Supporting people

with sensory loss

Guide for social
service professionals
2 Supporting people with sensory loss

Contents
• Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

• Legal responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

• Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

• Access to services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

• Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

• Advocacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

• Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

• Equipment and technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

• Policies and procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

• Further information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

• Appendix: RNIB Clear print checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Definitions
The term ‘people with sensory loss’ refers to:

• people who are Deaf, deafened or have a hearing loss

• people who are blind or partially sighted
• people who are deafblind: those whose combined sight loss and hearing loss causes
difficulties with communication, access to information and mobility.
 Supporting people with sensory loss
Introduction
Sensory loss affects one in five people in Wales
In Wales there are 575,500 people who are
deaf or have hearing loss, 110,000 who are blind
or living with sight loss and 20,786 who are
deafblind. This number is set to rise dramatically,
as our population ages, and the prevalence of
people with health conditions related to sensory
loss, such as diabetes, increases.
People with sensory loss are more likely to feel
isolated and cut-off from their local community.
And for you, as service providers, it can be
challenging, taking their needs into account
and engaging with them as well as you’d like.
“The social worker and rehabilitation officer
have been great, but it would be nice to be
supported by a worker who understands
my needs as a deafblind person.
I like to be active in my community. But,
without the support from a social worker
and note taker, I am restricted in what I can
do, which has made me feel more and more
isolated.”
3
We – Action on Hearing Loss Cymru and
RNIB Cymru – are determined to help change
this. In this guide we provide highly practical
information and advice so you can improve
your day-to-day practice. It will help you build
your awareness and understanding of the
specific needs of people who are deaf, or have
a hearing loss, who are blind or partially sighted
or deafblind – and you can use it as a handy,
straightforward reference guide.
It’s been developed following lengthy
consultations with focus groups of people with
sensory loss, who have had support from their
local social services department(s). By quoting
their personal experiences throughout the guide,
we hope you will gain a greater understanding
of the common problems they face.
This best practice guide is part of a series that
will help you, if you’re working in housing, social
services and/or health, to communicate well
with people who are who are blind or partially
sighted or deafblind, blind, partially sighted or
who are deafblind.
4 Supporting people with sensory loss
Legal responsibilities
The Social Services and Wellbeing (Wales) Act
2014 sets out the legal duties of local authorities
when providing social care services within Wales.
The Act aims to improve the way people’s needs
are assessed – and how services are delivered.
In this section we provide a summary of the key
parts of the Act that relate to service delivery
for people who are deaf, who are blind or
partially sighted or deafblind, blind, partially
sighted or deafblind.
The Act states that:
• The local authority must ensure that the
service provides information, advice and
assistance to a person in a manner which
is accessible to that person (Section 17, 3B).
• It is imperative [that] all individuals,
whatever their accessibility needs,
understand what is available to them
and that they are actively involved in their
assessment and support plan. Information
and advice should be presented in the
individual’s preferred format and/or
communication style and language
(Code 2, 324).
“I am hard of hearing and wear two hearing
aids – however, I had no idea about the
support available from social services.
I would like to see stronger referral process
between the hospital departments and
social services.”
Local authorities must provide deafblind
children and adults with information, advice
and assistance in their preferred format, which
may include (but are not limited to) lipreading,
Tadoma, deafblind manual alphabet, block
alphabet, Braille, Moon, BSL (British Sign
Language), visual frame signing, close-up
signing, tactile signing, hand-under-hand
signing, sign-supported English, and Makaton.
• Local authorities must make sure deafblind
children and adults have access to specially
trained one-to-one support workers, if this
is required (Code 2, 325).
• Section 18 requires local authorities to
establish and maintain registers of adults
and children who reside in the local area
and are sight impaired, severely sight
impaired, hearing impaired, severely
hearing impaired or have both sight and
hearing impairments which, in combination,
have a significant effect on their lives
(Code 2, 390, 391).
• Local authorities must identify and make
contact with all people who have both
sight and hearing impairments. A local
authority must also identify the linguistic
circumstances of all those people in
the relevant register. This would include
individual preferences for communication,
for example, BSL, Braille, or Welsh
(Code 2, 392).
• The local authority must involve, in the
assessment, someone with specialist skills,
knowledge or expertise (Code 3, 30).
• An assessment for a deafblind person must
be carried out by a specially trained person/
team (Code 3, 31).
 Supporting people with sensory loss 5

The Best Practice Standards: Social Services for

“I am new to the area and I was referred Deaf and Hard of Hearing People produced by
from my previous local authority. When we
moved here we had a meeting with workers the Association of Directors of Social Services
from different social services departments. (ADSS), in conjunction with the Welsh Local
I preferred meeting all the workers Government Association (WLGA), Action on
including social worker, occupational Hearing Loss (when we were known as the
therapists and rehabilitation officers as I
Royal National Institute for Deaf People) and
didn’t have to keep repeating my history
and needs to each new worker I met.” the British Deaf Association (BDA), contains
further guidance for social service professionals
when supporting people who are deaf and or
• The assessment process should be fully
have a hearing loss .
accessible. Documentation must be in easy
read or another appropriate format – and
RNIB’s 10 Principles of Best Practice in Vision
people must have the right communication
Rehabilitation gives you straightforward
support. Deafblind people should be
information about working with visually
assessed by specialists on a case-by-case
impaired people. Go to:
status (Code 3, 53).
rnib.org.uk/nb-online/
• The director of social services must good-practice-guide-vision-rehab
have overall responsibility for deafblind
services as an explicit element of her/
his responsibilities. A local authority must
ensure that services provided to deafblind
people are appropriate to the specific needs
of people with a dual hearing and sight
impairment (Code 4, 71).

To find out more about the Social Services and

Wellbeing Act 2014, including its full wording,
please go to:
gov.wales/topics/health/socialcare/act/

In addition to the statutory obligations set out

above, you can refer to other service-standard
guides, published by public and third sector
organisations.
6 Supporting people with sensory loss

Recommendations
Here are our recommendations for how you can make your services as accessible
and effective as possible. They are based on our consultations with people who have
a sensory loss.

Access to services Communication

Do: Do:

• Make sure buildings are truly accessible.
For example, you should install an
accessible intercom system, with a video
display for visitors who are deaf or have
hearing loss; your internal and external
signage must be clear, and you should
install flashing smoke alarm systems to
ensure the safety of all staff and visitors.
Make sure all rooms and public areas are
well lit.
• Establish a clear point of contact for people
with sensory loss. Ideally, make it easy
for people to contact you through their
preferred communication method: this
could include voice call, SMS messaging,
Text Relay, email – and face to face. Your
service should have dedicated members
of staff responsible for monitoring these
communication points.
• Make sure all staff are aware of all available
forms of communication – and train them
how to use them!
• Install induction loop systems in all areas
used by members of the public, with clear
signage highlighting the availability of a
loop system.
• Consider using passwords on an individual’s
case file, so that authorised family
members, friends and carers can contact
you on their behalf.
• Make sure information is available in Braille,
large print, audio and electronic formats.
And show your colleagues how to access it.
“I am profoundly Deaf, I have no speech
and I am a first language BSL user. I find it
difficult to read and understand English.
I need support to read and respond to
letters that I receive. It would be great if
we could have an advocacy worker for the
Deaf who could help me to respond to
letters, complete benefit forms and make
phone calls.”
• Use RNIB clear print guidelines, as standard,
for all written communication (See
Appendix One).
• With their consent, keep a record of
a person’s preferred communication
method and style on their file. This should
be regularly updated and consulted,
whenever you’re in touch.
• Make sure meetings are conducted
in a way that’s appropriate to the individual:
for example, use specialist support workers
who have the right experience and
communication skills to support someone
with sensory loss.
• Make sure all staff are aware of the various
communication styles used by people who
are deaf, or have hearing loss, blind, partially
sighted or deafblind.
 Supporting people with sensory loss 7

• Make sure all staff who deal with the public • Produce clear procedures on how to book
have a basic understanding of BSL, so that communication support, such as a BSL
they can communicate with deaf visitors. interpreter or speech-to-text operator – and
train staff how to work with interpreters and
• Make sure all specialist staff, supporting
other communication support professionals.
people who are deaf, have a strong
understanding of BSL and other
communication methods used by people
who are deaf, have a hearing loss or are
deafblind or deafblind.

Advocacy

“My first language is BSL and my biggest

“We used to have weekly advice sessions
need is with communication. I find it
with a social worker who specialises in
difficult to understand written English,
working with deaf people; it would be great
especially letters. I rely on my social worker
if we had these regular sessions again to
to help me respond to letters, help fill in
provide us with information and advice.”
benefit forms. When the social worker is
not available I have waited for three weeks
before I can get support.”
If people who are deaf, or have hearing loss,
are blind, partially sighted or deafblind have the
• If someone with sensory loss is referred
right advocacy support, they can understand
to an external advocacy service, make sure
and contribute to their personal support plan.
that the advocates are aware of the needs
Your support should empower individuals –
of people with sensory loss, including their
giving them the chance to make their voices
communication and access requirements.
heard – and provide them with the right,
up-to-date information and advice. • Make sure that you keep, and update,
a record of local advocacy services
Do: supporting people with sensory loss.

• During the assessment process, identify
those individuals with sensory loss who
may require an advocate to access support
and improve their wellbeing. Record this on
their file.
• Establish processes for referring people,
with sensory loss, to local organisations
that offer appropriate advocacy support.
Make all relevant members of staff aware
of these referral links.

• Provide an accessible advice, information

and assistance service – in the individual’s
preferred language.
8 Supporting people with sensory loss
Training
Do:
• Make sure all public-facing staff receive
specialist awareness training. This should
include: deaf awareness training, visual
impairment awareness training and
deafblind awareness training.
• Ensure that a person with sensory
loss delivers the training sessions.
• Offer sensory impairment awareness
training as part of staff induction and
ensure the training is regularly refreshed.
• Provide additional training to public-
facing staff to ensure they’re aware of the
communication needs of people who are
deaf and or have hearing loss, and how to
access specialist services.
Equipment and technology
Do:
• Ensure anyone given new equipment
or technology is shown how to use it.
• Perform annual checks on safety equipment
such as smoke alarms and carbon monoxide
detectors.
• Regularly maintain induction loop systems.
Policies and procedures
Do:
• Create procedures for staff to book
communication support such as note-takers
or BSL interpreters.
• Ensure procedures are in place to monitor
incoming enquiries; and that they are
responded to within set time scales.
• Consider creating a sensory loss task group
to ensure that the needs of people with
sensory loss are being met. This group
should be made up of social care and health
professionals and service users who are
deaf, or have a hearing loss, or are blind,
partially sighted and deafblind.
“I am Deafblind and desperately need
support from social services. I have been
assessed by the Social Worker for the Deaf
and the rehabilitation officer for visually
impaired people, but there is no specialist
for deafblind people.
 Supporting people with sensory loss 9

Further sources of information and advice

Deafness and hearing loss Deafblind

Action on Hearing Loss Cymru Deafblind UK

Anchor Court, Keen Road, Cardiff CF24 5JW
Telephone 02920 333034
Textphone 02920 333035
Fax 02920 333036
Email wales@hearingloss.org.uk
National Deaf Children’s Society
2 Ty Nant Court, Morganstown, Cardiff CF15 8LW
Telephone 02920 373474
Textphone 02920 811861
Email ndcswales@ndcs.org.uk
North Wales Deaf Association
77 Conway Road, Colwyn Bay, Conway LL29 7LN
John & Lucille van Geest Place, Cygnet Road,
Hampton, Peterborough PE7 8FD
Telephone 01733 358100
Textphone 01733 358100
Fax 01733 358356
Email info@deafblind.org.uk
Sense Cymru
Caerphilly Business Park, Van Road, Caerphilly
CF83 3ED
Telephone 03003 309280
Textphone 03003 309282
Fax 03003 309281
Email cymruenquiries@sense.org.uk

Telephone 01492 530013

Textphone 01492 524983
Fax 01492 532615
SMS 07719 410355
Email info@deafassociation.co.uk
10 Supporting people with sensory loss

Sight loss Deafblind

RNIB Cymru

Jones Court, Womanby Street, Cardiff CF10 1BR

Telephone 02920 828500

Email cymru@rnib.org.uk

North Wales Society for the Blind

325 High Street Bangor, Gwynedd LL57 1YB

Telephone 01248 353604

Email admin.nwsb@btconnect.com

Wales Council of the Blind

2nd Floor, Hallinans House, 22 Newport Road, Cardiff CF24 0TD

Telephone 02920 473954

Email staff@wcb-ccd.org.uk

If you would like to get further accreditation for delivering good services for people with sensory
loss, both Action on Hearing Loss Cymru and RNIB Cymru currently run an accreditation scheme:

Action on Hearing Loss – Louder Than Words

Website actiononhearingloss.org.uk/louderthanwords

RNIB – Visibly Better

Website rnib.org.uk/wales-cymru-how-we-can-help/
designing-accessible-housing-and-buildings

This best practice guide was produced by Action on Hearing Loss Cymru and RNIB Cymru, thanks
to funding from the Welsh Government’s Equality and Inclusion Grant.
 Supporting people with sensory loss 11

Appendix Are there any uneven gaps between

words or letters?

Text should be evenly spaced

RNIB Clear Print Checklist
Are there 60-70 characters per line?
Is the type-face at least 14 points or
Is there enough space between columns?
above?
Does text follow easily from column
Font point size should be 14 as standard,
to column?
18 as a minimum for large print
Is the page layout clear and unfussy?
Does the text contrast clearly with the
background? Is there a contents list?

There should be a high contrast between Are page numbers and headings
the text and background colours consistent and in the same place
on each page?
If the type is reversed, does it contrast
sufficiently with its background? Is it big Is there a space between paragraphs?
enough?
Is the text set horizontally?
Is there space between each line of type?
Vertical text is hard to read
Line spacing should be 1.5 or double
Have you set text around illustrations?
Is the typeface roman, semi-bold
This can be confusing
or bold?
If the reader needs to write on the page,
Try to avoid italics or stylised fonts
is there enough space?
Are whole sentences written
If there are images, are they clearly
in capital letters?
defined and easy to read?
This should be avoided as it is difficult for
Are images clearly separated from
people with sight problems to recognise
the text?
capital letters
Is the paper matt?
Are the numerals clear?
Avoid glossy paper and have a weight
Numbers 1-10 should be written out in full
of at least 90gsm
Are any words split between two lines?
Is the page a size which is easy
Words should be kept whole to handle?

Is text unjustified, aligned to the Do folds obscure the text?

left margin?
Can the document be flattened,
Text should be aligned to the left, so that it can be placed under a
heading and titles can be centralised scanner or a screen magnifier?

Extracts taken from the RNIB See it Right Pack, available from: rnib.org.uk Telephone 020 7388 1266
 Action on Hearing Loss (formerly RNID) is
the largest UK charity helping people who are
confronting deafness, tinnitus and hearing loss.

We give support and care, develop technology

and treatments, and campaign for equality.
We rely on donations to continue our vital work.

To find out more, visit actiononhearingloss.org.uk

Contact our free, confidential Information Line:

Telephone 0808 808 0123
Textphone 0808 808 9000
SMS 0780 000 0360
(standard text message rates apply)
Email information@hearingloss.org.uk

Join us
Action on Hearing Loss
@ActionOnHearing

Action on Hearing Loss is the trading name of The Royal National Institute for Deaf People.
A registered charity in England and Wales (207720) and Scotland (SC038926). A1329/1216