Supporting Social Workers to Include Sex and Relationship Needs in Care Act Assessments for People with Learning Disabilities and for Autistic People: A Qualitative Study

Research Question This study aims to understand how social workers can be better supported to consider and include the intimate lives of people with learning disabilities and autistic people in Care Act assessments and reviews, and to develop tools, training, and evidence of good practice to facilitate this. Background Intimate relationships are an ordinary part of adult life, yet people with learning disabilities and autistic people often encounter stigma and barriers around sex and relationships, leading to increased loneliness and isolation. Positive intimate relationships can help mitigate loneliness, reduce suicide risk, and improve mental health. The Care Act (2014) emphasises the importance of supporting adults in developing and maintaining relationships as part of their overall well-being. However, our previous research shows that the intimate lives of people with learning disabilities and autistic people are often overlooked in social care policy, and social workers rarely address sex and intimate relationships during adult Care Act assessments and reviews. This results in inconsistent and limited support, often only offered in response to safeguarding concerns. Research Objectives 1. To conduct interviews and focus groups with social workers about their experiences with Care Act assessments to understand how they can be best supported to include sex and intimate relationships in these assessments and reviews. 2. To facilitate workshops with people with learning disabilities and autistic people to produce tools and guidance to facilitate conversations about sex and intimate relationships in Care Act assessments. 3. To develop, deliver, and evaluate free online training to support social workers in addressing sex and intimate relationships in Care Act assessment. 4. To produce case studies on good commissioning practices to promote commissioning of effective support for sex and intimate relationships. Methods This 20-month project includes a set-up phase, two concurrent work packages (WPs), and an end of project phase. The advisory group—comprising autistic people, people with learning disabilities, social workers, and commissioners—will guide all phases of the project. WP1: We will conduct 12-15 semi-structured interviews and two focus groups with social workers who conduct Care Act assessments for people with learning disabilities and autistic people. We will hold workshops with people with learning disabilities and autistic people to develop Care Act assessment tools and guidance. Data will be analysed using thematic analysis, and findings will inform a training pack which will be delivered to 80 social workers and refined through iterative feedback. WP2: We will identify and document three case studies where local authorities have commissioned sex and relationship support. These case studies will be developed through emergent design, incorporating interviews, ethnography, and document analysis. Anticipated Impact and Dissemination This project will produce outputs, developed with input from social workers, people with learning disabilities, and autistic people, that can directly inform social work practice in England to provide more consistent, proactive, and effective support for people with learning disabilities and autistic people. Free-to-download assessment tools, training resources, and resources will be disseminated widely, and project reports will be shared in accessible formats, including plain language and easy-read versions.