Appendix 2 – Hookstead and St Nicholas Day Services Equality Impact Analysis
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Title of Project/Service/Policy |
Hookstead and St Nicholas Day Services
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Team/Department |
Learning Disability Directly Provided Services |
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Directorate |
Adult Social Care and Health (ASCH) |
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Provide a comprehensive description of your Project (Service/Policy, etc.) including its Purpose and Scope |
Summary of changes to original proposal Following the consultation process and equality impact analysis the proposal has changed. It is now recommended to keep Hookstead open but to reduce capacity by 25% (details provided below). The revised recommendation would reduce disruption to care and support and address the concerns raised about increased travel time and impacts upon the mental and physical health of people who use the service. Throughout the consultation process stakeholders were engaged and their feedback and contributions considered. As a result of this alternative options to the proposed closure of Hookstead have been explored and the original proposal modified to Hookstead remaining open for four days a week, but with a 25% reduction in capacity. This would result in the service being available to 34 adults per day, reduced from 45 per day. As Hookstead is currently operating below its capacity, with the maximum attendance being 33, this should not impact on adults currently accessing the service as their provision would be unchanged. Original Proposal Hookstead is a day service for people with a learning disability and it is based in Crowborough. The services that are managed within Learning Disability Directly Provided Services support over 500 adults across East Sussex. This support is offered in a number of different service areas: day services, community support services, respite services, Shared Lives and supported accommodation. As part of the savings plan there is a proposal to close Hookstead and move adults to St Nicholas or another a service if they prefer. The service is operational four days a week (closed on Wednesdays) between the hours of 8.30 and 19.30, sessions are offered throughout this time from 9am –12 noon; 12.30pm – 3.30pm and 4pm-7pm. The building-based daytime sessions include art, cookery, music, baking, journalism and gardening. The twilight sessions focus on a more social model and include supper club, music night and a movie evening. The service is used by 42 adults across the week using the building-based provision and community sessions. Several adults who live in the Ferns, a supported living service in the same building, attend Hookstead day service. The original proposal was to consolidate two services into one, closing the day service at Hookstead and extending the opening of St Nicholas to 5 days a week. It was proposed to increase the current building-based provision at St. Nicholas by 25%, and maintain offering 3 sessions a day, AM, PM and twilight. St Nicholas, as with all our day services, have a standard adult to staff ratio of 5:1 and provide 1:1 support to adults where required.
Through maximising capacity of the sessions, increasing twilight and community-based sessions, along with adding an additional day, there would be capacity to offer most adults who attend Hookstead an alternative at St Nicholas day service. It is unlikely that it would be possible to offer the same times and days as their current offer.
Closing Hookstead would achieve a saving of the staff and non-staff costs of the service. To enable us to provide a day service option for the adults who use Hookstead, St Nicholas Day service would need to increase its staffing capacity and open for an additional day each week. Therefore, the saving is the budget of Hookstead less the cost of increased provision at St Nicholas. Adults with Learning Disabilities and their Carers will be affected by this proposal.
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1. Update on previous EqIAs and outcomes of previous actions (if applicable)
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What actions did you plan last time? (List them from the previous EqIA) |
What improved as a result? What outcomes have these actions achieved? |
What further actions do you need to take? (add these to the Action Plan below) |
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When savings had to be made in 2018, the EqIA action plan included: · Carrying out adult and carer individual reviews · providing information taking communication needs into account · putting transition plans in place · supporting adults to find alternative services |
The changes allowed us to focus support on those who needed it most. Alternative support provisions were arranged by Care Management. |
None. Actions for the current proposal are set out for each section below. |
2. Review of information, equality analysis and potential actions
Consider the actual or potential impact of your project (service, or policy) against each of the equality characteristics.
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Protected characteristics groups under the Equality Act 2010 |
What do you know? Summary of data about your service-users and/or staff |
What do people tell you? Summary of service-user and/or staff feedback |
What does this mean? Impacts identified from data and feedback (actual and potential) |
What can you do? All potential actions to: · advance equality of opportunity, · eliminate discrimination, and · foster good relations |
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Age |
According to the 2021 Census, the proportion of the population of East Sussex aged 65 and over now stands at 26.1%, up from 22.7% in 2011.
Proportion of Population by age range (%): East Sussex 0-19 20-44 45-64 65+ 21 25 28 26 England 23 33 26 18
The age range of adults using these services is:
· 18-30 9 · 31-40 8 · 41-50 5 · 51-65 12 · 65+ 7
The numbers of young people with a learning disability who will be turning 18 and transitioning to ASC are:
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Within the consultation the age range for over 64 was the top respondent group (14%) followed by 25-34 (10%) and 45-54 (10%), although we had responses from most age groups.
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There is a smaller proportion of those aged 65+ compared to the population of the county and ASC adults receiving long term support overall. This is to be expected as life expectancy is considerably lower for people with a learning disability. |
The revised proposal to maintain day services at Hookstead mitigates the identified impacts.
No specific mitigations required for this characteristic. |
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Disability |
In the 2021 census, 20.3% of East Sussex residents were living with a long-term physical or mental health condition or impairment that affected their ability to carry out day-to-day activities in 2021, the same proportion as in 2011 (compares to 18% for England & Wales). 34.8% of households in East Sussex had at least one member identifying as disabled under the Equality Act in 2021.
According to Ofcom research, people with a learning disability are most likely to say that their use of TVs or computers is either limited or completely prevented due to their condition. Nearly 2 in 10 (18%) said their use of TVs or computers was limited or prevented, while around one in ten said the same for the internet, landline, smartphones or simple mobile phones.
All adults are being supported due to a learning disability. There are 5 adults with Autism, 3 with additional physical needs, 2 with Sensory impairments (one of these with additional physical needs), and 1 with a neurological disability - 11 adults in total. 1 adult is visually impaired. 1 adult relies on full staff support for dealing with information given.
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A third of respondents to the consultation (34%) have a physical or mental health condition or illness lasting or expected to last more than 12 months.
The 2024 consultation told us that the service is seen as providing a safe environment and a high standard of care and happiness for adults with a learning disability.
Feedback was that those who attend Hookstead have established a routine, social connections and stability which could be lost if the proposal went ahead, potentially resulting in distress.
Accommodating a larger group of people at St Nicholas could result in a busier environment, meaning those with sensory sensitivities may be unable or unwilling to attend.
NHS Sussex said “consideration should be given to what services there would be for people who need a quieter environment due to other diagnoses and sensory sensitivities. Funnelling the adults to other day services could make them even busier and therefore inaccessible to some. Issues which may result in a service user requiring a quieter service, such as sensory sensitivities, can overwhelm and lead to difficulties with social communication and/or interaction, requiring appropriate support and provision. If these needs are not met, it could lead to increasing instances of behaviours that challenge services, and require more resource intensive, higher cost, multi-agency input in the medium and longer term.”
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All adults accessing the services included in the proposals have a learning disability or are recognised as having additional needs. Some people may have further complexities such as sensory impairment, physical disabilities and other health problems which may impact on them further.
A change in routine may cause adults anxiety and less opportunity for social interaction and ongoing skills development. Any changes agreed may also cause adults increased emotional and/ or psychological distress. There may be an increased reliance on other services for example, mainstream health.
St Nicholas day service only has one accessible bathroom. To meet the needs of an increased number, including 7 wheelchair users currently identified as needing the service, a new accessible bathroom would be essential which would require a small capital investment.
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The revised proposal to maintain day services at Hookstead mitigates the identified impact and addresses the concerns raised about increased travel time and impacts upon the mental and physical health of people who use the service.
Where necessary we will ensure information is given in an appropriate and accessible format. Staff should be available to support those who need it to process the information. Advocacy services will be offered.
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Gender reassignment |
The 2021 East Sussex Lesbian Gay Bisexual Trans Queer + (LGBTQ+)[1] Comprehensive Needs Assessment estimates that there may be 5,572 Trans and Gender Diverse (TGD) people (1% of the population) living in East Sussex 2021 Census: 1640 residents declared their gender identity was different to that assigned at birth which is 0.4% of the population.
Adult data tells us that there are no adults with this protected characteristic.
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No responses were received in terms of impact upon those with this protected characteristic.
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There are no adults with this protected characteristic. |
No specific mitigations required for this characteristic.
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Pregnancy and maternity |
There are just under 5,000 births per year in East Sussex. Hastings has the highest overall birth rate as well as for women aged 15-19 years. Lewes and then Rother have the highest birth rates for women aged 35-44 years.
Adult data tells us that there are no adults with this protected characteristic.
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No responses were received in terms of impact upon those with this protected characteristic.
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There are no adults with this protected characteristic. |
No specific mitigations required for this characteristic. |
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Race (ethnicity) Including migrants, refugees and asylum seekers |
88.3% of usual residents of East Sussex said that they belonged to the White: English, Welsh, Scottish, Northern Irish or British ethnic group. Black and minority ethnic groups including white minority groups (Irish, Gypsy or Irish Traveller, Roma, Other White) make up 11.7% of usual residents in East Sussex. This compares to 18.8% in England. In 2021, 93.9% (512,440) of usual residents in East Sussex identified their ethnic group within the high-level "White" category, a decrease from 96.0% (505,420) in the 2011 Census, but still significantly higher than the English national average (81.0%) and also higher than the average for the South East region (86.6%).
4.6% were of another white background; 1.6% were Asian/ Asian British, 0.5% were Black/ Black British and1.3% were from other ethnic backgrounds. Those selecting a non-UK identity only accounted for 5.5% of the overall population (29,880 people), which is an increase from 4.3% of the population (23,090 people) in 2011. The most common non-UK identities are Polish, Irish, Romanian, Portuguese and Italian. A higher percentage of the population in East Sussex identified as Gypsy or Irish Traveller than the national average (0.2% compared to 0.1%).
Ethnicity of adults using this service is as follows: · White British 39 · Asian/Asian British – Bangladeshi 1 · White - Any Other Background 1
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No responses were received in terms of impact upon those with this protected characteristic.
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95% of adults using these services are White British, this is higher than the County’s population (88.3%). However, this reflects referrals into the services so no impact is identified for this protected characteristic. |
The revised proposal requires no specific mitigations for this characteristic.
We will ensure access to translation and interpreting services if required; ensure staff are aware of the process and that the information translated is in Easy Read.
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Religion or belief |
In 2021, 45.9% (250,330) of usual residents of East Sussex identified as Christian, down from 59.9% (315,650) in 2011. The second most common religion in East Sussex after Christianity is Islam. The proportion of the population stating they were Muslim increased from 0.8% of the usual resident population (4,200) in 2011 to 1.1% (6,190) in 2021. This is low compared to both the South East Regional and the English national averages, with 3.3% of residents in the South East specified their religion as Islam, and 6.7% across the whole of England. Details of the impact upon religion and belief on ASC: Religion and Belief in Health and Social Care Assessments –
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No responses were received in terms of impact upon those with this protected characteristic.
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We do not routinely collect this information. However, where an adult requests a specific need to be supported with their religion this is recorded on their support plan.
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No specific mitigations required for this characteristic. |
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Sex |
Of the population of East Sussex, 299,064 (52%) are female and 270,788 (48%) are male. Of those affected by this proposal: · Female 21 · Male 20
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No responses were received in terms of impact upon those with this protected characteristic.
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The data for this characteristic is reflective of the County, as such there would not be a disparate impact in terms of this protected characteristic. |
No specific mitigations required for this characteristic. |
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Sexual orientation |
The 2021 East Sussex LGBTQI+ Comprehensive Needs Assessment estimates that there may be between 17,273 and 39,004 LGB+ people living in East Sussex (between 3.1% and 7% of the population)
According to the 2021 Census 3.3% of East Sussex residents declared themselves as LGB+.
Data recorded for this characteristic: · Heterosexual 8 · Unsure 5 Data was not available for the remainder. |
No responses were received in terms of impact upon those with this protected characteristic.
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Data on this protected characteristic is limited. However, based on the data we do have for people using this service there will be no negative impact for this protected characteristic. |
Improve data collection on this characteristic. |
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Marriage and civil partnership |
According to 2021 census data for East Sussex: · Single 29% · Married 46.5% · Civil Partnership 0.4% · Divorced 11% · Widowed 8%
5 adults recorded as single, data was not available for the remainder. |
No responses were received in terms of impact upon those with this protected characteristic. |
No adults are recorded with this protected characteristic, so no impact is expected. |
No specific mitigations required for this characteristic.. |
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Armed Forces |
There were 19,917 households (8.3% of all households) in East Sussex with at least one person who had served in the UK armed forces. Whilst adults will not have served in the Armed Forces, it is not known whether anyone in their households has.
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No responses were received in terms of impact upon those with this protected characteristic.
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This does not affect any of the adults using this service. |
No specific mitigations required for this characteristic. |
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Impacts on community cohesion |
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Crowborough Town Council told us that the 18+ offering provided by Hookstead forms part of a transitional service supporting families and allowing carers to remain economically active within the community. Change to this offering could lead to families reassess the viability of working outside the home or the ability to care for their young person at home.
People using the service told us they have built good friendships that could be severed, leading to loneliness and isolation.
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Community connections built up around Hookstead, via for example the use of local venues or businesses, will be lost. However, adults may still be able to access community activity at St Nicholas. Some adults living in the Ferns, a supported living service in the same building, attend Hookstead day service and would be impacted in terms of changes to travel.
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The revised proposal requires no specific mitigations for this characteristic.
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Additional categories
(identified locally as potentially causing / worsening inequality)
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Characteristic |
What do you know? |
What do people tell you? |
What does this mean? |
What can you do? |
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Rurality |
74% of the population in East Sussex lives in an urban area with the remaining 26% living in a rural area (2021 census).
The majority of adults live in Crowborough, Uckfield or Heathfield.
Below is a map of adults’ addresses.
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The consultation raised concerns that there would be no service in the north of the county, noting that there are very few alternative options outside of the coastal parts of the county.
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Transport links and services are less available in some rural areas compared to larger towns, which may reduce the availability and choice of alternative services e.g. Personal Assistants or day-time opportunities should these be required. Adults who live in rural areas may experience a sense of isolation and reduced social contact. |
The revised proposal requires no specific mitigations for this characteristic. |
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Carers |
There are over 10,000 persons claiming Carer’s Allowance (CA) in East Sussex. (Source DWP Feb 2020). Care for the Carers estimates that there are 69,241 unpaid carers in East Sussex, and below are the estimated figures for each area. It is difficult to know the actual number of carers because so many carers are hidden.
21 adults live with carers or family, 4 live alone, and the remainder live in a residential or supported setting.
25 adults in total have unpaid carers.
A map of adults addresses is below:
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The consultation told us that family members and carers rely on Hookstead for much needed respite.
Their family member attending the service helps them to cope with their caring role, maintain employment and their other responsibilities.
Many people are concerned about the practicality of traveling to St Nicholas in Lewes instead, and that the proposal would place an additional burden on their family.
If people have to attend a day service that was so much further away it would affect their routines and could affect their family and carer’s ability to continue with their caring role and maintain their employment |
Carers of working age who are employed may be negatively impacted. This may result in carers not being able to maintain their current employment and potentially experiencing a reduction to their income.
The proposals may cause additional stress on family environments and family life as a whole. Carers may also have other caring responsibilities for other family members e.g. children or other relatives. |
The revised proposal requires no mitigations for this characteristic.
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Other groups that may be differently affected (including but not only: homeless people, substance users, care leavers) |
East Sussex is the fifth most deprived of 26 County Councils.13% of people aged 60 plus were living in poverty in 2019 (source Joint Strategic Needs Assessment). 10.3% of households were in fuel poverty in 2019 compared to 9.3 % in England.
In East Sussex, of the adults who are in receipt of support for a learning disability, 5.7% are in paid employment, compared to 5.1% of people with a learning disability in England. This is significantly less than the 74% of all working adults and 54% of all disabled people.
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Some respondents to the consultation were concerned that they would not be able to afford any increases in transport costs. |
According to research by British Association of Social Workers (2023) people with a learning disability are likely to be at higher risk of the potential health risks and consequences of cold weather and fuel poverty than the general population. As such the financial implications of additional transport costs are more likely to impact people who use this service. |
The revised proposal requires no specific mitigations for this characteristic.
Learning Disability England has been running a cost of living hub . There is information on resources, campaigns, advice on staying warm & financial help in there.
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Assessment of overall impacts and any further recommendations- include assessment of cumulative impacts (where a change in one service/policy/project may have an impact on another) |
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Original proposal We received 266 responses to the consultation. Nearly half of the survey respondents were someone who uses or has used the service, or the family/carer or someone who uses/has used the service (45%), followed by people who live in East Sussex (20%). Most people strongly disagreed with the proposal to close Hookstead day service, although a small number recognised the need to make savings and agreed with the proposal. The keys issues raised within the consultation were that transport would be difficult, change would be unsettling, and there would be an impact on socialisation as well as the mental and physical health of adults and their families and carers, including the ability of carers to maintain work. There were also concern as to whether alternative facilities would be suitable for those with sensory sensitivities. Whilst alternative locations would be offered, meaning access to day services would remain, this proposal may result in increased levels of social isolation amongst adults using the service. It is likely that adults and their families and carers would experience anxiety related to change.
If the original proposals were agreed, all adults who are affected would be offered an individual review to consider whether their support package, in light of service changes, continues to meet their assessed needs. Where it is deemed that the services directly provided by Adult Social Care are not sufficient to meet the assessed needs of individuals, Care Managers would seek alternative support solutions.
The original proposal may also impact directly on carers’ mental and physical health. As part of the individual service reviews mentioned above, carers would be offered a carer’s assessment, or a review of their assessment, to determine whether support packages continue to meet their assessed need.
There will be as much notice as possible to allow consultation and time for adjustments to changes to be made.
If the original proposal is agreed we will communicate changes to adults and their parents/carers appropriately and will work with them to identify action needed. Options may include information and advice about alternative services where available as well as referral to advocacy services. Communications’ preferences will be met via the following options:
· All communication materials produced in ‘Easy read’ formats · Easy read posters giving details of Advocacy support and scheduled Advocacy meetings · Any meetings about the changes for parents/carers will be scheduled to take place both during the day and in the evenings to provide flexibility for people who work during the day. Meetings will be held in a range of venues across the county · Easy read posters giving details of Advocacy support and scheduled Advocacy meetings · Information in accessible format for those with sensory impairments · Information and advice translated into other languages, in easy read format, as required
To ensure existing and future service provision continues to meet the needs of those coming through from Children’s Services, we would work closely with the Transitions team.
If the revised proposal is agreed, Hookstead would continue to deliver the service as it currently does and there would be no change for the people who attend. There would be no change to the day service at St Nicholas other than a change to session times. People attending either service would still be able to arrive from 08:00. Issues and concerns identified via the EqIA and consultation processes are therefore mitigated by this new proposal.
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3. List detailed data and/or community feedback that informed your EqIA
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Source and type of data (e.g. research, or direct engagement (interviews), responses to questionnaires, etc.) |
Date |
Gaps in data |
Actions to fill these gaps: who else do you need to engage with? (add these to the Action Plan below, with a timeframe) |
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ESCC 2024 Consultation |
Nov/Dec 2024 |
N/A |
N/A |
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Inclusion Advisory Group, Disability Rights Reference Group (awaits) |
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Disabled users access to and use of communication devices and services Research summary: Learning disability (Ofcom 2019) |
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East Sussex in Figures – Data Observatory – Welcome to East Sussex in Figures |
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Spotlight on Poverty: People with Learning Disabilities | BASW |
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4. Prioritised Action Plan
NB: These actions must now be transferred to service or business plans and monitored to ensure they achieve the outcomes identified.
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Impact identified and group(s) affected |
Action planned |
Expected outcome |
Measure of success |
Timeframe |
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All |
The revised proposals mitigate the impacts identified through consultation and the EqIA for the original proposal. Therefore the only identified action for the revised proposal would be to communicate in ways which are accessible for all stakeholders. |
People are clear about the new proposals |
Care and support needs continue to be met and anxiety and disruption is allayed. |
To reflect implementation of savings’ proposals (all actions). |
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Sexual orientation |
Improve data collection on sexuality |
Better information on sexual orientation of people with a learning disability |
Better dataset on this characteristic |
From March 2025 |
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