Sensory impairment

For the purposes of this Joint Strategic Needs Assessment (JSNA) the definition of sensory impairment is:

  • deaf people and people with a hearing impairment
  • blind people and people with a visual impairment
  • people with severe sight and hearing loss combined (dual sensory loss/deafblind).

Berkshire Sensory Consortium Service (SCS), hosted by the Royal Borough of Windsor and Maidenhead, provides the specialist educational support for children and young people with sensory impairment in Slough. In addition two schools have Resource provision for deaf students; Foxborough Primary School for deaf pupils requiring sign provision and Langley Academy for secondary pupils primarily learning through the auditory oral route. The local authority special school, Arbour Vale, also makes provision for pupils with sensory impairment and these are additionally supported by contractual arrangements with Berkshire Sensory Consortium Service.

From a social care perspective, services are provided for children and young people (CYP) with a sensory impairment as well as other complex needs or learning difficulties by the Children with Disabilities Team which is part of the integrated Service for Children with Learning Difficulties and Disabilities. This Service comprises social workers, occupational therapists, outreach worker, special educational needs (SEN) case workers, SEN Careers Advisers and a respite care unit. The Service also works closely with the voluntary sector to provide a range of short breaks for CYP without the need for a referral to social care. CYP can receive a joint assessment of their education and care needs through this service and the SCS.

The Children with Disabilities Team provides support for CYP up to the age of 18 years who meet the eligibility threshold. Where CYP do not meet the eligibility threshold they will be provided with information, advice and guidance as appropriate and may have their needs met through Slough’s early help offer. Children and young people who have a sensory impairment but no other difficulties are unlikely to meet the eligibility threshold for this Team.

All known CYP and adults with a sensory impairment are recorded on the Council’s register.

Adult social care has undergone a review of the operating model and staffing structure to implement and embed the personalisation and independence model as a whole and this includes adults with sensory needs. The staffing structure now includes a specific sensory needs officer (in recruitment phase) to compliment the arrangements in place with various organisations that are commissioned to deliver sensory needs care services for the Council these include Optailis and Berkshire County Blind Society.

What do we know?

Vision impairment (VI)

The number of children with VI is increasing which is demonstrated by a steady year on year increase of children registered as blind or partially sighted (Mirty,D Bunce,C.Wormald,R and Bowman,R, 2013). "The number of people in the UK with sight loss is set to increase dramatically. It is predicted that by 2050 the number of people with sight loss in the UK will double to nearly four million" (Access Economics, 2009).

The prevalence of vision impairment is significantly higher in children with learning difficulties than in the overall child population (Emerson, E and Robertson, J, 2011 and RNIB, 2012). Premature birth and low birth weight babies are at risk of underdevelopment of ocular structures, increased risk of squint and Cortical vision impairment (Cotter et al, 2001).

Hearing impairment

There are 35,000 deaf children in England. Around 85% are taught in mainstream schools. Deafness is not a learning disability. With the right help, there is no reason why deaf children can’t do as well as other children. Deaf children are underachieving on a very significant scale across England. They are 43% less likely to get five GCSEs, including English and Maths, at grades A* to C, than all children (NDCS Report "Hands up for Help", April 2011).

Multi-sensory impairment: In Slough there are currently 7 pupils identified in either mainstream placements or in special schools. Comparative data is hard to collect on this very low incidence group because of the extremely and often complex nature of their levels of sight impairment, hearing impairment and often complex additional disabilities.

Data collected by the National Sensory Impairment Partnership (NATSIP) shows that the Berkshire SCS enables good outcomes for pupils with sensory impairment and the Service is highly valued by schools and families working in close partnership with Health.

Social care

Reviews of the services for adults with sensory impairment are currently underway through the Care Group Commissioning function of the Council. This includes services that are purchased on an individual ‘spot purchase’ basis as well as the overall ‘block’ contracts.

The sensory needs officer within Adult Social Care maintains the sensory needs register and issues equipment to people as necessary. Where more complex assessments are called for, these are provided by Optalis which is a service commissioned from Wokingham Borough Council. This can include mobility training and support for deaf/blind people. Slough Borough Council provides information packs and guidance materials to universal services. Berkshire County Blind Society also provides support that include:

  • Ensuring visually impaired people have access to equipment and technology to support and improve their everyday living
  • visiting visually impaired people in their homes to ensure they have the help they need. Supporting a network of clubs in Berkshire
  • training and supporting volunteers for information desks at hospital eye clinics
  • offering a varied programme of social and sporting events
  • supporting young visually impaired people and their families
  • producing newsletters in large print, Braille, USB, CD and audiotape
  • acting as agents for the Talking Books Service and the British Wireless for the Blind Fund.

Children and Young People (CYP) with sensory impairment should have access to good quality education, care and support for their health needs and in order to support community inclusion there is an emphasis on developing local provision in order to meet these needs. This is addressed through a range of good educational provision in Slough, individualised packages of care which can include the option of a direct payment where the CYP has other complex needs, access to support services such as the SCS, speech and language therapy and support for the school staff working with the CYP in schools in Slough. CYP with a sensory impairment may have a Statement of Special Educational Needs if the provision they require costs more than an additional £6k per annum.

Facts, figures, trends

Children and young people

Table 1: Children and young people receiving sensory services in Slough

SCS support 12-13 VI SCS support 12-13 HI Resource school within Berkshire 12-13 VI Resource school within Berkshire 12-13 HI Out of county specialist school 12-13 VI Out of county specialist school 12-13 HI Totals 12-13
50 119 <5 17 <5 <5 191
SCS Pre-school HI SCS Primary HI SCS Secondary HI SCS Pre-school VI SCS Primary VI SCS Secondary VI
31 46 42 17 21 12
Visual impairment - profound Visual impairment - severe Hearing impairment - profound Hearing impairment - severe
12/13 12/13 12/13 12/13
<5 15 <5 5

Source: Sensory Consortium Services Annual Report.

Over the last 10 years there has been significant growth in the number of pupils with severe and profound sensory impairment in Slough. The numbers of these pupils appears to have stabilised over the past two years but there are now a high number of new referrals being balanced by numbers of pupils exiting the authority. This creates significant pressure on services whilst not being seen as a growth need. There are now more pupils requiring a Braille programme than a Sign provision. There has been a significant drive to maintain pupils with sensory impairment in Slough local community schools and the outcomes for these pupils have been good and parents support the placements.

Adults Aged 18+

From the national Projecting Older People Population Information (POPPI) February 2013 and Projecting Adult Needs and Service Information (PANSI) February 2013 data the following number of people are estimated to have a hearing impairment and or a visual impairment in 2012 and the estimated increase in numbers to 2020.

Table 2: Estimated number of adults with sensory impairments

Slough 2012 2020
Total population aged 18 and over predicted to have a moderate or severe hearing impairment 8,562 10,209
Total population aged 18 and over predicted to have a profound hearing impairment 172 219
People aged 18-64 predicted to have a serious visual impairment 59 65
People aged 65-74 predicted to have a moderate or severe visual impairment 1,569 1,870

Source: POPPI/PANSI.

As at September 2013, the Slough Borough Council sensory needs register includes:

  • 390 people with a visual impairment
  • 127 people with a hearing impairment.

Since April 2013, 38 referrals have been made to Optalis for adult social care. Out of this number, 10 people have received mobility training. In addition 32 people with a hearing impairment have been assessed by adult social care.

National and local strategies (current best practices)

The arrangements for providing special education services for children and young people with sensory impairment in the six Berkshire authorities including Slough were highlighted as good practice in the government’s Green Paper of special educational needs. (9 Section 5.48).

In its Hands Up For Help report on specialist support for deaf children, the National Deaf Children’s Society (NDCS) highlighted the Berkshire Sensory Consortium Service as an example of good organisational practice. It urges the government and local authorities to develop similar models throughout the country.

The Summary Report of the Newborn Hearing Screening Programme (NHSP) Risk Assessment and Quality Assurance in Berkshire in September 2012 rated the services for the newborn hearing care pathway which included Quality Standards and Key Performance Indicators as follows:

  • screening: Acceptable standard of service is met
  • audiology: Acceptable standard of service is met
  • medicine: Acceptable standard of service is met
  • early Intervention: Acceptable standard of service is exceeded.

There is also a wide range of government policy, guidance and legislation that is relevant to sensory impairment.

The UK Vision Strategy (RNIB 2013-2018) sets out a framework for the development of eye health and sight loss services to:

  • improve eye health in the UK
  • eliminate avoidable sight loss and deliver excellent services for people with sight loss
  • enhance inclusion, participation and independence for people with sight loss.

Seeing it My Way Action for Blind People (2011) is embedded in the UK Vision Strategy and sets out 10 outcomes, that have been developed by blind and partially sighted people:

  • I have someone to talk to
  • I understand my eye condition and the registration process
  • I can access information
  • I have help to move around the house and to travel outside
  • I can look after myself, my health, my home and my family
  • I can make the best use of the sight I have
  • I am able to communicate and to develop skills for reading
  • I have equal access to education and life long learning
  • I can work and volunteer
  • I can access and receive support when I need it.

What is this telling us?

Education

This is telling us that despite the growth in numbers and severity of needs of CYP with sensory impairment the current strategies and provisions for pupils with sensory impairment are meeting their needs and enabling successful outcomes for the CYP in Slough. Schools in Slough support the placement of pupils with sensory impairment.

Where high needs funding is required, the Service for Children with Learning Disabilities and Difficulties co-ordinates multi-agency statutory assessments and ensures that these are completed within the statutory timeframe and CYP are allocated appropriate provision as quickly as possible.

Care

The Care Commissioning Group team in Slough Borough Council needs to complete its review of the services that are commissioned/provided for adults with sensory impairment to ensure the services are meeting the needs of the growing number of adults who have sensory impairments. With the rise in numbers of CYP with sensory impairment this is likely to result in an increase in the numbers of adults in the future and the growing older population will also increase the number of people with a sensory impairment.

What are the key inequalities?

The decreasing number of Slough CYP requiring sign provision (three in primary) makes it more difficult to meet the needs of these pupils in local authority secondary schools. Their need for a signing peer group has resulted in an alternative placement being more relevant for a pupil and family on occasions.

Families with a deafblind CYP are likely to require significant out of school support such as the provision of an intervenor to access out of school community and leisure activities. Joint assessments between the SCS and Children with Disabilities Team can be undertaken to understand the holistic needs of these CYP in the context of their family.

"Nearly half of blind and partially sighted people feel ‘moderately’ or ‘completely’ cut off from people and things around them." (Douglas, et al, 2006).

Employment

"Two-thirds of registered blind and partially sighted people of working age are not in paid employment." (Douglas, et al, 2006).

Deaf people are far more likely to be unemployed when compared to results of the English Housing Survey. The unemployment rate in the Deaf Community is 12% compared to the national average of 4% and similarly the percentage of those classed as being economically inactive is 15% compared with a national figure of 8% (Research into the Health of Deaf People, SignHealth 2013).

Health

Deaf people have worse than average physical health. The percentage saying their health is Poor or Very Poor is 16% compared to the national average of 6%. Deaf people are four times more likely to have a Visual Impairment, 4% compared to 1% (Research into the Health of Deaf People, SignHealth 2013).

Crucially the mental wellbeing of the Deaf Community is far worse than the national average with 10% of Deaf people having a Psychological or Emotional Condition. (11).

Transition to adulthood

Sensory impairment experienced support from social care is required to support the growing numbers of young people entering the Slough adult community having had successful local education outcomes and developing expectations to enter the adult community and gain employment. This will be considered through the review of commissioned/provided services.

Through the Council’s work on support in to employment, consideration needs to be given to how to support prospective employers and encourage them to recognise the potential of people with sensory impairment as employees. This is something that is increasingly being developed by Voluntary organisations.

What are the unmet needs/service gaps?

Knowledge and understanding in Further Education of support needs of pupils with sensory impairment because of the recent growth of progress in to these provisions. This can be addressed through partnership working with the Further Education colleges.

Slough does not have its own Auditory Oral Primary Resource provision for deaf pupils although this is provided by a school in the Royal Borough Windsor and Maidenhead. The Council and the local schools will consider this need through developing the next Additional Needs Strategy.

Support for prospective employers to develop their understanding of the employability of young people and adults with sensory impairments through the council’s work on support in to employment.

Accessibility of sign interpreters particularly to support leisure opportunities is low and even where funding is available it is not easy to attract people with the right skills. The council will need to consider this within its future commissioning.

Opportunities to support adults with sensory impairment to have good access to leisure and work opportunities should be considered through the review of commissioned services and support in to employment.

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