This document summarizes data from North Lanarkshire, Scotland regarding their supported employment program. The program placed over 100 individuals with learning disabilities and other disabilities in paid employment from 2007-2008. On average, individuals worked 24.2 hours per week. After employment, total income increased 113.2% on average compared to pre-employment welfare benefits. The annual cost of the supported employment program was £4,304 per person, lower than the annual cost of day services. The program resulted in cost savings for the government and significantly improved financial outcomes for individuals with disabilities.

2. Why Supported Employment? Stephen Beyer Welsh Centre for Learning Disabilities Cardiff University Wales, UK

3. Percentage of people with a learning disability in paid work Estimates of people in paid work Scotland- 12.1% 2007 17% - English National Survey 2003/04 7.5% - English Local Authorities, Commission for Social Care Inspection 2007/08 WORKSTEP - about a third of people placed 2008 Pathway to Work pilots- about 2% New Deal- about 3% Access to Work- about 4% We do not know what hours people are working

6. WORKSTEP primarily over 16 hoursNational Survey 2003/04

7. Problems of awareness and definition There is little shared definition across social care and employment services of: Learning disabilities “Mild, moderate or severe” Awareness of their work potential, and support needs, is low among: Families People with learning disabilities DEAs Some employment providers Social workers and social care staff

8. Key problems of moderate and severe learning disabilities Majority of people will have problems with: speech and language memory cognitive processing More people with severe learning disabilities are are likely to experience additional: sensory and physical impairments poor vision measurable hearing loss epilepsy

9. Key problems of moderate and severe learning disabilities Ability to understand verbal instruction and to provide information Cue dependency creates difficulty transferring tasks learned here (training) to there (job) Small changes can lead to the person being unable to do a well known task : Changes in task sequence Changes in work machinery Changes in work materials Changes in a co-worker role Changes in workplace environment All this weakens the relevance of pre-training

10. Why supported employment for people with learning disabilities? Effective task training research going back into 1970s Complex & dangerous tasks Matching “ecology” of workplace to person’s wishes, talents and specific strengths researched in 1980/90s “Zero reject” vocational profiling in use since the mid 1980s instead of “work/can’t work” testing Training in a specific workplace crucial to this client group Put together, these techniques were called “supported employment” and success with people with learning disabilities demonstrated in US University evaluations in 1980 and 90s

11. What works for people with a learning disability learning jobs? Severe Moderate Mild Training on the job- Systematic Instruction Job coach support on-site Breaking tasks into steps “Chaining” tasks together Hierarchy of cues Physical guidance Gestures Verbal prompts Job adaptation if needed Managing praise and reinforcement more closely Specific social training strategies Work-based accreditation of skills demonstrated Pre-employment training is possible Verbal instruction & demonstration Simple language Greater time to learn Use of naturally occurring praise and re-inforcement through: Supervisors, work-mates Ordinary pay incentives Managing work pressure/ productivity demands Shaping social contact through co-workers Qualifications for job and career development

12. What works in finding jobs? Severe Moderate Mild Greater use of support to find & plan Families Job coaches Extended Vocational Profiling/ Discovery 20+ hours in various environs? Interests and what good at Relevant experiences Work types and environments Days and schedules Welfare benefit planning Use of practical job tryouts to aid decision-making Aided CV and support planning Proactive and specific job finding and matching jobs to people Employer presentation and negotiation Adaptation of interview and induction Greater independent action More use of generic help to identifying strengths, interests and experience Use of more generic sources for vacancies Greater use of courses, “job clubs” CV development Job search Writing applications More use of mainstream job application & interviewing and induction processes

13. Outcomes from supported employment Shafer et al. (1990) 27 states- 1,400 SE programs People with a learning disability most frequent participants 157% increased participating individuals during the study period Individual placement superior to other models West et al. (1992) 42 states- 74,960 individuals in SE People with a learning disability 62.8% of all participants 30.4% classified moderate, 8.7% as severe or profound Individual placement model dominant model

14. Outcomes from supported employment Schalock, Mcgaughey and Kiernan (1989) 1629 vocational services wages per hour in SE double those in sheltered work average full-time hours higher in SE Confirmed by Lewis et al. 1992; Noble et al, 1991 Beyer et al. (1996) UK less positive wage outcomes over half of workers increasing income by less than 60% only 2% of workers more than doubled their income 17% experienced no change in income

15. North Lanarkshire Generated significant interest because of reported high levels of employment of people with learning disabilities for 16 hours per week or more Significant financial benefits to the people reported Noted for challenging the view that the 'benefits trap' is the biggest problem restricting movement into employment An opportunity arose to examine in detail the North Lanarkshire experience and to analyse their data.

16. North Lanarkshire North Lanarkshire Supported Employment (NLSE) operates within a framework of a Supported Employment Partnership from 1999 By 2007: Two bases- Motherwell & Aidrie- one more planned One service co-ordinator Two senior support officers 16 job coach posts (often not all filled) 2 care and support workers LD clients mainly, but people with mental health issues and acquired brain injury also served since 2005

17. NLSE Process Referral visit (7 days) An assessment to ensure that the agency’s criteria are met Home visit (within 6 weeks) Explain the service Check on Welfare Benefits with Welfare Rights Officer if needed Vocational profiling (8-12 weeks) Agree person’s preferences and conditions the person wants, jobs and specific employers Twice per week for 2-3 hours per session Meeting 1:1 in a variety of settings, at different times, and involving different activities, including social outings Information also sought from family, professionals and relevant others Period includes 2 short job tasters, supported by a job coach

18. NLSE Process Job finding (Meet 1-2 hours per week) Registering person with Job Centre Plus Pursuing employers Assisting person in job search Interview preparation Further work placements as needed Job coaching (as long as needed) Providing training at work and fading support Mentoring and evaluation (agreed with person/employer) Agreeing criteria and monitoring success of placement from employer and employee perspectives Career development (No timescale) Updating Vocational Profile Taking action to improve current, or change, job

19. NLSE Process Validation Average hours provided to a sample of young people with learning disabilities in transition

20. North Lanarkshire Day Services 2005/06 Day Services in North Lanarkshire composed of 5 Day Centres Registered populations for these 5 day centres was higher at 332 places/264 people By 2007/08 a system of 5 community-based locality day services had been developed to replace traditional day centres (+ 1 opening) Registered population 334 places/295 people

21. Jobs 2007-143 jobs (138 people, 5 with 2 jobs)- 114 people with learning disabilities; 21 with mental health issues; and 3 with brain injury All people with a learning disability “either came from day centres or had an eligibility to attend the same”

22. Jobs Unemployment was 6.9% in the area compared with 4.7% for Scotland and 5.4% for the UK (ILO definition) Full data existed for 104 people in work at 2007 (96%), of which: 88 were people with learning disabilities 15 mental health issues 1 person with brain injury Data presented relates to these 104 people for whom we have data, with sub-analysis for 88 people with learning disabilities

23. Hours Mean Hours= 24.2 hours per week >16 hours= 91.3% all (89.8% LD)

24. Welfare Benefit Before (LD) The mean total income from Welfare Benefits before people entered employment was £137.60 per person (£139.51 for LD)

25. Impact of benefits advice There was a small increase in take-up of DLA at this point from 93% to 98%. Mean total income from Welfare Benefits after maximisation was £141.93 per person, an average increase of 3% on the pre-employment income. Income actually increased only for 9 people (7 for LD) Average increase in income from Welfare Benefits being 91%, or £50.03 per week (94% and £50.83 for LD) Range of individual increases being from 6% to 306% (same for LD)

26. Welfare Benefit After (LD)

27. Benefit changes Overall, Welfare Benefits represented: 99.4% of income before employment (98.7% LD) 100% after maximisation (100% LD) 48.5% when in employment (49.7% LD) Reduction in Welfare Benefits from: a mean of £137.60 per person before (£139.51 for LD) to a mean of £122.05 per person (£122.65 for LD) a fall of 11.3% (12.1% for LD) This represents a total saving to the taxpayer of per year £84,032 for the total group of clients (£77,168 for LD).

28. Wage income The average salary earned in employment was £134.29 per week (£129.60 for LD) The average hourly rate was £6.11 per hour (£6.09 per hour for LD), 14% above the adult National Minimum Wage of £5.35 in place for 2006/07 On its own, salary was slightly lower than both the average pre-employment and the maximised Welfare Benefit incomes before employment However, 40.4% of the workers had a higher gross income from salary alone, than their maximised Welfare Benefit income before employment (34.1% for LD)

29. “Better off” Overall, average total gross income from all sources after employment was £256.34 per week per person (£252.25 for LD) Better off by +113.2%, based on 104 people for who we have all data (+94.8% for 88 people with LD) Most common increase 51% and 75% A slightly greater proportion of people from other client groups (mental health, brain injury etc.) in the 200%+ better off group People with learning disabilities showed the full range of better off outcomes

30. Tax? No better off data net of Tax and National Insurance, as North Lanarkshire does not collect this data Using Tax Benefit Model Tables for 2007 (DWP 2007) can estimate the tax paid On average people would pay £16.91 tax/NI per week (£9.80 for LD) This would reduce income in employment to an average net figure of £239.43 per week per person (£242.45 for LD) Percentage better off in employment, net of tax/NI reduced slightly to +102.7% (+86.8% LD)

31. Costs to LA The annual costs of SE in North Lanarkshire, based on 2007/2008 budget was £4,304 per person per year, based on “actual capacity”- 202 people Equivalent Locality Support Service, which catered for 295 people on a full- and part-time basis with an annual cost of £14,998 Using the average number of people in jobs 122 (ranging from 109 Jan. to 129 Dec. 2007) the cost per employed person of SE rises to £7,126 per job. This still represents 47.5% of the cost of a LSS place

32. Full Cost:Benefit Analysis? Missing: Access to Work, Grants Included: Workstep payments (6 places)

33. Change in Net Saving over time 0.60 0.50 Saving 0.43p 0.40 per 0.30 £1 spent 0.20 0.10 0 1 2 3 4 5 5+ Years in operation

34. Full Cost:Benefit Analysis?

35. Conclusions North Lanarkshire have been successful in placing people from the general Social Work Services population of people with learning disabilities in employment of 16 hours per week or more This has been with relatively unfavourable unemployment levels locally. It is likely that this can only be achieved with this client group if the key approaches used in North Lanarkshire are replicated, particularly the focus on 16+ hours per week. Any reduction of cost:benefit ratios is cumulative and must be assessed across the body of people shifted from day service to employment Year 1 costs are much higher than year 9 costs Any “saving” in costs related to day service can only be redeemed if there is a strategy of shifting resources from day service to employment outcomes

36. Conclusions Skilled job coaching and investment in a staff group of sufficient size is important, and it is likely that replication would require: Investment at a significant level to provide enough job coach and Welfare Rights Advice and management resources effective training in the process Replication of the intensive SE process, and including expert Welfare Rights Advice Monitoring to ensure the process is delivered to an adequate level of intensity There remain some uncertainties in the cost analysis that would benefit from a more detailed costing of the full package of support for supported employees and day service alternatives for future workers

37. Reference Beyer, S. (2008) An evaluation of the outcomes of supported employment North Lanarkshire (2007). Motherwell: North Lanarkshire Council. Beyer, S. Goodere, L. and Kilsby, M. (1996) The Costs and Benefits of Supported Employment Agencies: Findings from a National Survey. Employment Service Research Series, No. 37. London: Stationery Office. Beyer, S., Grove, R., Schneider, J., Simons, K., Williams, V., Heyman, A., Swift, P., and Krijnen-Kemp, E. (2004) Working lives: The role of day centres in supporting people with learning disabilities into employment. London: Department of Work and Pensions. Beyer, S., Kaehne, A., Grey, J., Sheppard, K. and Meek, A. (2008) What works?- Transition to employment for young people with learning disabilities. Chippenham: Shaw Trust. DoH (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. London: The Stationery Office. DWP (2005) Improving the life chances of disabled people. Sheffield: Department for Work and Pensions.

38. Acknowledgement We are grateful to: Duncan Mackay and George McInally of North Lanarkshire Social Work Services for being prepared to share their time and their experiences with others Maureen Cook, Margaret Gavan, and Margaret Wilson for background to the services the NLSE team for producing the original updated data, to Ruby Stewart for compiling the data Patrick McAviney for providing comparative financial data. Simon Whitehead of the Valuing People Support Team for his support and VPST and CSIP