Archive for the ‘ guide ’ Category

DLA Applications and Appeals

I know that DLA is vanishing very soon but there are still lots of people who are still applying & appealing the benefit.

If you are then you might well find this free guide from the Disability Law Centre extremely helpful. It details in plain English exactly what they are looking for to award DLA. If you are answering the initial questions then bear these criteria in mind when you write your answers

So, if you believe that you qualify for Lower Rate Care you need to meet at least one of the following two statements;

1. To get the low rate you have to need care and attention in connection
with your bodily functions for ‘a significant portion of the day’ (usually at least
an hour); or
You are unable prepare and cook a main meal for yourself. This is known as
the ‘Cooking Test’. 

If in your form you don’t clearly express that you are unable to prepare AND cook a main meal for yourself then you won’t be eligible. Or if when explaining how many minutes care you need for various tasks they don’t add up to at least an hour you quite probably won’t be found to meet the requirements either.
Of course it’s no guarantee that it will go through straight away, they may miss something, say your evidence to support your claims was inconclusive, you didn’t score highly enough on a Atos assessment or a whole host of other things. 
You can though use the information in this guide to really help you write a strong appeal. If when you appeal you follow a simple format where you quote the criteria you think you meet to start with like this;
“I believe I meet the criteria for the Low Rate Care Component because I cannot reliably/ I cannot prepare and cook a main meal for myself.”
Then you really should finish off by tying that statement to the relevant evidence such as;
“I get extremely disorientated when trying to cook which makes it impossible for me to complete either the preparation or cooking of food. My doctor/consultant/OT/social worker explains this in the letter I have included/did include with my initial application as evidence.”
If it doesn’t work as part of a written appeal then hopefully a tribunal will listen.
If anyone else has any good resources then please list them in the comments section.
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What Is The Mental Capacity Act?

Last week I attended an interesting talk on the Mental Capacity Act (for beginners I should add) and I thought I’d share what I learned with you.

History

In 1994 a man with profound learning disabilities and complex care needs was released from residential care to live with a family in Surrey. He developed a routine and went about his life without serious incident until 1997. The family said of the first 3 years “It’s fair to say that it was a challenge – but it was rewarding to see how much [he] benefited from living in a family setting. At first he was very institutionalised, but he gradually became more confident and progressed beyond all expectations.”
He attended a day centre once a week and did so without issue until one day he got on the bus to find he had a different driver who took a different route to the day centre. The man arrived feeling very agitated and staff had difficulty calming him down. The next thing the family he lived with knew was that he had been “admitted informally” into hospital without their consultation. They were also informed that they were not allowed any contact with him. This was all done after one quick consultation with a doctor who did not know the man or his family, because of how the system worked then all they had to do was claim it was in the man’s “best interests” and they could remove his liberty with no option for appeal.
The family began a lengthy legal battle which lead to the man coming home and the discovery of the abuses he had experienced whilst detained. The Department of Health fought the legal action and eventually it ended up at the European Court of Human Rights. In 2004 the ECHR ruled in the man’s favour and as a result the UK government released the Deprivation of Liberty Safeguards, part of the Mental Capacity Act 2005, which came into force in 2009. This case is known as the Bournewood Case if you wish to do more reading.

Purpose

The Mental Capacity Act 2005 (MCA) should provide a legal framework for dealing with adults over the age of 16 (18 with regards to deprivation of liberty cases) who are believed to lack the capacity to make decisions for themselves. This does not just apply to people with profound learning disabilities or cognitive disabilities but also applies to people who have lost conciousness*, are in shock or any other state that means they may (even temporarily) lack the capacity to make crucial decisions.

Principles

The MCA is decision specific. This means that it is only applied to somebodies ability to make one particular type of “decision” at a time. This should help to stop someone who lacks the capacity to make complex financial decisions also automatically loosing the ability to choose what to eat, whether to undergo a particular medical procedure or which activities they can safely engage in. It bears in mind that not being able to dress is not the same as not being able to bank. The only people thought to lack all capacity are those who are unconscious. On to of that there are five key principles which provide a framework for applying the MCA:

  1. Presume Capacity – when assessing people should always be presumed to have full capacity in all areas until it its proven otherwise.
  2. Allow for Unwise Decisions – it’s important to remember that people with capacity can still make unwise decisions. If someone with diabetes decides they want to eat a bag of sugary sweets it’s not necessarily a sign of a lack of mental capacity. Part of having capacity is having the ability to make both wise and unwise choices.
  3. Maximise Communication – not being able to communicate easily is not the same as lacking capacity. If someone can make choices then every attempt to help them communicate meaningfully should be made so they can maintain independence. If someone is in an acute state of shock and a choice can wait until they have regained their ability to communicate then it should be left until they can make it. If someone can communicate via eye movement only then systems need to be put in place so they can do that rather than declaring them to lack capacity.
  4. Best Interests – If after looking at the above principles someone is still thought to be lacking capacity to make a specific decision then it must be ensured that any action taken is thoroughly in the persons best interests. Not the best interests of local government, a care firm or friends/family members but the best interests of the person deemed to lack capacity. This should help protect the individual from abuse.
  5. Least Restrictive Option – When deciding what action to put in place for someone deemed to lack capacity the least restrictive option should always be used. If someone is deemed to lack the capacity to make serious medical decisions they shouldn’t be institutionalised. All other options, such as the use an advocate should be exhausted first.

Assessment

The assessment is normally done in two stages:

  1. They look to see if there is an impairment in the functioning of the mind or brain. If there is no impairment then a person has capacity and the process stops there. If there is an impairment then they go onto the next stage.
  2. Assessors check to see if the individual, with regards to a specific decision, can; understand information, retain information, use information and communicate decisions. 
If the assessment/assessors is looking at a potential deprivation of liberty situation (when restraint/medication used to “restrain”/1 to 1’s/ 2 to 1’s etc… are being used over a long period of time) then 6 assessments should take place which are preformed by a GP and a Best Interest Assessor to ensure it’s in a persons best interests and the least restrictive option available. The longest deprivation of liberty orders are for 12 months.
Mental Health Act
I should say that the Mental Health Act (MHA) and the MCA are two different thing with some overlap. People sometimes assume the two things are the same, they are not. The MHA is designed to ensure people who need treatment for a severe mental health disorder receive it, even if it goes against their wishes (as long as it can be shown that not treating them would put themselves or others at risk). People with severe mental health disorders can still maintain full capacity, so if they need to be detained so that treatment can be provided the MHA would be used, not the MCA. If someone with capacity is “Sectioned” because of a mental health problem and is being deprived of liberty then that is nothing to do with the MCA. On the other hand, someone could have a mental health disorder that has had the effect of removing capacity to make certain decisions but is not severe enough to warrant a deprivation of liberty under the MHA. In that case the MCA could come into play.
I hope you found that as interesting as I did, and I’m sorry if there are any parts I’ve not explained very clearly. 
* I don’t know if you remember but in the USA there was a spate of stories about people who had undergone CPR suing those who tried to save them for assault (because CPR frequently results in broken ribs and bruising), the MCA now protects those in the UK from the same threat of legal action as long as the action is clearly in the persons without capacities best interests.

Making Spaces More Accessible

One thing I get asked from time to time is “How do we make this event/ website more accessible?”.  I have a couple of ideas about how to go about this so I thought I’d share.

When thinking about access I like to divide it up into two different categories, direct access and indirect access.

Direct Access

This is how physically accessible your venue/website/event/business is for someone with a disability. Things to consider include;

  • Step free access – steps may well be a problem for people with mobility issues, rolators, prams, wheelchairs and visual impairments. Does the space have ramps and/or working lifts?
  • Stepped access – steps often can’t be avoided but it’s still useful to try and ensure they have hand rails and are not too steep to help people with impairments effecting mobility and balance. It’s also useful to check they are in a well lit area and have clearly marked edges (like a stripe in a contrasting colour) to help people with visual impairments.  Have an idea how many there are so you can tell people who ask that there are ‘x’ steps into the building and then ‘x’ step to the toilets and ‘x’ steps to the meeting room.
  • Background noise – making sure the levels are not too high can help those with hearing impairments, it can also help people with some mental disabilities too.
  • Lighting levels – making sure things are well illuminated can be really helpful for people with visual impairments.
  • Clutter – a simple, clutter free layout is much easier to navigate and therefore more welcoming to everyone.
  • Communication – do you need someone to interpret? How are you going to make sure that people who can’t see your PowerPoint presentation can access it?
  • Text – think about easy to read fonts, this doesn’t mean sticking to  triple line spaced, 18pt Ariel all the time but it does mean re-considering that size 6 squiggly nightmare you were thinking about using. Keep it easy to access to maximise the diversity of your audience. You might want to think about braille for for the visually impaired, or making sure you’ve thought about how a screen reader will deal with your website.

Indirect Access

This is all about how emotionally/ psychologically accessible it is. This looks at the atmosphere you create and the messages that get sent out to disabled people interacting with that space. Some ways you can improve indirect access are;

  • Avoid stereotypes – just because the media suggests all disabled people develop a compensatory super-power/ are sinister/ are benefit frauds/ should be pitied/ are sexless/ are infantile/ are inspirational it doesn’t mean it’s right. 
  • Impairments are personal – curb your curiosity, disabled people are not curio’s for your entertainment. It is really rude to put someone in a position where they feel like they have to explain their health history. Don’t ask if you don’t need to know, especially not before you’ve said hello and asked what their name is.
  • Avoid disablist language – many people feel uncomfortable with (often archaic) medical terms being used as interchangeable with the words rubbish, annoying or volatile. Think before you call someone lame, crazy, mental, cripple, retarded, a flyd, spaz and so on. Some disabled people choose to reclaim those words, but many more don’t. Some disabled people don’t mind those words but can you be sure your audience is comprised of those people? It’s your right to use offensive language but the effect may well be to exclude disabled people. Don’t forget hate speech is illegal.
  • Don’t talk about someones disability unless it’s relevant. Examples include; calling people by their names not their conditions (use Emma, not ‘wheelchair Emma’ or Jo, not ‘the epileptic’). If you have to talk about disability in general terms then the social model suggests you say disabled person rather than person with disabilities. If you need to talk about it with regards to an individual then avoid using emotive language like suffers from/ burdened with/ victim of / struggling with to describe someones impairment (use person with epilepsy not epilepsy sufferer).
  • Keep a reign on comments online – There are great arguments for not moderating comments, but you need to decide if you want your website to be accessible to disabled people. By not working to keep it a safe space then people will be excluded the way they are from other websites. It’s not just the prolific use of disablist slurs that can turn disabled people away. Those who delight in picking on spelling, punctuation and grammar make it clear that those with certain learning disabilities or neurological conditions are not welcome. Yes, it can be difficult to read but does that really require a full on flaming? Will it change the persons impairment?
  • Avoid assumptions about capability – most people would rather be treated like they are more capable than they are than to be patronised.
  • Are you running a competition or game? Have you made sure it’s something accessible to all? By forcing disabled people to either do something they will struggle with or have to avoid you make it clear that they are being excluded from that activity.
  • Create an environment where disabled people can point out problems and suggest solutions without fear of being ostracised or minimised.
  • Don’t think that a summer with a broken leg is comparable to a lifetime of disability.
  • Don’t assume watching House on TV means you are an expert in other peoples conditions.
  • Remember that each disabled person is different, has had different experiences and has a different outlook on life. Not everything about them is tied to disability.

Not all of these things solely benefit disabled people either. A route suitable for a wheelchair will be suitable for a pram, describing diagrams and text can help those who are aural learners rather than visual engage with a presentation.

There are an awful lot of other things that could be added to this I’m sure, but this is just a quick list of things that can help make somewhere more accessible from off the top of my head. If you have suggestions of things that could/ should be added please feel free to pop them in the comments!

Birmingham Access Guide Launch – DisabledGo

Today I attended a launch event announcing the arrival of a access guide for Birmingham created by the organisation DisabledGo in conjunction with Birmingham City Council and sponsored by Marks & Spencers.

It began with a member of the council explaining Birmingham’s commitment to “addressing inequalities”. He then went on to talk about how this new IT support service would be a big step forwards in addressing a lot of the existing inequalities. I don’t quite agree with that, but I’ll explain that side of things later. Next up was a lady from DisabledGo who explained about the principles of the access service.

  • It covers 700 venues across Birmingham including mixture of independent businesses and larger chains
  • It covers theatres, cinemas, restaurants, shops, health care providers, education providers, travel, accommodation, banks, professional companies and more
  • These were chosen from the most popular recommendations put forwards by community steering groups at initial consultations
  • Disabled surveyors with various impairments visited each venue using a standard set of questions produced in consolation with disabled people & disabled peoples organisations
  • Users will be able to grow the database by suggesting new places to add as well as commenting on out-dated/ incorrect entries
  • There will also be steering groups twice annually to help direct and grow the guide
  • It is the 90th Access Guide launched by DisabledGo
  • It was match funded, Marks & Spencer provided £40,000 and the council are matching it over 5 years to ensure longevity of the service
  • The service will recruit more local volunteers to act as surveyors as it grows in size
  • The service will be made available to those without internet access through training of front line council and tourist information staff. It will also be possible to get hard copies of the guide.

The guide itself is pretty good. The website; www.disabledgo.com is  available in a range of colour contrast options, variable text sizes and has pro-reader settings.

You can search via post code if you are a local looking for services in specific parts of the city or, if you’re coming to visit then you can choose by area (for Birmingham you’d choose the Midlands, then choose Birmingham City Council from the list of councils covered).

It’s by no means exhaustive, Birmingham has a lot more than 700 businesses, venues, medical providers etc. but it is a good start. Having had a quick look there are a couple of local pubs and restaurants I’ve been avoiding because they appear inaccessible which actually have level access hidden round the back which is rather handy. I still get pretty grumpy about using places that make disabled people use the back entrance or having to ask staff to move bins so we can get in via a odd fire-escape, but having the option of access is better than none. I understand that it’s a step forward and that pre-1990’s civic-planning and architecture was pretty much always built without access for disabled people in mind yet still, segregated entrances will never sit well with me. Anyhow, I digress. 

There were some problematic aspects with regards to the launch, which can be problematic with any initative helping a community as diverse as those who are disabled;

  • I was pretty much the only person not attending as part of a organisation/charity. There were very few individuals. That is an issue because an awful lot of disabled people don’t have contact with the select group of organisations attending. 
  • It was mentioned repetitively that DisabledGo wanted to work with organisations representing disabled people, which means that the views of charities/organisations like RNIB, RNID, Cerebral Palsy Midlands, Spokz People etc… and the often limited range of disabilities they represent will have a larger sway over the direction of content.I would rather see the content driven by all potential users. Even those that don’t attend day centres and are not in frequent contact with charity representatives.
  • There was little there covering access from a specific Mental Health standpoint from what I saw & heard. Though, much of the guide could be very useful to people with Mental Health issues, especially in the anxiety clusters.
  • They give a mark to companies that say their staff have received disability awareness training, but there is no scale for how through this training is nor whether it is kept up to date. From personal experience working with some major UK supermarket chains diversity training is often a 15 min talk given by someone with very little knowledge about the field covering the bear minimum. As a disabled person I find that this ‘training’ more often than not doesn’t seem to stay with staff or stop them acting in a less than ideal manner which makes that certification rather pointless in my opinion.
  • The closing message by one of the project directors spoke about how this project wasn’t intended as an ‘ DDA/equalities act audit’ and how the council was using this to put ‘nice’ pressure on businesses by explaing that their is £18bn to be made from disabled customers in the UK every year and giving them a gentle nudge towards becoming more accessible in small ways. he was very keen to emphasise that they didn’t want to ‘force’ businesses to become accessible because that might create bad feeling. There was also mention that we shouldn’t be ‘too mean’ to business that don’t live up to access requirements. I, personally, feel much more radically about these things. If a business is not DDA/Equalities Act compliant I feel they should be told they are breaking the law and that they need to deal with the breach asap. Businesses will always have an excuse not to part with money in the short term for staff training/ colour defined steps/ wheelchair ramps/ hearing loops and so on and so forth. I don’t think a business’s owner’s right to feel comfortable exceeds disabled peoples rights to basic choice, access & independence. If we don’t start enforcing the equalities act the only people who will suffer are the already oppressed and disadvantaged.

All in all I though the product they were launching is a very useful tool and will become more so over time if plenty of people buy into it. I for one plan to take advantage of it. Still, there were issues with how it’s being rolled out and in my mind it is being used by the council to cover some rather counter-productive attitudes to disability and access.

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