Rehabilitation Services

Please click on the green play button below to listen to the audio version of the Rehabilitation Services section of the Statutory Accounts.

KAB's rehabilitation teams each provide a wide range of services:

• Registration as severely sight impaired (blind) or sight impaired (partially sighted)
• Assessment of individual needs plus information and advice on visual impairment and eye conditions
• Training in all aspects of rehabilitation, daily living and communication
• Mobility training - at home, at work, and in school & community settings
• Support to children and young people in schools and at home
• Equipment provision
• Low vision support
• Welfare rights & benefits advice
• Dedicated service to people with learning disabilities
• Access to peer and social support via KAB's network of local groups and clubs
• A range of volunteer support based on individual needs

KAB provides rehabilitation services under contract to Kent County Council (KCC), Medway Council, and the London Borough of Bromley. We also provide support services in the London Borough of Bexley. These core contracts, together with small local authority grants for specific activities comprised £1,256,161 of KAB’s income in 2010/11, compared with £1,312,768 in the previous year.  The reduction in income represents a fall in one-off project grants, reflecting the current difficult economic climate. In the previous year such grants had been received for training, and purchasing equipment for loan and demonstration. All other funding remains similar for the year ended 2011.

The cost of our rehabilitation service has fallen over the year from £1,565,182 in 2009/10 to £1,512,434 in the current year. The majority of the reduction is the result of falling staff costs due to the redundancy of a Rehabilitation Operations Manager (ROM) post in August 2010. The ROM posts were developed in 2008 to support our rehab services through a period of major change within health and social care, and this reduction from 2 to 1 ROM posts was part of a planned strategy. Occasional vacancies in the rehab teams also contributed to the reduction.  

In 2009/10 KCC disaggregated its adults’ and children’s services, and a new 3-year children’s contract was agreed. As part of this disaggregation, £40,000 was transferred from the adults grant to the children’s grant. The new contracts commissioned specific work with named children, and has brought about very encouraging changes in our work with children and young people. Traditional mobility practices have been challenged and new techniques have been trialled and developed, leading to exciting new mobility methods with some very young children.  In Spring 2011, KCC again restructured and adults and childrens services came back together within a single directorate.  An aim for KAB for 2011/12 will be to ensure that our current high level of service – both quality and quantity - continues, and to ensure the charity is well placed to bid for future contracts in competitive tendering processes.

KAB has dedicated rehab workers who carry out preventative work with people with learning disabilities, who are 30-40% more likely than non-learning disabled people to have some form of sensory impairment. Following research into local needs carried out in 2008 and 2009, last year we established a detailed work plan for the next 18 months.  Key aims for 2011 were improving awareness of KAB’s work among local authorities, health care professionals and service users, seconding a worker to a health team to try and develop better protocols for joint working and reduce duplications and omissions, increasing face to face contact time with people with a learning disability and increasing preventative work by identifying clients whose eye health needs have previously gone unmet. This work has already led to a better understanding of joint working and smoother referral pathways, but, because of the major changes in health service provision and structures, we feel that we need to revisit our learning disability strategy in autumn 2011, and once that is done we may reconfigure some elements of provision if needed.

A key aim for 2010/11 was to reinforce evaluation and ensure excellent practice throughout our rehab services. Definite progress has been made, albeit more slowly than originally planned due, in part, to staff changes. A new Head of Rehab Services came into post in summer 2010 following the retirement of the previous postholder, and a new Rehab Operations Manager was recruited in spring 2011, so we have invested time in our new colleagues’ induction.  Since then progress has been swift: new client evaluation forms have been successfully piloted, and the resulting information has fed into the development of new professional practices.  However, we acknowledge that we still have a way to go to be able to effectively gather, respond to, and evidence good feedback, so this remains a key aim for 2011/12.   

Following the economic crisis of the past two years and the austerity measures introduced by the current government, significant changes are expected to our contracts and funding in the future, and managing the change and the risk involved will be a key challenge for KAB in 2011/12.  We have already experienced low level cuts in funding from the London Borough of Bromley, where budget constraints led to a suspension of funding for equipment and Talking Books at the end of 2010.  Following a review in summer 2011, we were pleased to see limited equipment provision resume, but it is unlikely that Talking Books will be funded again.  

We had good news from Bexley Council, which again agreed funding for our part-time Volunteer Co-ordinator and part-time Learning Disability Worker in Bexley (both 3-year agreements), and also from Bromley Council who have renewed our small contract for provision of services to children until March 2012.

The requirement to tender for services that we previously provided under grant or contract will become a reality for KAB in 2011/12, as local authorities are required to put services out to competitive tender. Often this is being preceded by detailed service reviews such as the one carried out by KCC in late 2010/11. Early experience indicates that the reviews and the tendering processes are fairly bureaucratic and will make very significant demands on senior staff members’ time in 2011/12.

Local authorities need to make savings and demonstrate efficiencies, and in some areas, means-testing and higher eligibility criteria for (free) services means less rehab work is being paid for. Set against this background of decreasing funding is the fact that the majority of sight loss is age-related, so KAB can expect that demands for our help will continue to rise. For many years, more than 60% of our annual income has come from local government, but local authorities urgently need to make major spending cuts, and sensory impairment is seen by many in our field as an easy target because of its low profile. Whilst we appreciate the need for efficiencies, we are determined that our service users should not bear an unfair share of the cuts, especially as we are convinced of the long-term savings that result from early and efficient interventions. Therefore a key aim for KAB in 2011/12 is to try to ensure commissioners fully understand the real needs of our service users, and the potential cost savings that arise from early professional support.

We are also starting to see an increase in the number of takeovers and mergers within the visual impairment charity sector. KAB favours collaboration, and has a track record of investing in partnership working, and of co-funding new initiatives with other groups to achieve the best possible services for local people.  A key aim will be to continue to develop partnerships as long as they are of benefit to our service users, and whilst we are not planning on mergers or takeovers, it is likely that we will continue to develop partnership arrangements during the year ahead, and that these may be on a more formal footing than previously.