A review of Manx Care’s Adult Learning Disability Services (ALDS) has identified significant shortcomings in residential care.
The report, conducted by Cordis Bright, highlights systemic challenges but also acknowledges the dedication of frontline staff.
It has called for immediate action to address poor placement matching, restrictive practices, and a lack of strategic direction.
Despite the criticisms, the report highlights optimism, noting “enthusiasm and good will” among staff and families and said improving residential services “is an achievable task”.
Findings
The review found that ALDS “has a long way to go before it meets modern, high quality, person-centred practice standards.”
Residents experience care that is “not person-centred, does not routinely maximise their choices or independence, and in some instances, places inappropriate restrictions on their freedoms.”
One major issue is the use of restrictive practices, including limiting residents’ access to facilities or isolating individuals due to safety concerns.
The report notes these practices were often “well known to staff” but remained unresolved for extended periods.
Workforce
Staff shortages and low morale were repeatedly cited, with a 23% vacancy rate in November 2024. The report states, “There is a need for a clear workforce plan” to address recruitment, training, and culture.
Strategic leadership was also criticised, with the 2020-25 Strategic Plan for Adults with a Learning Disability described as lacking co-production, evidence, and accountability. “It is difficult to see strong alignment between the stated principles of the strategy and the five priorities,” the review notes.
Recommendations
The report urges Manx Care to:
- Resolve poor placements: “Alternative accommodation should be sourced for individuals who are poorly matched.”
- Develop a strategic vision: The new commissioning plan must be “rooted in evidence” and “co-produced with service users, families, and staff.”
- Improve workforce and property strategies: “Extra resources will not be sufficient to resolve the challenges… Without better planning, it is unlikely that any additional resources will be well spent.”
Response
Manx Care has said it “recognises and acknowledges that this report highlighted a number of issues within the service, and that it needs to focus on significantly improving the support it can provide to individuals across the island”.
It has also said it will hold sessions with service users and their families as soon as possible following TT, to start moving forward with them.
Minister for Health and Social Care, Claire Christian, added: “This report highlights how important these services are for our community, especially for making sure that service users and their families are properly connected and supported.
“The Department will continue work with Manx Care as they now look to implement the recommendations in the report and to develop and modernise our service, alongside Manx Mencap, who have consistently worked incredibly hard to support our community.”
You can read the full report here:
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