Transforming care for people with a learning disability

28 June 2019

In her fifth blog for us, Beth Britton writes about how care and support for people with learning disabilities needs to change and what good support looks like. (You can also learn more about this issue by visiting our disability home care services section.)

If, like me, you were angered and distressed by watching the recent BBC Panorama investigation on the hospital abuse scandal that highlighted the abuse of people with autism and learning disabilities at Whorlton Hall, a specialist hospital in County Durham, then you are probably also a supporter of Transforming Care.

Transforming Care was borne out of the Winterbourne View scandal, which came to light after another BBC Panorama investigation eight years ago. One of the cornerstones of Transforming Care is the mantra ‘Homes not Hospitals’, a nod to the need for institutional care for people with learning disabilities and autism to end in favour of community-based support.

Anyone who understands institutional care will know its shortcomings. As far back as 1851, the American physician and philanthropist Samuel Gridley Howe documented the “evils” of institutional care. He wrote, “All such institutions are unnatural, undesirable and very liable to abuse. We should have as few of them as possible, and those few should be kept as small as possible. The human family is the unit of society.”

Sadly, Transforming Care has not lived up to its hype or targets, but the need for it to succeed remains given that around 1.5 million people have a learning disability in the UK. Learning disabilities can be mild, moderate or severe, with approximately 350,000 people having what is termed a severe learning disability that would make them at particular risk of institutional care.

The alternative, of course, is care closer to home, or in the case of live-in care, within the person’s own home. These are undoubtedly the kind of options that would fall into Samuel Gridley Howe’s vision of the ‘human family’, and have numerous benefits for the person’s health and wellbeing. Community-based care is much more empowering, focuses on promoting independence, supports choice and control, and in the simplest terms gives the person a life, not just a service. This is perhaps best summed up by Martin’s story.



The need for good community-based services is further underlined by looking at the statistics that were published for the recent Learning Disability Week, which this year was themed around sport and inclusion. Mencap surveyed over three hundred 18 to 35-year-olds with a learning disability from September to November in 2015 and found that:

  • 49% would like to spend more time outside their house
  • 1 in 3 spend less than 1 hour outside their homes on a typical Saturday

To improve these statistics on an individual basis means people with a learning disability having the support that they need to get out into their communities and enjoy a range of activities that can help to boost their confidence and self-esteem, a world away from the locked doors and limited lives that people in institutions are experiencing.

Another statistic from that Mencap survey is that 18% of those surveyed felt alone and cut off from other people, which again points to the need for people with a learning disability to form positive relationships with those who support them. Promedica24 often find that their live-in care workers become more like friends to the people they support, and that type of companionship can be the catalyst to open up the world of a person with a learning disability, providing the support that they need to grow and achieve their maximum, regardless of their age or disability. When that happens, it is truly transformational.


About the author:

Beth Britton is a leading campaigner, consultant, writer, blogger, and Skills for Care Endorsed Training Provider. More information on Beth’s website:

Promedica24 and Learning disabilities:

To find out more about how Promedica’s live-in care can help to a person with a learning disability, please call 0800 086 8686 or email




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