Knowledge of mental capacity assessment in staff working with people with learning disabilities

2019 ◽  
Vol 14 (1) ◽  
pp. 14-24
Author(s):  
Ashley Chapman ◽  
Karen Dodd ◽  
Laurence Rogers
Keyword(s):  
Learning Disabilities ◽  
Decision Maker ◽  
Clinical Work ◽  
Evidence Base ◽  
Mental Capacity ◽  
Care Staff ◽  
Future Research ◽  
Capacity Assessment ◽  
Case Scenario ◽  
Content Type

Purpose The purpose of this paper is to evaluate staff knowledge of Mental Capacity Act (MCA) capacity assessments within the Learning Disabilities division of a Mental Health and Learning Disabilities Trust. The limited research available suggests staff knowledge tends to be poor, particularly concerning who is the decision maker. Design/methodology/approach A 12-item multiple choice questionnaire, which reflects the five core principles of MCA (2005), was developed. Questionnaires were completed by 262 health and social staff members who support people with LD. Findings Results show high variability of MCA capacity assessment knowledge within the LD division. However, qualified staff and those from health services scored significantly higher across all categories on the questionnaire compared to non-qualified and social care staff, respectively. On average, all staff scored poorly when asked to identify “who is the decision maker?” in a case scenario question. Research limitations/implications The main limitation is that we did not collect data on how many previous capacity assessments and discussions each person had been involved with. The findings clearly suggest current methods of training lack efficacy in helping staff apply MCA knowledge to their clinical work. Originality/value Compared to past literature, this study utilised a novel and more comprehensive questionnaire. This focused on case scenario questions to assess staff situational judgement. In addition, the findings add to a sparse evidence base that provides a foundation for future research.

The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review

2015 ◽  
Vol 20 (2) ◽  
pp. 54-64 ◽  
Author(s):  
Caroline Jennings ◽  
Olivia Hewitt
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Cognitive Behaviour Therapy ◽  
Evidence Base ◽  
Small Sample ◽  
Future Research ◽  
Behaviour Therapy ◽  
Content Type ◽  
Psychological Therapies ◽  
Cognitive Behaviour

Purpose – Cognitive behaviour therapy (CBT) is currently one of the recommended treatments for depression for the general population and guidance recommends that people with a learning disability should have access to the same treatments as people without a learning disability. The purpose of this paper is to identify, outline and evaluate current research on the effectiveness of CBT for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach – A systematic search was conducted and five relevant articles were identified for critical review. Findings – There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications – The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications – Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. Originality/value – This paper provides a comprehensive and up to date review of the current literature regarding the use of CBT for depression for people with a learning disability. This will be of value to clinicians working with people with a learning disability as well as those commissioning services.

Examining the utility of the Stages of Change model for working with offenders with learning disabilities

2018 ◽  
Vol 9 (2) ◽  
pp. 91-101
Author(s):  
Holly Panting ◽  
Charlotte Swift ◽  
Wendy Goodman ◽  
Cara Davis
Keyword(s):  
Learning Disabilities ◽  
Stages Of Change ◽  
Clinical Work ◽  
Evidence Base ◽  
Historical Narrative ◽  
Offender Rehabilitation ◽  
Motivation To Change ◽  
Service Model ◽  
Content Type ◽  
Research Questions

PurposeThe purpose of this paper is to investigate whether the Stages of Change (SOC) model can be applied to working with offenders with learning disabilities (LD), and furthermore, to determine if it might be efficacious for this approach to be incorporated into a wider service model for this population.Design/methodology/approachThis paper reports on the results of a consultation to a specialist forensic LD service in the South West of England. A two-pronged approach was taken to consult to the service in relation to the research questions. First, a comprehensive literature review was undertaken, and second, other forensic LD teams and experts in the field were consulted.FindingsThere is a dearth of research that has examined the application of the SOC model to working with offenders with LD, and as such, firm conclusions cannot be drawn as to its efficacy in this population. The evidence base for the SOC model in itself is lacking, and has been widely critiqued. However, there are currently no other evidence-based models for understanding motivation to change in offenders with LD.Research limitations/implicationsThere is a clear clinical need for more robust theory and research around motivation to change, which can then be applied to clinical work with offenders with LD.Originality/valueThere has been a historical narrative in offender rehabilitation that “nothing works” (Burrowes and Needs, 2009). As such, it is more important than ever for the evidence base to enhance the understanding of motivation to change in offending populations.

Commentary on “Diabetes and people with learning disabilities: issues for policy, practice and education”

2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
Content Type ◽  
Policy Practice

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.

scholarly journals Conceptualising bereavement in profound and multiple learning disabilities

2016 ◽  
Vol 21 (4) ◽  
pp. 186-198 ◽  
Author(s):  
Hannah Young
Keyword(s):  
Learning Disabilities ◽  
Future Research ◽  
Emotional Wellbeing ◽  
Theoretical Frameworks ◽  
Content Type ◽  
Making Sense ◽  
Cognitive Approaches ◽  
Grief Responses ◽  
Grief Reactions ◽  
Grief Theories

Purpose Bereavement and loss are key factors in poor emotional wellbeing among people with profound and multiple learning disabilities (PMLD). However, little attention has been drawn to this group in the grief and disability literature. The purpose of this paper is to make sense of bereavement and loss in people with PMLD, with reference to theoretical contributions to the field and studies of grief reactions. Design/methodology/approach A systematic review revealed 34 relevant published works. These were analysed for relevant contributions. Findings Three main types of theoretical contributions have been made; traditional grief theories, cognitive approaches and attachment-based perspectives. Although a limited number of case studies exist, a range of grief reactions have been reported in people with PMLD. Traditional grief theories and cognitive approaches are somewhat limited in making sense of grief responses in this group, while attachment-based perspectives may prove useful in providing theoretical and therapeutic direction. Research limitations/implications Further research is required to more accurately describe the nature of relationships in people with PMLD. Practical implications Major contributions to the field point to the value of facilitating engagement with the grieving process, through communication around the loss and training for staff. In addition, attachment-based perspectives are offering routes for establishing therapeutic relationships that may help to resolve behavioural difficulties. Originality/value This paper provides an overview of the perspectives within bereavement and disability, drawing together clear theoretical frameworks for future research and practice.

Configurations of leadership practices in hospital units

2015 ◽  
Vol 29 (7) ◽  
pp. 1115-1130 ◽  
Author(s):  
Ninna Meier
Keyword(s):  
Leadership Practices ◽  
Clinical Work ◽  
Comparative Case Study ◽  
Future Research ◽  
Clinical Settings ◽  
Content Type ◽  
Work Settings ◽  
Hospital Units ◽  
The Everyday ◽  
Everyday Work

Purpose – The purpose of this paper is to explore how leadership is practiced across four different hospital units. Design/methodology/approach – The study is a comparative case study of four hospital units, based on detailed observations of the everyday work practices, interactions and interviews with ten interdisciplinary clinical managers. Findings – Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied here, especially in more unpredictable work settings. Practices of symbolic work and emotional support to staff were particularly important when patients were severely ill. Research limitations/implications – Based on a study conducted with qualitative methods, these results cannot be expected to apply in all clinical settings. Future research is invited to extend the findings presented here by exploring leadership practices from a micro-level perspective in additional health care contexts: particularly the embedded and emergent nature of such practices. Practical implications – This paper shows leadership practices to be primarily embedded in the clinical work and often shared across organizational or professional boundaries. Originality/value – This paper demonstrated how leadership practices are embedded in the everyday work in hospital units. Moreover, the analysis shows how configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested “configurations of practice” as a way to carve out similarities and differences in leadership practices across settings.

scholarly journals Exploring the role of volunteers in social care for older adults

2020 ◽  
Vol 21 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Paul B. Willis ◽  
Liz Lloyd ◽  
Randall Smith
Keyword(s):  
Older Adults ◽  
Older People ◽  
Social Care ◽  
Evidence Base ◽  
Care Staff ◽  
Small Scale ◽  
The South ◽  
Content Type ◽  
South West

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.

Factors influencing the quality of care learning disabled patients receive in hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Quality Of Care ◽  
General Hospital ◽  
Learning Disabled ◽  
Care Staff ◽  
Content Type ◽  
Increased Risk ◽  
Disabled Patients

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.

“Take home” naloxone: what does the evidence base tell us?

2015 ◽  
Vol 15 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Josefien J. F. Breedvelt ◽  
Derek K. Tracy ◽  
Emily C. Dickenson ◽  
Lucy V. Dean
Keyword(s):  
Evidence Base ◽  
Future Research ◽  
Opioid Overdose ◽  
Pilot Studies ◽  
Content Type ◽  
Practical Concern ◽  
Drug Overdoses ◽  
Associated Risk Factors ◽  
The Uk

Purpose – Opiod users are at high risk of suffering from drug overdoses. Naloxone has been used for decades in emergency treatment settings to reverse the symptoms of opioid overdose. Pilot studies and regional programmes have been rolled out to make naloxone more widely available. This review of user/carer administration of naloxone – so-called “take home naloxone” – aims to provide health professionals and interested readers with an up-to-date evidence base, clinical implications and practical concern considerations for such community management. The paper aims to discuss these issues. Design/methodology/approach – A review and analysis of the recent literature on naloxone. Findings – The evidence base suggests training and education is effective in preparing users for wider naloxone distribution. Furthermore, studies of varying quality indicate that naloxone may prove useful in reducing overdose-related deaths. However, even after implementation ineffective response techniques continued to be used at times and there remained a heistance to call medical services post overdose. Intranasal naloxone may reduce some of the risks associated with intramuscular naloxone. Ethical considerations, including provision of a needle and syringe kit to the community, should be considered. Studies suffered from a lack of follow-up data and methodological difficulties are associated with establishing opioid-related deaths post implementation. Two running trials in the UK might mitigate these concerns. Research limitations/implications – Future research is needed to address wider context of an overdose and targeting associated risk factors. Originality/value – Clinicians and other professionals will be informed on the most up-to-date evidence base and which areas are improtant to consider when take-home naloxone is introduced in their services.

Commentary on “Why study the history of learning disability?”

2015 ◽  
Vol 20 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Jill Bradshaw ◽  
Peter McGill
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Design Methodology ◽  
Care Staff ◽  
General Application ◽  
Content Type ◽  
Theoretical Concepts ◽  
Theory To Practice ◽  
History Of ◽  
The Difference

Purpose – The purpose of this paper is to provide a commentary on “Why study the history of learning disability?” by Goodey. Design/methodology/approach – In his paper, Goodey makes the point that the term “learning disability” is not a fixed, stable concept, but one which has changed and evolved over time. This commentary explores the difference between care staff and professional understandings of people with learning disabilities including how these have changed in recent times. Findings – Care staff knowledge is likely to be based on direct experiences of particular people with learning disabilities whilst professional knowledge is likely to be based on theoretical concepts of general application. These differences in source of knowledge may interfere with desired collaboration between staff and professionals. Originality/value – This commentary suggests that differences in understandings should be recognised and the application of theory to practice is far from simple.

scholarly journals An exploration of the challenge's fathers' experience when parenting a child that presents with dyspraxia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyle Jackson ◽  
Michelle Andipatin
Keyword(s):  
Learning Disabilities ◽  
Mental Health Professionals ◽  
Developmental Disorders ◽  
Treatment Plan ◽  
Learning Disorders ◽  
Future Research ◽  
Depth Information ◽  
Subjective Experiences ◽  
Content Type ◽  
Individual Interviews

PurposeDue to the limited research on fatherhood and dyspraxia, this study is critical as it highlights the challenges that fathers face in parenting a child that presents with dyspraxia. The purpose of this study is to inform various interventions while simultaneously highlighting a largely neglected area of research.Design/methodology/approachThe principal aim of this study was to explore the subjective challenges that fathers experience in parenting a child that presents with dyspraxia in the Cape Metropole area. This study adopted a qualitative approach utilising an exploratory design to understand and provide in-depth information about fathers' subjective experiences of parenting a child that presents with dyspraxia (Mack et al., 2005). Data were collected using semi-structured individual interviews with fathers.FindingsThe authors’ findings highlight that fathers' roles are inextricably more complex, shifting between more traditional conceptions such as the provider toward the all giving and nurturing care. Future research would benefit from adopting a more masculinity-focused framework to determine the effect that learning disorders have on constructing and challenging more traditional gendered constructions of what it means to be a man, masculinity and what it means to be a father, fatherhood and fathering.Research limitations/implicationsThe study was limited to the challenges faced by fathers whose children were engaged in some or other treatment plan. In addition, the study was limited to children who presented with dyspraxia, rather than those who had received an official diagnosis and this relates directly to the obscurity and ambiguity surrounding diagnosis of the disorder itself.Practical implicationsThe study has shed light in terms of the common features between dyspraxia and that of other developmental disorders. This is further extended to include the comorbidity of this disorder with other learning disabilities.Social implicationsMental health professionals may benefit from identifying the issues raised by fathers within this study and to further aid and support both children and parents in the treatment of dyspraxia.Originality/valueThe study has shed much needed light on two very neglected areas – the area of learning disabilities, in particular, the issue of dyspraxia and second, including fathers’ voices in the discussion of their experiences.

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