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A different ending: addressing inequalities in end of life care: people with a learning disability
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2016
- Pagination:
- 4
- Place of publication:
- Newcastle upon Tyne
This document outlines the barriers to good end of life care experienced by people with a learning disability. The report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. There are challenges in delivering good end of life care in prison, and the experience of prisoners at the end of life is variable. The reviewers asked a group of people with a learning disability about what was important to them for good end of life care. They said that it was important to have family and friends nearby, to have privacy, peace and quiet, preferably not to be in hospital, to be able to go outside, and to have the support of a care coordinator when needed. They thought that services should talk more to people who have a learning disability to get their views and check that they are improving and inclusive. The document focuses on staff lack of knowledge around learning disabilities, communication and coordination of care. The Care Quality Commission encourages commissioners and providers to support early identification of people with a learning disability who may be approaching the end of life, as part of improved health care; and to make sure that health and care staff have the skills and support they need to communicate well with people with a learning disability who may be approaching the end of life. This includes access to appropriate communication aids and tools. (Edited publisher abstract)
Provider collaboration review: care for people with a learning disability living in the community during the pandemic
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2021
- Pagination:
- 21
- Place of publication:
- Newcastle upon Tyne
Initial findings from a provider collaboration review exploring the care for people with a learning disability who live in the community, and what impact the COVID-19 pandemic has had on them and the services they receive. Many of the issues emerging from review are not new. In a lot of cases, the pandemic has simply served to shine a light on pre-existing challenges, gaps and poor-quality care. There are some approaches to care delivery that can provide people with the care that they need, in a way that enables them to lead their best lives. For example: giving people choice, control and independence; access to the right care and support at the right time; and collaboration between services, and with the person and their families. The findings of this provider collaboration review support our wider ambitions to improve our regulation of services for people with a learning disability and autistic people. The document also updates data on: the number of deaths of people in care homes; and the number of deaths of people detained under the Mental Health Act. (Edited publisher abstract)
Review of adult learning disability services phase II
- Author:
- REGULATION AND QUALITY IMPROVEMENT AUTHORITY
- Publisher:
- Regulation and Quality Improvement Authority
- Publication year:
- 2016
- Pagination:
- 66
- Place of publication:
- Belfast
Review of community services for adults with learning disability in Northern Ireland, which assesses the performance of the five health and social care trusts against the Department of Health’s Service Framework for Learning Disability. The review assessed the quality of services delivered to adults with a learning disability against 30 standards. The findings are presented in the areas of: safe care; effective care; compassionate care; and well led services. The review found staff were familiar with the content of the service framework, but that there was not a standardised approach to its implementation across the five health and social care trusts. Evidence of improvements identified since the 2013 review included: access to a wider range of day activities for adults with a learning disability; assessments by GPs of the health needs of adults with a learning disability; and the establishment of specialist teams within trusts to support carers in managing challenging behaviours. Areas requiring improvement included: the provision of family support services; an increase in the uptake of carer’s assessments and direct payments; the development of a single regional community based information system. The review makes 25 recommendations to support improvements in the provision of services for adults with a learning disability across Northern Ireland. (Edited publisher abstract)
Health care in care homes: a special review of the provision of health care to those in care homes
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2012
- Pagination:
- 8p.
- Place of publication:
- London
This review explores how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity. The results are based on an analysis from the inspections of 81 care homes in 9 primary care trust areas during January and February 2011. The inspection teams interviewed managers, residents and staff, observed care provided to residents, and examined case files. The findings are discussed against 4 themes: involvement and information; personalised care, treatment and support; safeguarding and safety; and suitability of staffing. Among the findings were that 77% of care plans considered the views of the resident, and that 96% of care homes identified the changing health care needs of residents through informal or responsive monitoring. However, the review also showed that: 25% of residents did not feel they were offered a choice of male or female staff to help them use the toilet; 44% of care homes indicated they received routine visits from GPs; 30% of nursing homes did not have a 'do not attempt resuscitation' policy (and, of those that did, just 37% of staff had received training on it); 35% of homes reported they sometimes had problems getting medicines to residents on time; and 10% of care homes said they paid for their GP surgeries to visit.
Safeguarding children with disabilities and complex health needs in residential settings: phase 1 report
- Author:
- CHILD SAFEGUARDING PRACTICE REVIEW PANEL
- Publisher:
- Child Safeguarding Practice Review Panel
- Publication year:
- 2022
- Pagination:
- 90
- Place of publication:
- London
This report sets out the findings from phase 1 of the Child Safeguarding Practice Review Panel's review into the safeguarding of children with disabilities and complex health needs in residential settings. The phase 1 report looks in particular at the experiences of 108 children and young adults placed from 55 local authorities at Fullerton House, Wilsic Hall and Wheatley House specialist, independent, residential settings between 1 January 2018 and 21 March 2021. These settings were located in the villages of Denaby Main and Wilsic, Doncaster, and run by the Hesley Group. The children placed at Hesley's children’s residential settings in Doncaster functioned significantly below their chronological age and exhibited behaviour that challenges. They had been diagnosed with complex needs, including: autism (82%), learning disabilities (76%), mental health difficulties such as anxiety, obsessive compulsive disorder and bipolar disorder, and attention deficit hyperactive disorder (25%). Many of the children had profound difficulties with receptive and expressive communication, but were not supported when they displayed behaviours, signs and symptoms that were indicative of child abuse. They were among the most vulnerable children in society, yet they experienced systematic and sustained physical abuse, emotional abuse and neglect. Our report sets out: what happened to the children and young adults placed in these settings; why it happened; urgent action to be taken by local authorities by November 2022, to provide assurance about the safety and care of children who may be residing in similar specialist settings; wider systemic issues raised by the findings from phase 1, to be explored in depth in phase 2 and completed by spring 2023. (Edited publisher abstract)
The right to advocacy: a review of how local authorities and NHS Boards are discharging their responsibilities under the Mental Health (Care and Treatment) (Scotland) Act 2003
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2018
- Pagination:
- 53
- Place of publication:
- Glasgow
This report investigates access to independent advocacy services for people with mental health problems, learning disability, dementia and related conditions in Scotland. It is based on information received from health boards, local authorities, and from the new health and social care partnerships (HSCPs). The report also investigates whether the integrated children’s services plans of local authorities cover the provision of independent advocacy services for children and young people with mental illness, learning disability or related conditions. The results show that the planning and provision of advocacy services across Scotland is variable and lacks clarity. It found services for adults were often prioritised for those who were receiving compulsory care or treatment .There is a lack of clarity on which organisation is responsible for co-ordinating the preparation of strategic advocacy plans, and on how advocacy providers and people using advocacy services will be involved in planning. The report identifies significant gaps in service provision for children and young people, with some of the services not providing independent advocacy and very restricted eligibility criteria. (Edited publisher abstract)
The second year of the Independent Mental Capacity Advocacy Service 2008/2009
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2009
- Pagination:
- 54p.
- Place of publication:
- London
The Mental Capacity Act 2005 created the Independent Mental Capacity Advocate (IMCA) service as a safeguard for people without the capacity to make certain important decisions and without family or friends to support them. The Act also introduced a legal duty on NHS bodies and local authorities to refer eligible people to the IMCA service. The service started on 1st April 2007 and this is the report on its second year’s work. There was a 27 percent rise (to 6582) in the number of people receiving representation from the IMCA service compared to the first year. This comprised a 14 percent increase (to 3496) for decisions relating to accommodation moves; a 102 percent increase (to 387) for decisions relating to care reviews; a 43 percent increase (to 968) for decisions relating to serious medical treatment; and a 29 percent increase (to 960) in adult protection proceedings. There is concern that the service is not yet reaching all the people who would benefit, particularly with regard to the continuing low rate of referrals for serious medical treatment. A small study revealed that commissioners were mainly pleased with the service though they wanted IMCAs to be more available and to deliver reports faster. MCA leads in local authorities commented on the professionalism of IMCAs and the benefits to the client group. However, there was a perception within health care settings that involving an IMCA delayed treatment..