Starting out

Help from social services

About the Starting out series

The Starting out series aims to give people who are losing or have recently lost their sight essential information about living with sight loss. Other titles in the series are:

Benefits, concessions and registration Education Employment Emotional support Housing Making the most of your sight
All these leaflets are available in audio, print and braille formats. To order please contact our Helpline on 0303 123 9999 (all calls charged at local rate), email helpline@rnib.org.uk or visit rnib.org.uk/shop. If you or someone you know is living with sight loss, were here to help. For a full list of the information sources used in any of these titles please contact publishing@rnib.org.uk

Contents
Introduction Getting help from social services Your assessment Eligibility criteria for getting support Your care and support plan Self-directed support Rehabilitation Residential care Support after leaving hospital Support for your carer Support for parents Making a complaint to social services Further information 4 6 7 15 17 21 25 28 30 32 34 36 38 3

Introduction
Your local councils social services department is there to give you the help and support you need to continue to lead an independent life. This help and support often called community care or social care can include specialist help for blind and partially sighted people, as well as help for anyone who looks after you. In this booklet we look at how you can get social care support from your council, how social services assess what help you need and decide what help they can give, what type of help might be available to you, your options for arranging any services you need and how to complain if you are not happy with any aspect of your contact with your social services. Although social care is available across the UK, there are significant differences to the way these are organised in Scotland and Northern Ireland. Because these differences are too complex to explain briefly in this booklet, we shall focus on how local councils provide social care in England and Wales. Please call our Helpline on 0303 123 9999 if you want to find out more about or need help with getting social care in Scotland or Northern Ireland, and one of our advisers can give you more information. 4

Please let us know if you have problems accessing services in your area. We are campaigning to improve services across the UK and we may be able to take up your case if you are not getting the support you need.

How social services assess the help you need...

Booking your assessment Preparing for your assessment Results of your assessment Your care plan Funding your care see page 6 see page 11 see page 15 see page 17 see page 21

Getting help from social services

The first steps
Before contacting your local social services department, think about what help you need or want to stay independent. If possible, make notes of who you speak to, and when. Your local councils social services telephone number should be in the phone book, or directory enquiries, or contact our Helpline on 0303 123 9999 for their details. When you call them, make it clear that you are blind or partially sighted and that you would like an assessment of your needs. Ideally you should be able to speak to a specialist team within social services (often called a Sensory Impairment Team) that has direct experience and training for helping people with sight loss. Sometimes, however, you may have to speak to another member of staff first. If youre unable to make the call yourself or are uncomfortable with doing this then someone can do this on your behalf.

Your assessment
Finding out what help you need

What is an assessment?
An assessment, called a Community Care Assessment in England and a Unified Assessment in Wales, is when a social worker or a similar professional spends time finding out more about your situation, health and disabilities. In Wales, this is a joint Social Services and Health responsibility, therefore the assessment could be undertaken by a nurse or occupational therapist.

The aim of an assessment is to provide a full view of what you can manage to do by yourself and the support you get from other people. Once social services has this information, they can then decide:

what help you may need from them what services they should provide for you according to
their eligibility criteria. Once they have completed the assessment, your local council will carry out a financial assessment to decide, if they do provide you with services, how much you might have to contribute towards the cost of these and how they are managed. We look at these in more detail later on.

Photo: Alexander Raths/Shutterstock.com

If you are caring for someone else, both you and the person you care for can ask for separate needs assessments. The council must take into account your ability to continue caring when they assess the person you care for. (See Support for your carer on page 32.) Your local social services cannot refuse you an assessment. You have a right to an assessment once social services is aware you may have a need for support. Your financial situation does not matter and you do not have to be on your councils register of blind and partially sighted people. However, if you are on the register this may provide evidence of the seriousness of your disability during the assessment. If you are already receiving help from social services, but you believe your needs have changed, you can ask for a review assessment.

Timescales for your assessment and getting help

Social services should tell you how long you are likely to have to wait for an assessment. How quickly your assessment is completed will partly depend on the severity of your needs and the level of risk to you. Social services should also tell you how quickly they will put in place any help that you are entitled to following the assessment. Good practice is completion of the assessment within 28 days, but times may vary. You can contact social services again if you feel you have waited too long for an assessment or if your needs are urgent.

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Preparing for your assessment

Once your social services department has contacted you to let you know the day and time of your assessment, spend some time getting ready for it. Think carefully before the assessment about any difficulties you are having, and the kind of support you might need so you can discuss these with the assessor. You could make a list of things you find difficult, or keep a daily diary of when you have needed help or found things difficult to do. It is important not to underestimate your needs, and to give as full a picture of your life as possible to the person doing the assessment. You do not have to limit your answers to the questions that you are asked by the assessor. Tell the assessor about aspects of your life that might improve with some support even if they do not ask you about these. Give real examples of when you find it hard to manage, or you are prevented from doing something, especially if that has an effect on your health and safety. Also tell the assessor if you have had any accidents, for example when cooking at home, or while trying to walk outdoors, such as a fall.

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You might think about whether you need assistance in any of the following areas:

domestic tasks such as cleaning, cooking and

shopping learning to manage everyday tasks, and advice about special equipment advice on how to make the best of any sight that you have getting around safely indoors and outdoors including using transport advice about accommodation, including any adaptations your home might need, for example improved lighting, guide rails, use of contrasting colours advice about communication such as using a keyboard or audio equipment, or learning braille getting a telephone meals, at home or at a suitable centre, for example a luncheon club personal care such as bathing, getting up and going to bed health care advice about your financial affairs such as benefits and budgeting advice about your leisure and employment choices 12

 advice about taking a break, for you or someone

looking after you adjusting to your disability, counselling or talking over any personal problems.

Carrying out the assessment

A rehabilitation worker for blind and partially sighted people, social worker, care manager or other professional will carry out the assessment and they will usually do this in your home, so that they get a better understanding of your home life. Sometimes they may carry it out at other places such as a social services office, a day centre or a resource centre. You can have someone with you during the assessment and they can speak on your behalf if you wish. This could be your partner, a carer, a relative or a friend; or it may be possible to get help from a local advocacy service. It is important that you or anyone who is helping you, are given a reasonable opportunity to explain your circumstances, your difficulties and your needs. Remember not to downplay the extent of your needs.

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The person carrying out your assessment should look at how your sight problem affects your independence, what you can and cannot do, and what you could do if you had some support. They will look at all your needs as a whole, including your health and housing needs and refer on to the appropriate organisation, such as the housing department in your local authority or your GP. Talk about anything else that you feel is important and should be taken into account, such as your family responsibilities, and support from friends and relatives. Your emotional, social, religious and cultural needs should also be taken into account.

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Eligibility criteria for getting support

Once your social services department has completed your assessment and has the full view of your needs, they next have a legal duty to decide whether your needs fall into the categories of needs that they will fund. There are four bands of eligibility need: critical, substantial, moderate and low. These are based on things like the likelihood of risk to you and your health, your ability to look after yourself, your family responsibilities, your ability to take part in work or social activities, and so on. Each council decides which of the four bands of eligibility it is able to provide services for. Your council should publish this information and make it available to you.

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Most councils now only provide services for needs that fall within the critical and substantial bands. If your needs fall below this (moderate or low) then it is very unlikely that they will fund services for you, but they should still give you information and advice about other sources of help. This could include help with benefits, your health, transport and support organisations such as local societies for blind and partially sighted people. If your needs fall into the bands that your council funds, you now have a legal right to receive services to meet those needs and your assessor will draw up a care and support plan to deliver those services.

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Your care and support plan

Your council should agree a written record of the support plan (England) or care plan (Wales) with you or someone acting on your behalf. You should get a copy of your care plan, in a format you can read such as large print, audio or braille. The plan should include:

a statement of your eligible needs identified during the

assessment agreed outcomes and how support will be organised to meet those outcomes a risk assessment including any actions to be taken to manage risks contingency plans to manage emergency changes any financial contributions you have been assessed as eligible to pay (more on this later) support which carers and others are willing and able to provide support to be provided to address needs identified through the carers assessment, where appropriate a review date.

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It is important for you to have a detailed care or support plan, so that if you are unhappy with the services you receive you can make a complaint (see page 36) and explain how this falls short of what is set out in the plan. If you are not clear about, or would like to know more about what help is being provided or arranged for you, ask the person who drew up the plan to explain it in more detail. The council may provide you with support directly or it may use other organisations to do this on their behalf. If you are receiving a lot of help, you may be allocated a care manager or care coordinator, who will try to make sure that things are running smoothly.

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Where your eligible needs could be met equally well through different service options, the council may offer the option that is cheapest for it to provide or arrange, as long as it meets all of your needs. The services you are offered must meet your agreed needs even if these cost more than the authoritys usual expenditure limit.

Changes in circumstances and reviews of your needs

Your council should review your needs regularly, a minimum of once a year but more often depending on whether you have a new plan. If your circumstances change such as if you become ill or develop a new disability, or a carer can no longer offer the same level of support as before you should ask your social services department to reassess your needs. They can then determine whether this means there is an increase in your eligible needs and decide whether it should increase the amount of help you get. 19

The council may decide, following a review, that you no longer qualify for the services that you have been getting, either because your needs have changed or because its eligibility criteria have altered. But the council should not reduce or withdraw a service from you without reassessing your needs. If your services are withdrawn or reduced, you have a right to appeal against the outcome of the reassessment by using the complaints system (see page 36).

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Self-directed support
More choice and control for you
Your council may offer you something called self-directed support. This is where you either receive a payment (known as a Direct Payment) to arrange help or equipment for yourself, or you are allocated an amount of money (known as a Personal Budget) and you choose how to spend this to make sure you get the help or equipment you need. With self-directed support you can also assess your own care needs by way of a self-assessment, although you do not have to. Direct Payments or Personal Budgets are provided to cover the cost of meeting your assessed needs. The kinds of support you could have include personal care, domestic help and equipment, for example a personal computer. You may be asked to contribute to the costs of any services you get depending on your income and savings. Direct Payments or Personal Budgets do not directly affect any welfare benefits you may get. It is not an income and is non-taxable.

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There are independent support brokerage services that can, if you wish, assist you to plan and implement the services you get. Social services can give you the details of brokerage services in your area. Social services must be sure that you, or a suitable person, are able to manage payments. They should help you to get any support you need, such as with keeping records or managing paperwork. If you employ your own care workers, you might need advice about meeting your responsibilities as an employer.

Paying towards the cost of your services

Your council can ask you to contribute financially for the services you get, whether it arranges them for you or you receive a Direct Payment:

in England, councils set their own charges in line with

government guidance. Some councils place an upper weekly limit to the amount a person has to pay in Wales, there is a maximum charge of 50 a week for non-residential care services (although you may be charged an extra flat-rate amount for low-cost services such as meals on wheels).

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The council will usually ask you to complete a financial assessment form, stating your income and expenditure. It is important that you give accurate information about your financial circumstances to ensure that you are not charged more than you can reasonably afford to pay. Remember to include any extra costs you have because of your poor sight or other disability. These might for example include expensive convenience or take-away food because you have difficulty with cooking, or taxis because you cannot safely use public transport. If you receive the mobility component of Disability Living Allowance or Personal Independence Payment, the council will not take this into account when considering your income.

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It is worth checking that you are not missing out on any welfare benefits or concessions that you may be entitled to. These could help if you have to contribute towards the cost of any help or services that you receive. If you have to use some savings or other capital to help with the costs you might be able to get benefits that you were not entitled to before. The council should check that you are receiving your full benefit entitlement. Please contact us for a copy of our booklet on benefits and concessions, or you can contact the RNIB Helpline for a full benefit check, telephone 0303 123 9999 or email helpline@rnib.org.uk You can ask for a review of the charge if you believe that the charges are too high in your circumstances. Your council cannot withdraw a service only because you are unable to pay the charge.

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Rehabilitation
Rehabilitation workers or officers should be available in your area to help you to adapt to living with sight loss. They are specially trained professionals that can support you in learning or relearning a range of activities, including:

getting about safely indoors and outdoors daily living skills such as cooking, cleaning and looking
after yourself plus equipment or simple changes you can make to help you with all these tasks communication skills such as using a keyboard, mobile phone or even learning braille leisure activities.

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They can also refer you to other services you might need, such as emotional support or whats called a low vision assessment to find out how to make the most of the sight you have. The rehabilitation worker could be part of the specialist social services team that works with blind or partially sighted people or could be based with a local society for people with sight problems. Rehabilitation should be provided free of charge.

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If the rehabilitation worker identifies specialist equipment or adaptations that will help you:

in England, your local social services should provide

you, for free, with any of these that cost less than 1,000 in Wales, your local social services may provide some equipment and adaptations free of charge or you may have to pay towards these, depending on your income and savings. The rehabilitation worker should also be able to refer you on to other organisations for adaptations that you may need to your home, such as Care and Repair.

Mobility assessments
If you are finding it difficult to get about at home or getting out and about, a mobility assessment can be provided. Your local social services, or an agency such as a local society for blind people acting on its behalf, can provide training on walking and travelling independently and the use of mobility aids such as white canes and guide dogs. They can also help with confidence building, including hints and tips on moving about safely.

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Residential care
Social services will always try to help you live independently in your own home wherever possible. At some stage in your life, however, you may consider moving into a residential care home. As this is such a significant decision to make, it is worth getting independent advice about your care options. This includes whether or not you might be able to remain living safely at home instead, with appropriate support, if that is your preference. Your local authority has a duty to provide, or help you to arrange, permanent care in a home for you if they have assessed you as requiring this care and it is not otherwise available to you. This includes where your level of care needs mean that you cannot reasonably be supported to live in your own home. You will have to contribute to the costs of your accommodation and personal care in a care home from your income, and from savings above certain limits. There is a means test based on national guidelines.

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Information and advice on residential care

Your local social services department should be able to advise you about finding a care home or other housing options such as sheltered housing (specially adapted properties with support from a warden on the site) or extra care sheltered housing (similar to sheltered housing but with extra facilities and support on the site). RNIB can also offer advice about finding a residential home and we have a leaflet on housing that you may find useful to read if you are considering your options. Call our Helpline on 0303 123 9999 or email helpline@rnib.org.uk The national charity for older people, Age UK, provides information and advice about residential care. Call their Helpline on 0800 169 6565. ageuk.org.uk/home-and-care/care-homes/finding-acare-home The Social Care Institute for Excellence, an independent charity, has a website that provides advice, and a directory of care homes. findmegoodcare.co.uk

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Support after leaving hospital

If youve had to stay in hospital for any reason you may be able to get extra support for up to six weeks after you leave hospital. This should help you during your recovery and improve your chances of remaining at home. Before you are discharged from hospital, you should receive an assessment, and hospital and social services staff agree on a plan of care for you. You may be offered NHS services such as physiotherapy and occupational therapy, as well as social care support. Services may begin while you are still in hospital and continue for a number of weeks or months once you leave.

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You could also receive free rehabilitation. This is about helping you to relearn daily living skills with the sight that you have, such as washing, dressing and preparing food. The aim is to help rebuild your confidence, improve your mobility and help you find out what youre capable of doing. After the initial period of your care ends, you should receive another assessment to see how you are getting on and whether you need any ongoing social care or NHS support.

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Support for your carer

If you have someone that looks after you then the council should take their needs into account when they decide what services to arrange for you, including what help your carer is willing and able to provide. The assessor should not make any assumptions about the extent or quality of support from your carer without discussion and agreement with both you and your carer. Your carer should, if available, be given the opportunity to talk alone to the rehabilitation worker, social worker or other professional during your needs assessment. If your carer helps to meet some of your needs, they have the right to request a carers assessment. It does not matter if your carer is a relative or a friend, or if they live in a different council area to you. The assessment will look at things such as:

how much help the carer is able to give while still doing
other activities, such as work and leisure what if any help they may need when and for how many hours a week they care for you what sort of care they give you what effect your housing situation has on your carer (for example if you have any difficulties moving around your home) 32

 planning how you would be looked after if your carer

was suddenly unable to do it. Following the assessment, if social services agree to provide support this is normally included in your care plan. This is because even though carers have a right to an assessment, your council is not obliged to provide services to carers. But your carer can request their own confidential carers plan and can have a carers assessment even if you yourself do not wish to receive support from social services. Your carer may get help with caring duties, equipment, as well as things like respite care breaks. Your carer may also be eligible for specific benefits available for carers such as Carers Allowance or Carers Premium. Your local social services department should be able to advise you about carers benefits or you can contact RNIB for a copy of our booklet on benefits and concessions. The RNIB Helpline offers a full benefit check for both you and your carer, call 0303 123 9999 or email helpline@rnib.org.uk to find out more. You can also call Carers UK on 0808 808 7777 for information and advice about carers rights and how to get support.

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Support for parents

If you are the parent of a blind or partially sighted child, you have the right to ask for an assessment of your childs needs as well as one for yourself. Social services may then be able to provide support for your child or to help you as their carer. Your council may have a children with disabilities team that you, or someone acting on your behalf, can contact. A social worker from the team will carry out the assessment. The process for the assessment is very similar to that for adults (see page 7). The same tips apply, such as before the assessment think about what would help you and your child, and what support and services you could do with. The assessment must take into account the particular needs of your child, including around their health, development, disability and education, and should consider how far their needs are currently being met. Please note that your council may ask you to contribute towards the cost of services provided for children aged under 16 years, as well as for any services provided for you.

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The kind of services that may be offered to you and your child following an assessment include:

practical assistance in the home home adaptations and facilities respite care and holidays meals providing, or help to get, a television, wireless

internet connection, radio, telephone and other related equipment, and access to a library or similar recreational facilities recreational facilities outside the home help to use educational facilities travel and other assistance advice, guidance and counselling. Visit rnib.org.uk/parents, or call our Helpline on 0303 123 9999 to find out more about help and support available for your child. For support within Wales, contact RNIB Cymrus Children and Family Team on 029 2045 0440 or email claire.milton@rnib.org.uk You can also contact: National Blind Chidrens Society: 01278 764 770 nbcs.org.uk/help-and-advice Action for Blind People: 0303 123 9999 actionforblindpeople.org.uk/children 35

Making a complaint to social services

If you are not happy with how the council has dealt with you, or with your community care assessment, or the services that they have either provided or have refused to offer you, you can complain. Every council has a complaints procedure and must offer you help and support in using this. Ask your council for information. If you are unhappy with the outcome of your needs assessment it would be helpful to obtain a copy of the assessment and the councils eligibility criteria, and an explanation of why the council cannot offer you help. You may feel reluctant to complain, but dont be put off. Councils can only improve their services if they know whats going wrong. Your comments might benefit other blind and partially sighted people. Your complaint may be dealt with informally and quickly by talking to the person who is responsible for providing the service. However, if you are not satisfied you can make a formal complaint. The council or a local advice or advocacy agency can help you to put your complaint in writing. 36

The council should try to resolve your complaint and not just give a response to it. It should acknowledge your complaint within three working days and offer to discuss how you want the complaint investigated to achieve a resolution. The council should also inform you how long it will be before you will receive a written decision. If you are not happy with the outcome you can take the complaint further, to the Local Government Ombudsman in England or Public Services Ombudsman in Wales. You can ask your local councillor, or voluntary organisations for support in making your complaint, or call our Helpline on 0303 123 9999 to speak to one of our advisers.

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Further information
RNIB Helpline
Our Helpline is your direct line to the support, advice and products you need. Well help you to find out whats available in your area and beyond, both from RNIB and other organisations. Whether you want to know more about your eye condition, buy a product from our shop, join our library, find out about possible benefit entitlements, be put in touch with a trained counsellor, or make a general enquiry, were only a call away. Telephone 0303 123 9999 or email helpline@rnib.org.uk Were ready to answer your call Monday to Friday 8.45am to 5.30pm. Outside these times leave us a message and well get back to you as soon as possible. Standard call charges apply.

RNIB Advice Service

Our Advice Service can provide you and your carers with further information or advice about social care.

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RNIB Legal Rights Service

Our Legal Rights Service can provide further advice and information on complex community care issues, including making a complaint.

RNIB Sightline directory

Find organisations in your area that support blind and partially sighted people including social services teams and local societies by using our online directory. Visit sightlinedirectory.org.uk

Become a Member of RNIB

Join today to meet other blind and partially sighted people, share your experiences and keep up to date with the latest news and special offers from RNIB. RNIB Membership costs 15 if paying by direct debit, or 17 if paying by other methods. Become a member by calling 0303 1234 555 or emailing membership@rnib.org.uk

Age UK
Age UK provides information and advice to older people. They can provide details of local Age UK branches. Information Line 0800 00 99 66 ageuk.org.uk

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Carers UK
Carers UK is fighting for the recognition of the true value of carers contribution to society with carers getting the practical, financial and emotional support they need. They provide information and advice to carers about their rights and how to get support. Advice Line 0808 808 7777 open Wednesday and Thursday from 10.00am to 12.00pm and 2.00pm to 4.00pm carersuk.org

Citizens Advice Bureaux (CAB)

CAB provides information and advice on a wide range of legal matters in local branches with contact details available in your local telephone directory or at adviceguide.org.uk

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We value your feedback

Please help us improve the information we supply by sharing your comments on this publication. Please complete the form and return to: FREEPOST RSCB-GJHJ-HLXG RNIB Publishing, 105 Judd Street London WC1H 9NE (There is no need to use a stamp.) Alternatively, you can email publishing@rnib.org.uk Please include your contact details if you request further information. 1. Where did you receive your copy of this leaflet?

2. Did you find that the information was presented in a way that was easy to read and easy to understand? Please give details of anything you feel could be improved.

3. Is there any information you would have found helpful, or were expecting to find, that was missing?

4. Further comments. Please use the space below for any other comments you have on the information in this leaflet or any aspect of your contact with RNIB.

12373/10/13

Further information about RNIB

The Condent living series is for people who are losing or have recently lost their sight and are trying to build their condence to continue to lead full and independent lives. Titles in the series are:

Leisure Living safely Managing your money Reading Shopping Technology Travel
All these leaets are available in audio, print and braille formats. To order please contact our Helpline on 0303 123 9999 (all calls charged at local rate), email helpline@rnib.org.uk or visit rnib.org.uk/shop. If you or someone you know is living with sight loss, were here to help.

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If you, or someone you know, is living with sight loss, were here to help. Ask RNIB is the simple, easy to use way to nd the answers to your questions online try it today at rnib.org.uk/ask

Cover photograph Anne-Marie Briscombe Printed: October 2013 Review date: October 2014 RNIB Registered charity number 226227 ISBN 978-1-4445-0152-0 PR12373P