Search results for ‘Subject term:"learning disabilities"’ Sort:
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Outcomes from the National High Secure Learning Disability Service: findings and challenges
- Authors:
- MORRISSEY Catrin, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(3), 2015, pp.116-1233.
- Publisher:
- Emerald
Purpose: The “outcomes revolution” in healthcare has yet to impact strongly on secure intellectual disability (ID) services in the UK. The purpose of this paper is to review the service-level outcome studies that exist for this population, and to explore some of the challenges of conducting such research. It further describes some illustrative routine outcome data from the National High Secure Learning Disability Service. Design/methodology/approach: Routinely collected outcome measures (length of stay; violent incidents; Emotional Problem Scale (EPS) Behaviour Rating Scale and EPS Self-Report Inventory) were analysed for two overlapping cohorts of patients resident in the high-secure service between 2008 and 2013. Findings: The median length of stay of those discharged during the study period (n=27) was around 9.9 years (range one to 40 years). A significant proportion (25 per cent) of discharges resulted in an eventual return to high security. There did not appear to be a treatment effect over two to three years using staff-rated global clinical measures, but patient-rated clinical measures did reduce. Violent incidents also reduced significantly over a longer period of four years in treatment. Research limitations/implications: There are identified challenges to research design and outcome measurement which need to be addressed in any future cross-service studies. Originality/value: There are relatively few published outcome studies from forensic ID services. None of the studies have used clinical measures of changes or patient-rated outcome measures. (Publisher abstract)
An evaluation of a community living initiative in Ireland
- Authors:
- SHEERIN Fintan, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 19(3), 2015, pp.266-281.
- Publisher:
- Sage
- Place of publication:
- London
One of the central principles underpinning Irish intellectual disability policy is that of decongregation. Allied to this is the belief that life in community settings offers greater opportunities and richer experiences than does life in institutional settings. This study explores the experiences of a group of adults with intellectual disabilities who moved from residential settings to living units in the community. Using a qualitative descriptive approach, it considers the significance of that move for them and seeks to understand the extent to which their lives have changed. Whereas it emerges that this was a positive period in their lives, it is clear that a number of issues remain to be addressed and these provide useful information for similar developments in the future. (Publisher abstract)
Developing an easy read version of the Adult Social Care Outcomes Toolkit (ASCOT)
- Authors:
- TURNPENNY Agnes, et al
- Publisher:
- Quality and Outcomes of Person-centred Care Policy Research Unit
- Publication year:
- 2015
- Pagination:
- 89
- Place of publication:
- Canterbury
This study aims to develop and test a robust easy read version of the Adult Social Care Outcomes Toolkit (ASCOT), and ensure it meets the needs of respondents with learning disabilities. ASCOT is a measure of social care-related quality of life and is used as part of the Personal Social Services Adult Social Care Survey in England. An easy read version of ASCOT could ensure that social care research include people who, although having capacity to consent to taking part in research, are not able to respond to standard questionnaires and surveys. This study indicates that the revised easy read version adequately represents the ASCOT domains and the standard questionnaire. However, ASCOT-ER might benefit from further systematic testing, particularly around validity and reliability. (Edited publisher abstract)
Longitudinal investigation of vocational engagement
- Authors:
- SPREAT Scott, CONROY James William
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 12(4), 2015, pp.266-271.
- Publisher:
- Wiley
The vocational engagement of 216 individuals with an intellectual disability was followed over a 15-year period. Engagement was operationally defined as activity in five simple categories: competitive, supported, or sheltered employment, plus prevocational and nonvocational daytime activities. Authors sought a long-term view of trends in vocational and nonvocational engagement among all people who were receiving residential and day supports in the U.S. state of Oklahoma, and for whom data collection visits had been conducted during the entire 15-year period. This was intended to assess what progress toward eventual employment has been made over the past two decades, and this information was aimed toward policy initiatives related to Employment First models. Authors selected all people for whom on-site quality-of-life data were collected continuously from 1994 to 2009. Their primary types of daytime activities were reported, and the number of hours in each type were submitted to analysis. The overall amount of vocational, prevocational, and nonvocational activities changed sharply during the 15-year period. Vocational and prevocational activity declined, while nonvocational engagement more than doubled, both in numbers of people and hours. During the same time period, the number of employed individuals consistently declined, as did the total number of hours worked. The decline was primarily evident in segregated forms of vocational activity, such as sheltered workshops and prevocational activities. There was no collateral increase in the use of more integrated forms of employment. Age did not appear to be a factor in this decline. The current emphasis on Employment First models would seem to be justified in view of this sample's longitudinal engagement outcomes. However, this analysis was done in only one state, and results must be compared and contrasted to those in other states. (Publisher abstract)
Developing and piloting the QOMID – quality outcome measure for individuals with intellectual disabilities and dementia
- Authors:
- DODD Karen, BUSH Alick, LIVESEY Alexandra
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.298-311.
- Publisher:
- Emerald
Purpose: Outcome measurement is a key priority for services. There are no papers on specific overall quality outcome measures for people with intellectual disabilities who have dementia. The purpose of this paper is to describe the development and piloting of a new measure. Design/methodology/approach: A process was developed to measure quality outcomes across all stages of dementia. The reliability of the tool was measured using Cronbach’s α coefficients, along with data about its clinical utility. Findings: The QOMID has good reliability, face validity and internal reliability suggesting that all domains contribute equally towards the construct of quality outcome. An exploratory factor analysis revealed that there may be four or five sub-factors within the QOMID, The clinical utility of the assessment tool was explored and it can be concluded that the QOMID is simple, fairly quick and effective. Research limitations/implications: The scale has good psychometric properties and the initial parameters for the QOMID were met. Further exploration of factors needs to be considered with a larger sample of participants. Practical implications: The scale was liked by assessors and gives a practical tool that can both measure the quality outcome for people at each stage of their dementia, and help to develop more effective care plans. Originality/value: This is the first measure to look at quality outcomes for people with intellectual disabilities and dementia and which takes a staged approach. (Publisher abstract)
Developing outcome measures for a family intensive support service for children presenting with challenging behaviours
- Authors:
- MULLIGAN Bethany, et al
- Journal article citation:
- British Journal of Learning Disabilities, 43(3), 2015, pp.161-167.
- Publisher:
- Wiley
Seven per cent of individuals with learning disabilities also display challenging behaviour, which has an effect on the whole family. This is a retrospective pre- and post- evaluation study examining the utility of specific outcome measures assessing the effectiveness of interventions addressing behavioural problems within a Family Intensive Support Service (FISS). After one year, FISS successfully reduced problematic behaviours and increased a sense of coping and ability to manage the behaviour for parents. The outcome measures used were sensitive enough to show change on specific subscales of the measure. Further research is needed to look at whether there is a need to create a new measure encapsulating the best elements of these measures. (Edited publisher abstract)
Making a difference? Ten years of managing people with intellectual disability and forensic needs in the community
- Authors:
- DE VILLIERS Jana, DOYLE Michael
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 6(3/4), 2015, pp.165-174.
- Publisher:
- Emerald
Purpose: Nationally community services for patients with intellectual disability and forensic needs are limited, and research to guide service development for this patient group with highly complex needs is sparse. The purpose of this paper is to provide an overview of referrals to and case management by the multi-agency Fife Forensic Learning Disability Service (FFLDS), including demographic data, treatment, risk assessments and outcomes. Design/methodology/approach: All referrals received between 2004 and 2014 were reviewed to identify key demographic factors and to clarify the outcome of the referrals. Risks levels and presence of factors related to ongoing risk management were identified. For those accepted, final outcomes were noted. Findings: In total, 145 referrals were received by FFLDS between 1 January 2004 and 31 December 2014. Of these 117 were accepted for ongoing case management. In total 106 patients were discharged from FFLDS over the review period, with the vast majority remaining in community settings. Patients were overwhelmingly male, with an age range of 16-79 (mean age of 30). Approximately half of referrals were from criminal justice agencies, and sexual and violent offences predominated. Alcohol and/or illicit substance use was problematic in 49 per cent of patients. Research limitations/implications: FFLDS needs to consider building links with Drug and Alcohol Services, for assistance in developing expertise in managing problematic alcohol and/or illicit substance use. Links with professionals working with female offenders may increase the rate of referral of female patients. Originality/value: Policy and legal frameworks emphasise the need to manage people with learning disabilities and forensic needs in the least restrictive environment possible. This paper provides information on a cohort of forensic patients over a ten-year period, including characteristics and outcomes, to inform the evaluation of these frameworks and the planning of both community and in-patient services for this patient group. (Publisher abstract)
Resource allocation priorities in social care for adults with a learning disability: an analysis and comparison of different stakeholder perspectives
- Authors:
- DAVIES Sue, et al
- Journal article citation:
- Tizard Learning Disability Review, 20(4), 2015, pp.199-206.
- Publisher:
- Emerald
Purpose: How resources for social care are allocated to individual service users has long been a concern. There are debates regarding the priority given to certain needs in Resource Allocation Systems (RASs). The purpose of this paper is to compare the views of adults with a learning disability and Directors of Adult Social Care regarding their priorities for resource allocation with priorities arising from observed resource allocation decisions. Design/methodology/approach: In a consultation workshop, 12 adults with learning disabilities were asked to rank the perceived importance of eight needs-related outcomes. Directors of Adult Social Care completed an online questionnaire concerning the distribution of resources across the same eight outcomes. Actual resource allocation data from 11 local authorities were also modelled against these outcomes. A variable importance metric (the percentage contribution of each outcome to predicting costs) was used to rank the importance of these outcomes in terms of determining actual resource allocation. Findings from these data collections were compared. Findings: There were discrepancies between the views of adults with a learning disability, the perspectives of Directors and actual resource allocation data. Whereas adults with a learning disability perceived psychological well-being as most important, Directors and actual resource allocation data stressed the importance of activities of daily living and carer burden. Originality/value: This analysis will prove useful in understanding the concerns of adults with a learning disability and whether these are adequately addressed by current RASs. (Publisher abstract)
Home visits: a reflection on family contact in a specialist forensic intellectual disability service
- Authors:
- CHESHIRE Lucinda, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(4), 2015, pp.186-195.
- Publisher:
- Emerald
Purpose: There is little published literature about the number of home visits provided to patients within forensic intellectual disability units, and there is no published data on variables that affect home visits. There is a need for a baseline audit that can formulate standards for future practice. The paper aims to discuss these issues. Design/methodology/approach: This paper describes the home visit programme within a forensic intellectual disability service, and a baseline audit of the programme. The audit measured the number of home visits, any factors that adversely affect home visits, and the extent of family contact. The authors propose audit standards for evaluation of good practice in this area. Findings: The audit involved 63 patients over a one-year period. In total, 81 per cent of patients had some form of family contact and 54 per cent of patients at least one home visit. However, 19 per cent of patients had no contact with their family due to a variety of reasons. There were no significant differences in the number of home visits between men and women, patients on civil vs criminal sections or those treated “within area” or “out of area”. Patients in rehabilitation wards had significantly more visits than those in low or medium secure. Originality/value: Conventional wisdom is that reduced family contact is the direct result of patients being placed “out of area”. The results of this audit suggest that, at least in this group, the reasons may be much more nuanced and that the current definition of “out of area” has to be improved to incorporate the actual distance between the patient’s current family home and the service. Audit standards have been proposed to monitor family contact and home visits. Future work should focus on the relationship between family contact and treatment outcomes. (Publisher abstract)
Making a difference: the impact of the Confidential Inquiry into premature deaths of people with learning disabilities
- Author:
- HESLOP Pauline
- Journal article citation:
- British Journal of Learning Disabilities, 43(2), 2015, pp.142-149.
- Publisher:
- Wiley
The Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD) was commissioned by the Department of Health in England in 2010 to investigate the avoidable or premature deaths of people with learning disabilities through retrospective reviews of deaths. Both the process of conducting CIPOLD and the findings of the study itself made an impact on the way in which professionals thought about issues relating to people with learning disabilities and led to changes in policy and practice. Much of the impact of CIPOLD came from arming practitioners, family carers, people with learning disabilities and policy makers with the research findings and encouraging them to take on the mantle of change from there, for example, by increasing the provision of training or reviewing their current practice. There were a number of challenges that the research team faced. First, they needed to ensure the assiduous recording of any impact that took place throughout the duration of the research and beyond. Secondly, they were careful to make sure that as far as possible, professionals were involved and that it was a learning experience for them from which they had something to gain. Thirdly, self-reflexivity on the part of the research team was required in order for them to understand where their own strengths and limitations lay. (Publisher abstract)