The Transforming Care agenda: admissions and discharges in two English learning disability assessment and treatment units

2019 ◽  
Vol 24 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Francine Washington ◽  
Samantha Bull ◽  
Ceri Woodrow
Keyword(s):  
Learning Disability ◽  
Service Provision ◽  
Care Providers ◽  
Content Type ◽  
Discharge Rates ◽  
National Guidance ◽  
Assessment And Treatment ◽  
Alternative Service ◽  
Delayed Discharges ◽  
Preventable Admissions

Purpose The purpose of this paper is to evaluate whether two regional intellectual disability (ID) assessment and treatment (A&T) units in England were meeting the recommended length of stay stipulated by the Learning Disability Professional Senate, in line with the Transforming Care (TC) agenda. A secondary purpose of the study was to evaluate the reasons for admissions and delayed discharges in order to inform how to reduce these. Design/methodology/approach A retrospective evaluation of 85 admissions across two A&T units was conducted over a three-year period (2013–2016) following publication of the TC agenda. Findings There were 85 admissions compared to 71 discharges. Of the 85 admissions, 11 were readmissions. The most common factors thought necessary to prevent admission were early support for care providers or alternative service provision. There were barriers to discharge in over half of admissions; the main reason was a lack of suitable service provision. Practical implications The study suggests that providing specific support or training to care providers could prevent (re)admission and ensure shorter admissions. Further research to establish reasons for the reported lack of suitable providers would be beneficial. Originality/value This study provides current admission and discharge rates for regional A&T units, as recommended by the TC national guidance. It also provides potential reasons underlying preventable admissions and delayed discharges and therefore indicates what might be necessary to prevent admissions and reduce the length of inpatient stays for people with ID and/or autism.

Contributing factors to providing an effective community-based forensic service for people with a learning disability: a literature review

2019 ◽  
Vol 10 (3) ◽  
pp. 45-57
Author(s):  
Anna Leonie Wark
Keyword(s):  
Learning Disability ◽  
Service Provision ◽  
Quantitative Methods ◽  
Community Services ◽  
Individual Autonomy ◽  
Service Improvement ◽  
Community Based ◽  
Content Type ◽  
Effective Community ◽  
Published Research

Purpose Legislative guidance stipulates that people with a learning disability have the right to receive local provision of personalised support within the least restrictive environment. On these bases there is a growing emphasis on the requirement for local authorities to develop appropriate services for people who are currently in a hospital setting. The purpose of this paper is to examine the literature addressing factors influencing the provision of effective community-based forensic services. Design/methodology/approach The six articles were analysed separately using the evaluation tool – Currency, Relevance, Authority, Accuracy, Purpose. The six articles used divergent sample groups and employed both qualitative and quantitative methods to collate data. The articles shared a purpose of examining forensic community service provision with an aim to improve services. Findings There were three themes that emerged consistently across the literature these included: balancing risk management vs individual autonomy; multi-disciplinary and multi-agency working; service improvement. There is a growing emphasis on the need to replace long-term hospital placements with specialist, community provision, employing least restrictive methods and positive responses to crisis situations. In this climate, it is crucial that multi-disciplinary agencies from local authority, health and the charitable and private sector continue to work collaboratively on the integration of service provision in order to bring about the development of effective and responsive community services. Research limitations/implications Research limited to peer reviewed and published research papers focusing on the subject of community forensic services with publications specifically made within the time frame of the Transforming Care Agenda. Practical implications This paper looks to examine the practical solutions to providing effective community forensic services for a person with an intellectual disability and makes recommendations for research into improving service specific training for support staff. Social implications Following the Winterbourne View Hospital scandal (BBC One, 2011) instigations were made to make legislative change under the Transforming Care Agenda. Despite a renewed conviction in the rights of people to be a part of their local community without segregation or discrimination, professionals in the field continue to report a failure to reduce numbers of people in long stay hospitals and secure settings. With commissioning under pressure to make these intentions a reality it is a really good time to reflect on practice and evaluate service models to establish the factors that bring about positive outcomes for individuals enabling inclusion within community settings. Originality/value This review will focus on the literature evidencing positive intervention and outcome focussed methods of supporting people with a forensic history in the community. This is an entirely original piece of work analysing peer reviewed and published research.

Commentary on: “Ordinary lives” means ordinary schools: towards a unitary 0-99 years policy for adults and children with learning disabilities

2020 ◽  
Vol 25 (1) ◽  
pp. 47-52
Author(s):  
Becky Hardiman
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Service Provision ◽  
Role Models ◽  
Design Methodology ◽  
Content Type ◽  
The Future ◽  
Adults And Children ◽  
Effective Inclusion ◽  
Future Of Education

Purpose The purpose of this study is to reflect on some of the challenges faced by caregivers when making decisions relating to school placements for their child with a learning disability. Design/methodology/approach Quotes from parents and caregivers, contacted via a national syndrome support charity, are shared, along with broader perspectives gained through the charity’s helpline service. Findings A number of themes are discussed, including friendships and role models; expectations and educational targets; training, speciality and capacity of staff and managing a widening gap. Originality/value When considering the future of education provision, it is important to consider some of the tensions between an ideology of inclusion and the current realities of service provision. To create effective solutions to achieving more effective inclusion, the concerns and experiences of families, as well as children, must be considered.

Assisting individuals ageing with learning disability: support worker perspectives

2015 ◽  
Vol 20 (4) ◽  
pp. 213-222 ◽  
Author(s):  
Stuart Wark ◽  
Rafat Hussain ◽  
Helen Edwards
Keyword(s):  
Learning Disability ◽  
Health Care Providers ◽  
Rural Areas ◽  
Daily Practice ◽  
Care Providers ◽  
Support Worker ◽  
Content Type ◽  
Daily Work ◽  
South Wales ◽  
Or Practice

Purpose – While ageing with an intellectual (learning) disability has been subject to increased research in recent years, there remains little knowledge regarding the daily practice issues that disability workers struggle most to support in this cohort. The purpose of this paper is to gain feedback directly from staff regarding the problems they experience in daily work, and to evaluate whether any changes to legislation or practice could potentially alleviate identified areas of concern. Design/methodology/approach – A Delphi project was conducted over three rounds with participants from rural areas of New South Wales (NSW). The panel was composed of support workers who assist people ageing with a learning disability. Participants were asked their perceptions of the main practice issues facing them while they provide support. Findings – The panel identified 29 issues that were considered problematic in the provision of support to people ageing with a learning disability. A thematic analysis indicated three main themes of access to services; time constraints; and funding. Research limitations/implications – The participants in this study were all disability workers employed by non-government organisations in rural NSW, and as such, many of the issues identified may be specific to this population cohort and geographic setting. Any generalisation of these results to other locations or populations must be considered within these limitations. Originality/value – Identification of the issues facing disability staff may facilitate government, health care providers and disability organisations to proactively plan to address current and future problem areas. The consequent effect of improving practices can assist individuals to receive better support and lead to a corresponding improvement in their quality of life. The current implementation of the National Disability Insurance Scheme in Australia is an ideal opportunity for cross-sectoral collaboration to change practice to facilitate better support for a highly vulnerable group of the community.

The experience of COVID-19 “lockdown” for people with a learning disability: results from surveys in Jersey and Guernsey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sinead Peacock-Brennan ◽  
Kitty Stewart ◽  
Rosalind Jayne Angier ◽  
Julian Morris ◽  
Rachel Rud ◽  
...  
Keyword(s):  
Learning Disability ◽  
Service Provision ◽  
Design Methodology ◽  
Service Evaluation ◽  
Disability Services ◽  
Content Type

Purpose The purpose of this paper is to outline a service evaluation that gathered feedback from people with a learning disability on their experience of lockdown in Jersey and Guernsey. This feedback was intended to guide planning for service provision during any future lockdown and for life as we exit lockdown. Design/methodology/approach An accessible survey was sent to everyone accessing learning disability services across the two islands and Mencap in Jersey. Data was analysed quantitatively and qualitatively to identify patterns in the data and key themes. Findings Most respondents felt safe, calm and happy and valued support from services. Key themes emerging from the data included the importance of relationships, messages of safety, keeping busy and communication. Originality/value This survey has been undertaken at a time where there is a paucity of research and consultation with individuals with a learning disability self-reporting on their experiences of lockdown, during the COVID-19 pandemic.

scholarly journals Scottish survey of learning disability psychiatrists

2002 ◽  
Vol 26 (8) ◽  
pp. 302-304 ◽  
Author(s):  
E. Smiley ◽  
S.-A. Cooper ◽  
S. Miller ◽  
P. Robertson ◽  
N. Simpson
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Service Provision ◽  
Clinical Implications ◽  
Day Hospital ◽  
Catchment Population ◽  
Wide Range ◽  
Assessment And Treatment

Aims and MethodA survey was undertaken to determine the working arrangements of learning disability psychiatrists in Scotland. A questionnaire was sent to each of the 15 NHS providers of learning disabilities services in Scotland. Results were converted to the equivalent of whole time equivalent (WTE) consultant.ResultsThe results showed a wide range in the level of psychiatric staffing throughout services. The median consultant learning disability psychiatrist in Scotland covers a catchment population of 160 000 and works with 0.65 WTE non-consultant career-grade psychiatrists and 0.68 WTE training-grade psychiatrists. They are responsible for a median of 3.7 assessment and treatment beds, no rehabilitation beds, no day hospital places, 23 long-stay beds, 0.6 respite beds and 0.7 forensic beds. At the time of the survey, 15.6% of consultant posts were vacant.Clinical ImplicationsService provision appears to be variable across Scotland. The implications of this may warrant closer scrutiny.

scholarly journals Antimicrobial Stewardship: Development and Pilot of an Organisational Peer-to-Peer Review Tool to Improve Service Provision in Line with National Guidance

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Olaolu Oloyede ◽  
Emma Cramp ◽  
Diane Ashiru-Oredope
Keyword(s):  
Public Health ◽  
Peer Review ◽  
Antimicrobial Stewardship ◽  
Service Provision ◽  
Good Practice ◽  
Survey Method ◽  
Global Public Health ◽  
Inappropriate Use ◽  
National Guidance ◽  
New Antibiotics

Antimicrobial resistance continues to be a considerable threat to global public health due to the persistent inappropriate use of antibiotics. Antimicrobial stewardship (AMS) programs are essential in reducing the growth and spread of antibiotic resistance, in an environment which lacks incentives for the development of new antibiotics. Over the years, a variety of resources have been developed to strengthen antimicrobial stewardship. However, the differences in resources available present a challenge for organisations/teams to establish the best resources to utilise for service provision. A peer review tool was formulated using four national documents on AMS and tested through three phases with feedback. A survey method was used to collect feedback on the validity, feasibility, and impact of the AMS peer review tool. Feedback received was positive from the earlier pilots. The tool was found to be useful at identifying areas of good practice and gaps in antimicrobial stewardship across various pilot sites. Feedback suggests the tool is useful for promoting improvements to AMS programs and highlights that the content and features of the tool are appropriate for evaluating stewardship.

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.

Human rights-based conceptions of deservingness: health and precarity

2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Health Care Providers ◽  
Health Care Access ◽  
Migrant Health ◽  
Dominant Negative ◽  
Care Providers ◽  
Content Type ◽  
Care Access ◽  
Health Related

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

scholarly journals Learning disability market position statements, are they fit for purpose?

2017 ◽  
Vol 22 (4) ◽  
pp. 198-205 ◽  
Author(s):  
Sarah Broadhurst ◽  
Keri Landau
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Good Practice ◽  
Market Position ◽  
Content Type ◽  
Fit For Purpose ◽  
Potential Impact ◽  
Senior Officers ◽  
Market Shaping

Purpose The purpose of this paper is to review whether current learning disability market position statements (MPS) are actually helping to shape the market and explore their implications for people with learning disabilities and their families. Design/methodology/approach Published learning disability MPS were identified via the Institute of Public Care’s MPS database. The quality of the MPS was analysed using a good practice checklist developed by a range of stakeholders. Findings Learning disability MPS are not currently fit for purpose. They demonstrate that local authorities are not fully engaging in their market-shaping duties, as required under The Care Act 2014. It is suggested that this is in part due to the lack of recognition that market shaping is a council-wide responsibility and can only be successful if senior officers across the council (and their partners) acknowledge this and are held accountable. Unless this happens, people with learning disabilities will continue to lack the enablers that support them to lead the lives they choose in their communities. Originality/value This is the first review of the quality and potential impact of learning disability MPS.

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