Sensory disabilities

Sensory disabilities refer to visual and hearing impairment.

Visual impairment (blind or partially sighted)

There are two main areas that are looked at when measuring a person’s vision:

  • Visual acuity: This is the central vision used to look at objects in detail, such as reading a book or watching television;
  • Visual field: This is the ability to see around the edge of your vision while looking straight ahead.

Hearing impairment (hard of hearing or deafness)

There are three main types of hearing loss:

  • Conductive hearing loss: Sounds are unable to pass from the outer ear to the inner ear, often as the result of a blockage such as earwaxglue ear or a build-up of fluid due to an ear infection, a perforated ear drum or a disorder of the hearing bones;
  • Sensorineural hearing loss: Sensitive hair cells either inside the cochlea or the auditory nerve are damaged, either naturally through ageing, or as a result of injury;
  • Mixed hearing loss: It is possible to get both types of hearing loss at the same time.

Dual sensory impairment

Dual sensory impairment is the combined loss of hearing and vision.

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Evidence indicates that the prevalence of visual and hearing impairments increases with age. With an ageing population, this means there will be more people acquiring these conditions.

Most sensory impairments develop gradually and are often secondary to other disabilities.

The impact of sensory loss and other health determinants can dramatically increase risk and demand on health and social care services. 

People with sensory loss are at greater risk of social isolation.

It is estimated there are more than ten million people in the UK with some form of hearing loss.

There are around 360,000 people who are registered as visually impaired in England. As many as 2 million people in the UK may be living with some degree of visual impairment.

It is estimated that around 1 in 5 people over the age of 75-years-old have some degree of visual impairment.

Age-related macular degeneration leading cause of blindness in adults. Other significant causes of sight loss are glaucoma, cataracts and diabetic retinopathy.

For adults with sight loss there is a correlated loss of independence and an increased   risk of poverty.

Sensory disabilities is linked with the following JSNA topics:

Carers

Employment

Housing

Transport

Education

Diabetes

Mental and behavioural disorders

Last updated: 2016-01-27 10:24:03
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1. What are the key issues?

It is estimated that 5.9% of the population of Middlesbrough has some form of sensory impairment.

Last updated: 06/11/12

2. What commissioning priorities are recommended?

2012/01

Stimulate local markets to ensure the availability and choice of cost-effective provision which meets needs locally by:

  • Making information and advice on support services available (including making costs available to service users and carers in appropriate formats);
  • Working alongside providers to ensure their practices comply with the outcomes-based aspirations of service users.

2012/02

Promote personalised systems that place the person at the heart of any process, provide information & advice and stimulate universal access to all services by:

  • Developing and implementing a ‘Citizens Portal’ (an online resource that acts as a gateway to information in Middlesbrough);
  • Carrying out research into how social media can be used in social care as a communication tool;
  • Providing training and awareness of information delivery strategy, sources and their responsibilities (social workers, staff in provider services, VCS organisations, local authority staff);
  • Ensuring that the government targets for the implementation of personalised budgets are met;
  • Reconfiguring management structures within social care to develop locality-based services;
  • Reviewing the ‘Integrated Occupational Therapy Service’ arrangements in light of vertical integration between South Tees Hospitals Foundation Trust and MRCCS;
  • Introducing universal information, advice and advocacy service to meet the needs of customers;
  • Implementing changes to the first contact point in social care to improve response to the public.

2012/03

Promote health and well-being (including early intervention) to prevent/reduce reliance on service provision by:

  • Reviewing Middlesbrough Council’s approach to the use of Telecare and its Carelink services (including remodelling and marketing where applicable and  link to Telehealth);
  • Implementing the Combined Delivery Plan in affiliation with the members of the Safer Middlesbrough Partnership (SMP).

2012/04

Ensure that the principles of quality, equality and value for money are embedded within processes and service provision by:

  • Implementing an alternative and improved model of support for Deaf Centre users;
  • Implementing a single resource allocation system;
  • Giving all new service users, those within existing services and those in transition a resource allocation and the opportunity to take up an individual budget if appropriate.
Last updated: 06/11/12

3. Who is at risk and why?

Visual impairment

Age

The vast majority of people with sight loss are elderly. Visual impairment prevalence increases with age.

Socioeconomic status

People from deprived areas are less likely to seek eye health checks and therefore are at higher risk of undiagnosed eye conditions.

Ethnicity

People from African/African-Caribbean populations are four times more likely to develop glaucoma and have higher risk of age-related macular degeneration (AMD). People from Asian populations are at higher risk of cataracts. Both groups are at higher risk of diabetic eye disease.

Lifestyle

Smokers double their risk of developing AMD; they also tend to develop it earlier than non-smokers do. 

Smoking can make diabetes-related sight problems worse, and has been linked to the development of cataracts.

Obesity has been linked to several eye conditions including cataracts and AMD.  Obesity also has a strong link with diabetes and an exacerbation of sight deterioration in diabetic retinopathy.

Illness

An estimated 60% of stroke survivors have some sort of visual dysfunction following a stroke. The most common condition is some loss of visual field which occurs in 30% of all stroke survivors.

Uncontrolled high blood pressure can cause retinal damage by constriction of the retinal blood vessels.

Diabetic retinopathy can lead to sight loss.

Dementia sufferers may have eye conditions such as cataracts or AMD; others will have a type of dementia that impairs their vision by affecting perception of depth, colour and detail. It is estimated that around 2.5% of people over the age of 75 will have dementia and significant sight loss. 

Depression

Older people with sight loss are also almost three times more likely to experience depression than people with good vision. 

Stress from living with visual impairment places a strain on relationships, as people become less able to live independently and are compelled to rely on family and friends to meet their needs.

Learning disabilities

Adults with learning disabilities are ten times more likely to be visually impaired than the general population. In the past people with learning disabilities have been less likely to have eye examinations.

Falls

People with visual loss are 1.7 times more likely to have a fall and 1.9 times more likely to have multiple falls.

Of the total cost of treating all accidental falls in the UK, 21% was spent on the population with visual impairment.

Hearing impairment

Age

The vast majority of people with hearing loss are elderly. Prevalence increases with age. It is estimated that there are 3.7m aged between 16 and 64-years-old with a hearing loss and 6.4m aged 65-years-old and above.

Babies will be at risk of failing to develop language skills and of low educational attainment if their hearing impairment goes undetected.

Ethnicity

It is believed that prevalence of hearing impairment is higher in BME communities, particularly in more recent immigrants from countries with low levels of immunisation against conditions such as rubella.

Illness

People receiving ototoxic drugs are at greater risk of a hearing impairment.

People with hearing loss may also have other additional disabilities or long-term health conditions that limit their daily activities such as arthritis and mobility problems. This often means that barriers to inclusion and feelings of isolation are worsened.

Environment

People regularly subjected to loud noise are at greater risk of a hearing impairment.

Injuries

Direct head trauma can cause hearing loss.

People with hearing loss are also highly likely to have problems such as tinnitus and balance disorders which contribute as risk factors for falls and other accidental injuries.

Those who become suddenly deafened through trauma or infection are likely to experience acute emotional distress and find it difficult to cope.

Last updated: 06/11/12

4. What is the level of need in the population?

Middlesbrough council recorded data

Number of people in Middlesbrough formally recorded as having a visual or hearing impairment

Age Group

Visual Impairment

Hearing Impairment

0 - 17

50

15

18 - 64

206

323

65+

361

721

Total

617

1,059

 

This group accounts for 5.86% of Middlesbrough residents, of these 45.9% are male and 54.1% are female. There are also 57 people from the BME community, where the majority (44) are aged between 18 and 64-years-old.

Age/impairment split of people in Middlesbrough formally recorded as having a visual or hearing impairment

POPPI and PANSI

PANSI and POPPI systems estimate there may be up to 13,048 people in Middlesbrough who have some form of auditory impairment.

POPPI and PANSI data to show age-band and hearing impairment type

Age Band

Moderate/Severe

Profound

Total

18-24

37

0

37

25-34

91

0

91

35-44

232

0

232

45-54

1,067

9

1,076

55-64

1,773

20

1,792

65-74

2,087

66

2,153

75-84

4,852

49

4,901

85+

2,631

134

2,765

Total

12,770

278

13,048

 

 

Referrals, assessments and packages of care (RAP)

Between April 2010 and March 2011, there were 13 new registrations of service users who were blind or partially sighted and six who were deaf or hard of hearing.

Section P1 of the RAP return can allow us to see what is happening with the number of people with sensory impairments over a period of time.

It is worth noting that this section refers to people who have a primary client type of “physical disability” and/or the following subsets:

  • Frailty and/or temporary illness;
  • Hearing impairment;
  • Visual impairment;
  • Dual sensory loss;
  • Have been in receipt of a service “provided by or commissioned by” the local authority in the relevant financial year.

As a consequence, this number may not represent all registered cases of sensory impairment. However, it should give a good indication as to the likely trend and the proportions of people affected by age group.

RAP data to show number with a hearing impairment, Middlesbrough, by age-band, 2006-2011.

Those aged 65-years-old and above, have shown a general decrease in number over the last five years but have begun to increase again during 2010/11.

Those aged 18 to 64-years-old have increased slightly in number each year since records began, falling back slightly in the last financial year.

RAP data to show number with a visual impairment, Middlesbrough, by age-band, 2006-2011.

The number of people aged 18 to 64-years-old accessing services has been static in and around 30 to 40 individuals per year.

RAP data to show number with dual sensory loss, Middlesbrough, by age-band, 2006-2011.

There has been a decline in numbers aged 65-years-old and above from 32 in 2006 to 19 in 2011.

Last updated: 06/11/12

5. What services are currently provided?

National

Newborn Hearing Screening Programme (NHSP)

The Newborn Hearing Screening Programme (NHSP) aims to identify moderate, severe and profound hearing impairment in newborn babies. The programme automatically offers all parents the opportunity to have their baby's hearing tested shortly after birth.

National Deaf Children's Society 

The National Deaf Children's Society  is a telephone helpline for children with a hearing impairment.

Jobcentre Plus

Jobcentre Plus offers a service for disabled workers by putting them in touch with a disability employment advisor (DEA). A DEA will help clients to find work or to gain new skills for a job. They can help with work preparation, advocacy, recruitment, and even confidence building. DEAs offer an employment assessment to find out what types of work would suit the individual best.

Staying Put

The Staying Put Agency assists older, vulnerable and disabled people to remain independent and in their home by offering a range of financial and practical support services including disabled facilities grants, equipment repairs and minor adaptations.

Tees-wide

North Tees and Hartlepool Audiology

The North Tees & Hartlepool Audiology department provides a complete diagnostic and hearing aid rehabilitation service making special provision for deaf and hearing impaired patients and offering guidance and support to patients and their families.

South Tees ENT and Audiology

The South Tees ENT and Audiology department provide the regional cochlear implant service as well as NHS treatment for patients with more complex hearing disorders.

Peripatetic services

The peripatetic service based in Middlesbrough is for teachers of the deaf who provide support for children and young people throughout their education. 

Teesside Society for the Blind

Teesside Society for the Blind is contracted to provide a visiting service for people with visual impairments. The visitors are volunteers who assist people with a range of tasks such as reading of mail, writing letters, escorting to appointments, shopping trips or social engagements.

Middlesbrough

Ransdale House

Middlesbrough Borough Council has commissioned the Ransdale House care home which is operated by the Royal National Institute for the Deaf (RNID) and provides residential care for up to six people with hearing impairments.

Middlesbrough Borough Council

The council operates a team who work with people of working age with disabilities who want to work. They deliver tailored support with a view to the person finding a sustainable job paying a living wage. Since 2008, the service has received referrals for 655 people and currently has over 200 active clients.

Last updated: 06/11/12

6. What is the projected level of need?

Visual impairment

The chart below estimates the people aged over 65-years-old predicted to have a moderate or severe visual impairment.

Predicted number of people with moderate or severe visual impairment aged 65+

2012

2013

2014

2015

2016

2020

2025

2030

1,954

1,983

2,014

2,042

2,054

2,173

2,436

2,689

 

Hearing impairment

The chart below estimates the people aged 18 to 64-years-old predicted to have a moderate or severe hearing impairment.

Predicted number of people with moderate or severe hearing impairment aged 18-64

2012

2013

2014

2015

2016

2020

2025

2030

3,200

3,172

3,191

3,188

3,215

3,187

3,054

2,857

 

The chart below estimates the people aged over 65-years-old predicted to have a moderate or severe hearing impairment.

Predicted number of people with moderate or severe hearing impairment aged 65+

2012

2013

2014

2015

2016

2020

2025

2030

9,454

9,531

9,785

9,846

10,071

10,642

12,109

13,386

 

The chart below estimates the people aged over 65-years-old predicted to have a profound hearing impairment.

Predicted number of people with profound hearing impairment aged 65+

2012

2013

2014

2015

2016

2020

2025

2030

245

247

256

258

271

293

333

370

 

Last updated: 06/11/12

7. What needs might be unmet?

Specially adapted housing is required in certain locations.

Last updated: 06/11/12

8. What evidence is there for effective intervention?

National Services Framework for Long Term Conditions, 2005.

Putting People First: A Shared Vision and Commitment to the Transformation of Adult Social Care, 2007.

World Class Commissioning and the Darzi Review: Our NHS, Our Future, 2007.

The National Carers Strategy, 2008.

The Equality Act, 2010.

Improving the Life Chances of Disabled People (Jan 2005)

A cross-government policy. The vision is for disabled people in Britain to be respected as members of society by 2025. 

Our Health, Our Care, Our Say

White paper, the Government’s Vision for Health and Social care services is underpinned by achieving four main goals:

  • Better prevention and early intervention for improved health, independence and well-being;
  • More choice and a stronger voice for local individuals and communities;
  • Tackling inequalities and access to services;
  • More support for people with long-term needs.

Independence, Well-being and Choice (DH 2005)

This offers a vision for the future of social care for adults in England. Person centred, proactive and seamless services are promoted so that people who use social care services will have more control, more choice, and the chance to do things that other people take for granted.

UK Vision Strategy

The strategy aims to:

  • Improve the eye health of the people of the UK;
  • Eliminate avoidable sight loss and deliver excellent support to those with a visual impairment;
  • Enhance the inclusion, participation and independence of blind and partially sighted people.

 

Last updated: 06/11/12

9. What do people say?

Middlesbrough Council has consulted with people with sensory impairments, their carers, service and voluntary providers to understand the requirements of those with visual or auditory impairments. The following recommendations are based upon this consultation.

Information and communication

  • Use properly trained interpreters.
  • Find alternative ways of communication with people who have visual impairments or are deaf.

 Awareness Raising and Promotion

  • Make sure that staff understand the issues faced by people with sensory impairments.

 Education and access to employment

  • Review the support available to enable people to prepare, look for and retain jobs and access education. 

Independence and well-being

  • Investigate people’s daily needs to enable them to live independently in the community.

 Community safety

  • Review how community safety can be improved, for example by tackling hate crime, removing obstacles on paths and in public buildings and providing appropriate methods for deaf people to contact emergency services.

 Access and transport

  • Ensure all buildings are accessible to people with sensory impairments.
  • Consider the needs of people who are reliant upon public transport, for instance, ensuring bus stops are identifiable and can supply audible information on times and routes.

 Active citizenship and partnership

  • Ensure there are methods which help people to speak for themselves, including discussion panels and advocacy services.
Last updated: 06/11/12

10. What additional needs assessment is required?

There are no further needs assessment required at present.

Last updated: 06/11/12

Key Contact

Name: Erik Scollay

Job Title: Assistant Director, Social Care

e-mail: erik_scollay@middlesbrough.gov.uk

phone: