Gaps in learning disability care

Support for people with learning disabilities in Wales is fragmented, leaving some living far away from their families, according to a new report. The Healthcare Inspectorate Wales (HIW) review said there were major gaps in the system, especially at school leaving age.

Patients should be offered the chance to live near their families, said HIW, which made 27 recommendations in all. About 60,000 people in Wales have some form of learning disability.

The HIW review came in the wake of a 2006 English report which found "significant failings" in learning disability services provided by Cornwall Partnership NHS Trust. Inspectors visited units, wards and residential establishments and discussed care provision with staff, service users, their families and carers.

The HIW found that young adults are often left at a dead end when they left the education system and their families had to struggle for the right support. Concern was also raised about the number of people being placed in residential care far away from home, often at a huge cost to local authorities.

Inspectors found in 60 cases people were placed in residential care across the border in England. Liz Neil, from the charity Mencap Cymru, said this put a huge strain on clients and their families. "It is expensive, it is time consuming, it is difficult to maintain regular and consistent contact. People on the whole lose their friendships."

Mandy Collins of HIW said young people with learning disabilities and their families often felt let down after they left school. "They have been supported through the child sections of life but in adulthood they have to reapply for services," she said.

It is a situation Usha Sarangi and her family found themselves in after her son Rakesh turned 20. Rakesh, who has cerebral palsy and needs constant care, attended a specialist school near the family home in Cardiff until last year. "It was the most difficult and most appalling period of our life as a whole as a family," she said, of the lack of care and support Rakesh received after leaving school. I have never felt trapped and suffocated before, even though we have a disabled boy. It's been the most disabling event."

Care standards were also criticised in the review, which highlighted regional and sector differences in care provision.

A "stagnation" in services for people with learning disabilities was also found. Among the HIW recommendations were to improve the quality and depth of activities and therapies available to people. It also called for more investment in speech and language therapy and better policies to aid a smooth transition for children with a learning disability into adulthood.

HIW chief executive Peter Higson said while there had been improvements, there was still room to get better. "The quality and depth of activities necessary for supporting people to reach their maximum potential differs considerably throughout Wales and we identified 'institutionalised comfort' wherein people are well cared for in terms of fundamentals but lack stimulation," said Dr Higson.