Learning disability care in Barnet

This report, produced by Healthwatch Barnet and Inclusion Barnet’s People’s Choice team, examined the experiences of people with learning disabilities receiving support in Barnet. The research was prompted by concerns raised through the Learning Disability Parliament about the quality of support provided both at home and in day services. Researchers gathered evidence from 72 people with learning disabilities, 10 support workers and four family carers through interviews, focus groups, surveys and drop-in sessions. 

Overall, the report found that most people with learning disabilities were satisfied with the support they received and felt they had a good level of independence and choice in their lives. Around 80% reported being happy with the balance between support and personal independence, while 85% felt well supported to participate in social activities, maintain family relationships and access leisure opportunities.

However, several recurring concerns emerged. Many service users reported feeling isolated when support workers spent excessive time on mobile phones during support sessions. Around 20% of respondents raised concerns about mobile phone use, saying it made them feel ignored, undervalued or reluctant to speak up about problems. Some individuals also reported experiencing disrespectful behaviour, such as support workers speaking harshly or calling them negative names. 

The report identified concerns about household support and health and safety. Some service users felt that housework was not always completed because support hours were focused on community activities. This sometimes resulted in untidy or potentially unsafe living environments, including cluttered floors, unwashed dishes and inadequate cleaning. 

Most people were satisfied with support around money management, but isolated concerns were reported where budgeting support had been inadequate. Service users also raised concerns regarding personal care, including clothing choices that did not match their preferences, fit properly or suit the weather. A small proportion felt their choices about what to wear were not always respected. 

Food and nutrition were another area of concern. Some respondents said support workers purchased foods they had not requested or encouraged unhealthy food choices despite health needs that required healthier diets. There were also reports that food labels and expiry dates were not always monitored effectively, leading to food spoilage and waste. 

The report found that service users did not always understand how support arrangements worked. Some were unclear about what happened when support sessions were cancelled, when staff were unavailable or how support hours were allocated and funded. Researchers concluded that greater transparency was needed around support contracts and service arrangements. 

Support workers generally described their work as rewarding and entered the profession because they wanted to make a positive difference to people’s lives. However, many identified difficulties supporting people to navigate the benefits system. They described dealing with welfare agencies as stressful, frustrating and time-consuming and felt they often lacked specialist support when helping service users with benefits issues. 

Family carers reported some of the most significant challenges. Many described feeling isolated, overwhelmed and under-supported. Several explained that caring responsibilities had substantially changed their lives and reduced their personal freedom. They also felt they had received insufficient training in key areas such as first aid, moving and handling, dementia awareness and health and safety. Many believed greater access to respite care and support services would improve their wellbeing. 

A case study included in the report highlighted concerns about balancing support and independence. In this example, a person receiving direct payments felt that a support worker spoke negatively to them, while evidence suggested that the worker may have exercised significant control over aspects of the individual’s finances and daily decisions. The case study illustrated the importance of ensuring support remains person-centred and promotes genuine choice and control. 

The report concluded that, although overall satisfaction with support was reasonably high, improvements were needed to enhance day-to-day experiences. Key recommendations included improving access to benefits advice, providing more information and training for family carers, increasing transparency around support agreements, reducing inappropriate mobile phone use by support workers, ensuring household tasks are completed where agreed, and making sure service users understand how to raise concerns or complaints about the support they receive.