Learning disability care reform needed - review

The normalisation of restrictive practices and and mismatch of accommodation were among issues identified in a review of care for adults with learning disabilities.

The findings have been published in an independent review by specialists Cordis Bright into the residential care services provided on the Isle of Man.

The review was commissioned by Manx Care after a number of safeguarding concerns were raised in the autumn of 2024.

Chief executive Teresa Cope said the report identified "significant areas for improvement" but the organisation was "fully committed to supporting adults with learning disabilities".

In the wake of the review the organisation would "work with partners across the system to build a strategy for the future", she said.

Director of charity Manx Mencap Fran Tinkler said the report confirmed what families had "experienced for years".

Services could be "fragmented, under-resourced, and may not meet the needs of people with learning disabilities and their families", she said.

"This must be the moment that promises turn into progress, supported by proper investment, clear accountability, and timelines for change", she added.

The report found that in some cases people cared for in residential homes faced restrictive measures such as lack of access to the kitchen because other residents risked hurting themselves if if allowed to use the facilities, for example by drinking from a kettle.

In a limited number of cases residents who could not safely spend time together were sometimes restricted to their own rooms to avoid contact, the review said.

It also found restrictive practices put in place for extended periods of time to maintain the safety of residents were were often in response to staffing shortages.

Another key challenge identified was that people were placed into one of the 17 residential homes based on availability rather than suitability.

This, the review said, meant that there were people who were living together whose support needs were "very different".

That could lead to those with high needs contending with people who are more able than them, and those with lower needs may be placed under "undue restrictions", the review continued.

Several homes had also been "poorly maintained or had become shabby", with some having issues such as persistent damp or leaks, or needing repairs, the review said.

In some cases, "inappropriate workarounds" became the norm, the review said, with one home still without wi-fi.

Recommendations from the report included ensuring greater variety of options for support, and reducing the current "over reliance on residential care", better engagement with family members, and a property strategy to improve accommodation options.

Another key recommendation was the creation of a workforce strategy to address issues of low morale, ensure appropriate training and meet the need for a greater variety of care, the review added.

Health and Social Care Minister Claire Christian said the department would continue to work with Manx Care to implement the recommendations and to "develop and modernise our service" alongside Manx Mencap.

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