9.6 Register of Sight Loss / Certificate of Vision Impairment

1. Introduction

Local authorities must keep a register of people who are severely sight impaired (blind) and sight impaired (partially sighted). In Salford, the Sensory Team manage the Certificate of Vision Impairment (CVI) registration process, including maintaining the CVI register. CVI’s are received via the Adult Social Care Contact Team and then referred on to the Sensory Duty Team so that appropriate contact and follow up can be made.

Registration is voluntary, however individuals should be encouraged to consent to being registered as it may assist them in accessing relevant support services and benefits. People who agree to be registered may be entitled to some benefits, for example, an increase in personal tax allowance, a reduction in the cost of a TV licence, a free bus pass and parking concessions under the Blue Badge Scheme. It is important that strong links exist between local authorities, health services and voluntary organisations to identify those who may benefit from registration.

The data which registration provides the local authority are also of benefit in service planning for health and care and support. However, access to care and support is not dependent upon registration, and those with eligible needs for care and support should continue to receive it regardless of whether they wish to be registered.

Local authorities should help health and social care organisations to work together to meet the needs of people who have sight loss, for example, ensuring that care and support services know what help somebody needs in their home when they leave hospital. Timely assessment and person-centred care and support planning that is integrated with health offers the potential to make improvements in experience and outcomes for people who are sight impaired, as well as improving system efficiency.

2. Registration

If the person consents to registration they will be included on the local authority’s register and be provided with a registration card. The register can also be used by the local authority to ensure that accessible information about services is provided to the person, for example to ask if support could be given to assist them to participate in electoral events.

3. The Certificate of Vision Impairment

The Certificate of Vision Impairment (CVI) formally certifies someone as being sight impaired or as severely sight impaired. Where the person has given their consent, a copy of the CVI should be sent to the local authority by the hospital staff. However, people in receipt of a CVI should not be added to the local authority register until they have given their specific consent for registration.

Local authorities may take the date of certification given on the CVI as the effective date of registration. If the adult has not given their consent for their name to be added to the register of sight impaired adults, however, they should still be offered a needs assessment.

The CVI is an important source of information for local authorities in relation to their registration duties. The local authority should satisfy themselves that the CVI is completed correctly and it contains valid signatures as required (currently the consultant ophthalmologist and the patient). Both electronic versions and paper copies of CVIs can be accepted for registration.

3.1 Certification

The CVI is issued by a consultant ophthalmologist to the patient certifying as sight impaired or severely sight impaired.  The Certificate of Vision Impairment: Explanatory Notes for Consultant Ophthalmologists and Hospital Eye Clinic Staff (gov.uk) explains who should be certified as severely sight impaired and sight impaired.

Certification is not the final stage, but often it is the point when people begin to accept the severity of their sight loss and feel ready to access to practical and emotional support.

It is expected that NHS services will keep the completed certificate, signed by the consultant and the patient, for their records. Where the patient has given their consent, a copy of the certificate should be sent to the relevant local authority and the patient’s GP within five working days of its completion. The Certificate of Vision Impairment Explanatory Notes for Consultant Ophthalmologists and Hospital Eye Clinic Staff provides information on this.

Local authorities should note that there will also be people who have a reduced / low vision but do not meet the criteria for certification, their needs should still be considered in service planning.

3.2 Transferring and retaining the CVI

The CVI should be kept until the person moves to another area or has passed away. In the event of a person’s death, the local authority should keep the CVI for at least six years as it may be necessary for tax purposes to establish if a deceased person was registered with a local authority.

3.3 Making contact

Within two weeks of receiving the CVI, the local authority should make contact with the person issued with the CVI to arrange their inclusion on the local authority’s register (with the person’s informed consent) and offer individuals a registration card. Where there appears to be a need for care and support, local authorities must arrange an assessment of their needs in a timely manner.

To maximise the ability of people who have sight impairment to be involved in their own care planning and decision making, they should have early access to information and advice in an accessible format so that they can adapt to their situation as quickly as possible and obtain any aids and support that will help them to manage their lives better.

4. Continuity of Care

A person may decide to move home and live in another local authority area (see Continuity of Care chapter). The first local authority should ensure that the person’s care and support needs will continue to be met during their move. The process requires the original authority to provide the authority the person is moving to with relevant information to support the move such as a copy of the person’s care and support plan, their latest assessment, and any other documentation the second authority requests. This should include a copy of their CVI. The second authority should add the person to their register (if they give their consent to this) and the former authority should remove that person’s name to avoid duplication.

5. Care Planning

Royal National Institute for Blind People (RNIB) have developed resources to help social care professionals care for people with sight loss.

Following completion of a needs assessment, the local authority must prepare a care and support plan for everyone with eligible needs or other needs which it is going to meet. Where someone has sight loss, this should be recorded in the care and support plan (see Care and Support Planning chapter).

Local authorities should consider securing specialist qualified rehabilitation and assessment provision (whether in-house, or contracted through a third party), to ensure that the needs of people with sight loss are correctly identified and their independence maximised. Certain aspects of independence training with severely sight impaired and sight impaired people require careful risk management and should only be undertaken by professionals with relevant experience and training. This type of rehabilitation should be provided to the person for a period appropriate to meet their needs and help the person to gain new skills, for example, training to use a white cane.

Rehabilitation for sight impaired people is a specific form of reablement and is not limited to the usual six week period for rehabilitation as this could take longer. There are some characteristics which define rehabilitation as being distinct from other forms of reablement. It is therefore not appropriate to take a one-size-fits-all approach, and the local authority needs to ensure that individual needs are met appropriately.