RNIB Cymru supporting people with learning disabilities and sight loss to live their lives

For most of us, carrying out everyday tasks and getting around safely and independently in our own homes is merely part of our daily routine. However, people with learning disabilities and sight loss can find such day-to-day tasks extremely challenging because housing does not meet their needs. Simple changes can make a big difference!

RNIB Cymru is responding to the needs of people with both learning disabilities and sight loss by producing a new guide for housing providers: Homes for people with learning disabilities and sight loss – A guide to providing safe and accessible environments’.


There are approximately 1.5 million adults in the United Kingdom with a learning disability, around 1 in 10 of whom have serious sight loss which impacts greatly on day to day life. However, with better design, houses can be made more accessible for people with learning disabilities and sight loss in order to reduce the risk of falls and accidents in the home, improve wellbeing and quality of life, and support independence which will reduce the levels of care and support required.


RNIB Cymru’s guide provides clear and simple guidance on how to design, refurbish and maintain accommodation in a way that will best support the needs of people with both learning disabilities and sight loss. This includes the appropriate use of colour, lighting, wayfinding, signage, surfaces, acoustics, accessible gardens and external areas, and advice on accessing eye care services.


Ceri Jackson, Director RNIB Cymru said:


“People with learning disabilities are 10 times more likely to have serious sight loss, and yet a person’s sight loss may not be obvious to other people which means that many people with learning disabilities and sight loss may live in housing that is not designed or adapted to take account of sight loss.


“RNIB Cymru’s vision, supported by this publication, is to have housing and buildings in Wales that are inclusively designed and accessible for all, so that people with sight loss can stay safe, maintain their independence and have the best possible quality of life without having to worry about the home environment around them.


“The guidance, along with the work of our highly-respected Visibly Better team, which carries out access consultancy, training, research and accreditation for builders and designers across Wales, highlights the changes that are needed to make accommodation accessible. They are often quite simple and easy to implement, but can make a huge difference to a person’s quality of life.”


The Welsh Government have provided funding for the RNIB publication, and

Rebecca Evans, Welsh Government Minister for Social Services and Public Health, commented:


“The Welsh Government is pleased to support the launch of this new RNIB Cymru publication which, when the guidance within is implemented, will improve the lives of people with learning disabilities and sight loss.


“Making such changes to homes can help people to live independently for as long as possible, preventing or reducing the demand for health and care services. It can also help in facilitating earlier discharges from hospital, allowing people to go home sooner."


The guidance can be accessed via: www.rnib.org.uk


For further information please contact Bilingual Communications Manager richard.timothy@rnib.org.uk 029 2082 8563


Case study – Caroline is a 37 year old woman with a learning disability living in supported accommodation. Staff have concerns regarding her increased falls at home and had been advised by rehabilitation staff to check if Caroline’s hearing was affecting her balance, which they did and were able to confirm that she had no hearing difficulties. Staff then decided to check if there was an underlying visual cause. The RNIB Visual Impairment and Learning Disability Service (VILD) project has supported Caroline to access eyecare which has involved a full functional vision assessment from a RNIB worker, support through optometry and the provision of a person-centred vision report. The main concerns which prompted the referral were Caroline’s mobility and her behaviour. She was falling up to seven times in any given week, clinging onto walls when she was attempting independent mobility, and required the support of a care worker to be ambulatory around her living environment. Caroline also had poor posture with her head tilted to the right-hand side.


On occasions, staff found Caroline’s behaviour frustrating as they felt she was over-reliant on their support. She would become disappointed and upset when there were no staff available to support her into and out of a taxi which meant she could not visit her friends. Staff have admitted that they essentially thought Caroline “was simply being difficult” when they challenged her about behaviour and mobility difficulties, and attributed all of these to her learning disability and physical problems. She was recently referred to physiotherapy in an attempt to improve her posture. The physiotherapist had recommended that Caroline not hold onto the walls so as not to weaken her back, and for Caroline to hold her head up when walking. She advised staff to support Caroline by holding her left elbow joint because she leaned heavily on them when mobilising.


Intervention – Following a functional and clinical assessment of her vision, Caroline was found to have severe difficulties in focusing her eyes, in addition to a squint in her left eye. Caroline is not able to focus her eyes on any given image and seems to be processing information through sound and touch. This means Caroline may be considerably disabled in her ability to judge distances and depths because both eyes are not being used together and there was possible vision loss in her right eye. It was also found that Caroline is sensitive to glare.


Conclusions and Recommendations – It was concluded that Caroline’s poorly-contrasted living environment was extremely disabling and reduced her independence. Dark walls and carpet, plus low lighting left only two white skirting boards as a visual reference. This was undoubtedly a contributory factor in her unusual gait and head posture.


Outcomes – Caroline’s mobility around her supported housing has dramatically improved and staff are now only reporting two, if any, falls in a week. When adequate lighting was installed, Caroline was immediately able to find her way unsupported to her own room – which she had never been able to do. Caroline’s mobility has improved so much that she is now able to visit her friends without support, giving her the independence, choice and control she so desired. Staff have particularly noted a significant reduction in the need to manage Caroline’s behaviour and have attributed this to improvements following assessment, and their awareness of the practical support needed to maximise the use of Caroline’s remaining vision. Caroline is now much less reliant on support from staff, giving them more time to attend to other tenants. With her improved mobility came a concomitant improvement in posture and as a result, Caroline has now been discharged from physiotherapy.


Impact – It is estimated that the supported tenancy are saving 2 hours per week in support time. Support needs are reduced for her mobility around the home environment, as are the needs to deal with falls and their aftermath (accident reporting, casualty visits etc.).

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Team @ AberdareOnline

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