Redbridge Voices - Redbridge Concern for Mental Health

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Redbridge Voices The views of Deaf, vision impaired, hard of hearing and disabled people

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Contents Contents 2 Key Findings 3 Recommendations 7 Project Team 20 About Redbridge Disability Consortium 21 Introduction 22 The Methodology 23 Welfare and Benefits 24 Form Filling 25 Changes to Welfare Benefits 27 Health and Social Care 29 Social and health staff and treatment 31 The benefits of Individual Budgets 32 Booking an appointment at the GP service 33 Poor treatment of older people in hospital 34 Lack of deaf awareness and poor treatment of Deaf people by health and social care workers 35 A very poor Wheelchair Service 37 Getting out and about and 
 transport in general 40 Pavements and roads 41 Poor access to buses for wheelchair users and those with limited mobility 43 A lack of help and support for people with limited mobility or wheelchair users by bus drivers. 43 Crime, anti-social behaviour and safety 45 Low level anti-social behaviour 45 The danger created by cyclists riding on the pavement 46 Housing 48 Lack of accessible accommodation 49 Inadequate service for Deaf, hard of hearing, vision impaired and disabled people provided by private landlords. 50 Social isolation in both public and private accommodation 51 The way public housing is offered 51 Acknowledgements
 This Report would not have been possible without the support of our partner organisations. The Redbridge Disability Consortium would especially like to thank: 
 ActivEyes; Action on Hearing Loss, Sensory Services Redbridge; British Deaf Association, Centre for Independent and Inclusive Living - Redbridge; Disability BackUp Hackney, Healthwatch Redbridge; Link Place and Redbridge Transport Action Group.


Key Findings
 “It’s the same old story. It never improves. It is the same story. They have raised the issues before, two years ago. Nothing has improved since that. So they keep feeding back but there hasn't been a change since the last meeting and that's the worry.”
 
 Redbridge resident from the Deaf Community, June 2014

From listening to Deaf, hard of hearing, vision impaired and disabled people at the focus groups it became immediately apparent that the feelings and perceptions among the the majority of participants were overwhelmingly negative. So many people reported negative experiences and frustrations in light of the fact very little has been done to address many aspects impacting on their daily lives. It is not surprising, therefore, that disabled people are cynical as to whether this report will improve things. 


During the meetings, Deaf, hard of hearing, vision impaired and disabled people repeatedly told us that they had complained about their experiences before but very very little had changed and no one cared. It is a major concern that they lack any belief that they will be listened to now even though they agreed to participate.
 


The big picture: Deaf, hard of hearing, vision impaired and disabled people are worried There is a wide range of issues that are of concern, some of them are unique to Deaf people or people with physical, visual

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or hearing impairments. Most were universal issues that they all shared.Many of the issues have been around for a long time and were identified in previous Disability Equality Schemes. It is therefore of some concern that more progress has not been made in some areas. Added to this are concerns drawn from the current political and social climate. There is an increasing amount of evidence that austerity measures, welfare reforms and other policies have disproportionately impacted on Deaf, hard of hearing, vision impaired and disabled people. Certainly local Deaf, hard of hearing, vision impaired and disabled people felt they were bearing the brunt of the cuts. This has been made harder by worsening negative attitudes towards them particularly in the media. For instance, the narrative around "the deserving and undeserving poor”. All in all this, has created an environment where most people felt that progress on equality is going backwards.

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Interplay of disadvantage There was also a sense that different issues interplay with each other. For example:
 • Poor Street environments made getting out and about so much harder which added to social isolation and made the prospect of getting to and from activities (including shopping and work) more difficult.
 • Social isolation increased dependency on social services, but ironically, cut people off from the information to make best use of it. It also had an impact on people’s confidence and their physical and mental health.
 • People felt that social care is being provided at mere subsistence levels which in turn created real basic barriers to participating equally in society such as support and assistance for basic tasks such as getting out of bed, having a showering and leaving the home. A lack of trust




People are wary of Public Sector Bodies (Redbridge Council and Redbridge NHS) not meaning what they say when it comes to consultation. There are also some unique considerations when consulting with Deaf, hard of hearing, vision impaired and disabled people if you want to properly involve them and reach all parts of this diverse constituency. But if things are done differently, there is a unique opportunity to involve people more effectively, deliver more effective outcomes (thus saving time and money in a time of reduced budgets for social care), and better serve a significant subgroup of the Ilford population.

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Where Deaf, hard of hearing, vision impaired and disabled people spoke about specific issues, their concerns covered: • Welfare and benefits cuts and affects of poverty
 • Health and Social Care, especially the lack of dignified treatment by social and health care professionals
 • Lack of accessible expert advice and support particularly around benefits
 • Getting out and about and transport in general
 • Not being listened to
 • Crime, anti-social behaviour and safety 
 • Lack of affordable and accessible Housing


• Limited employment opportunities and discrimination in the work place

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Recommendations

“Stop talking about it - Just do it!” From listening to Deaf, hard of hearing, vision impaired and disabled people and the organisations working with them, the following recommendations have emerged which if implemented will ensure that Redbridge provides equal life chances to all as well making sure that disabled residents have the opportunity to participate and enjoy in all that Redbridge has to offer.

1. Poverty Evidence and research clearly demonstrates that insufficient income is associated with worse outcomes across virtually all domains of health, including long-term health and life expectancy. Disabled people are, for example, twice as likely to live in poverty as everyone else; and are more likely to be working in low-paid jobs (when working at all). Increases in financial support are crucial for many disabled people in to enable them to do day-to-day things that many of

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us take for granted such as: getting out bed; cooking a meal; shopping; having a shower and getting around. Recommendations • Redbridge Council initiatives to protect disabled groups from the impact of cuts.
 • Redbridge Council to commit to adequately funded social care.
 • Redbridge Council to pursue a multi-faceted strategy to break the link between disability and poverty, that links education, skills, and employment.
 • Redbridge Council to produce Cumulative Impact Assessment to determine impact of cuts, welfare benefit changes and welfare reforms on disabled residents.


2. Expert Welfare Advice Many disabled people in Redbridge have a need for specialist advice on a wide range of issues including: housing, council tax, PIP, Disability Grants, Employment Support Alliance and Blue Badge. Recommendations • Redbridge Council to provide increased resources and capacity to support for organisations that provide this expert information within the Borough to meet increasing levels of demand.

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3. Employment Disabled people remain significantly less likely to be in employment than non-disabled people. In 2012, 46.3% of working-age disabled people are in employment compared to 76.4% of working-age non-disabled people.
 Recommendations • Redbridge Council and the NHS are two of the largest employers in the borough and must therefore lead by example by setting meaningful and stretching targets to recruit more disabled people. • Redbridge Council to commission a Disability and Health Employment Strategy for Disabled Adults Redbridge Council. It should be a multi-faceted strategy to break the link between disability and poverty, that links education, skills, and employment. • Redbridge Public Sector to incentivise employers to employ and promote more disabled people – not through communications campaigns (as now) but through the power of contracts – only giving contracts to companies with good records in employing disabled people; and expecting large companies to be transparent about how many disabled people they employ at different levels, as they do in relation to the number of women on Boards.
 • Redbridge Public Sector to set example as a procurer, tenderer and commissioner.

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4. Redbridge Wheelchair Service There is great anger about the quality of the Wheelchair service as well as a profound loss of confidence in the ability of the service to provide a quality service meeting the varied and complex needs of wheelchair users. Recommendations
 • Independent organisation commissioned to find out from users the kind of wheelchair service people want and need. • When having equipment repaired or replaced, inform the user of all available options (including not having the equipment repaired at all) to enable them to choose the best option for themselves. • Orders for new equipment and repairs can take a long time, so keep users up to date with regular (weekly) progress reports. • The cost of new equipment is a key issue for many user. Ensure that users are made aware of all the Page 10 of 52

ways in which a wheelchair can be partially or fully funded and who will pay for the cost of maintenance.

5. Independent Living Fund (ILF) We are very concerned that the closure of the ILF, at this point in time, will have a negative impact on many Redbridge ILF recipients who are likely to see their support reduced or perhaps lost altogether. Recommendations • Redbridge Council to ring fence the transferred money to ILF recipients.
 • Redbridge Council to commit to care packages being funded at the same level or above once the transfer has taken place. • Redbridge Council to co-produce the Redbridge transfer plans by bringing ILF users together and involving their local representative.

6. Housing Although the gap in non-decent accommodation has closed over recent years, 1 in 3 households with a disabled person still live in non-decent accommodation. Moreover, 1 in 5 disabled people requiring adaptations to their home believe that their accommodation is not suitable.
 


Recommendations
 • Implementation of a strategic and sustained programme of building social housing to the standards of universal design and accessibility.

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• Redbridge Council should set targets for building new accessible housing.
 • When carrying out refurbishments and housing upgrades, considering the needs of existing tenants and seeking funding where available to meet accessibility standards including Lifetime Homes Standards.
 • Operating a maintenance and repair system that identifies residents who are vulnerable and prioritises repair and response times according to their needs.
 • Ensuring that all staff receive 'disability equality' training and ensuring that temporary staff and contractors are equally aware. Specifically monitoring the satisfaction of disabled tenants to ensure equality of service.

7. Accessible Redbridge: 
 Achieving an inclusive environment Thinking beyond 'bricks and mortar' and giving greater consideration to the wider need of disabled people for public transport links, dedicated car-parking spaces, better environmental design and community facilities. Recommendations • Redbridge Council to draw up action plan to monitor and evaluate how the council is conforming to the new planning guidance on accessibility for developments in London issued by the Mayor.


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• Redbridge Council to ensure all new developments in Redbridge to achieve the highest standards of accessible and inclusive design and supports the principles of inclusive design which seek to ensure that developments

- Can be used safely, easily and with dignity by all regardless of disability, age, gender,ethnicity or economic circumstances.


- Are convenient and welcoming with no disabling barriers, so everyone can use them independently without undue effort, separation or special treatment.


- Are flexible and responsive taking account of what different people say they need and want, so people can use them in different ways.


Pavements and Par king Recommendations
 • We call for more parking bays accessible and dedicated to disabled people in Redbridge.
 • London Borough of Redbridge should make concerted efforts to enforce the law on pavement parking and parking on crossovers. Page 13 of 52

• In areas where LBR permits car parking on the footway (and forces pedestrians to walk on the carriageway) this practice should be re-examined and the needs of disabled pedestrians taken into account. • Targeted measures should be taken to eliminate uneven pavement surfaces. • Cycling on footways should be firmly discouraged by the enforcement of sanctions such as spot fines by policing teams and more signage and a Council led campaign similar to ones run by Islington Council. • Redbridge Council to ensure that the positioning and visual contrast of street furniture and the design of approach routes to meet the needs of wheelchair users and people with visual impairments • Entrances to buildings are clearly identified, can be reached by a level or gently sloping approach and are well lit. Buses - Recommendations
 • Bus companies should directly involve disabled people in bus driver training and TfL should include the views of disabled people in bus design. • A bus without a properly working ramp should not be in service. Equipment checks, before leaving the garage, should be more thorough. • Highway authorities (TfL and Redbridge Council) should ensure all bus stops are accessible as a

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matter of priority.
 • Refresher courses for TfL staff on disability equality and awareness, passenger safety and their duty of care to passengers should be robustly institutionalised. Dial-a-Ride/Taxicard
 Community Transport Recommendations • Given the difficulties experienced by disabled people in using these services, management of them needs to focus upon flexibility and orientation towards the needs of the client Twenty is Plenty • To help make roads safer for all, Redbridge Council to follow lead of Islington Council and introduce a 20mph speed limit on all its streets.


8. Hate Crime and AntiSocial Behaviour Recommendations • That there is a Police Hate Crime Liaison Officer in Redbridge with the time and resources to devote to building relationships with DDPOs and other protected groups and to support victims and witnesses of crime.
 • Police staff and officers need to represent the general population so greater numbers of Deaf and

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disabled people and people from other protected groups are recruited and retained and with good career progression possible.
 • We recommend that the capability and attitude of all front line police offices is improved by specialised hate crime reduction training to ensure that:


- all reports of hate crimes are respected by police and appropriately recorded.

- Victims are effectively supported by the police from the moment a hate crime is reported through to prosecution of the case.

- The investigation of hate crimes improves so the number of increases.

successful prosecution

- Front line police officers with specialist skills in dealing with hate crime are developed and promoted in each borough.

- A hate crime reduction-training module for all student police officers is put in place.

9. Accessible Communication Significant improvements to accessible communication services, especially BSL interpreting provision are of fundamental importance such as public sector staff undertaking deaf awareness training. Redbridge Council is the first council in the Country to be given the ‘Louder than Words’ Charter Mark for the whole of its services. This nationally recognised charter mark is for best practice for offering excellent levels of service and accessibility for staff and customers who are Deaf, or hard of hearing .

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Recommendations • Redbridge CCG, local NHS organisations and Doctor’s Surgeries and other front line services to emulate Redbridge Council and attain ‘Louder than Words’ Charter Mark.
 • Local authority to promote and encourage local businesses to adopt ‘Louder than Words’ Charter Mark.
 • Staff need to be aware that double appointments will need to be made for BSL users with provision of BSL interpreter as it takes longer for information to be put across to the patient and service users. 
 • Staff need training in sensory awareness and should be aware how to book appropriate communication support.
 • A high number of patients admitted to hospital have reported that their hearing aid has been lost by staff and this has not been rectified during the hospital stay. Many staff on wards do not seem to be aware of the vital importance of arranging replacement of Hearing Aids as soon as possible. A solution could be ensuring hospital wards have personal listeners to assist as well as arrange replacement hearing aids asap via audiology.
 • NHS Hospital staff to be made aware of the fact that for many, hearing aids are a vital communication need and without a hearing aid a lot of patients can become isolated on the ward, and not understand consultants, nurses and other ward staff.


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• Ensure room loops are working effectively
 • NHS and Local Authority staff need training and also to be made aware of how to communicate effectively with someone who has a hearing loss. For example, not to shout as this only distorts lip patterns and makes the person’s facial expressions look angry.

10. Independent Living It is important to keep disabled people in their own homes when this is the most appropriate place for them to live. If it isn’t possible for the disabled person to live at home (or they don’t want to do so) then it requires high quality residential provision to be made which is suitable to the disabled person’s needs and respects their wishes, feelings and preferences. Redbridge must ensure and secure a sufficient supply of inhome, residential, and other community support services for disabled people, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community. Recommendations
 • In determining which available living arrangement is the most appropriate, Redbridge Council or NHS body must have due regard to the need to ensure disabled people remain in or close to the local community with which they identify.
 • Maintain links between disabled people and their family and friends.


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• Support disabled people to access employment, education and / or training and other activities in the community.

11. Participation

Participation by disabled people in development and decision making is vital – from seeking feedback through to full decision making and leadership by disabled people. To achieve fully inclusive outcomes i.e. disabled people taking part in society requires fully inclusive processes. In other words, disabled people participating at all stages in planning and decisionmaking. These approaches can also help Redbridge public sector bodies meet their obligations under the Equality Act 2010 and the UN Convention on the Rights of Persons with Disabilities. Disabled people need to move from being recipients of services to influencers and decision makers. There has been much discussion in recent years of ‘shifting the balance of power’, ‘choice and control’ and increased power of the citizen including the disabled citizen. But the experience in Redbridge is that power imbalances often remain. Moreover, to ensure the participation of as many people as possible the information needs to be well publicised, be available in different formats and give plenty of notice so people can attend for example BSL videos, plain English and visual clues.

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Project Team
 Lead Researcher - Dr Ossie Stuart
 


Dr Stuart is a researcher and an independent equalities consultant, who has written key works on race, disability and social care. As an academic, he was a researcher at both St Antony’s College, Oxford, and York Universities. He also taught social history at the University of Surrey. 
 


Since 2002 he has worked as a freelance researcher and consultant and has been commissioned by the Department of Health, disabled people’s user led organisations and other voluntary sector organisations to provide advice and research relevant to social care. Dr Stuart’s current commission is to evaluate the significance of ethnicity within the personal assistant workforce for Skill for Care and the Department of Health. Research Assistant Amy Jenkins Further Information Email: Tel:

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[email protected] 020 8925 2435

About Redbridge Disability Consortium Our work is driven by the goal of a society in which disabled people are treated with dignity, fairness, respect and understanding. We are passionate about developing high quality, accessible services for disabled groups, working in partnership to influence policy and outcomes affecting disabled groups; and challenging the stigma and discrimination that disabled people encounter in their day-to-day lives. We know that many disabled people face barriers in their every day lives that prevent them from being full and active members of our community. We know that significant progress has been made to improve accessibility. Nonetheless, our research as well as our day-to-day experience of working with, supporting, assisting and providing advice and information has shown that progress is patchy and that is why the challenge is for Redbridge to do more.

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Introduction
 During 2014, Redbridge Disability Consortium, along with its partner organisations, held a number of focus groups with people from Deaf, vision impaired, hard of hearing and disabled communities. This was an opportunity to talk, not only about their experience of social care and the NHS in Redbridge but also to explore the quality of services such as housing and transport and other issues that affect people’s day-to-day lives. We called this project ‘Redbridge Voices’. Its purpose is provide information that will be used by Redbridge Council, the NHS and other organisations to improve services and to make the borough more accessible and a fairer place for Deaf, hard of hearing, vision impaired and disabled people. This Report describes the views of over 200 local Deaf, hard of hearing, vision impaired and disabled people who took part in nine focus groups or meetings. It covers not only what issues people talked about, it also includes recommendations and suggested next steps.

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The Methodology
 This is qualitative rather than quantitative report. The aim is to capture the views and opinions of Deaf, hard of hearing, vision impaired and disabled people and, therefore, it is important that they speak for themselves. As a result, the report has focused upon the quality, emotions and feelings expressed by the people who attended the focus groups and other meetings. Suffice to say over 200 people participated in the focus groups and other activities organised to capture the views of Deaf, hard of hearing, vision impaired and disabled people. A wide variety of people attended reflecting the ethnic diversity within the borough. Although we had over 200 people contribute to our Report, we are well aware that many more were unable to attend. Some were simply unable to leave their home. Others, did not receive any information about the focus groups. These people will be older people, usually with a visual or hearing impairment, who will spend the vast majority of their time in their homes, usually alone. This invisible group must not be forgotten by this Report.

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Welfare and Benefits 
 “I am now almost completely blind. I returned to the UK after 10 years in India helping my family. I am unemployed and it’s impossible to get a job. Yet, when I go to the job centre they tell me that I’m not entitled to any support whatsoever because I have not contributed enough. I don’t even understand what that means, but I do know that I have no money and have to rely on my brother but he will not be able to support me forever.”
 _______________________________________________
 Redbridge resident with a physical impairment


Biggest barriers: • Lack of organisations and capacity in Redbridge providing expert advice for disabled people. • Problems and challenges around form filling. • A lack of access to information that can be easily understood. • Cuts to benefits as well as new and restrictive criteria that exclude Deaf, hard of hearing, vision impaired and disabled people from access to benefits. 


Summary
 
 It was clear from our discussions with all the groups that the primary issue concerning welfare and benefits were lack of accessible organisations providing expert advice; form filling; a

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lack of information; and restricted access to benefits, especially those linking to ability to work as well as poor provision of expert welfare and benefits advice in Redbridge. Many people reported bring worried about all aspects of welfare. Many struggled to understand their rights and what they were entitled to and also the changes that have taken place. Many felt they needed more information about the changes, without which left many fearing for the worst. Form Filling


Completing forms was considered one of the worst things for service users. In all the focus groups participants described this as complicated, and often not accessible. Often many ended up not applying for different benefits, not because they do not want to or are not entitled to them, but because they do no understand what is being asked of them. Many participants found the whole experience challenging and replete with obstacles and hurdles. Many considered online forms to be just as poor. While, useful for people who have a computer or can access one, an overwhelming number of participants were not able to do this. Online form filling excludes people unfamiliar or unable to use computers as well Page 25 of 52

as those whose first language is not English, for instance British Sign Language (BSL) users. Many publications are available in other language formats but not in BSL

“Form filling is a problem if you only do it once in a blue moon. Would be good to have someone very good at doing different forms because you would feel more confident.” 
 ___________________________________________
 Redbridge resident with a physical impairment
 March 2014

Access to information Participants were concerned and worried by the fact that so much information was now being put on the internet. The vast majority, particularly amongst older respondents, said that they found accessing the Internet very difficult or impossible. People with a hearing impairment and from the Deaf community said their biggest problem was a lack of accessible Page 26 of 52

information. Their primary source would be friends or relatives, but as many pointed out this source was only as good as the knowledge their friends had. As more and more forms, benefits, information and advice go on line and public services become ‘digital by default’. Redbridge like the rest of the UK is facing the growing problem of vulnerable groups becoming more and more excluded. The fact is those who need access to services most, are the least likely to take up these on-line services even when access is available. This is compounded by the fact that there has been a reduction in expert advice across Redbridge for disabled people and resources have not kept pace with increasing demand.

Changes to Welfare Benefits 
 “How else would you find out if you want to find out a about benefits what is available? What you are getting? Are you making sure your state pension is right? All these new rules….Those internet aware people have an advantage because the Government thinks everyone is on the internet but what about if you are not on the internet?”



 It’s not just changes to levels of benefits that worried people, but changes to eligibility for payment as well. These concerns were shared almost universally across the focus groups but were especially strong for people with physical impairments, who also predicted the gravest impacts.

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This is significant because this group thought that benefits and housing services did not serve disabled people well. Given that they have the highest levels of need, they all had the poorest opinion of relevant services and the most pessimism. People with a physical impairment wanted good advice and support to cope with the changes. Older people with a sensory impairment also felt that the benefits system was too complex to understand and inaccessible. Furthermore, because of means testing and tightening of criteria, more Deaf, hard of hearing, vision impaired and disabled people were finding that they were no longer eligible for as much assistance as in the past.

“You ask about benefits? The worst thing I find is completing all those forms. All those questions, why do they ask all those questions? The forms are complicated enough and hard to understand and the boxes are so small, quite often I just give up and don’t apply because I would probably get turned down anyway.”
 ___________________________________________
 Redbridge resident with a physical impairment
 March 2014

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Health and Social Care 
 I had a social worker who arranged for my son to go into a respite centre for one night. In the morning his hand had been blisteredI went to the staff, but no one told me what had happened. He had to stay in Whipps Cross. The social worker never checked on him or did safeguarding. They stick together; they were saving themselves no investigation into the respite centre. If I said something, they would say his mother can’t look after him that was 2-3 years ago. I don't want to send him again…”
 _____________________________________ 


Redbridge resident with a physical impairment
 March 2014

Significant issues ‣ Profound lack of confidence in social and health care staff ‣ Many instances of poor treatment when using health or social care services ‣ Inaccessible booking systems at GP surgeries ‣ Instances off poor treatment of older people in hospital ‣ Lack of deaf awareness and poor treatment of Deaf people by Health and Social care workers. Poor treatment comes from poor communication or lack of appropriate communication support for BSL users which can and has led to poor diagnosis and lack of appropriate treatment. ‣ A very poor Wheelchair Service

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Summary Health and social care occupied a large part of the discussion at each focus group, regardless of the impairment group. It became very clear that there was a lack of confidence in social health care staff, who were often considered indifferent, at best and hostile at worst towards people with physical or sensory impairments. Whether with the GP clinic, a hospital or a social care provider, many participants of the focus groups reported frustration and even, sometimes, fear when having to use these services.


 “My wife went into King George. She came out with bed sores only four days… I am concerned about level of care in Whips Cross. We the family care for them in hospital. I still wash and clean because I can't trust the nurses!” __________________________________________ Redbridge resident with a physical impairment
 March 2014

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Social and health staff and treatment My social worker is bloody useless because she kept me waiting for so long I went to her boss, but I shouldn't have to keep chasing the all the time.” ___________________________________________ Redbridge resident with a 
 physical impairment, March 2014 
 The participants of all the focus groups were united in their belief that social work and health care professionals cared little about their needs. Whether it was to support them in time of crisis, or obtain a service participant after participant reported poor treatment at the hands of health and social care professionals. Many of them had no confidence in them and felt that they were not on “their side” when dealing with social and health care issues.

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Despite many of the participants having profound impairments, very few of them had as social worker assigned to them. Those that had received a service, did so as a matter of luck rather than design. The low opinion continued with regard to health care workers as well. It is a matter of great concern that people who are most likely to need to use social care services appear to receive poor treatment at the hands of the people that deliver it.

The benefits of Individual Budgets 
 “It works for me, I use an agency with direct payments. I have been with them for 6 years and nothing wrong yet, so I can’t moan…. If you understand the system it works well, but I do understand that when it is going wrong if you do not understand the system it doesn’t work.” _______________________________________________ 


Redbridge resident with a physical impairment
 March 2014


Despite the publicity surrounding Individual Budgets, few at the focus groups were aware of this form of social care provision. Those that were, had learnt about it through their social worker. Given what has been said above about the difficulty of seeing social workers, this might explain why few people are aware.
 
 For example, out of 15 people who attended the focus group session for visually impaired people, only one person received

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a direct payment. The rest had never been made aware that this was possible. Those that had a direct payment or individual budget had mixed comments and views on their success. There were some who were very happy with it and understood the empowerment it gave them. However, there were others who found it complex and hard to manage. Key concerns were the amount they could pay their carer or personal assistant, the quality of the care agency that they used, a lack of confidence about what to do if things go wrong and managing the money. All these things served to put some people off from opting for an individual budget.

Booking an appointment at the GP service
 
 “I have to go the surgery, an elderly women like me, you have to go up there to get an appointment. But the queue it is already really long before I get there. So I have to stand up in the cold and rain, then there is still trouble getting an appointment. You often have to wait for ages. Even then you can’t always see your own doctor. So you can either take an appointment with a doctor you don't know, or come back the next day to the process again, to hopefully get a time with the doctor you do know.” ________________________________________ 


Redbridge resident with a physical impairment
 March 2014


The vast majority of the participants at each of the focus groups reported great frustration when attempting to book a GP appointment. The reasons for this are as follows:

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‣ Often, the only method available was by phone which was in some instances at a premium rate. ‣ The Internet booking system was inaccessible to the majority who attended the focus groups. ‣ When they finally were able to book one, the GP they were offered was often a stranger to them. ‣ Most want to see a GP they are familiar with, and considered this extremely important, and would spend many days attempting to do just that. ‣ Finally, they found reception staff to be unsympathetic and inflexible regardless of the fact that they have a disability or an impairment which made booking an appointment very difficult. This applied particularly to people from the Deaf community. 


Poor treatment of older people in hospital 
 “I am old and I was admitted to A&E at night and then I was transferred very late that same night, it was very dark and I could not see anything and was not sure what was going on. There was no explanation by anyone. The next day the consultant came to see me and told me I could go home. I received no results or any reassurance that I would be fine. I felt that they were brushing me out and not listening to me. So when the porter arrived, I went to the toilet stayed there! They were not rushing me anywhere!” ______________________________________ 


Redbridge resident with a visual impairment
 March 2014


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Older people who attended the focus groups, regardless whether they had a physical or sensory impairment, were all of the opinion that older people were treated as second-class citizens when in hospital or as outpatients. They complained of: ‣ Being abruptly discharged without relevant information. ‣ Moved from ward to ward, late at night, sometimes very early in the morning, for example, at 3 AM. ‣ Older inpatients complained of not being regularly washed or properly fed. ‣ A reluctance to make complaints for fear of retribution from hospital staff. ‣ Significant differences of treatment between hospitals, with King George’s Hospital identified as being especially poor at providing information and treating people with dignity.

Lack of deaf awareness and poor treatment of Deaf people by health and social care workers People from the Deaf community have poorer health outcomes than the rest of the population. This is for a number of reasons one of which being the fact that they are unable to access healthcare services as easily as everyone else. This is because there is a lack of available, reliable and prompt interpreting services in Redbridge. Whether it’s accessing a doctor’s clinic or hospital outpatients, people from the Deaf community experienced significant barriers because of the lack of interpreting services. When the service works it means they have to book an appointment many Page 35 of 52

weeks in advance to ensure an interpreter will be present. Unfortunately, too often when they arrive for the appointment there is no interpreter. This is usually compounded by a lack of knowledge or understanding by healthcare staff of how important the presence of an interpreter is for a Deaf person.
 
 “I was pregnant a little while ago and there was no interpreter coming in. I wanted an interpreter through my pregnancy. But I had to bring my mum with me, there was no interpreter there. No health visitor, no one, I received nothing, no visits for 9 months, nothing. I had to have my mum with me all the time.” ______________________________________ 


Redbridge resident from the Deaf community
 June 2014
 Deaf people complained of the following: ‣ The time it takes for GP surgeries or outpatient clinics to obtain an interpreter for a Deaf patient (often over 6 weeks). ‣ The failure of GP surgeries or hospitals to ensure an interpreter is booked promptly and will be present. ‣ The assumption made by health professionals that Deaf people will bring family members to interpret for them. ‣ The failure of Accident and Emergency service to recognise the importance of an interpreter when treating a Deaf person who has had an accident.

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‣ A perceived unfairness that the ‘Patient Advice Liaison Service’ only appears able to meet foreign language interpreting needs, but not BSL.

A very poor Wheelchair Service

There is great anger about the quality of the service provided by the Wheelchair Service in Redbridge among all the focus group participants who used a wheelchair, or had family member who did. They listed the following complaints: ‣ Very arrogant Wheelchair Service Staff. ‣ Inflexibility in making appointments, forcing wheelchair users to stay in all day or to cancel holidays. ‣ Refusal to listen to wheelchair users or take into consideration their opinions. ‣ Deaf, hard of hearing, vision impaired and disabled people were often forced to buy their own personal chair.

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‣ The length of time it took to receive agreed equipment (sometimes as long as a year). ‣ Failure to communicate appropriately about decisions made. ‣ A grudging service which appears to be pennypinching and one that will look for the smallest opportunity to place the full cost of the wheelchair on the user. ‣ No regular checkups to check that the wheelchair remains appropriate for an individual’s needs. ‣ Wheelchair users in Redbridge would also add: “the failure to provide a wheelchair service in Redbridge.” 
 “The Wheelchair Service? That’s not a service, all they want to do is take your wheelchair away from you.” “My wife’s wheelchair is very heavy. It is hard to lift out of the car or to go up high curbs or cross the road. The Wheelchair Service did an assessment and didn't follow up. Maybe my English wasn't good enough.”
 “When I ring the Wheelchair Service, they say it is not their responsibility. When they take the chair to get it repaired they will not leave another one, so my child is stuck in bed for two weeks!” 


——————————————————————— Comments from a number of different focus groups participants

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Wheelchair users are very angry about the inadequacy and failure of the Wheelchair Service. We could not find one person to say a positive thing about this service. Indeed, it was the arrogance and hostility of the staff who ran the Wheelchair Service that really angered those we spoke to. The consequence of this has been that, either, wheelchair users are using equipment that is wholly inadequate for them and their families or they have been forced to purchase the correct wheelchair from their own resources. Both of these situations could be avoided had the Wheelchair Service provided a better service.
 “After receiving a disabled facilitates grant I had an assessment. I was assessed for a wheelchair but it was not available. 
 
 So in the meantime I was told to get my own and my wife would have to push me. But my wife has sclerosis of the spine. 
 
 When I asked who would pay for it I was told that I would have to until the wheelchair was provided. “





 


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Getting out and about and 
 transport in general 
 Significant Issues: ‣ Poor quality of the pavements and roads ‣ Great difficulty recognising the buses they need ‣ Poor access to buses for wheelchair users and those with limited mobility ‣ Lack of help and support for Deaf, hard of hearing, vision impaired and disabled people by bus drivers Summary Being able to get out and about is a key component of independence and being included in society. Most of the participants at the focus groups rely upon some sort of publicly subsidised services, such as Taxi Card, the Blue Badge scheme or the Freedom Pass. These are greatly appreciated. Nonetheless, the participants felt let down and badly served by a number of issues.

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Pavements and roads Poor street maintenance, where patched up pavements leave uncomfortable bumps that make navigation with a wheelchair much harder. Dropped kerbs blocked off by parked cars impede both people who are visually impaired and wheelchair users. Also, haphazard and random street furniture, such as advertising boards, chairs and tables outside coffee shops and even sprawling vegetable displays have been reported as a barrier to, both, people with vision impairments and wheelchair users. “I am visually impaired… navigating the roads… I just go slower then everyone else is going, I let them pass. When there are things in the middle of pavements like signs this can cause me to trip because I can’t see them.” There was also a degree of cynicism that anything would be done about these things because people in these focus groups felt that they were a low priority for the local authority.


Great difficulty recognising the buses they need and to get on and off. “Buses, my dog leads me to the front of the bus stop, but all the buses cue up behind them so they are not at the bus stop. I can’t see what number is there and often missed the buses as I don't know its here. Especially from the Ilford Library stop this happens a lot. I often miss buses this way.”


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The most frequent complaint among people with visual impairments was buses not stopping close enough to the bus stop to be aware of its presence. This, and also failing to stop close to the curb, was a complaint that wheelchair users shared too. Many people suggested greater awareness by drivers of how Deaf, hard of hearing, vision impaired and disabled people navigate the public space and get on and off buses would help a great deal.

“Sometimes buses don't stop… 2 buses will go past, how does that make one feel? I feel a bit annoyed and frustrated. We want someone to complain to.” When to get off the bus. Some people have experienced bus drivers who were too hasty to move off to give them time to get off the bus before shutting the doors. Others pointed out that often they are not informed when to get off the bus because the announcing system is not working. Finally, Deaf people rely

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upon electronic information inside the bus to know where they are and when they should get off. If this fails or is not working they will not know when to get off. Many people wondered why buses were allowed to operate with this system broken?

Poor access to buses for wheelchair users and those with limited mobility Those wheelchair users who attended the focus groups did not take travelling by bus lightly. Many felt that public transport was still not really accessible. Very few had the confidence to travel by public bus, as more often than not, bus drives would drive past, or the ramp did not work, or there were buggies in the wheelchair spaces and mothers would not put down their buggies to make space for a wheelchair user. People also pointed out that the bus driver is not confident enough to challenge them. “I used to go to Barkingside on my own. Then, I was knocked over by the ramp of a bus whilst in my wheelchair, and it has really knocked my confidence.” Many people felt that this issue was getting worse, not better and that something should be done to ensure disabled people in wheelchairs could use the buses with confidence.

A lack of help and support for people with limited mobility or wheelchair users by bus drivers. 
 “It is the bus drivers responsibility to get the buggies to fold up and let wheelchair users to get on.”

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Deaf, hard of hearing, vision impaired and disabled people at our focus groups, regardless of whether they had a physical or visual impairment or hearing impaired or from the Deaf community, all considered bus drivers key to their confidence in using public transport. They expect drivers to ensure that they can gain access to a bus, that they are safe while on the bus and they will be able to get off the bus at the appropriate stopping point of their choosing. The fact this is not the case is a considerable cause of concern for many Deaf, hard of hearing, vision impaired and disabled people we spoke to. It is important to understand the role that drivers play in ensuring independence and inclusion of Deaf, hard of hearing, vision impaired and disabled people. Therefore, they should be trained to carry out this role effectively and with confidence. 


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Crime, anti-social behaviour and safety 
 “I was standing at a bus stop and a young man comes there. ‘Give me money, give me money’, and I was so scared and after two minutes another man came, very well dressed up. ‘Give me £1 pound’. I know what they are going to do and I opened my purse. It will all go. It is very scary. I am saying that and usually I am very strong.” ________________________________________ 


Redbridge resident Hearing Impaired Focus Group June 2014

Significant issues: ‣ Low level anti-social behaviour has a significant bearing upon Deaf, hard of hearing, vision impaired and disabled people’s participation in the local community. ‣ The danger created by cyclists riding on the pavement. ‣ personal safety and fear of crime were issues that all the participants considered important.

Low level anti-social behaviour 


Low level anti-social behaviour has a significant bearing upon Deaf, hard of hearing, vision impaired and disabled people’s participation in the local community.

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“I have never tried buses with my son I'm scared. He has a big wheelchair and buses lack of space. School time when kids are about you would not be able to do it…”

“We got on the bus and by the time we got to the Post Office, where we have to get off, there was so many children standing there. I never had chance.”
 It is antisocial behaviour, like the examples recounted above, that have a big impact upon Deaf, hard of hearing, vision impaired and disabled people. It deters them from using public transport or travelling at certain times of the day. Many people agreed that travelling at night was something they simply did not do because of the fear of crime and anti-social behaviour of some kind. While it is important to identify improved services throughout Redbridge and improve access to public spaces, this will be undermined if low-level antisocial behaviour is not addressed and tackled at the same time. A coordinated, rather than piecemeal approach to improved access will be essential to ensure that people with physical and sensory impairments feel confident to take advantage of the improved social spaces.

The danger created by cyclists riding on the pavement “Fathers with their children, they ride on the pavement. You don't stand a chance.”
 A number of participants highlight the problems cyclists created by repeatedly riding on the path, even in areas of Ilford that Page 46 of 52

were totally predestinated. They complained that the risk of a collision with someone who had a visual or hearing impaired, or were from the Deaf community or had limited mobility was high, but nobody seemed to want to do anything about this. Some of the participants said that this form of anti-social behaviour was one of the main reasons they were scared to go into Ilford, or go out at all. They were fearful that, one-day, they would get knocked down. 


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Housing “I’m nearly 30 years old, I have cerebral palsy and I have been living with my parents all my life. I have been on the waiting list for housing since I reached 25 years old. I do not have a job, but I volunteer as much as possible. 
 


I have just been informed that I had been removed from the housing waiting list because I no longer meet the criteria for public housing. The letter was so complicated I had to go to my local disability organisation to have it explained to me. My parents were unable to understand it either.
 


This means I have to live with my parents for the foreseeable future there will be overcrowding and frustration that comes with this. I am very angry.”

Significant issues: ‣ Households with a disabled person are more likely to be overcrowded. ‣ Lack of adequate and accessible housing makes it impossible for young disabled adults to leave the family home. ‣ Private landlords fail to provide adequate accessible accommodation for people with visual or physical impairments. ‣ Social isolation in both public and private accommodation. ‣ People felt strongly about adaptations at the events. People felt that they were not spoken to about what was

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needed. What could be provided was not flexible. This meant that aids and adaptations sometimes did not help ‣ People felt they waited too long for adaptations. This meant people could not live an independent live at home. They often had to rely on support from other people.

Lack of accessible accommodation “They (the council) have not helped at all. They have forced him to move. Maybe had a  look at a house and it is not suitable. They are saying well you have to move because that's all we've got. I have got no power as well. What are my rights? What are my needs? Nothing. Just limited information, not the full information and I do panic

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because I've got children and it is now down to what they are saying.” A lack of accessible accommodation means that Deaf, hard of hearing, vision impaired and disabled people are being obliged to either accept totally inadequate housing or reject it and be forced to remain in overcrowded and inadequate accommodation. The failure to build enough accessible housing has a significant impact on Deaf, hard of hearing, vision impaired and disabled people.

Inadequate service for Deaf, hard of hearing, vision impaired and disabled people provided by private landlords. Private landlords are unwilling to provide an adequate service to Deaf, hard of hearing, vision impaired and disabled people. Whether it is to meet the communication needs of a Deaf tenant, or the access requirements of someone who is visually impaired, or a wheelchair user, it is unlikely that a private landlord would be willing to invest to do so. It means that most Deaf, hard of hearing, vision impaired and disabled people will find themselves in inadequate private accommodation. This is another reason why accessible publicly funded accommodation should be a priority for this group.
 


“My private landlord, he just turns up. I've been in my pyjamas. He just turns up at home. He doesn't let me know he's coming. Then he has come to get rent, and so turns up and not communicating. 


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I was ill and I was in my pyjamas and the landlord just turned up for the rent so there are a  lot of issues. Doesn't text me even though they know I'm deaf.”

Social isolation in both public and private accommodation In private accommodation Deaf, hard of hearing, vision impaired and disabled people were less likely to meet others in a similar circumstance and, therefore, would be more likely to miss important information. For example, a major difference that was highlighted was between those that lived in supported flats near Link Place and those who lived independently. Those who lived together in the supported flats had support from an assistant who helped them with form filling etc. Those who lived on their own do not have access to support like that and thus did not have an opportunity to access that support, or did not know where to go to access the support.

“I get letters, but it's hard to see them, no one can tell you what’s happening. I heard about the bedroom tax, but that’s why I came here.” There are real benefits for Deaf, hard of hearing, vision impaired and disabled people living in public housing, however, this, on its own, cannot guarantee that people will not still experience social isolation.

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There is a lack of properly designed and accessible accommodation in Redbridge. Nevertheless, the housing rules obliged Deaf, hard of hearing, vision impaired and disabled people to accept inadequate public housing. They feel obliged to accept wholly inadequate accommodation for fear of being removed from the waiting list. Many Deaf, hard of hearing, vision impaired and disabled people think this policy is unfair because a lot of accommodation is inadequate and poorly designed, but they are fearful of losing out if they do not accept what is offered. Deaf, hard of hearing, vision impaired and disabled people want to be considered equally with everyone else when housing policy is shaped. They do not want preferential treatment they would like fair treatment. “I am a disabled person from a Muslim background. I have physical difficulties as well as mental health problems. In the past 16 months, I have moved into three different private accommodations within the borough. As a consequence, I have experienced a number of housing issues, for example: harassment, isolation, unaffordable rent, intolerable living conditions (damp), insecure tenancy etc. This has further exacerbated my physical and mental health, and as a result I have been left feeling very insecure - I am worried about my future. I have been informed by the Housing that I have no priority to housing, having lived in the area for less than 2 years. What is someone in my position expected to do?”

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