Easy Read for Supported Decision-Making in Learning Disability Services
Easy Read can support decision-making in learning disability services when it helps people understand what decision is being made, what options exist and what may happen next. It should not be used as a shortcut to obtain agreement. Its value is in giving people clearer information, more time and a better chance to influence decisions.
Strong providers use Easy Read as part of wider communication and accessibility in learning disability support and connect decision support with learning disability service pathways and support models. This matters because daily choices, care planning, health decisions, tenancy issues, relationships, activity planning and service changes all depend on communication that the person can understand.
Concept explained clearly
Easy Read for supported decision-making means presenting information in a clear, paced and accessible way so the person can engage with a decision as far as possible. It may include simple words, familiar photos, short sections, comparison cards, yes/no options, consequences, time to revisit information and support from trusted people.
It should be linked to the person’s communication profile. Some people need Easy Read alongside objects, visual sequences, Makaton, advocacy, family input, video or repeated supported conversation.
Why it matters in real services
People may appear to agree when they have not understood the choice. They may also refuse because the information was unclear, too fast or presented in a way that felt overwhelming. This can lead to weak involvement, poor capacity evidence, avoidable anxiety and decisions being made around the person.
Providers should be able to evidence how Easy Read helped the person understand, express preference, ask for more time or show that another communication method was needed.
What good looks like
Good Easy Read decision support separates information into manageable parts. It explains the decision, the options, what may happen, who can help and how the person can say yes, no, not now or I need more help.
Strong services demonstrate a clear line of sight from accessible information to the person’s response, staff action and decision outcome.
Operational Example 1: Choosing a new day opportunity
Context: A person was offered a choice between two day opportunities. Staff had described both verbally, but records showed only that the person “seemed happy with either option”.
Support approach: The provider created Easy Read comparison cards using real photos of each setting, transport, activities, staff and return-home routine.
Five practical steps:
- Staff identified the actual decision and the two realistic options available.
- Each option was shown using the same structure so the comparison was fair.
- The person visited both services with the Easy Read cards available afterwards.
- Workers recorded repeated selection, rejection, hesitation and emotional response.
- The final decision record explained how the person’s communication shaped the choice.
Day-to-day delivery detail: The person repeatedly selected the gardening photo from one service and pushed away the noisy dining-room image from the other. Staff gave several days between visits so the person was not rushed.
How effectiveness was evidenced: The person started attending the preferred service with lower anxiety. Records showed the decision was based on repeated accessible choice evidence, not staff assumption.
Deepening decision support through total communication
Easy Read should sit within total communication beyond spoken language. A person may show preference through reaching, looking, pushing away, smiling, withdrawing, becoming still, returning to an image or choosing an object linked to an option.
This means staff should not rely only on spoken answers or signed forms. Decision support should include observation of how the person responds over time and in context.
Operational Example 2: Supporting a decision about room changes
Context: A residential service planned to redecorate communal areas and offered people choices about colours and furniture. One person became distressed when shown a catalogue and did not appear to understand the decision.
Support approach: The provider replaced the catalogue with Easy Read choice cards, fabric samples and photos of the current room, helping the person understand what would change and what would stay the same.
Five practical steps:
- Staff reduced the decision to two colour options and two seating choices.
- Easy Read cards showed “same room”, “new colour” and “new chair”.
- The person explored choices using photos and physical samples.
- Staff recorded clear responses across several calm sessions.
- The final decision was shared back using an updated visual plan.
Day-to-day delivery detail: The person rejected a bright colour card but repeatedly touched a soft blue fabric sample. Staff also showed that their usual chair would remain available during decorating.
How effectiveness was evidenced: Anxiety reduced before the room change. Records showed that accessible decision support helped the person influence the environment rather than being presented with a completed change.
Systems, workforce and consistency
Supported decision-making needs consistent staff practice. Teams should know how to prepare Easy Read information, avoid rushing, check understanding and record communication evidence without overstating certainty.
Supervision should review whether staff give people enough time and whether records distinguish between preference, agreement, uncertainty and lack of understanding. Handovers should note when a person needs more sessions before a decision is made.
Operational Example 3: Supporting a health decision
Context: A person needed to decide whether to attend a dental treatment appointment. Staff were concerned that previous explanations had focused on attendance rather than understanding.
Support approach: The provider developed Easy Read health decision information aligned with accessible information standards in learning disability services. The material explained tooth pain, treatment, what would happen at the appointment and what support the person could request.
Five practical steps:
- Staff identified the information needed for the person to understand the decision.
- The Easy Read material used real photos of the dental surgery and support worker.
- The person was supported to revisit the information over several short sessions.
- Workers recorded questions, rejection, anxiety cues and acceptance of support options.
- The appointment plan included reasonable adjustments based on the person’s responses.
Day-to-day delivery detail: The person accepted the dental chair photo only when the familiar support worker photo was placed next to it. They also selected a “stop” card, which staff arranged to use during the appointment.
How effectiveness was evidenced: The person attended with agreed support and used the stop card once during treatment. Records showed that Easy Read supported understanding, control and reasonable adjustments.
Governance and evidence
The audit trail may include Easy Read decision materials, preparation records, communication observations, capacity-related notes, advocacy involvement, family input, staff supervision, decision records and outcome reviews.
Data may show clearer choice evidence, reduced distress, improved participation, better health attendance or fewer disputed decisions. Qualitative evidence should explain how the person engaged with the information and how their response influenced the outcome.
Commissioner and CQC expectations
Commissioners expect providers to support rights, involvement and person-centred outcomes. Easy Read decision support helps evidence that people are not just consulted, but supported to understand and influence decisions.
CQC expects effective communication, consent-aware practice, person-centred care, dignity and good governance. Inspectors may look at whether people are supported to make decisions and whether information is adapted to their needs.
Common pitfalls
- Using Easy Read to secure agreement rather than support understanding.
- Offering too many options at once.
- Recording “choice made” without evidence of how the person responded.
- Providing information too close to the decision point.
- Ignoring uncertainty, hesitation or rejection cues.
- Failing to use advocacy or another communication method when Easy Read is not enough.
Conclusion
Easy Read can strengthen supported decision-making when it gives people clearer information, more time and better ways to express preference. Strong providers demonstrate that Easy Read is used to support understanding, not simply to record agreement. When evidence is clear, decisions are more person-led, rights-based and defensible.