We are committed to ensuring that the people we support at Advance have access to health services and have the resources and support to achieve good and healthy level of wellbeing in all aspects of their life.
It is well known that many health inequalities exist for people with learning disabilities and mental health conditions. These barriers include:
- a lack of accessible transport links
- patients not being identified as having a learning disability
- health staff having little understanding about learning disabilities
- failure to make reasonable adjustments for access to healthcare
- failure to recognise that a person with a learning disability is unwell
- failure to make a correct diagnosis
- minimal accessible information
- a lack of holistic care recognising that people with learning disabilities or a mental health condition often have multiple health needs
- anxiety or a lack of confidence for people with learning disabilities
- lack of joint working from different care providers
- not enough involvement allowed from carers
- inadequate aftercare or follow-up care.
(Adapted from Mencap)
For many, these inequalities have been exacerbated by the Coronavirus pandemic. The experience and access to health services and the ability to maintain or improve wellbeing has been severely affected by a range of recent factors including the national lockdown, interacting with nurses wearing PPE, digital inclusion and a lack of interaction with family or support networks.
Overcoming barriers at Advance
We have been working hard across all our teams and services over the recent months to make sure that our customers and support staff can adapt to the situation and still access health services and wellbeing resources. One of the most significant ways of doing this has been increasing access to health services and wellbeing services for our customers. Promoting digital access has been a driving force behind our work around customers’ health and wellbeing. In addition, we have a separate Health & Wellbeing group which are working on a future plan to overcome the other barriers that our customers might face.
Making the most of the internet
In response to the national lockdown in spring 2020, support staff and other teams across Advance kept a lookout for useful resources and information to share across the organisation in order for our customers to keep active and healthy from their homes.
These resources include, activity packs, mental health tips and links to events taking place online. A separate page on our website and intranet page was created in response to the pandemic in order to ensure straightforward access for both our staff and members of the public visiting our pages.
Our intranet has had very positive feedback and we know that - 88% of users find content to be up to date and relevant - a further 74% find the intranet helpful to do their job
We have used the Mental Health Foundation’s 5 Ways to Wellbeing advice as a framework for our intranet page where users can find useful links in order to Connect, Be Active, Take Notice, Keep Learning and Give.
At the start of the pandemic our Head of Complex Needs Support, Michelle O’Neill, wrote her own document containing lots of suggestions to stay creative, active and resourceful for customers who were stuck inside. In some cases customers were unable to receive their usual amount of support which left our staff keen to do what they could remotely. Michelle’s document was shared across the organisation and linked to our website and dedicated health and wellbeing page so that everyone could access it during lockdown.
Michelle explains – ‘Lockdown has affected many of the routines people rely on to make them feel safe. Changes in routine can be very difficult for people with challenging behaviours and may lead to great anxiety and result in behaviours that other find difficult to manage. We felt it was important to put together an alternative plan and set up a new daily routine. This has helped people to remain calm and safe knowing what was going to happen during their day despite the changes and restrictions. For instance, we are supporting a lady with autism who became very distressed when she realised she could not attend her usual activities in the community. Using social stories, we explained why, and agreed a new predictable routine with her by looking at the activity folder to get ideas of what she may enjoy.
Every morning she uses her visual calendar for her new activities.’
The Mental Health Foundation, along with other health publications, describes the benefits of being creative for people struggling with their mental health.
Our Community Aspirations Team in London usually runs a weekly arts and crafts group that many of our support customers attend. When community groups were cancelled due to the national lockdown, the team decided to send out art and crafts packages to customers to make sure everyone was still able to get creative whilst staying safe indoors.
‘It was nice to see [my support worker] cycling up the street and he left the pack on the garden wall and we had a chat from the doorstep.’
Staying informed and connected
Our communications team have also worked alongside support teams to put together a regular support update, sharing tips and official information as well as health and wellbeing resources. As a result, Advance support workers are up to date with the best ways to encourage health and wellbeing amongst our customers regardless of where they are geographically.
We know that not feeling connected to others can lead to loneliness and isolation. So, the communications team have been sharing stories on our online channels of activities that our customers have been doing to keep well over the past few months. This has allowed teams and customers at other services across the country to celebrate each other’s work and also take inspiration for new activity ideas.
As a staff member recently commented, ‘It gives sense of community, positive stories about staff and customers.’
Conversations with Customers
Working in partnership with the people we support is a priority at Advance. We make sure we create opportunities and projects for our customers to share ideas, experiences and work together with staff to make sure we provide the best services. Our Customer Engagement Manager organises regular Customer Collectives with services, these have been held virtually since the pandemic. We have been sure to discuss mental and physical wellbeing during these calls in order to ensure that customers across the organisation have increased access to information, a safe online forum to discuss the topic with others and can learn about health and wellbeing in general. On average about 6 customers attend each Collective. As customers become more familiar with the sessions we are hoping that attendance will continue to increase. The feedback on the Collective sessions has been good, with customers telling us it helped them to feel informed and connected.
Working specifically around health and wellbeing, our Customer Engagement Manager and Quality Improvement Manager held a customer workshop to discuss organising a health survey. This has enabled the direction of the project to be driven by the customers themselves. As a result of the workshop the project received customer input on which topics to cover in a health survey, which questions to ask, how to ask them and who should ask them. The customers involved also volunteered to test-run the survey when it’s ready.
The Government’s Better Health Campaign
The government began a ‘Better Health’ campaign in July 2020. The campaign provides access to a range of apps and tools to help people stay in shape and make healthier food choices to prevent future weight gain, including Easy Meals, Food Scanner, Couch to 5K and Active10.
This has been a campaign which we have supported and signposted to in order to support our customers to maintain a healthy lifestyle. Given the increased probability of obesity and diabetes amongst individuals with learning disabilities, we recognise the importance of promoting access to these useful tools.
We take the following statistics very seriously and work hard to address them:
- Less than 10% of people living in supported housing eat a balanced diet
- Less than 20% meet UK government guidance levels for exercise. But fewer people smoke or drink alcohol. (Emerson et al. 2012)
Our staff and customers have not been afraid to get creative in order to use space efficiently and maintain their health in times of restriction. We have been proud to see customers using outdoor space to keep active safely with socially distanced tennis, walks and gardening. Staff have even led yoga sessions with customers, supporting people to access online classes and videos. We’ve also seen customers in a shared living service group together to cook and enjoy a Slimmer’s World meal every other week.
A survey of our Housing customers in November 2020 showed that 85% feel ‘quite’ or ‘very’ healthy – an increase of 2.5% from 2019.
Easy Read Guides
Health challenges have increased for people with learning disabilities and mental health conditions over recent months, with constantly changing and severe restrictions on day to day life. At Advance we have regularly published and signposted people to accessible and accurate information so that our customers have felt up to date and prepared to deal with changing situations.
‘I think it’s extremely important that people with learning disabilities are able to understand health documents as it can be hard if it is not in easy read… there is lots of information on health but unfortunately not always easy read friendly.’ We have used many Easy Read guides to cover a full range of topics related to the pandemic. These vary from government guidelines, tier restrictions, the test and trace app and face coverings to the vaccine and bereavement. It is important that our customers are not excluded and have the opportunity to learn about the health and wellbeing challenges being faced on a national level. Easy Read information enables individuals to access this information in an accessible format.
Our most recent customer newsletter went out in the autumn and included accessible information regarding the flu jab and guidance on how to follow Covid guidelines. The newsletter is accessible for all our customers.
We posted 1570 copies of our autumn 2020 newsletter and a further 523 copies were sent by email to customers who signed up on our website.
Advance feels passionate about supporting vulnerable adults to live the life they choose. Our intention is to provide the right information, support and services so that our customers can enjoy the same quality of life as everyone else.