Vision rehabilitation: improving outcomes and saving care costs, an unsung profession

Simon Labbett, Vision Rehabilitation Worker, at Bradford Metropolitan District Council shares an insight into what his role involves.

If you’re reading this then you have an advantage over most people I work with in my professional life. If you drive to work, you also have that advantage. Likewise, if you can see the face of your partner or children.

I work with people who are losing their sight or who have gone blind.

Rehabilitation after stroke or after falls is a well-recognised part of NHS provision, but did you know that the equivalent rehabilitation for sight-loss and blindness is part of statutory social care delivery, and framed within the scope of the Care Act?

I work as a vision rehabilitation worker for Bradford Council in adult social care and a simple case study of my work should illustrate my profession’s integral role at the boundary between health and social care.

Supporting Carlton

Carlton has bipolar disorder. He was referred by the NHS community mental health team because he was due to be discharged from hospital into a new flat, after having been sectioned for eight months.

The flat is situated miles away from his family. Carlton has a degenerative sight condition and now is almost blind. He had never had to cook for himself prior to admission and had no links in the new community.

The job of the multi-disciplinary team was to support Carlton to build a new life in a new place - but with no sight.

My role has been to teach Carlton how to get out and about safely.

I’ve been teaching him to use a white cane, how to walk with confidence and locate the crossing point of the road, and decide when to cross safely (doubly difficult in this case because there’s no zebra crossing or traffic light on this stretch of road), and then find the shop and identify what it is he needs to buy in the shop.

Carlton’s biggest sense of frustration was needing carers to read his private mail for him, but this is where the newest text-reading phone apps were a real help. Apps are indeed great, but they still need to be taught, and sleek smooth smartphones are not always the easiest bits of kit to use by touch alone.

I’ve also been teaching Carlton how to prepare and cook his favourite dish – pasta and bolognese sauce. This means teaching him how to put a pan squarely on the gas ring, know when the gas is on or off, and know how to drain the boiling water without scalding himself. If you’ve ever tried doing this with your eyes closed – well, I wouldn’t recommend it!

I’ve been working with Carlton for about four months and things are really moving on for him. He no longer needs a morning and evening care call to check medicines and prepare tea – he’s doing these for himself using specialist equipment and the best resource possible: his own skills and self-belief.

The next step is to learn to travel by bus to get to visit his family; that means knowing when the bus is coming, finding a seat, working out where to get off, and then stepping down on to the pavement.

Vision rehabilitation is a job that requires skilled risk-management, resourcefulness, and adaptability. But it’s genuinely incredibly rewarding and fascinating.

The qualification process to become a vision rehabilitation worker lasts two years - it’s been one of the government’s trailblazer apprenticeship standards for four years now.

My qualification and mandatory continuing profession development (CPD) requirement means I’m on the accredited Professional Register of Vision Rehabilitation Workers – a register recognised by the Professional Standards Authority in 2022.

In some local authority settings, vision rehabilitation workers are part of occupational therapy or early intervention teams. However, in Bradford I work within the sensory needs service where I sit alongside specialist social workers (for both visually impaired people and deaf people), as well as a qualified dual-sensory impairment specialist and British Sign Language (BSL) interpreting team.

Bradford employs four fully-qualified vision rehabilitation workers and one apprentice. The blend of our early intervention skills and the social workers’ care management role ensures that the service can evaluate where early intervention is sufficient or where a package of care and support is still required.

One thing our team recognises is that work with visually impaired people is very rarely about “only” vision.

Vision loss is a significant component in work providing support with ageing, falls, stroke, diabetes, learning disability, and dementia. Our collaborative way of working in these areas – particularly where we look at communication deficits that are made worse by vison loss – are integral to providing better care for people, as well as reducing isolation, and reducing care costs.

The charity Fight for Sight states that there are over two million people with sight loss in the UK and that this number will reach 2.7 million by 2030 and double by 2050.

Around 250 people start to lose their sight every day. Statistics are one thing, but the effect on an individual losing sight is a life-changing experience with social, psychological, and emotional consequences for them and their family. Almost everything we do in life is governed by our ability to see.

For more information about Vision Rehabilitation and its role in meeting statutory duties to prevent, reduce or delay the need for care and support within the Care Act, ADASS published this position statement.

You can also find more information about cost avoidance through vision rehabilitation provision in this guide from the Rehabilitation Workers Professional Network.

Interested in a career in care? Find out more about different roles on Think Care Careers.

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