scholarly journals Home visits: a reflection on family contact in a specialist forensic intellectual disability service

2015 ◽  
Vol 9 (4) ◽  
pp. 186-195 ◽  
Author(s):  
Lucinda Cheshire ◽  
Verity Chester ◽  
Alex Graham ◽  
Jackie Grace ◽  
Regi T Alexander

Purpose – There is little published literature about the number of home visits provided to patients within forensic intellectual disability units, and there is no published data on variables that affect home visits. There is a need for a baseline audit that can formulate standards for future practice. The paper aims to discuss these issues. Design/methodology/approach – This paper describes the home visit programme within a forensic intellectual disability service, and a baseline audit of the programme. The audit measured the number of home visits, any factors that adversely affect home visits, and the extent of family contact. The authors propose audit standards for evaluation of good practice in this area. Findings – The audit involved 63 patients over a one-year period. In total, 81 per cent of patients had some form of family contact and 54 per cent of patients at least one home visit. However, 19 per cent of patients had no contact with their family due to a variety of reasons. There were no significant differences in the number of home visits between men and women, patients on civil vs criminal sections or those treated “within area” or “out of area”. Patients in rehabilitation wards had significantly more visits than those in low or medium secure. Originality/value – Conventional wisdom is that reduced family contact is the direct result of patients being placed “out of area”. The results of this audit suggest that, at least in this group, the reasons may be much more nuanced and that the current definition of “out of area” has to be improved to incorporate the actual distance between the patient’s current family home and the service. Audit standards have been proposed to monitor family contact and home visits. Future work should focus on the relationship between family contact and treatment outcomes.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bushra Elhusein ◽  
Yassin Eltorki ◽  
Oraib Abdallah ◽  
Mohamed El Tahir

Purpose Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar. Design/methodology/approach This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured. Findings This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices. Originality/value This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.


2014 ◽  
Vol 5 (4) ◽  
pp. 160-166 ◽  
Author(s):  
Alyssa Cox ◽  
Hayley Simmons ◽  
Ginny Painter ◽  
Pippa Philipson ◽  
Rachel Hill ◽  
...  

Purpose – Patients treated within secure/forensic settings experience numerous barriers to meaningful vocation, including restrictions under the Mental Health Act, which limit community access. The purpose of this paper is to describe the development of Real Work Opportunities, an inclusive and accessible vocational rehabilitation programme within a forensic intellectual disability service. The programme involved setting up employment and interview workshops, interviews, and interview feedback, and job roles within the secure service, to simulate the real work process. Design/methodology/approach – A reflective account of the development and implementation of the Real Work Opportunity programme with a forensic intellectual disability population. Findings – The programme was well received by the patients involved and a high attendance rate was maintained over time despite the demands that were expected. Roles have been advertised for two employment periods and have had two sets of successful candidates. Patients demonstrated skills development throughout the employment process, including general work-based skills, punctuality and time management, managing duties, responsibility, specific role-related skills, interpersonal skills and personal presentation. Research limitations/implications – Despite limited experience of work prior to admission, many patients were enthusiastic and motivated to work. The initial trial of the programme has been well received by both patients and staff. Future developments will include widening the number and types of opportunity offered by the programme. Originality/value – This paper describes a vocational rehabilitation programme for a particularly marginalised population, people with intellectual disabilities within a forensic service. The programme proved highly popular with patients, and enabled them to develop transferable employment skills.


2021 ◽  
Vol 26 (3) ◽  
pp. 160-168
Author(s):  
Faye Banks ◽  
Amy Fielden ◽  
David O'Sullivan ◽  
Barry Ingham

Purpose Research into culture within intellectual disability services, has predominantly focussed on small group homes in Australia. The current investigation aimed to explore the transferability of the dimensions of culture identified in the literature, to a residential Intellectual Disability service in the UK. The purpose of this study was to better understand the impact of informal culture upon the behaviour of direct care staff, particularly around managing behaviour that challenges. Design/methodology/approach Semi-structured interviews were conducted with direct care staff. Interview transcripts were analysed thematically using template analysis. Findings Themes regarding leadership, perceptions of managers, team functioning, and relationships between direct care staff and service users, were identified, corroborating the existing literature. Additional themes relating to being aware of the risks posed by service users, and the emotional impact of behaviour that challenges, also emerged. Originality/value To the best of the authors’ knowledge, this is the first qualitative study to explore informal culture within a community residential Intellectual Disability service in the UK.


Author(s):  
William Jackson

Purpose – The purpose of this paper is to discuss the development and proposal of a values evidence-based model of clinical supervision (CS) for the implementation by nursing staff (registered and non-registered nurses) within a forensic intellectual disability service. Design/methodology/approach – This is a conceptual and technical paper providing a descriptive account for a service provision with nursing staff. Findings – The paper does not present any research findings but does demonstrate a novel and innovative approach to the conceptualisation and implementation of CS. Originality/value – The paper examines the dominant concepts that shape existing thinking around CS and suggests a new interpretation that involves greater pragmatism through a values evidence-based approach.


2018 ◽  
Vol 14 (3) ◽  
pp. 188-196 ◽  
Author(s):  
Gautam Gulati ◽  
Valerie Murphy ◽  
Ana Clarke ◽  
Kristin Delcellier ◽  
David Meagher ◽  
...  

PurposeWhile individuals with an intellectual disability form a significant minority in the worldwide prison population, their healthcare needs require specialist attention. In Ireland, services for prisoners with intellectual disabilities need development. However, there is little substantive data estimating the prevalence of intellectual disabilities within the Irish prison system. The paper aims to discuss these issues.Design/methodology/approachThe authors systematically review published data relating to the prevalence of intellectual disabilities in prisons in the Republic of Ireland. The authors searched four databases, governmental websites and corresponded with experts.FindingsLittle published data were elicited from searches except for one nationwide cross-sectional survey which reflected a higher prevalence than reported in international studies. Studies from forensic mental health populations are narrated to contextualise findings.Originality/valueThis study found that there is little data to accurately estimate the prevalence of intellectual disabilities in the Irish prison system and the limited data available suggests that this is likely to be higher than international estimates. The authors highlight the need for further research to accurately estimate prevalence in this jurisdiction, alongside the need to develop screening and care pathways for prisoners with an intellectual disability.


2019 ◽  
Vol 201 (17) ◽  
Author(s):  
Dragutin J. Savic ◽  
Scott V. Nguyen ◽  
Kimberly McCullor ◽  
W. Michael McShan

ABSTRACTA large-scale genomic inversion encompassing 0.79 Mb of the 1.816-Mb-longStreptococcus pyogenesserotype M49 strain NZ131 chromosome spontaneously occurs in a minor subpopulation of cells, and in this report genetic selection was used to obtain a stable lineage with this chromosomal rearrangement. This inversion, which drastically displaces theorisite relative to the terminus, changes the relative length of the replication arms so that one replichore is approximately 0.41 Mb while the other is about 1.40 Mb in length. Genomic reversion to the original chromosome constellation is not observed in PCR-monitored analyses after 180 generations of growth in rich medium. Compared to the parental strain, the inversion surprisingly demonstrates a nearly identical growth pattern in the first phase of the exponential phase, but differences do occur when resources in the medium become limited. When cultured separately in rich medium during prolonged stationary phase or in an experimental acute infection animal model (Galleria mellonella), the parental strain and the invertant have equivalent survival rates. However, when they are coincubated together, bothin vitroandin vivo, the survival of the invertant declines relative to the level for the parental strain. The accompanying aspect of the study suggests that inversions taking place nearoriCalways happen to secure the linkage oforiCto DNA sequences responsible for chromosome partition. The biological relevance of large-scale inversions is also discussed.IMPORTANCEBased on our previous work, we created to our knowledge the largest asymmetric inversion, covering 43.5% of theS. pyogenesgenome. In spite of a drastic replacement of origin of replication and the unbalanced size of replichores (1.4 Mb versus 0.41 Mb), the invertant, when not challenged with its progenitor, showed impressive vitality for growthin vitroand in pathogenesis assays. The mutant supports the existing idea that slightly deleterious mutations can provide the setting for secondary adaptive changes. Furthermore, comparative analysis of the mutant with previously published data strongly indicates that even large genomic rearrangements survive provided that the integrity of theoriCand the chromosome partition cluster is preserved.


2016 ◽  
Vol 22 (6) ◽  
pp. 1099-1117 ◽  
Author(s):  
Boyd A. Nicholds ◽  
John P.T. Mo

Purpose The research indicates there is a positive link between the improvement capability of an organisation and the intensity of effort applied to a business process improvement (BPI) project or initiative. While a degree of stochastic variation in applied effort to any particular improvement project may be expected there is a clear need to quantify the causal relationship, to assist management decision, and to enhance the chance of achieving and sustaining the expected improvement targets. The paper aims to discuss these issues. Design/methodology/approach The paper presents a method to obtain the function that estimates the range of applicable effort an organisation can expect to be able to apply based on their current improvement capability. The method used analysed published data as well as regression analysis of new data points obtained from completed process improvement projects. Findings The level of effort available to be applied to a process improvement project can be expressed as a regression function expressing the possible range of achievable BPI performance within 90 per cent confidence limits. Research limitations/implications The data set applied by this research is limited due to constraints during the research project. A more accurate function can be obtained with more industry data. Practical implications When the described function is combined with a separate non-linear function of performance gain vs effort a model of performance gain for a process improvement project as a function of organisational improvement capability is obtained. The probability of success in achieving performance targets may be estimated for a process improvement project. Originality/value The method developed in this research is novel and unique and has the potential to be applied to assessing an organisation’s capability to manage change.


2017 ◽  
Vol 46 (8) ◽  
pp. 1475-1492 ◽  
Author(s):  
Hannah Meacham ◽  
Jillian Cavanagh ◽  
Amie Shaw ◽  
Timothy Bartram

Purpose The purpose of this paper is to examine how HRM practices enhance and/or impede the employment, participation, and well-being of workers with intellectual disabilities in three hotels located in Australia. Design/methodology/approach The research employs a case study methodology, including interviews with three HR managers, three department managers, 17 workers with intellectual disabilities, and focus groups of 16 supervisors and 24 work colleagues. Findings The research found that the opportunities to participate in work are driven primarily by developing a social climate that enables social cohesion through the altruistic motives of managers/supervisors and reciprocal relationships. Originality/value The findings lend support for the importance of both formal and informal HR practices, such as inclusive recruitment and selection, mentoring, and training and development, as well as individualised day-to-day support provided by supervisors and colleagues, to improve the participation and well-being of workers with an intellectual disability.


Author(s):  
Siti Zakiah Zulfa ◽  
◽  
Cesa Septiana Pratiwi ◽  

Background: In developing country, malnutrition of under five children was still a severe problem because it may have an impact on the quality of human resources in the future. Various program has been tried in many places to overcome this problem, one of which is through a home visit program, which is very necessary for educational purposes to manage malnutrition. This study aimed to determine how to implement a home visit program to improve the nutritional status of under five children in developing countries. Subjects and Method: A scoping review method was conducted using Arksey and O’malley (2005) framework with five steps: (1) Identify the scoping review question; (2) Identify relevant articles; (3) Article selection; (4) Mapping; (5) Present the results, discussion and conclusion. The search included Pubmed, Wiley, Ebsco, Science Direct, and Google scholar databases. The inclusion criteria were original articles in Indonesian and English from developing countries published from 2010 to 2019. The data were reported by PRISMA flow chart. Results: Five of the 159 articles were selected, and found that five themes were summarized, namely: (1) effective implementation of home visits, (2) types of rehabilitation of nutritional status of under-five children on home visits, (3) home visit officers 4) time and activities for conducting home visits and 5 ) constraints on home visits for malnutrition education purposes. Conclusion: Home visit program is an effective and significant strategy to reduce the incidence of underweight, moderate and severe malnutrition, stunting and wasting in under five children only when combined with other programs. Several knowledge gaps identify which confirm through further research. Keywords: home visit, nutritional status of under-five children, malnutrition, developing countries Correspondence: Siti Zakiah Zulfa. Universitas ‘Aisyiyah Yogyakarta. Jl. Ringroad Barat No.63, Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta. Email: [email protected]. Mobile: 085641349694. DOI: https://doi.org/10.26911/the7thicph.02.11


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