Scottish Economy

Report – Scotland’s adult social care system for people with learning disabilities

The system that delivers social care and support for adults with learning disabilities in Scotland is not doing enough to enable people to live safe, secure and fulfilling lives.

Download the report

Read our latest report on adults with learning disabilities in Scotland here.

Click here for an easy read summary.

Summary of findings

Despite positive developments and significant change over the last ten years, our latest report highlights where there are shortcomings in the system. We analysed a wide evidence base and found that:

  • The closure of long stay hospitals and institutions was driven by consensus from policy makers and civil society, and delivered by means of substantial financial investment to help people transition to community-based support. Any future substantial changes in the way care is delivered should learn lessons from how this was achieved.
  • Since the financial crisis, there has been a loss in some of the non-statutory support that was so vital for people, particularly with mild to moderate learning disabilities, to live their lives independently. This means the ambitions set out in the Scottish Government’s strategy, The Keys to Life, have had little chance of being realised. 
  • It is crucial that there is a system in place that allows people to access the support that they need. Self-directed support should have helped achieve this, but we’ve been told that the complexity of the system has arguably made it harder for people with learning disabilities to access what they need. This highlights the issue with assuming that all social care users will benefit in the same way from innovations in how support is delivered. 
  • The transition from childhood services to adult services is a critical time for young people with learning disabilities. There is no question that young people need more support in navigating this time in their lives so that they know what their rights are and how to access the support that can enable them to achieve their ambitions. 
  • Housing is a cornerstone of independent living, yet an undersupply of quality accommodation for people with learning disabilities constrains choice and results in delays.  Suitable accommodation is a vital form of support in itself and accounting for this undersupply will require planning in housing strategies.
  • The Covid-19 pandemic has been detrimental to the support relied upon by people with learning disabilities. Some of this has been the result of restrictions on face to face contact, and given the heightened risks that people with learning disabilities face, in many cases this was unavoidable. However, there can be no doubt about the harm this has had on people and their families. Now there are fears that support will not return post-pandemic at the same level it was before. The opposite needs to be true if people are to recover from the harms created over the past year. 

Ultimately, these findings raise questions about what the system of support for adults with learning disabilities is designed to achieve. Is it there to help people ‘get by’ and respond to crises, or should it act as an enabler for people to live a fulfilling life and access their human rights? 

This report is being published in the same week as the Scottish Government’s Independent Review of Adult Social Care. Our research looks in more detail at the experience of those with learning disabilities and those who work in Health and Social Care Partnerships that provide support. Our research echoes many of the sentiments expressed in that review, but it is important to recognise that, whilst there may be common issues across the whole of the social care sector, the experience of people with a learning disability are very different from others and no two people with learning disabilities are the same. 

As we approach a new Parliament and a recovery from the pandemic, we are reaching a key decision point and what happens next could be crucial to the support and opportunities available to adults with learning disabilities in Scotland.


Knowledge Exchange Associate at the Fraser of Allander Institute

Emma Congreve is a Principal Knowledge Exchange Fellow and Deputy Director at the Fraser of Allander Institute. Emma's work at the Institute is focussed on policy analysis, covering a wide range of areas of social and economic policy.  Emma is an experienced economist and has previously held roles as a senior economist at the Joseph Rowntree Foundation and as an economic adviser within the Scottish Government.

Picture of Graeme Roy, director of the Fraser of Allander Institute
Graeme Roy

Dean of External Engagement in the College of Social Sciences at Glasgow University and previously director of the Fraser of Allander Institute.