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Out of area, out of sight: review of out-of-area placement arrangements made by social services and health for people with learning disabilities from the West Midlands
- Authors:
- GOODMAN Nicholas, NIX Jane, RITCHE Fiona
- Journal article citation:
- Tizard Learning Disability Review, 11(1), February 2006, pp.35-43.
- Publisher:
- Emerald
In 2004/2005 local partnership boards requested West Midlands South and Birmingham & The Black Country Strategic Health Authorities (SHAs) to review and report back on the circumstances of adults with a learning disability placed out of area. This review investigates, through questionnaires, information on 623 people and more detailed qualitative information on 111 people prioritised for visits by the district commissioners of services. The review found an increase in the number of out-of-are placements. With lack of monitoring and reviewing of placements, many people have been left solely to the care of provider organisations. The review calls for specific action to be taken to reverse this trend of increasing out-of-area placements and to make cost-effective local solutions.
How much will it cost? Characteristics of the most expensive residential placements for adults with learning disabilities
- Authors:
- McGILL Peter, POYNTER Jo
- Journal article citation:
- Tizard Learning Disability Review, 16(2), April 2011, pp.54-57.
- Publisher:
- Emerald
The high cost of residential services for some adults with learning disabilities is of concern, especially in a period of financial retrenchment in publicly funded services. Valuing People Now (DH, 2009) acknowledged that too often people are sent to expensive out-of-area placements. This collaborative research between the Valuing People Now Team, the Challenging Behaviour National Strategy Group and the Tizard Centre aimed to identify the characteristics of the highest-cost placements in the South-East of England. Between November 2009 and June 2010 commissioners in 19 local authority areas were asked to provide information on their 5 most expensive adult placements. Information was provided on 70 placements from 14 of the areas. The mean placement cost was £172,000 per annum, with a range from £83,000 to £333,000. The article discusses the individual characteristics, placement characteristics, differences between in-area and out-of-area placements, and predictors of higher costs. The article concludes that a small number of placements consume a significant amount of local authority resources. On average the authorities surveyed spent £0.9 million annually on their 5 most expensive placements. Suggestions for further research are provided.
Why are people with intellectual disability moved "out-of-area"?
- Authors:
- PERRY David W., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 4(3), September 2007, p.203–209.
- Publisher:
- Wiley
Some people with intellectual disabilities (ID) continue to be provided with accommodations that are outside their local area, away from familiar people and places. Although studies have been scarce on this topic, there is evidence to suggest that this does not always provide the best outcome for individuals in terms of quality of life. The authors undertook a survey to look at the personal characteristics of 89 persons with ID originally from the city of Coventry in the UK, and now situated by local health or social services authorities in locations other than the immediate Coventry area. The authors found that the number of people being placed "out-of-area" is increasing; among them are persons with autistic spectrum disorder (particularly those transitioning into adulthood), those with a past history of behaviour resulting in action by the criminal justice system, and those with a history of aggression toward others. There are concerns that the commissioning and provision of "out-of-area" services echo the dehumanizing institutionalization policies that dominated the first part of the 20th century, are lacking in coordination, and are proving to be more expensive than locally provided services.
Too far to go?: people with learning disabilities placed out-of-area
- Authors:
- BEADLE-BROWN Julie, et al
- Publisher:
- Tizard Centre
- Publication year:
- 2005
- Pagination:
- 72p.
- Place of publication:
- Canterbury
Researchers have discovered that a substantial number of people with learning disabilities are placed in residential homes in Kent from other authorities. The study, the first to evaluate this kind of data, set out to discover why this is, and the effect of these placements on the individuals and their families.
At what price?
- Author:
- SAMUEL Mithran
- Journal article citation:
- Community Care, 21.09.06, 2006, p.47.
- Publisher:
- Reed Business Information
The increased life expectancy for people with learning difficulties is great news, but it is also putting pressure on services. This article looks at the pressures facing Somerset Council and how they and other councils are trying to control costs.
Learning disabilities census report: England, 30th of September 2013
- Author:
- HEALTH AND SOCIAL CARE INFORMATION CENTRE
- Publisher:
- Health and Social Care Information Centre
- Publication year:
- 2013
- Pagination:
- 28
- Place of publication:
- Leeds
This report presents initial findings from the 2013 Learning Disability Census, which provides a snapshot of inpatients with learning disabilities, autistic spectrum disorder and/or challenging behaviour, and the services they receive. The survey was one of the initiatives commissioned in response to the abuse at Winterbourne View Hospital. Sections cover the profile of service users; ward security level and length of stay; service users by region, local authority and distance between residence and placement; and types of provider. The Census data was collected on 30 September 2013. Responses from 104 provider organisations were received on behalf of 3,250 service users. (Edited publisher abstract)
Recent trends in out-of-area placements for adults with learning disabilities in England
- Author:
- WHELTON Beckie
- Journal article citation:
- Tizard Learning Disability Review, 14(1), February 2009, pp.44-48.
- Publisher:
- Emerald
This article examines the trends for out-of-area placements of adults with learning disabilities, aged 18-64, between 2006 and 2008. A table showing detailed figures for individual councils in the London Boroughs is included.
Individual characteristics and service expenditure on challenging behaviour for adults with intellectual disabilities
- Authors:
- HASSIOTIS Angela, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(5), September 2008, pp.438-445.
- Publisher:
- Wiley
English policy argues that people with intellectual disabilities should be supported in their local communities. There is considerable evidence that this aspiration is not being achieved. This paper seeks to look at the subsection of people with intellectual disabilities who have expensive care needs because of challenging behaviour, to identify the decision-making processes that have led to current service provision and expenditure and to suggest improvements. A survey was carried out within five North London boroughs to investigate the characteristics of a cohort of people with intellectual disabilities and challenging behaviour in high-cost accommodation (over £70 000/annum). Postal questionnaires and face-to-face interviews were conducted with stakeholders with intellectual disabilities and patterns of current costs were estimated from existing data provided by the commissioning authorities in the five boroughs. Two hundred and five individuals with intellectual disabilities and challenging behaviour were identified. They were accommodated in placements provided by 97 separate providers, both in and out-of-area. Those more likely to be placed out-of-area were younger, had multiple health problems, significant challenging behaviour and mental health problems including autistic spectrum disorders. The local community intellectual disabilities teams identified a number of difficulties in meeting the needs of those service users. Expenditure on all placements for service users with intellectual disabilities is significant. There is a notable lack of investment in local service development. A coherent approach is required, often across service boundaries. The authors suggest a model for targeted investment aimed at supporting effective local services, and reducing the need for and expense of out-of-area placements.
'Out of area, out of sight?': review of out of area placement arrangements made by social services and health for people with learning disabilities from the West Midlands
- Authors:
- RITCHIE Fiona, et al
- Publisher:
- Birmingham and the Black Country Strategic Health Authority; West Midlands South Strategic Health Authority
- Publication year:
- 2005
- Pagination:
- 84p.
- Place of publication:
- Birmingham
People with learning disabilities have a different pattern of disease from the general population and high health needs that are frequently unidentified and unmet. Many require responses from general and specialist health services. A picture is emerging of some people with learning disabilities, often with complex care needs, moving from their home area on what is being termed, out-of-area placements, to receive specialist care. However, within the learning disability population, the impact on health services is not fully known.
Assessing the quality of service provision for people with challenging needs placed out of borough
- Authors:
- LEDGER Sue, SHUFFLEBOTHAM Lindy
- Journal article citation:
- Tizard Learning Disability Review, 11(4), October 2006, pp.19-27.
- Publisher:
- Emerald
This commentary raises a number of risk and practice issues relevant to out-of-area placements. It also considers briefly some of the changes needed to reverse the continued pattern of 'exporting' people with complex challenging behaviour needs. The article comments on a report of study looking at out-of-area placement in Lambeth.