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Commissioning services for people with learning disabilities in Scotland: linking evidence and practice
- Author:
- CAMPBELL Martin
- Journal article citation:
- British Journal of Learning Disabilities, 37(1), March 2009, pp.28-33.
- Publisher:
- Wiley
This paper describes the development of some practical guidance for people involved in commissioning services for individuals with learning disabilities. A national conference was organised in November 2005 to look at the question of 'What works in learning disability services?', i.e. what approaches have proven effectiveness in the planning, commissioning and provision of services for people with learning disabilities. This was followed by four workshops around Scotland to seek practitioners' views on commissioning, at a strategic and at an individual level. From this, written and online guidelines were devised, based on seven steps with a number of associated key questions. These guidelines aim to inform commissioners about available research and good practice, and provide a method of recording the basis on which commissioners make their decisions for models of care and their experiences in a way that could be shared with others.
Changing day services: do you agree?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Intellectual Disabilities, 16(3), September 2012, pp.205-215.
- Publisher:
- Sage
- Place of publication:
- London
Models of day services for people with intellectual disabilities in Scotland are changing. Buildings-based day services are being replaced increasingly with community-based provision in the form of alternative day opportunities. There has been some concern that a move to more flexible ‘alternative day opportunities’ is driven more by reduced budgets than a policy of modernising day services in response to individual needs. The aim of this study was to rate and collect views on existing day services in Fife, Scotland in order to inform the change process. A total of 60 questionnaires were completed by 36 carers, 18 service users, and 6 care staff. The questions were designed to evaluate day activities, care plans, opening times, transport and the most valued aspects of existing day services. The respondents indicated general satisfaction with existing day services, although half believed that day services should be reviewed. The most valued parts of day services were forming and building friendships, and a safe place to go. Any changes to these services should be responsive to needs and should achieve outcomes that are valued. The day service review process should be robust and transparent so that all views can be heard and the rationale for modernising day services should be clearly explained.
Adult protection in Scotland in 1857 and in 2015: what have we learned?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Adult Protection, 18(2), 2016, pp.96-108.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to compare recent developments in adult protection legislation, policy and practice in Scotland in 2015 with the first attempts at protection of adults at risk of harm, in 1857-1862, with a particular focus on people with learning disabilities. Design/methodology/approach: The paper uses comparative historical research, drawing on primary archive material from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers. Findings: Growing public awareness of the extent of neglect and abuse, and the need for overarching legislation were common factors in the development of both the “The Lunacy Act” of 1857 and the Adult Support and Protection (Scotland) Act of 2007. Both pieces of legislation also had the common aim of “asylum”, and shared some other objectives. Practical implications: Total prevention of abuse of vulnerable adults is an aspiration in law and in policy. There is an evidence base of effectiveness, however, in protecting adults at risk of harm from abuse. Some ecological factors recur as challenges to effective safeguarding activity. These include problems of definition, uncovering abuse, enforcing legislation, evaluating impact and protection of people who are not a risk of harm to others. Originality/value: This paper compares common themes and common challenges in two separate time periods to investigate what can be learned about the development of legislation and practice in adult protection. (Publisher abstract)
Review of adult protection reports resulting in “No Further Action” decisions
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 10(3), 2013, pp.215-221.
- Publisher:
- Wiley
In Scotland, the Adult Support and Protection Act of 2007 mandates effective interagency policies and activities to prevent harm to individuals unable to safeguard their own well-being, property, and rights because they are affected by “disability, mental disorder, illness or physical or mental infirmity.” This article examines the high proportion of adult protection referrals that resulted in “No Further Action” (NFA) decisions (these are referrals that did not lead to a full adult protection investigation). The review involved examining police referral data from 15 areas in Scotland as well as referral reports received over a 3-month period in one representative area. Data sources were case files, national reports, and Freedom of Information requests. Interviews conducted with key personnel were supplemented with statistical data with a view to making recommendations. Screening criteria for referral, main contributory factors in referral, and reasons for NFA decisions were analyzed. It was found that, typically, more than 40% of adult protection referrals made by the police to adult protection teams resulted in NFA decisions. Variations in the interpretation of threshold criteria were observed, and there was a perception of overreporting. While overreporting of cases may have implications for resources and impact on the process, the dangers of underreporting may have more detrimental implications for adults with intellectual disabilities. The authors call for robust data and recording processes to determine how effectively different systems are protecting adults who are most at risk. (Edited publisher abstract)
The importance of good quality services for people with complex health needs
- Author:
- CAMPBELL Martin
- Journal article citation:
- British Journal of Learning Disabilities, 36(1), March 2008, pp.32-37.
- Publisher:
- Wiley
This article describes the use of a set of evidence-based quality indicators to assess performance by 15 NHS Boards across Scotland in a national review, with a particular focus on the quality of services for people with complex health needs. Evidence based best practice and evaluative data from previous inspections were used to develop Quality Indicators in four domains. Areas reviewed were: involvement of children and adults with learning disabilities and carers in service planning; meeting complex health needs; inpatient/hospital services and planning services/partnership working. A connection between the group of quality indicators used to assess performance in ‘meeting complex health needs’ and overall measures of quality was observed. The importance of good quality services for people with complex health needs is discussed in light of these results.
The journey from first inspection to quality standards (1857-2016): are we there yet?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Adult Protection, 19(3), 2017, pp.117-129.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to qualitatively analyse the inspection and regulation of care for people with learning disabilities and mental health problems in Scotland, in two time periods. Design/methodology/approach: The paper uses comparative historical research drawing on primary sources from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers, to compare inspection methods, quality standards and to identify persistent challenges to effective inspection. Findings: Political, clinical and public awareness led initially to criticisms of existing care and eventually to the development of the “The Lunacy Act” of 1857. This Act resulted in the first attempts to set minimum standards of care for individuals at risk, with enforceable regulation. Some factors recur as challenges to effective practice in the inspection and regulation of care today. Practical implications: There are problems of definition, reliable monitoring of quality standards and adequate, independent inspection of services that respond to unacceptable standards of care. There is a growing evidence base about best methods of inspection of services for people in care who are most at risk. These methods attempt to strike a balance between evidence- and value-based judgments. Perspectives from history may help focus resources. Originality/value: This paper compares common and common challenges in two time periods to investigate what can be learned about the development of policy and practice in inspection and regulation of care. (Publisher abstract)
A pilot project: evaluating community nurses' knowledge and understanding of the Adult Support and Protection (Scotland) Act 2007
- Authors:
- CAMPBELL Martin, CHAMBERLIN Dionne
- Journal article citation:
- Journal of Adult Protection, 14(4), 2012, pp.188-196.
- Publisher:
- Emerald
The Adult Support and Protection (Scotland) Act 2007 was introduced by the Scottish Government to organise a more coordinated approach to supporting and protecting adults who may be at risk of harm or neglect. Community nurses working in learning disabilities services are in a prime position to implement adult protection. The aim of this study was to evaluate understanding and knowledge of the Adult Support and Protection (Scotland) Act 2007 in community nurses working in learning disability services in Scotland. The participants were 10 community nurses who worked in learning disability services in one NHS area who had previously received varying levels of training. The participants completed a questionnaire at 2 time points, 4 months apart. The questionnaire aimed to test understanding of: principles of the Act and definitions; adults at risk of harm; and protection, assessment, removal and banning orders. The questionnaire scores varied widely overall and across the 3 domains. There was no correlation between individual scores and training or length of work experience. The level of knowledge was below what might have been expected for this group, given the level of training and experience.
Reducing health inequalities in Scotland: the involvement of people with learning disabilities as national health services reviewers
- Authors:
- CAMPBELL Martin, MARTIN Mike
- Journal article citation:
- British Journal of Learning Disabilities, 38(1), March 2010, pp.49-58.
- Publisher:
- Wiley
Reducing health inequalities is a key priority for the Scottish Government. Health authorities are expected to meet quality targets. The involvement of people with learning disabilities in health service review teams has been one of the initiatives used in by National Health Service Quality Improvement Scotland to empower patients and improve health services. This paper describes this initiative, how it was planned, and an evaluation by health staff, carers and people with learning disabilities. Recommendations are made to ensure the future success of this type of initiative in Scotland and elsewhere. This initiative was evaluated positively and tested traditional assumptions, challenging the power imbalance in patient-provider relationships. The theory and the practice of including people with learning disabilities as 'expert patient' reviewers are discussed.
Joint inspection of services for people with learning disabilities in Scotland: compliance or commitment?
- Author:
- CAMPBELL Martin
- Journal article citation:
- International Journal of Integrated Care, 6(4), 2006, Online only
- Publisher:
- International Foundation for Integrated Care
The article describes the development of a practical model of joint, integrated inspection of managed care services for people with learning disabilities in Scotland. The model will give a reliable measure of the impact services are making to people's lives and the quality of service that individuals are actually receiving. At present health, social services and education services for people with learning disabilities in Scotland are inspected separately, by up to nine different agencies. The first joint, integrated inspections of all services for people with learning disabilities in Scotland will take place in 2006. This is the first inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Quality Outcome Indicators were developed in 21 different areas, or domains. Evidence based best practice, and evaluative data from previous inspections were the primary sources of data. This paper reviews the background and rationale for the integrated, joint inspection process. Strengths and constraints of this approach to inspection are discussed, including the crucial importance of commitment from services and from inspectors, rather than mere compliance with demands. Some guidance on how to fully involve staff, carers and services users in the inspection process is given. It is concluded that the model will produce data to inform decision-making for managers in integrated services and give services users clear information about how well local needs are being met, what areas need development, and what capacity the organisations have to improve. The model of inspection may be of interest to practitioners in a national and international context. The model will be evaluated, following the first joint inspection.