as unable to make
a decision unless all practicable steps to help
him to do so have been taken without success.
 A person is not to be treated as unable to make
a decision just because they make an unwise
decision.
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 An act done, or decision made, on behalf of a
person who lacks capacity must be done, in his
best interests.
.
 Before the act is done, or the decision is made,
regard must be had as to whether the aim can
be effectively achieved in a way that is less
restrictive of the person’s rights and freedom of
action.
 Evidence of lack of capacity from one decision
making process, for the individual, cannot be
used to justify a best interest meeting for a
different decision.
The responsibility is now on everyone, including
professionals, to make sure they can evidence they
are making every attempt to engage the person in
their own decision making before proceeding to
make Best Interest decisions for an individual
Growth in the population
It is estimated that there are about 15,000 people
with learning disabilities in Devon.
Most of these have a mild learning disability and get
on with their lives without receiving statutory
support.
Some of these people may still be excluded from
having equal access to universal services because
of communication issues.
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There are about 3,100 adults with
disabilities registered with GP practices.
learning
Devon County Council supports about 2,100 people
with learning disabilities with social care services.
The total population of people with a learning
disability is growing and more people are using
more accessible universal services to support
themselves, like employment and leisure services
but;
The number of people needing specialist support
because they have additional disabilities or more
complex needs is growing each year.
The chart below shows what the increase may be in
the future.
2010
266
Profound and
Multiple Learning
Disability
2,409 Moderate or
Severe Learning Disability
10,752 with a Learning
2025
+30%
+6%
2,550 Moderate or
Severe Learning Disability
+3%
11,117 with a Learning
Disability
445,000 people aged
18-64 in Devon
347
Profound and
Multiple Learning
Disability
Disability
+3%
458,500 people aged 18-64 in Devon
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What are the needs of the population?
Valuing People Now (2009) talks about 5 key areas
that will make a real difference to people’s lives.




Personalisation
Better Health
Housing
How people spend their time, including paid
work and leisure.
 Making sure that change happen (with more
effective Partnership Boards)
There are currently 4 key strategic priorities taken
from the list above that are being worked on by the
Devon Learning Disability Health and Social Care
Partnership and Partnership Board over the next
year. These are;




Better Health
Employment
Housing
Hate/Mate crime
1. Better Health
People with learning disabilities have higher health
needs and are more likely to die at a younger age.
It has been found that there needs to be changes in
all areas of health intervention, including access to
screening programmes.
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This will help people take responsibility for keeping
themselves healthy, understand and be involved in
decisions about their health needs.
The Disabilities Rights Commission (DRC) and
others, use the words “Diagnostic over shadowing”
to explain when healthcare professionals put
someone’s health symptoms down to their learning
disability. This means that their illness may be
overlooked and not investigated properly.
People with learning disabilities do have greater
health needs than the general population.
 People with learning disabilities are more
likely to suffer from epilepsy than the general
population.
 People with learning disabilities are more
likely to have sight problems than the general
population.
 40%, Nearly half, of people with learning
disabilities are reported to have hearing
problems.
 People with Down’s Syndrome have a higher
risk of losing their sight and hearing.
 People with learning disabilities are more
likely to be obese (be very overweight) than
the general population.
 People with learning disabilities are much
more likely to be obese than the general
population. The high level of overweight
status amongst persons with learning
disabilities is likely to be associated with an
increased risk of diabetes
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 People with learning disabilities are more at
risk of having mental health problems.
 Psychiatric disorders are a lot higher among
adults whose learning disabilities are
identified by GPs, when compared to general
population rates.
 People with learning disabilities who are over
65 are more likely to suffer from dementia
that the general population.
 People with Down’s Syndrome have a higher
risk of getting dementia.
 People with Down’s Syndrome are more likely
to get dementia at a younger age than the
general population.
 People with learning disabilities are 58 times
more likely to die before the age of 50 than
the general population and 4 times more
likely to have a preventable cause of death.
People with learning disabilities do have greater
health needs than the general population;
 People with learning disabilities are at a higher
risk of mental health problems. The prevalence
of psychiatric disorders is significantly higher
among adults whose learning disabilities are
identified by GPs, when compared to general
population rates.
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To make sure there is good treatment for an illness,
health needs must be met by people with learning
disabilities accessing mainstream primary and
secondary health services.
If it is needed, reasonable adjustment should be
made for a persons learning disability, to enable
them to access mainstream primary and secondary
health services, for example, a person may need a
longer appointment or information in an accessible
format.
To support people with learning disabilities to keep
healthy, they should have access to regular good
information and support to help make this happen.
This means that we need to increase the level of
knowledge amongst the people who provide support
to people with learning disabilities as well as to the
person themselves.
To ensure a good standard of treatment for an
illness, those health needs must be met within
primary and secondary health services with
reasonable adjustments being made to
accommodate the person’s needs around their
learning disability.
Some reasonable adjustments such as increasing
the methods of explanation of a procedure would
support a lot of people and others would need to be
for individuals.
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There is evidence, nationally and locally, that people
with learning disabilities do not have equal access to
mainstream health services in respect of general
health promotion, disease prevention, screening or
treatment.
If some services are not yet able to adjust on site to
support certain individuals, then their reasonable
adjustments may be to access specialist provision
off-site.
2. Employment
In England?
 Less than 10% of people with a learning
disability are in employment.
 48% of people with disabilities are in
employment.
 70% of the general population are in
employment.
In Devon
 5.5% of people with a learning disability are in
employment.
 73% of the general population are in
employment.
Until recently, there was no expectation that people
with a learning disability should work.
Evidence shows that people with a learning
disability are most likely to get and keep a job if they
receive the right support and learn how to do a job
in the work place.
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Job Centre Plus have a pathway into work for
people who get out of work benefits.
Work is being done to help the Work Programme
providers to be able to provide a pathway into work
for people with a learning disability.
3. Housing
Before Valuing People, most people with a learning
disability lived with their families or in residential
accommodation.
Since 2001, in Devon some people with learning
disabilities have been able to buy their own home
through shared ownership shemes or get tenancies
for private rented or housing association homes.
There are 2 key things that need to be done;
1. increase the range of housing options
available
2. increase accessibility to universal housing
systems used by the general population.
There is more information about housing in the
Accommodation and Support JSNA.
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4. Hate and Mate crime
Hate crime is when someone is abused because of
their race or because they have a disability.
Mate crime is where a person is befriended so an
abuse can happen, this can be financial, sexual or
physical.
It is difficult to know if there are more hate or mate
crimes than before.
There is lots of work being done by voluntary and
private organisations to encourage and support
people to report hate and mate crime
Work is also being done with people with learning
disabilities and their carers to raise awareness about
hate crime.
What works
Increasing the awareness of people with a learning
disability and those who support them on a day to
day basis.
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Involvement of people with learning disabilities and
family carers in training into accessing and checking
of universal systems.
Access to a specialist advisor that has a good
understanding of the needs of people with a learning
disability and a good understanding of the universal
system or service that is trying to make the
reasonable adjustment for people with learning
disabilities.
Implementing the Mental Capacity Act
Regular contact with a person and their support
network to identify any difficulties earlier, like annual
health checks.
What is currently being done in Devon?
Liaison Nurses in GP surgeries and district
hospitals
Learning Disability Awareness sessions – training
and supporting better work with individuals
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Individuals’ and carers campaigns
Completing self assessments to see how we are
getting on, for example from Valuing People Support
Team and the Strategic Health Authority.
Widening out the remit of Devon Housing Options to
enable a range of shared housing tenancy
arrangements to be advertised with other rental
arrangements
Finding out how the specialist health services for
people with a learning disability can be changed to
support people with learning disabilities to access
main stream services to give better health
outcomes.
Working with Job Centre Plus to help the Work
Programme to give better employment outcomes for
people.
Find ways of supporting people with a learning
disability to report hate crime and protect
themselves from being victims of mate crime.
There is more information on current and planned
activities in Devon written in the Devon Learning
Disability Joint Commissioning Strategy, which is
currently being updated.
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Recommendations for commissioning
Increasing the range of support options available to
people with a learning disability both within;




employment
their own homes,
their health needs
when they are a victim of a crime.
Make sure people with a learning disability
have better information about how to take
responsibility for their own health and
safety.
Carry on building partnership relationships
with universal systems that are accessed or
should be accessed by people with a
learning disability
Increase the knowledge of different
methods of communication available to
make sure that people are enabled to make
decisions in all areas of their lives, to speak
out when the support they need is not
provided or abuse occurs.
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