Day services and things to do in the day for an adult with a learning disability

The words overlap and councils use them differently, so ask what a named service does on a named day rather than going by its title. A learning disability is a lifelong condition that affects how a person learns and understands; it is different from a learning difficulty such as dyslexia, which does not affect intellect, as Mencap explains. The family guide to learning disability covers the wider picture, and the disability care pillar sets out the kinds of support people use at home.

Some people like the same building, the same staff and the same friends every week. Others find a large group loud and tiring, and do better with one person beside them in a place of their own choosing. If the person is autistic as well, autism support at home covers routine, noise and preparing for change.

1. 1

   Ask the council for a needs assessment

   Free

   Under section 9 of the Care Act, the council must assess any adult who appears to need care and support, whatever their savings or income. Ring adult social care, or apply online through the council. If the person is already known to a learning disability team, ask them.
2. 2

   Say which outcomes are hard

   The eligibility test

   Needs are eligible if the person cannot achieve two or more of ten outcomes in the regulations and this has a significant impact on their wellbeing. Three of the ten are about the day: relationships, work or learning or volunteering, and using facilities in the community, including public transport.
3. 3

   Agree a care and support plan

   It belongs to the person

   The plan says how the eligible needs will be met, and the statutory guidance says the person should be involved throughout. It may name a day service, community support, a direct payment, or a mix.
4. 4

   A personal budget and a financial assessment

   What the person pays

   The personal budget is what meeting the needs costs the council. A financial assessment then works out what the person pays towards it from their own income and savings, and the council pays the rest.
5. 5

   Choose how the money is used

   Services or a direct payment

   The council can arrange the services itself, or pay the money to the person, or to someone on their behalf, as a direct payment to arrange their own support.

The regulations list the ten outcomes in full in the Care and Support (Eligibility Criteria) Regulations 2015. Before the assessment, write down what happens on each day of a normal week, including the days with nothing planned. The care needs assessment guide covers how to prepare and what to ask for. If you are the one providing most of the care, ask for a carer's assessment at the same time, because a day service often gives a family carer the only regular break in the week.

A direct payment gives the most room to shape the week. It can be used to pay a support worker or a personal assistant for outings where that meets the needs in the plan, and the statutory guidance gives the example of a man who uses his direct payment to pay for a council-run day service on the days he chooses to go. Direct payments explains how to ask for one, and personal assistants and direct payments sets out what the council will ask of you if you employ someone or engage somebody self-employed. The rules differ between councils, so ask what they will accept before you commit.

Getting there is part of the plan. A disabled person's bus pass is a legal entitlement in England for people who meet the definitions in the Transport Act 2000, and one of those definitions is having a learning disability; the council decides who qualifies, and you apply through the council. Ask the council whether it offers travel training, where somebody makes the same journey with the person until they can do it alone. Where a journey is too complicated to learn, a support worker can make it with them each week, which is covered below.

For a young person moving from school, the options at 19 and beyond are best planned in the year or two before, through the education, health and care plan and the council's preparing for adulthood work. The transition at 18 sets out what happens at each age. Where the aim is paid work, work and supported employment covers job coaches and Access to Work, and for friendships and a social life beyond organised clubs, relationships, friendships and dating goes further.

Start with the person rather than the services. Ask them, in whatever way works for them, what they enjoy, who they like being with, and which days feel long. Pictures, visits and short trial sessions can tell you more than a conversation, and the Mental Capacity Act starts from the assumption that the person can make their own choices with the right help. Making decisions for a grown-up son or daughter covers where the line sits when they cannot.

Then look at the shape. A week with something planned every day can be as hard as a week with nothing, so leave room for rest and for time alone. Keep the same things on the same days where you can, and put the calendar somewhere the person can see it. Notice which gaps are left: in Sam's week the day centre covers three days and family covers the evenings, and the gaps are the afternoons when he wants to be out doing something of his own. Those are the hours where a support worker makes the most difference.

Last, look at the family. If one parent is holding the whole week together, it is worth asking whether some of those hours should come from somewhere else, both for the parent's sake and so the person gets used to other people. Respite for parents of a disabled adult covers the forms a break can take.

PrimeCarers is an introductory service. We introduce self-employed carers and support workers, and we do not provide, arrange or manage care. The family, or the person themselves, chooses the carer, meets them first, and agrees the hours and the routine directly with them. They can keep working with the same person for as long as it suits them both. For someone who finds new places easier with a familiar face beside them, being able to choose that person, and keep them, is the reason to do it this way.

Before a carer's profile appears, we check their identity and right to work, confirm an enhanced DBS check (or PVG in Scotland, or Access NI in Northern Ireland) issued within the last 18 months, and interview them online. Separately, carers are insured while they work. How we vet carers sets out what the checks cover.

There is no way to search for carers by learning disability experience, autism experience or any kind of training, and we do not check qualifications, training or references. What a carer says about their experience is their own account on their profile, and reviews and references on a profile are not verified by us. Ask them at interview what they have done, for how long and with whom, and let the person take part in choosing. Questions to ask at interview has a list to work from, and can carers take you out? covers driving, public transport and days out.

Where the council is paying, ask the direct payments team whether a direct payment can be used for these hours. Where hours of personal care are needed at home as well, care at home for an adult with a learning disability covers the rest of the week, and a free volunteer is another option for company, as befriender, volunteer or paid companion explains.

The review duty is in section 27 of the Care Act, and chapter 13 of the care and support statutory guidance covers how reviews should be carried out, including the involvement of the person and their carer. A change in the day can bring out distress that looks like difficult behaviour, and challenging behaviour and positive behaviour support explains how to understand what the person is telling you.