Search results for ‘Subject term:"learning disabilities"’ Sort:
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Impact of an individualized planning approach on personal outcomes and supports for persons with intellectual disabilities
- Authors:
- GOSSE Leanne, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 14(3), 2017, pp.198-204.
- Publisher:
- Wiley
Planning initiatives for individuals with intellectual disabilities (ID) have shifted from traditional planning primarily conducted by caregivers to an individualised planning approach controlled by the person with ID him/herself. The goal of this paradigm shift is to increase individualisation of supports to accomplish personal objectives and improve quality of life. Despite the widespread acceptance and promotion of individualised planning, there has been little empirical research to demonstrate its effectiveness. This study compares traditional planning to individualised planning on supports obtained and personal objectives accomplished using a randomised between-group design. Persons receiving an individualised planning process improved in both supports and personal outcomes as compared to the traditional planning group. When the traditional planning group subsequently received individualised planning, they replicated the results of the first individualised planning group. The findings support implementation of an individualised planning approach in service agencies for individuals with ID. (Edited publisher abstract)
Community living for adults with intellectual disabilities: unravelling the cost effectiveness discourse
- Author:
- FELCE David
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 14(3), 2017, pp.187-197.
- Publisher:
- Wiley
This article considers the requirements for a rigorous cost-effectiveness analysis and then reviews the evidence base on services for people with intellectual disabilities (ID) with an emphasis on the transition from institutional services to those in the community and postodeinstitutionalization research on the costs and outcomes of different forms of community provision. Despite certain limitations, a number of conclusions are possible: (a) overall, community services provide for a better quality of life than institutional care; (b) whether community service costs are more or less than institutional costs may depend on factors such as funding mechanisms, wage rates and the level of investment in institutional services prior to deinstitutionalization, that are likely to differ between countries; (c) economies of scale are not pervasive but may arise among settings with very small group sizes depending on staffing model; (d) the costs of staffing are a major element in total service package costs and there is scope to relate staff input more precisely to the needs and characteristics of service users; (e) the factors responsible for variation in costs and outcomes are incompletely understood; (f) however, resource input does not appear to result in enhanced outcome; (g) greater staff input is inefficiently translated into performance which affects service users; and therefore, (h) operational culture and staff training and management are important determinants of ultimate outcome. More research is required on the factors that drive costs on the one hand and outcomes on the other. An international consensus is required on the important variables to be described when doing research on residential support arrangements, so that relationships between environmental characteristics and either costs or outcome can be identified with greater confidence. (Edited publisher abstract)
The factors associated with care-related quality of life of adults with intellectual disabilities in England: implications for policy and practice
- Authors:
- RAND Stacey E., MALLEY Juliette
- Journal article citation:
- Health and Social Care in the Community, 25(5), 2017, pp.1607-1619.
- Publisher:
- Wiley
Over the last three decades, quality of life (QoL) has been advocated as an indicator of social care outcomes for adults with intellectual disabilities. In England, the Adult Social Care Survey (ASCS) is conducted annually by local authorities to contribute to the evidence base of the care-related QoL of people receiving publicly funded adult social care. This study explores relationships between QoL and non-care-related factors to identify relationships that could inform social care policy and practice. Cross-sectional data collected from 13,642 adults who participated in the 2011 and 2012 ASCS were analysed using regression to explore the factors associated with QoL measured using the Adult Social Care Outcomes Toolkit (ASCOT). Self-rated health, rating of the suitability of home design and anxiety/depression were all found to be significantly associated with ASCOT. Other individual and survey completion factors were also found to have weak significant relationships with ASCOT. The models also indicate that there was an increase in overall ASCOT-QoL and in five of the eight ASCOT domains (Personal comfort and cleanliness, Safety, Social participation, Occupation and Dignity) between 2011 and 2012. These findings demonstrate the potential value of QoL data for informing policy for people with intellectual disabilities by identifying key factors associated with QoL, the characteristics of those at risk of lower QoL, and QoL domains that could be targeted for improvement over time. Future research should establish causal relationships and explore the risk adjustment of scores to account for variation outside of the control of social care support. (Publisher abstract)
Clinical needs and outcomes of adults with intellectual disabilities accessing an inpatient assessment and treatment service and the implication for development of community services
- Authors:
- SANDHU Daljit, TOMLINS Rose
- Journal article citation:
- Journal of Intellectual Disabilities, 21(1), 2017, pp.5-19.
- Publisher:
- Sage
- Place of publication:
- London
The role and future of assessment and treatment units for people with intellectual disabilities is once again the focus of debate and government policy. Reviewing the admissions to inpatient services can provide useful information about the characteristics, needs and clinical outcomes of clients. Data were collected retrospectively for all 36 referrals accepted to an inpatient assessment and treatment unit for people with intellectual disability, between January 2013 and April 2014. Clinical and demographic characteristics of service users were identified through descriptive analysis. Male service users, mild intellectual disability and diagnosis of autistic spectrum disorder were frequent, and a high proportion of admissions had complex and multiple needs. The Health of the Nation Outcome Scale–Intellectual Disabilities was used as a clinical outcome measure. The article concludes with recommendations for service development following closure of our inpatient service. (Edited publisher abstract)
Named Social Worker: learning report
- Author:
- INNOVATION UNIT
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2017
- Pagination:
- 32
- Place of publication:
- London
Interim report which outlines the experiences of six sites piloting the Named Social Worker project. The project, which was commissioned by the Department of Health and is being delivered by the Innovation Unit in partnership with SCIE, explores how having a named social worker can contribute to providing better continuity of care and support for people with learning disabilities. This learning report provides more information about progress in each of the six sites, detailing the specifics of what they consider the role to entail, the lessons from implementation, and their approach to evaluation. It covers the work of The six sites are Calderdale Council, Camden Council, Hertfordshire County Council, Liverpool City Council, Nottingham City Council and Sheffield City Council. It looks at the different approaches of the sites, with some sites focusing on how a named social worker role can generate systemic change and others focusing on what good social work practice looks like. The report also looks at what it means to be a learning organisation and provides some insights arising for the project. (Edited publisher abstract)
Development and implementation of a discharge pathway protocol for detained offenders with intellectual disabilities
- Authors:
- TAYLOR John L., et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(3), 2017, pp.144-154.
- Publisher:
- Emerald
Purpose: Building the Right Support, a national plan for people with intellectual disabilities (ID) in England aims to avoid lengthy stays in hospital for such people. Discharge planning is understood to be helpful in facilitating successful transition from hospital to community services, however, there is little guidance available to help those working with detained patients with ID and offending histories to consider how to affect safe and effective discharges. The paper aims to discuss these issues. Design/methodology/approach: In this paper, the development and implementation of a multi-faceted and systemic approach to discharge preparation and planning is described. The impact of this intervention on a range of outcomes was assessed and the views of stakeholders on the process were sought. Findings: Initial outcome data provide support for the effectiveness of this intervention in terms of increased rates of discharge, reduced lengths of stay and low readmission rates. Stakeholders viewed the intervention as positive and beneficial in achieving timely discharge and effective post-discharge support. Practical implications: People with ID are more likely to be detained in hospital and spend more time in hospital following admission. A planned, coordinated and well managed approach to discharge planning can be helpful in facilitating timely and successful discharges with low risks of readmission. Originality/value: This is the first attempt to describe and evaluate a discharge planning intervention for detained offenders with ID. The intervention described appears to be a promising approach but further evaluation across a range of service settings is required. (Publisher abstract)
Independent research and cost analysis of the use of Just Checking and the Just Right approach to identify appropriate levels of care for adults with learning disabilities
- Authors:
- UNIVERSITY OF BIRMINGHAM, KPMG
- Publishers:
- University of Birmingham, KPMG
- Publication year:
- 2017
- Pagination:
- 10
- Place of publication:
- Birmingham
Summarises the findings of research on the use of Just Checking activity monitoring equipment to help determine the most appropriate level of care for people with learning disabilities living in residential or supported living accommodation. The research involved nine local authorities working with 33 care providers in England. The Just Checking technology was installed in a sample of accommodations units, most of which were supported living accommodation. The data were used by care staff, with advice about person-centred planning, to discuss whether the current package of support is appropriate, or whether care could be reduced or adjusted to better meet the needs of the service user. The results found that care providers were able to use the technology to achieve improved outcomes for individuals, improved person-centred support and achievement of goals, as well as greater independence and autonomy for individuals. KPMG’s financial analysis of the findings, found that care providers identified no change in the level of care for 38 per cent of tenants, a potential over-provision of care for 34 per cent and a potential under-provision of care of 28 per cent of tenants. The analysis estimates that, even taking into account under-provision, Just Checking would pay for itself within 9 weeks. The report concludes that the Just Checking activity monitoring approach is viable, acceptable and useful to service providers and commissioners of care for adults with learning disabilities. It highlights factors that support the successful implementation of Just Right/Just Checking. (Edited publisher abstract)
Learning disabilities: identifying and managing mental health problems: QS142
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2017
- Place of publication:
- London
NICE quality standard covering the prevention, assessment and management of mental health problems in people with learning disabilities in all settings, including health, social care, education, and forensic and criminal justice. The standard describes what high-quality care looks like in five priority areas. The five quality statements for people with learning disabilities and mental health problems are: for annual health checks to include a review of mental health problems; that mental health assessments are carried out by a professional with expertise in mental health problems; that people with learning disabilities and a serious mental illness have a key worker to coordinate their care; that any psychological interventions are tailored to the preferences of people with learning disabilities and mental health problems; and annually documenting the reasons for continuing antipsychotic drugs. Each quality statement includes the rationale for the statement and suggestions for quality measures that can be used to monitor performance to the standard. (Edited publisher abstract)
Commissioning services for people with a learning disability: good practice guidance
- Authors:
- NATIONAL COMMISSIONING BOARD, OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2017
- Pagination:
- 46
- Place of publication:
- Oxford
Good practice guidance developed to help Regional Partnership Boards in Wales to develop their own approaches to the integrated commissioning of services for people with a learning disability. The guidance will help commissioners to follow the principles in the Social Services and Well-being (Wales) Act 2014, in terms of helping individuals to lead an ordinary life with dignity, and co-producing appropriate solutions to help individuals to achieve the outcomes important to them. The guidance looks at the role of the strategic commissioner, how they can lead cultural change and how to commission ‘good lives’ through co-production approaches. It also explains how taking a whole systems, lifespan approach to positive behaviour support can reduce placement breakdown and prevent hospital admission. The guidance has been developed by the National Commissioning Board in partnership with the Institute for Public Care. (Edited publisher abstract)
Gaps in the evidence on improving social care outcomes: findings from a meta-review of systematic reviews
- Authors:
- DICKSON Kelly, et al
- Journal article citation:
- Health and Social Care in the Community, 25(4), 2017, p.1287–1303.
- Publisher:
- Wiley
Adult social care continues to be a central policy concern in the UK. The Adult Social Care Outcomes Framework (ASCOF) is a range of measures nationally available to drive forward improvement on outcomes and quality in local councils. While there is an emphasis on improving transparency, quality and outcomes, drawing on research evidence to achieve these aims is often difficult because the evidence is not easily identifiable, is disparate or of variable quality. The authors conducted a meta-review to analyse and summarise systematic review-level evidence on the impact of interventions on the four outcomes set out in the ASCOF: quality of life, delaying and reducing the need for services, satisfaction with services and safeguarding of vulnerable adults. This paper focuses on the availability of review-level evidence and the presence of significant gaps in this evidence base. A range of health and social care databases were searched, including MEDLINE, ASSIA and The Cochrane Library in January and February 2012. All systematic reviews evaluating the efficacy of social care interventions for improving ASCOF outcomes for older people, people with long-term conditions, mental health problems or physical and/or learning disabilities were eligible. Two reviewers independently screened systematic reviews for quality and relevance and extracted data; 43 systematic reviews were included, the majority of which examined the impact of interventions on quality of life (n = 34) and delaying and reducing the need for support (n = 25). Limited systematic review-level evidence was found regarding satisfaction with services and safeguarding. There were also significant gaps in relation to key social care interventions and population groups. Research priorities include addressing these gaps and the collation of data on interventions, outcomes and populations more closely related to social care. Overall, a more relevant, comprehensive and robust evidence base is required to support improvement of outcomes for recipients of adult social care. (Edited publisher abstract)