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Settling in the community: a review of residents' progress since coming to Clach View, Maud
- Author:
- SEED Philip
- Publisher:
- University of Dundee. Department of Social Work
- Publication year:
- 1991
- Pagination:
- 41p.,tables.
- Place of publication:
- Dundee
Looks at the experiences of 5 adults with learning difficulties, 4 of whom were in residential care, in house in the community.
Coming home: a report on out-of-area placements and delayed discharge for people with learning disabilities and complex needs
- Author:
- MacDONALD Anne
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2018
- Pagination:
- 71
- Place of publication:
- Edinburgh
This two-year project, commissioned by the Scottish Government, collected national data on people with learning disabilities who have additional complex needs, and who are either placed out-of-area, or are within hospital-based assessment and treatment units, classed as delayed discharge. It aimed to gather information on the issues and suggest support solutions and actions that could improve outcomes for people with learning difficulties who have been unable to receive appropriate support in their communities. The project found that there were 705 people out-of-area in Scotland from 30 HSCPs, Of the group, 79 were placed out of Scotland and 453 were identified as being placed out-of-area not through choice. Challenging behaviour, and the impact that challenging behaviour has on service breakdown or hospital admission was a key issue for people with learning disabilities and complex needs. This was partly due to a lack of coordinated responses. Key elements contributing to good support for people with learning disabilities and complex needs were identified as: person-centred approaches, environments which support communication, active support and full lives, positive behavioural support, suitable accommodation, skilled and motivated staff, and good management and practice leadership. The report makes recommendations for Integrated Health Authorities, Health and Social Care Partnerships and the Scottish Government. It calls for a transformational change approach, with all stakeholders working together to address the issue. (Edited publisher abstract)
Do levels of evidence affect breadth of service? A study on the use of clinical guidance in a learning disability service
- Authors:
- PATERAKI Eleni, MacMAHON Kenneth
- Journal article citation:
- British Journal of Learning Disabilities, 45(2), 2017, pp.121-128.
- Publisher:
- Wiley
Background: For services across the UK, increasing emphasis is placed on the use of evidence-based psychological treatments. In this context, the Scottish Government published the MATRIX, a best-practice clinical governance document, with a brief section on therapies for people with learning disabilities. As with most clinical guidelines, randomised controlled trials were considered the “gold standard.” However, within the learning disability field, the existing evidence base is relatively limited, resulting in a narrow guidance for services. Methods: This study evaluated the use of best-practice guidance (the MATRIX), in a psychology service for adults with learning disabilities, covering one of the largest NHS Boards in Scotland. A randomly selected 50% (N = 73) of case notes opened since October 2011 (publication date for the MATRIX) was reviewed. Eight case notes were second-rated by an independent clinician. Results: Findings showed that service users typically presented with multiple psychological difficulties, and clinicians offered a range of therapies additional to those suggested in the guidance. This was particularly evident in cases managed by clinical psychologists. Conclusions: Applying rigid therapeutic recommendations may limit opportunities for integrative practice. The potential impact of inflexibly adopting clinical guidelines on service planning and resources is discussed. (Publisher abstract)
Mapping the employability landscape for people with learning disabilities in Scotland
- Authors:
- McTIER Alex, et al
- Publisher:
- Scottish Commission for Learning Disability
- Publication year:
- 2016
- Pagination:
- 85
- Place of publication:
- Glasgow
This report maps the employability landscape for people with learning disabilities in Scotland and seeks to better understand the scale and effectiveness of employability support. The report finds that the current landscape is complex, fragmented and seemingly under-resourced given the very low employment rate of adults with a learning disability. The employment rate for working adults with a learning disability is in the range of 7% to 25%, and there could be as many as 125,000- 150,000 out-of-work adults with a learning disability. Very small numbers of people with a learning disability appear to be engaged in mainstream employability programmes while supported employment services are estimated to have supported up to 2,000 people in 2014/15. The number of people with a learning disability enrolled in Scotland’s colleges is unclear, but it is estimated they have a 16 hours/job outcome rate of 12%. Specialist employability organisations appear to have an overall 16 hours/week job outcome rate of 14% and a cost per 16 hours/week job outcome of £17,200. Project SEARCH programmes achieve higher employment outcome rates with a 16 hours/week job outcome rate of 61% but with current capacity in Scotland of only 100-150 people per annum. The report makes a series of specific recommendations for a variety of stakeholders. They include the need to: overcome the low expectations held by parents, schools, colleges and employers; gather data more effectively, investing funding where people with a learning disability in Scotland secure both employment and support to develop in that job, and; recruit and train job coaches that can support people with a learning disability into employment and throughout their careers. (Edited publisher abstract)
Examining the support needs of ageing family carers in developing future plans for a relative with an intellectual disability
- Authors:
- TAGGART Laurence, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 16(3), September 2012, pp.217-234.
- Publisher:
- Sage
- Place of publication:
- London
Due to the increased life expectancy of people with intellectual disability, they are now more likely to be living with an ageing family carer. The aim of this study was to examine the support needs of ageing family carers in developing future plans for a relative with an intellectual disability. A mixed methods design was employed. In stage 1, a structured questionnaire was used to collate information on the health, caregiving demands and future planning preferences of 112 parent and sibling carers aged 60–94 years. In stage 2, 19 in-depth semi-structured interviews were undertaken with a sample of carers to explore a range of issues around future planning. Over half of the carers were lone carers, mainly female, with many reporting a wide range of health problems. The main preference was for the person to remain in the family home, with either the family or paid staff to support them. A minority of parent carers preferred the person to move into the home of a sibling, although some favoured the person moving to a residential facility with other people with intellectual disabilities. Four main themes were identified around future planning: unremitting apprehension; the extent of planning; obstacles encountered; and solutions for future planning. Avoidance, lack of guidance and a lack of appropriate residential provision were cited as obstacles to making future plans compounded by the emotional upset experienced by carers in thinking about the future.
The "forensicisation" of challenging behaviour: the perils of people with learning disabilities and severe challenging behaviours being viewed as "forensic" patients
- Authors:
- DOUDS Fergus, BANTWAL Ashwin
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(3), 2011, pp.110-113.
- Publisher:
- Emerald
Since the closure of long stay learning disability hospitals in 2005, focus in Scotland has shifted on to developing robust community services to cater for the healthcare needs of people with learning disabilities. A small number of individuals with learning disabilities and associated severe challenging behaviours do inappropriately get referred and sometimes admitted to forensic learning disability services. This study investigated this area of clinical practice in the context of referrals to the high secure forensic setting of The State Hospital, Carstairs, Scotland. Five referrals made to the State Hospital's forensic learning disability service between 2005 and 2010 were reviewed. Findings revealed that the identified determinants leading to the making of these referrals were classifiable into psychiatric, environmental and staffing themes. In conclusion, there is a requirement for a specialist in-patient service to meet the needs of this complex group of patients, which demonstrates ‘gaps’ within current services.
An anxious time? Exploring the nature of worries experienced by young people with a mild to moderate intellectual disability as they make the transition to adulthood
- Authors:
- FORTE Marisa, JAHODA Andrew, DAGNAN Dave
- Journal article citation:
- British Journal of Clinical Psychology, 50(4), November 2011, pp.398-411.
- Publisher:
- Wiley
Transition to adulthood can be particularly challenging time for young people with mild intellectual disabilities (IDs) because they are often more socially marginalised, remain more dependent upon their family, and have fewer options for future careers than their typically developing peers. The aim of this study was to examine the content and salience of worries experienced by young people with mild ID during their transition to adulthood. The participants were 26 young people with mild ID and 26 typically developing young people all recruited from a Further Education college in the West of Scotland. The participants underwent a semi-structured interview about their worries and completed self-report assessments concerning anxiety and self-efficacy. The findings showed that that the ID group's most salient worries were largely different from their non-disabled peers at this stage of transition. The ID group worried about: being bullied; losing someone they are dependent upon; failing in life; and making and keeping friends. The non-disabled group worried about: getting a job; not having enough surplus money; failing; and having to make decisions about their future choices. Not only was there a difference in the nature of worries expressed, but the intellectually disabled group also reported ruminating significantly more about their worries and being more distressed by them.
Prevalence and associations of anxiety disorders in adults with intellectual disabilities
- Authors:
- REID K. A., SMILEY E., COOPER S.-A.
- Journal article citation:
- Journal of Intellectual Disability Research, 55(2), February 2011, pp.172-181.
- Publisher:
- Wiley
Estimates of the prevalence of anxiety disorders in adults with intellectual disabilities (IDs) vary widely; general anxiety disorder ranging from less than 2% to 17.4% compared to 4.4% in the general public. Little is known about associated factors in this population. Information was collected regarding 1023 adults with IDs who participated in a large-scale, population-based study in Scotland. All had a comprehensive physical and mental health assessment. The point prevalence of anxiety disorders according to different diagnostic criteria was determined, as were independently associated factors. At the time of the assessment 3.8%, of the cohort had an anxiety disorder. Generalised anxiety disorder was the most common (1.7%), then agoraphobia (0.7%). Results are reported for eight types of anxiety disorder. Factors independently associated with having an anxiety disorder were not having any daytime employment, and having a recent history of life events. Having previously been a long-term hospital resident was independently associated with not having an anxiety disorder. The authors conclude that anxiety disorders are in fact common in the ID population. They suggest that it might be sensible for carers to be vigilant and to consider proactively providing additional support at times of significant life events.
Looking for love
- Author:
- ETHERINGTON Keith
- Journal article citation:
- Learning Disability Today, April 2011, pp.22-24.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The setting up and funding of the Dates-n-mates, a dating and friendship agency run by and for people with a learning disability is described. It operates as a project of C-Change for Inclusion, a Glasgow based supported living organisation and charity that provides creative person-centred services for people with learning disabilities and mental health issues.
Inclusion and healthcare choices: the experiences of adults with learning disabilities
- Authors:
- FERGUSON Morag, JARRETT Dominic, TERRAS Melody
- Journal article citation:
- British Journal of Learning Disabilities, 39(1), March 2011, pp.73-83.
- Publisher:
- Wiley
Those with learning disabilities have fewer decision-making opportunities than the general population. This study investigated the decision-making experiences of two groups of individuals with a learning disability. Group 1 included irregular attenders who had opted out of healthcare appointments for avoidable reasons, and group 2 included regular attenders who had attended all appointments or not attended for unavoidable reasons. Interviews were carried out with 4 people with learning disabilities and/or their 13 primary carers. In addition to these interviews, physiotherapy staff participated in a focus group. Those with learning disabilities described experiences of and opportunities for making everyday decisions but mostly identified others as being responsible for making their health care choices. Overall, the paper concluded that a greater understanding of the health care expectations and experiences of individuals with learning disabilities, and those that support them, is required to enable people with learning disabilities as participants in their own health care decision-making processes.