Young Disabled People: Social Care Services

Question

Asked by

To ask His Majesty’s Government what plans they have to address demand for support from young, disabled people and their families, particularly in relation to provision of social care services, as they transition to adulthood.

My Lords, the Government recognise the difficulties that young disabled people and their families can face when they transition into adult social care. This has been a neglected area, which is why the Department of Health and Social Care is now working across government to identify opportunities to better support young people and their families at this crucial stage in their lives. My ministerial colleague, the Minister for Care, Stephen Kinnock, has recently met his counterpart at the Department for Education to discuss how the two departments can make progress on this issue.

My Lords, for many people with learning disabilities, transition into adulthood is purely chronological. Their needs and care requirements remain exactly the same. Parents have described this transition into post-18 services as like jumping off a cliff.

I was approached by the parents of Cameron, a young man with severe learning disabilities. Melanie, his mother, was a nurse for 30 years, and his father, David, was a Royal Marine commando who fought in three wars. Their professional life serving the community and their country has not prepared them for the battle they are facing with Somerset Council to get the right accommodation for their son. Melanie told me that the day he turned 18, all support fell away. Will the Minister accept that these are the same people, with the same condition and the same continuing needs, and that, as part of adult social care reform, there needs to be a separate category for people with learning disabilities, who are so neglected? In this spirit, would His Majesty’s Government consider a Minister for learning disabilities?

I understand and am sympathetic to the points that the noble Baroness makes about Cameron and his family. I listened very closely to the concerns that she raised. As I mentioned in my Answer, we are very aware and absolutely accept that the services are not in the places they need to be. That is why I made the commitment to work closely with the relevant department.

Looking to the future, as recently as November we published what I regard as a very ambitious and wide-ranging whole-system plan, called Keeping Children Safe, Helping Families Thrive. It seeks to break the cycle of crisis intervention and to rebalance the system back towards earlier help for families, which I hope would have been helpful in the situation the noble Baroness describes. All local authorities, including Somerset, have to set out the support available for those with special educational needs and disabilities as they move into adulthood.

My Lords, the duty of local authorities to carry out a transition assessment includes whether the child, or their carer, is likely to have needs for care and support after the child in question becomes 18. In the light of that, what resources and guidance are the Government giving to local authorities about the needs of the carers of those transitioning to adulthood? Does the complexity of this whole issue not indicate the need for care co-ordination?

It certainly does. The noble Baroness has been positive about the plans that we have for the independent commission, led by the noble Baroness, Lady Casey, to resolve once and for all, on a cross-party basis, adult social care. The noble Baroness makes a very good point about the role of carers. Indeed, when we think of a young carer particularly, it is crucial that their needs are considered and that support is given. It is part of the whole way in which we support someone who needs social care, no matter what their age.

My Lords, when the Public Services Committee took evidence on the transitional arrangements for young people with disabilities, we experienced two extremes in that evidence. One was that the transfer from education services to social care services was badly handled in a lot of authorities. As the noble Baroness, Lady Monckton, said, it felt like falling off a cliff, with young people then described as unemployable. The second, which was quite inspiring, was where local authorities had established a local hub where employers could meet these young people. They discovered there things that could benefit both sides, and that the young people blossomed in work. Will the Minister do everything possible to encourage the second?

The noble Lord is correct to reference the committee’s findings. People should not be written off as unable to work. It is about getting the right support in place, with the right provisions and at the right time. I certainly share his view. That is why we are working across government to achieve the very thing that he talks about.

My Lords, I was with someone this morning who has a son at this stage and was told that the earliest time when they could have a transition interview would be December 2026. In the meantime, the only support they are getting is from the local branch of Mencap. As well as co-operation between health and social care, will the Government commit to supporting the voluntary sector, which provides such important services in this regard?

I have direct experience of the value of charities such as Mencap, and I thank it and all the other third sector organisations involved. I agree with my noble friend about the need to incorporate all sectors. That is the only way that we will provide the right provision in a timely fashion.

My Lords, we know it is true not only for this care service but for many health and care services that there is often concern when, upon reaching adulthood, the patient has to move from paediatric care to adult services—we have had a number of debates on that in this House. Often, that can involve a change of medical staff, from a clinician or caseworker who knows the patient to someone who is a stranger, as it were. Can the Minister tell noble Lords what guidance there is for the clinician or the health worker looking after the child, as well as for the clinician who will be looking after the child when they are an adult, whereby they talk to each other to ensure as smooth a transition as possible?

The transition assessment has to cover the whole range of provision, including healthcare, as the noble Lord rightly says. That is already embedded. I refer back to the point of my noble friend: it is indeed true that there are long waiting lists for transition assessments, which is far from ideal. This means that people are suffering from late planning and insufficient support, which we want to put right, no matter where the requirement comes from, whether it is in health, education or employment.

The Minister may recall that, in 2022, the Down Syndrome Act was passed by your Lordships’ House, having been introduced in another place by Sir Liam Fox MP and in this House by my noble friend Lady Hollins. Can the Minister tell us how far we have got in implementing the terms of that Act, especially in helping those with Down syndrome to find employment in the workplace?

It is a good point. I will be pleased to look into it in greater detail and write to the noble Lord.

My Lords, I had not intended to speak but I want to reach out to the noble Baroness, Lady Monckton, as I understand her frustration and why she is upset. I declare an interest as a mother of a child in this situation—he is now an adult, at 46 years old. That is precisely what happened to my family and my son; the service was no longer fit for purpose. There are hundreds and thousands of parents feeling exactly the same angst. Will the Minister’s review therefore build in space for advocacy on behalf of parents in any forward-looking strategy that the Government are considering?

The role of advocacy is extremely important. I take on board what the noble Baroness is saying.