Services for people with sight or hearing difficulties

See Hear Summary Report

Introduction

Sensory impairment refers to people with hearing and sight difficulties. In the UK 11 million people will experience some form of hearing loss, two million people are living with sight loss and around 250, 000 people have a dual sensory impairment (Deafblind). Between 15, 000-24, 000 people use sign language as their first language. Demographic changes within the population mean that the number of people with hearing loss will rise to 15.6 million by 2035 and the number of people with sight loss will double by 2050.

In Scotland, sensory impairment affects 150,000 (significant sight loss), 850,000 (hearing loss) and 5000 (Deafblind) people. It has been estimated that these numbers will double in the next 15 years for those with sight loss and by 50% for those with hearing loss in the next 20 years.

Sight and hearing (as well as dual sensory impairments) have been found to have an adverse effect on psychological well-being, self- esteem, interpersonal relationships and functioning, loneliness, mood, general well-being and quality of life, as well as other physical health issues.

Employment and participation in community activities such as social clubs and leisure activities helps to overcome feelings of social isolation, and improves quality of life, life satisfaction and the achievement of life goals.

When delivered in a way that is sensitive to the needs of people with sensory impairment, services such as health, leisure and transport can make a significant contribution to the quality of life, physical health and psychosocial adaptation of people with a sensory impairment.

The See Hear Framework (Scottish Government 2013) is a strategic framework that promotes a seamless multi-agency provision of assessment, care and support to people with a sensory impairment.

North Lanarkshire Health and Social Care Partnership (HSCP) and South Lanarkshire HSCP, along with specific Third Sector organisations are in the process of planning how to take forward the recommendations made in See Hear. In order to facilitate this planning both HSCPs (together with other agencies) sought to gather information from people experiencing a sensory (or dual sensory) impairment relating to the lived experience of sensory loss. This was with a view to identifying gaps in service provision and areas of good practice. This information will be analysed and used to inform decisions regarding service developments and to prioritise service provision in relation to the See Hear Framework.

It was decided to carry out a small piece of independent research using a combination of interviews, focus groups and surveys to gain people’s experience of living with a sensory impairment across Lanarkshire. This is briefly outlined below.

Research aims

To develop an understanding of the lived experience of having a sensory impairment in relation to well-being and access to services.
Identify gaps in service provision for people with a sensory impairment in North and South Lanarkshire.
To identify areas of helpful and effective practice and service provision for people with a sensory impairment.
To identify priority areas for service development regarding the See Hear Framework.
Obtain a baseline measure of the well-being of people that experience a sensory impairment in North and South Lanarkshire.

Method

A project group was established to take forward the research, which comprised of representatives from the University of the West of Scotland and colleagues from both HSCPs.

A mixed methods approach (as detailed above) was used and included:

An on-line survey regarding demographic characteristics and well- being was conducted from the population of the people with a sensory impairment living within the boundaries of North and South Lanarkshire. The data provided a baseline measure of well-being and was used to determine the level of need within North and South Lanarkshire.
Six focus groups comprising of a maximum of six people were established and facilitated. Those people taking part all identified themselves as having a sensory impairment. A few were carers. Individual interviews were offered to those people who felt they could not attend the groups.

Semi-structured prompt group questions based on key themes that underpin the See Hear Framework and the study were used as an approach to generate discussion.

At the end of each focus group participants were asked to make a list of recommendations for service design, then prioritise five from the list. The group meetings were also audio-recorded on a laptop computer (encryption). The data was transcribed and analysed using thematic content analysis. Key themes were identified and used to form the basis of this report.

Findings

Results focus on mental well-being, gaps in services and good practice points. As with all research, there are limitations with what can be drawn from the findings and though a concerted effort was made to reach children and younger people experiencing a sensory impairment, it is acknowledged that further, dedicated research needs to be undertaken in this area.

The lived experience of sensory loss

A total of sixty three participants were involved in the study and five themes emerged from the data: awareness, communication, physical access, social isolation and adaptation to sensory impairment. Each theme was further divided into sub themes, for example, communication included external support, contact with local Council services, emergency services and information in appropriate formats.

Wellbeing

The majority of people completing the survey (71%) reported an average range of well-being, 14.5% reported lower than average well-being and the remaining 14.5% reported above average well-being. Women within the survey were more likely to report significantly higher levels of mental wellbeing than males and participants with mild to moderate hearing loss also reported significantly better mental wellbeing than those with severe or profound hearing loss. There were no significant differences in wellbeing between people with a hearing impairment, people with a visual impairment and people with a dual sensory impairment.

Gaps in service provision

The ability of front-line staff in Councils and NHS facilities to communicate appropriately with people with sensory impairment is limited. Receiving healthcare related information in inaccessible and inappropriate formats prevented people from accessing important results, for example, test results from health checks. The lack of working loop systems in public buildings as well as a lack of specialised accessible toilets for those with a sensory impairment and complex health needs were reported.

Good practice

A number of good practice examples are highlighted throughout the report. Visibility Scotland and PAMIS (an organisation supporting people with profound and multiple learning disabilities and their carers) were commended as being effective at promoting and facilitating leisure and support services, which impacted positively on people with a sensory impairment and carers who have had contact with them.

Twenty recommendations are listed at the end of the report offering a prioritised list of areas for service provision. Key recommendations include awareness training for frontline staff, investment in training for Guides, increasing the flexibility of booking times for Guides, increasing the availability of on-call Interpreters in hospitals and the development of local activities and groups for sensory impaired children.

Concluding comments

This joint project sought to explore the lived experience of people with a sensory impairment in North and South Lanarkshire. Although a number of gaps in service provision were identified good practice was also evident. Participants spoke about gaps in service provision but also more widely of their ‘lived experience’, of difficulties accessing private sector facilities, of issues in relation to their emotional wellbeing and how this impacts on their ability to be active citizens within their own communities and so on. Many of the findings do not relate to new issues, but they do provide up-to-date evidence on the current needs of sensory impaired individuals. The themes that emerged from focus groups and interviews are consistent with those found in the literature and are closely linked with awareness, communication, physical access, social isolation and adaptation to sensory impairment. If the proposed recommendations are enacted this may help to provide the necessary improvements in communication, access to services, overcoming social isolation and enhancing adaptation and awareness. Consequently, these improvements will improve the quality of life, physical and psychological wellbeing of people that experience a sensory impairment across Lanarkshire.

Recommendations

Prioritised recommendations are listed below:

Provide basic sensory awareness training for public servants and frontline NHS and Council staff (for example: via LearnPro (online) modules). This could be further developed to include progressively more advanced awareness training for staff
Invest in training for Guides and Interpreters to a minimum standard of Level 3
Increase the flexibility of booking times for Guides, (for example: book same day)
Provide on-call Interpreters in hospitals, especially in Accident and Emergency
Liaise with the NHS to consider the format of communication for people with a sensory or dual sensory impairment, when issuing appointments/results from tests
Liaise with the NHS to introduce a password protected service to access personal information/results via phone
Following assessment and upon initial diagnosis of sensory impairment, Audiologists and Doctors to signpost service-users to rehabilitation services
Produce local newsletters as a way of delivering information to sensory impaired individuals’ homes. A Sensory Impaired Consultation Group could ensure that only relevant information is included
Utilise a text service for people who are deaf to alert them to local service works (for example: water being turned off in a certain Council area).
Consider provision of a designated Deaf Officer in the Council
Consider how individuals with a dual sensory impairment contact services in an emergency situation
Explore safety issues in public places (for example: swimming pools)
Improve audio-visual technology on buses and at bus stops in order to facilitate ease of access on public transport
Introduce ramp access to all public buildings
Introduce loop systems to all public buildings and ensure all are maintained at regular intervals
Develop more local support groups/activities and support those already existing in North and South Lanarkshire, to promote social engagement and reduce isolation amongst adults/older adults
Develop activities and groups specifically for sensory impaired children/young people (for example: sporting activity)
Improve communication with local services to streamline complex needs referrals, particularly in relation to young people at the transition stage
Develop lip-reading classes in North and South Lanarkshire delivered by appropriate personnel
Introduce a banner or ticket system in hospital waiting rooms