I thank the committee for the opportunity to speak briefly on the important matter of residential care for severely learning-disabled people.
I record my respect for and appreciation of the Maxwell family for all the significant work of the Muir Maxwell Trust in providing practical support to families raising children who have epilepsy and for widening understanding and awareness of that condition. That significant work is valued by everyone who benefits from it.
It has been a consistent policy priority across different Governments of different political parties since the 1980s that all adults with learning disabilities, including those with complex needs, should experience meaningful and fulfilled lives. That applies to where individuals live and the services that they receive. The closure of large-scale hospitals is widely acknowledged as a major step forward for the human rights of people with learning disabilities, and I am sure that no one here wants to return to having large-scale residential institutions.
Although we have come a long way since that time, I acknowledge that it has not always been a smooth road. However, from the early days of “The same as you?” and “The keys to life”, Scottish learning disabilities policy has been developed on a human rights basis and informed by listening to the views of people with learning disabilities and their families.
During that time, we have not heard a persistent call for more residential care establishments—indeed, we have heard quite the opposite. Nonetheless, finding appropriate and sustainable community placements for people with the most complex needs has proved difficult. It is true that the sector has examples of good practice in which people with complex needs are well supported and live full and active lives in their communities. However, when things have not gone so well, we find examples of individuals who have undergone multiple placement breakdowns, hospital admissions and difficult experiences and who have not received the right support at the right time in order to meet their desired outcomes.
We know that people with profound learning disabilities and the most complex health needs can be well supported with personalised care packages in their own homes and with their own tenancy agreements. In my view, that makes for better provision, and that is available around the country. All adults with severe or profound learning disabilities are entitled to that support; they do not have to live with their families unless they and their families wish that.
I will touch briefly on the recently published report that the Government commissioned from Dr Anne MacDonald. That report looked in some depth at why young people with learning disabilities end up being placed in care homes or hospital facilities that are far from their families and home communities. Dr MacDonald found that the factors influencing that are multifaceted and complex. As a consequence, solutions for young people in that situation need to be about more than individualised service changes and must instead be seen in the context of a more transformational systems change. We agree with Dr MacDonald’s conclusions and we are working with our integration authorities to take forward the report recommendations to ensure that that happens.
Support to people with learning disabilities needs to be framed in the broader context of equality and social justice and not solely in the narrower focus of service design and delivery, important though that is. Services or models of care should not be the sole focus; it is about everyone with a learning disability having access to the support that they need and, crucially, being involved in decisions.
I am committed to ensuring that we implement the recommendations of Dr MacDonald’s report. Our current work with people and their families who are directly engaged in and have personal experience of these issues, which we touched on in consideration of the earlier petition on the reform of adult social care, will help us to achieve that.