Disability and access to leisure

ESSS Outline
Published on 7 Sep 2018

Introduction

This evidence summary seeks to address the following question:

How can providers of leisure activities improve accessibility and inclusivity for people with disabilities and their carers?

About the evidence presented below

We drew on a wide range of evidence, including academic research in the fields of disability and social work in relevant databases (e.g. ASSIA, Campbell Systematic Reviews, CINAHL, ProQuest Public Health Database, PsycINFO, SCIE Social Care Online, etc.), on Google Scholar, as well as the websites of key organisations (e.g. Equality and Human Rights Commission, Scottish Government) and disabled people's organisations (e.g. Sense, Scope).

We collected evidence covering a broad range of community activities, such as arts and entertainment, outdoor recreation, sport and physical activities, visitor attractions and volunteering. There was limited evidence related to leisure for carers outside of traditional respite. Where possible, we have included examples of activities offered to people with and without disabilities, focusing on how these activities can be made more accessible to all. Due to the wide scope of this search, this is not an exhaustive list of activities, and there are many more organisations in Scotland and the UK working to improve access for people with disabilities.

Accessing resources

We have provided links to the materials referenced in the summary. Some materials are paywalled, which means they are published in academic journals and are only available with a subscription. Some of these are available through the The Knowledge Network with an NHS Scotland OpenAthens username. The Knowledge Network offers accounts to everyone who helps provide health and social care in Scotland in conjunction with the NHS and Scottish Local Authorities, including many in the third and independent sectors. You can register here. Where resources are identified as 'available through document delivery', these have been provided to the original enquirer and may be requested through NHS Scotland's fetch item service (subject to eligibility).

Where possible we identify where evidence is published open access, which means the author has chosen to publish their work in a way that makes it freely available to the public. Some are identified as author repository copies, manuscripts, or other copies, which means the author has made a version of the otherwise paywalled publication available to the public. Other referenced sources are pdfs and websites that are available publicly.


Background

According to the Department for Work and Pensions (2016), there are 12.9 million disabled people living in the UK. The Convention on the Rights of Persons with Disabilities (CRPD) (United Nations General Assembly 2006), which is now used by 160 nations, provides the following definition based on social model conceptualisations of disability:

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

The social model of disability was developed by disabled people to identify, and take action against, discrimination; rather than focusing on what someone can't do because of their impairment the social model identifies barriers are created by our society, which may be physical, organisational or attitudinal (Unlimited Impact 2015).

These barriers are present in many civic and recreational activities; in 2012-14, disabled adults were much more likely to report being limited in leisure activities (27.9%) than non-disabled people (2.8%) (Equality and Human Rights Commission (EHRC) 2017a).

Article 30 in the CRPD (2006) identifies the right of disabled people to take part on an equal basis with others in cultural life, and to participate on an equal basis with others in recreational, leisure and sporting activities. In the UK, a higher proportion of disabled adults report having little choice over their free time compared with non-disabled adults (22% and 13% respectively) (Papworth Trust 2018). Despite Scottish Government commitment on widening access and participation and ensuring that the necessary infrastructure is in place to deliver sporting and cultural opportunities, the Scottish Household Survey (Scottish Government 2015) found that cultural participation was lower for those with a physical or mental health condition.

Community activities provide great benefits to the health and wellbeing of people with learning disabilities and this improves their quality of life (Scottish Government 2014). In 2017, the Scottish Commission for Learning Disability (SCLD) (2017) reported that there were 8,076 adults with learning disabilities (34.8% of all adults known to local authorities) who had participated in regular, non-centre based activities, such as lifelong learning, sport or leisure, recreation and voluntary work. There were 9,206 (39.7%) adults in Scotland who did not have alternative opportunities for recreation. Common barriers to leisure for those with learning disabilities identified by Mencap (2017) include:

  • Lack of accessible venues and facilities
  • Lack of accessible information
  • Financial constraints
  • Mobility and transport considerations

Carers also face barriers to accessing leisure due to the demands of caring, with 40% reporting they hadn't had a day off from caring for more than a year (Carers UK 2017). Hill and Thompson (2017) highlight that existing concepts of social inclusion neglect to recognise the value of care. They note an absence of indicators to measure the contributions that care and carers may make to social inclusion, while also recognising the complexities of care relationships and that care may act as a constraint on some forms of participation.

Access

According to research conducted by the Papworth Trust (2018), the most commonly reported difficulties for disabled people in accessing goods and public services were:

  • Shopping (20%)
  • Cinema/theatre/concerts (15%)
  • Pubs and restaurants (14%)

According to Giraud (2018), "access means finding ways to ensure that fewer people are excluded". Poor access to leisure can affect the community and social life of disabled people, creating a barrier to independence and their enjoyment of leisure activities (EHRC 2017a). Mencap (2017) identify the following ways to improve inclusion in leisure for people with learning disabilities:

  • Training staff to understand the needs of people with a learning disability
  • Providing easy-read information about leisure activities
  • Providing greater funding for resources and transport
  • Greater encouragement for people with a learning disability to participate in leisure projects

Physical access

Physical access is not only about wheelchair access, but improving access for people with a wide range of impairments (Scope 2018). Around a third of disabled people experience difficulties related to their impairment in accessing public, commercial and leisure goods services (Papworth Trust 2018). Action to remove physical barriers in street environments, such as extending powers to restrict unsafe pavement parking, would help disabled people access social opportunities in their local community (Sense 2017).

In research conducted by Copestake et al. (2014), disabled people reported that the places and spaces they wished to visit were often inaccessible to them, with some of the barriers identified as:

  • Inaccessible buildings
  • Lack of reliable information about accessibility
  • Staff with limited knowledge and awareness of accessibility
  • Lack of clean and adequate disabled toilet and changing facilities

Copestake et al. (2014) also found that issues of inaccessibility contributed to feeling isolated, as it often seemed easier to stay at home rather than attempt a trip out.

Attitudes

Public attitudes can have a profound impact on individuals' ability to make connections and find common interests (Sense 2017). While the introduction of equality legislation and improved access to public spaces mean disabled people have greater opportunities, visibility and aspirations than ever before, negative public attitudes and awkwardness about disability prevail (Aiden and McCarthy 2014).

The evidence indicates that disabled people are more likely than people who aren't disabled to experience the attitudes of others as a major barrier to education, leisure, transport, access to public services, social contact and accessibility outside the home (Aiden and McCarthy 2014). Stigma and myths about dementia, for example, continue to persist in many local communities, which impacts on people's confidence and willingness to 'get out and about' (Older People's Commissioner for Wales 2018). People with learning disabilities have been increasingly exposed to the general community, but Overmars-Marx et al. (2014) raise doubts about whether they actually benefit from this exposure. Milner and Kelly (2009) found that service users reflected on a "shared reality" that community participation almost invariably involves a migration away from places where they feel known and validated, to spaces in which they occupy positions of inferior cultural knowledge, expertise or social capital.

Through their qualitative research, Power and Bartlett (2018) found that some people with learning disabilities experienced 'moments of inclusion' across different places in the home, neighbourhood, and city centre, but such moments were positioned within and alongside broader experiences of indifference, loneliness, and discrimination. Sense (2017) suggests that public awareness campaigns to promote increased understanding and acceptance of disabled people could improve social attitudes.

Transport

An absence of good quality, accessible public transport can prevent disabled people from accessing social opportunities (Sense 2017). While there has been significant progress in transport accessibility in recent years there are still a number of areas within transport provision where improvements are needed in terms of design, physical access and customer service (Department for Transport 2018). One of the key barriers to accessibility identified by many disabled people is a lack of consistency in the way that transport services and facilities are delivered (Papworth Trust 2018), and Sense (2017) recommend that all drivers and transport staff should also be adequately trained to assist disabled people accessing public transport.

Poverty

Disabled people are more likely to live in low income households and are more likely to rely on welfare benefits than their peers (Sense 2017). There are 4.2 million disabled people living in poverty, which is 29% of all people living in poverty (Papworth Trust 2018). The Department for Work and Pensions needs to ensure that rates of financial support provided by the welfare benefits system are set at a rate that allows people to remain independent, retain social connections and participate fully in society (Sense 2017).

Co-production

The best people to help you in making your work accessible are those that experience barriers themselves (Giraud 2018).

Despite disabled people being a significant part of the population, they are generally excluded when it comes to being in positions in society to initiate, lead and implement the policy decisions that affect their lives (Hammersmith and Fulham Disabled People's Commission 2017). Participation by disabled people in development and decision-making is vital – from seeking feedback through to full decision-making and leadership (Disability Rights UK 2014). However, disabled people may often feel they are in just 'consulted', 'involved', or 'informed' about decisions if they are involved at all (Hammersmith and Fulham Disabled People's Commission 2017). In their survey of disabled people, Copestake et al. (2014) collected a number of suggestions for changes to leisure, social and community life, including the involvement of disabled people in the design of places and spaces. In their disability action plan, Australia Council for the Arts (2017) highlight the need to utilise good practice and co-design in programme design and evaluation, and strategic planning processes.

Co-production is a way of working with, rather than doing to, people and communities to achieve better outcomes (Vallely 2018). In a report on inclusive user involvement, Beresford (2013) identified two essential issues for disabled people to enable co-production, both of which need to be in place. These are:

  • Access: ensuring all disabled people have effective ways into organisations and decision-making structures
  • Support: for example, building confidence and skills, offering practical help and opportunities to get together so disabled people are in a realistic position to get involved

Evidence

We collected evidence covering a broad range of community activities, such as arts and entertainment, outdoor recreation, sport and physical activities, visitor attractions and volunteering. Where possible, we have included examples of activities offered to people with and without disabilities, focusing on how these activities can be made more accessible to all.

Art and entertainment

Entertainment venues, services and accommodation need to be designed or adapted to provide better physical access for disabled people (Sense 2017).

Attitude is Everything (2016) State of access report (pdf)

State of Access Report is intended to provide a biennial snapshot of the live music industry when it comes to accessibility and inclusion for Deaf and disabled people. The report found that a third of venue and festival websites provide no access information, which is vital for disabled audiences to determine whether they can attend an event. In response, Attitude is Everything has created a Access Starts Online template for organisations, and also make the following areas of action for the future:

  • Increasing awareness of the access requirements of people beyond those with physical impairments
  • Extending disability awareness training sessions for live music industry professionals
  • Empowering event organisations to champion the immense value that exists in ensuring that access facilities are fit for purpose

Dimensions (2018) Autism friendly screenings – the adjustments (website)

These autism friendly adjustments are designed to make the cinema more inclusive and accessible for people with sensory sensitivities, and others who can benefit from this environment. These guidelines are currently used by ODEON, Cineworld, Vue and Showcase for their autism friendly screenings.

  • A relaxed environment where people understand the needs of children and families with autism
  • Lights left on low
  • Sound turned down
  • No trailers or advertisements (unless they are embedded in the film)
  • Staff trained in autism awareness
  • Disabled access
  • Chill out zone, where available
  • Freedom to move around and sit where you like
  • Bring your own food and drink
  • Free entry for carers with a valid CEA Card
  • Free social story template

Fletcher-Watson, B and May, S (2018) Enhancing relaxed performance: evaluating the autism arts festival. Research in Drama Education: The Journal of Applied Theatre and Performance, 23(3), pp.406–420 (open access)

A relaxed theatre performance provides an environment where it is acceptable to move around, make noise, and behave in non-normative ways with the aim of making performances more accessible to people with autism, learning disabilities, mental health conditions, neurological conditions, and chronic pain conditions as well as very young children. Typical accommodations include:

  • Reduced intensity of lighting and sound
  • Provision of visual stories to familiarise spectators with the venue and production
  • Trained staff to assist visitors

The Autism Art Festival was an attempt to develop the idea of a relaxed performance further to create an entire festival that was as autism-friendly as possible. This included giving each attendee an audience pack, which contained ear protectors, detailed information in the programme about sounds and potential triggers in shows, interaction badges (marked green, yellow and red), and a fidget toy. The festival also provided three chill-out spaces with sensory toys and comfortable furniture to allow people to self-regulate their social interaction. In addition to this, it is necessary for those attending, even if they are not themselves autistic, to respect the premise of the relaxed performance, i.e. not staring at an audience member who is stimming or making noises.

Giraud, C (2018) Demystifying access: a guide for producers and performance makers: how to create better access for audiences to the performing arts. Unlimited, Shape Arts and Arts Admin (website)

This guide covers the basics tips for integrating access into performance. This might include:

  • Audio description
  • Touch tours
  • Captioning
  • BSL interpreters
  • Relaxed performances
  • Social stories

The guide also provides case studies looking at adapting works, navigating costs and funding, venue access and marketing.

Hynt (2018) What is Hynt? (website)

Hynt is a national scheme in Wales that was set up to encourage new audiences to enjoy the arts and improve experiences for disabled people. They offer:

  • A card scheme that entitles cardholders to a ticket free-of-charge for personal assistants or carers to be used across participating theatres and venues in Wales
  • A website with information about accessible performances at venues across Wales, as well as access guides
  • A training programme working with all of its participating theatres and arts centres to improve accessibility and understanding

Project Ability (2015) Programme report (pdf)

Project Ability is an arts charity which fights to end the stigma of mental ill health and advocates for the wider inclusion of people with learning disabilities in public life. In their Aspire Programme, they use the arts as a tool to improve health and well-being, build confidence and better connections by working alongside like minded people, sharing skills and developing friendships.

Stay up late (2015) Gig Buddies project report (pdf)

Gig Buddies was established to help people with learning disabilities overcome some of the barriers they face to going out in the evening, such as not having anyone to go out with, limited access to support workers, limited access to transport, and concerns about safety issues. Like many community befriending programmes, some of the benefits include:

  • Removing practical barriers to going out
  • Increased connection with the local community
  • Respite for regular carers
  • Increased choice of leisure activities

Day respite

People need opportunities to have breaks together and apart, within the home and away from home in line with their views, wishes and feelings (Older People's Commissioner for Wales 2018). Service users staying overnight in a residential facility, known as 'residential respite', remains the most well-known and utilised form of respite in the UK (Southby 2017). However, non-residential respite care can provide access to recreational activities for disabled people, including those living with dementia. While respite is often primarily considered as something for the benefit of carers, for people living with dementia it can be an opportunity to sustain and maintain their physical, mental and psychosocial wellbeing (Older People's Commissioner for Wales 2018).

Older People's Commissioner for Wales (2018) Rethinking respite for people affected by dementia (pdf)

The traditional respite option of a night or nights away in an external care setting for the person living with dementia is not always restorative or helpful to building resilience within caring relationships. This report highlights the many alternative forms of respite which can be equally, if not more, impactful and can be provided at a lower cost. People particularly valued respite support where there was flexibility and choice in terms of whether the carer could join in or not, how long people chose to stay (such as drop-in services), and options at different times of the day and week. Respite at home can also be a positive option for some people living with dementia.

Southby, K (2016) Barriers to non-residential respite care for adults with moderate to complex needs: a UK perspective. Journal of Intellectual Disabilities, 21(4), pp. 366 - 386 (paywalled and author manuscript)

This article explores some of the barriers to non-residential respite care, which include lack of useful information, restrictive eligibility criteria, limited times and locations of services, excessive bureaucracy, and feelings of guilt or embarrassment. Accessibility can also be a barrier, with just over a tenth of survey respondents (10.2%), expressing concerns that staff or venues for non-residential respite will be inappropriate for service users. Their concerns include:

  • Maintaining the dignity of the service user
  • Unskilled staff and/or a lack of rapport
  • Inadequate or inappropriate facilities

Outdoor recreation

Risk is used to deny disabled people access to many parts of mainstream life, including outdoor leisure, and disabled people face many barriers in using outdoor leisure facilities (Burns et al. 2012).

Beach Wheelchairs (2017) Annual review (pdf)

The purpose of Beach Wheelchairs is to provide beach wheelchairs for hire at no cost so that wheelchair users can access the beach, as well as providing supporting facilities, such as ramp access. They have hired out wheelchairs over 250 times in their North Berwick location since 2015, and have recently established locations at Portobello and Seton Sands.

Forestry Commission Scotland (2013) Access for all: accessibility case studies (website)

Between 2010 and 2013 the Forestry Commission Scotland carried out a major review of the "all ability" paths on the National Forest Estate. They assessed whether they met accessibility standards, and identified possible improvements. Some of these include:

  • Provide clear, accurate information in accessible formats, off-site and on-site, that allows people to decide for themselves whether to visit a site and how well they would be able to use it once there
  • Consult with local disability groups about the best ways of addressing access design issues
  • Work towards the least restrictive option, based on consultation and evidence
  • If you are concerned about a key accessibility parameter, specify a higher standard than you actually need, so you build certainty and security into your project
  • Don't be afraid to delay the implementation of an accessible trail if you cannot deliver it in a way that will bring real benefits

Gaudian, K and McGinley, C (2012) Green Spaces: environments and activities for adults with autism. Helen Hamlyn Centre for Design (pdf)

The restorative qualities of gardens and the benefits of interacting with nature are widely documented. However there is a lack of guiding principles within the context of design for autism. This study is the third in a series of design research projects with the Kingwood Trust, aiming to improve living for adults with autism spectrum disorders (ASDs) through a better understanding of their needs, aspirations and physical environment. This research concentrated on the design of outdoor green spaces and on the special interests of adults with autism that can be addressed within them. The key principles of this research were identified as:

  • Enhance communication, independence and the development of skills by connecting garden spaces with a person's strengths, interests and aspirations to create occupation, exercise and leisure opportunities
  • Reduce triggers of agitation and anxiety by considering a person's hyper or hypo sensitivities in outdoor spaces
  • Keep residents and staff safe in a robust garden that is tolerant of unintended use
  • Give staff the tools to deliver people-centred care and ways to facilitate occupation, exercise and leisure activities in outdoor spaces

National Institute for Health and Clinical Evidence (2018) NICE Guideline 90: Physical activity and the environment (website)

This guideline covers how to improve the physical environment to encourage and support physical activity, including recommendations to make it as easy as possible for people with limited mobility to move around their local area, and to work with relevant third sector organisations to achieve this.

Sport and physical activities

In the UK, 72% of disabled adults had at least one barrier to playing sport compared with 54% of non-disabled adults (Papworth Trust 2018). In Scotland, disabled people are less active, have poorer experiences of physical education in school, and are less likely to participate in sport as adults (Research Scotland 2016). This is also true for carers, with 54% of carers in the UK reporting that they they have reduced the amount of exercise they take because of caring (Carers UK 2017).

There are well-recognised barriers to exercise ranging from physical barriers and attitudinal barriers to support barriers (Scottish Government 2014). Disabled people might also experience barriers in watching sport. For example, there have been widespread concerns raised over a number of years about the accessibility of Premier League club stadia (EHRC 2017b).

English Federation of Disability Sport (2018) Get out, get active (website)

Get Out Get Active is a programme that supports physical activities for both disabled and non-disabled people. The programme runs for over three years (2016-2019) and within 18 localities across the UK. It is based on the following principles:

  • Drive awareness of sport by using trusted channels and staying local
  • Engage different audiences by talking to personal values
  • Offer support and reassurance, including making it easy to discuss needs

Equality and Human Rights Commission (2017b) The state of play: how accessible is your club? Disability access at Premier League grounds (pdf)

This report sets out an initial assessment of the current provision for disabled fans across all Premier League clubs. Good services currently offered by some clubs include:

  • Offering clear, easy-to-find, detailed access statements on websites
  • Installing Changing Places facilities and sensory rooms
  • Meeting the minimum wheelchair spaces

Sports Coach UK (2016) Quick guide: inclusive coaching (pdf)

In coaching terms, an 'inclusive coach' has the ability to positively and effectively coach a group of athletes who may have very different needs. Through the use of an inclusion spectrum, this guide outlines five approaches to the delivery of physical activity programmes, ranging from fully open activities to totally segregated participation. Each approach aims to encourage and empower disabled and non-disabled people in order to enhance the quality of their involvement. These are:

  • Open activity: a simple activity based on what the entire group can do, with little or no modification
  • Modified activity: everyone does the same activity with adaptations to challenge the more able and support the inclusion of everyone
  • Parallel activity: participants are grouped according to ability, each doing the same activity but at appropriate levels
  • Separate activity: an individual or group do a purposefully planned different activity
  • Disability sport activity: aspects of physical activity based on disability sport programmes can be included in all approaches

Visitor attractions

In their 2017 review, UN Committee on the Rights of Persons with Disabilities made a recommendation that the UK should adopt a well-resourced, measurable action plan to ensure that disabled people have access to all sports facilities and heritage sites (EHRC 2018). According the the Papworth Trust (2018), 68% of disabled adults in the UK had at least one barrier to going to museums or historical places of interest compared with 58% of non-disabled adults.

Euan's Guide (2017) Castles and battlefields: accessible highlights (pdf)

This guide provides practical information about accessibility for local and visiting disabled people. Some of the elements contributing to the accessibility of these attractions include:

  • Availability of volunteers with knowledge of accessible routes and shortcuts
  • Information on physical accessibility, such as steep ramps
  • Tours that are adapted for the group, for example, using step-free routes for wheelchair users
  • Location of accessible toilets

Historic Environment Scotland (2017) Access Guide (pdf)

This guide provides access-related information for over 80 attractions in Scotland, with a focus on mobility and sensory impairments.

Volunteering

Volunteering is often presented as a means for disabled people to gain skills for employment (McNeish et al. 2016), however the evidence also describes the benefits of volunteering in addressing social exclusion and inequalities (Volunteering Matters 2017). SCLD (2017) collected statistics on the number of adults with learning disabilities who are in volunteering in Scotland, with 30 local authorities providing volunteering information on 10,484 adults (45.2% of all adults known to local authorities). There were 903 adults in volunteering, which is 3.9% of all adults known to local authorities.

Scope (2018) Inclusive volunteering (website)

Scope's guide for inclusive volunteering covers tips for inclusion as well as requirements for physical access, which is not only about wheelchair access, but improving access for people with a wide range of impairments. Some key points include:

  • Asking volunteers about their communication needs
  • Listening to volunteers, they know their impairment best
  • Address negative attitudes towards disability, from staff, other volunteers or clients

Volunteering Matters (2017) Barriers and benefits : tackling inequalities in health through volunteering (pdf)

According to this report, the most commonly cited reason why people with a disability do not take part in volunteering is because they have an illness or disability that prevents them. Organisations must acknowledge and address equity issues in accessing opportunities and ensuring that all population groups can benefit. This includes addressing the stigma and attitudes of others, which can be significant barriers to volunteering for people with a disability. This report also acknowledges the significance of access to resources in enabling people to volunteer.

Yanay-Ventura, G (2018) 'Nothing about us without us' in volunteerism too: volunteering among people with disabilities. VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, 29(1), pp.1-17 (paywalled)

This study discusses disability as a resource and outlines the unique contribution of volunteers precisely because of their disability. The author interviewed 35 adult volunteers with disabilities volunteering for beneficiaries with disabilities. They found that the volunteers crossed over from the role of merely extending services to their beneficiaries to becoming activists for political and social change. Their practices suggest that the volunteers' self- identity as individuals with disabilities has shaped their supportive approach. Therefore, understanding their unique resources as people with disabilities is key to developing an organizational culture that promotes integrative recruitment of volunteers.


References


Suggested reference: Allcock, A (2018) ESSS Outline: Disability and access to leisure. Iriss. https://doi.org/10.31583/esss.20180910

Associated resources