Three questions

The closure of day centres  – and other ‘building-based’ services – continues apace. I subscribe to a popular email group run by the Foundation for People with Learning Disabilities (http://www.choiceforum.org) and there has been a spate of messages recently from family carers and professionals raising concerns about this. There’s even a report of an area opening up a new day centre for people with complex needs, having closed the old one and decided that alternatives weren’t working.

The debate about day centres quickly becomes ideological and couched in black and white terms. One side believes that the alternative to day centres is casting people with learning disabilities out into a solitary existence in a ‘community’ that turns out to be at best elusive, and at worst, openly hostile. The other side believes that day centres are evidence that segregation and institutionalisation are far from the memories they should be.

I’m reminded of the anecdote a former colleague told me of a visit by an ageing member of the House of Lords to the day centre for older people my colleague was running. It became clear that Lord X might himself be in the early stages of dementia and also that he was having a very enjoyable time, chatting with people his own age. My colleague said to Lady X, as she was thanking him for his hospitality, that his Lordship would be welcome to drop in and use the facilities whenever he wished. “That’s awfully kind of you, but my husband is already a member of the most exclusive day centre in the world”.

Most of us belong, or would like to belong, to clubs and groups of one kind or another. The difference being, that most people have choices about what to belong to and to opt out of. Clubs and groups which want us as – usually paying  – members, have to design themselves around our changing wishes and needs. We often get to contribute as well as to recieve something. And we get the option of spending time on our own as well, when we wish.

I believe that the painful and often angry debates about building-based services could nearly always be avoided if, instead of asking “Should this day centre close?”, decision-makers always asked everyone concerned these three questions:

1. How could this building be used, and by whom?
2. What services do people want and in which locations are those services best delivered?
3. What relationships are there between the people who use this building, and how can we ensure that those relationships can continue, if people want them to?

If those questions were always asked, in most cases, some people would continue to use the building, at least some of the time, whilst it would also be made available to other groups within the local community. The building would be used more fully for more of the time and would have more chance of generating income for its upkeep. Some of the services in the building would continue, others would end and some new ones would begin, all in a variety of locations. Crucially, people who used the building would be more likely to share in its ownership and to shape activities and services taking place within it. And fewer people with learning disabilities would find themselves hanging around the local shopping centre, personal assistant in tow, bored and lonely.