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Specialist inpatient services for people with learning disabilities across the four countries of the UK
- Author:
- HATTON Chris
- Journal article citation:
- Tizard Learning Disability Review, 21(4), 2016, pp.220-225.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to compare data from national censuses on specialist inpatient service use by people with learning disabilities across England, Scotland, Wales and Northern Ireland. Design/methodology/approach: National statistics (England, Scotland, Wales, Northern Ireland) reporting inpatient service censuses including people with learning disabilities were accessed, with data extracted on trends over time, rate of service use, young people and length of stay. Findings: The number and rate of people with learning disabilities in specialist inpatient services varied across the UK: 230 people in Scotland (rate 4.88 per 100,000 population); 3,250 people in England (5.48); 183 people in Wales (5.90); 144 people in Northern Ireland (7.82). The number of people in inpatient services in Northern Ireland halved over four years, in other areas reductions were modest. Between 5 and 8 per cent of people in inpatient services were children/young people. Median length of stay in the person’s current inpatient service varied: 19 months in England; 33 months in Scotland; three to five years in Northern Ireland. Social implications: Different parts of the UK vary in the scale of their specialist inpatient services for people with learning disabilities. With the exception of Northern Ireland, which may still be in the last stages of completing a “regular” deinstitutionalisation programme, strong policy prescriptions for substantial reductions in specialist inpatient services are currently only resulting in modest reductions. Originality/value: This paper is a first attempt to compare national inpatient service statistics across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed. (Publisher abstract)
The impact of Irish policy and legislation on how adults with learning disabilities make choices
- Authors:
- CAREY Eileen, GRIFFITHS Colin
- Journal article citation:
- British Journal of Learning Disabilities, 44(2), 2016, pp.111-121.
- Publisher:
- Wiley
This paper reflects the impact of policy and legislation in the context of how adults with learning disabilities make choices. Following an overview of policies which have improved choice for people with learning disability in the United Kingdom, this paper reviews ‘choice’ in current Irish policy and legislation. This paper, while making comparisons with capacity legislation in the United Kingdom, presents a discussion on the perceived impact of the Assisted Decision-Making (Capacity) Bill (2013) based on submissions from the Citizens Information Board (2013a), Mental Health Reform (2014), and Quinn (2013). Further choice making challenges such as direct payments and information sharing which confront adults with learning disabilities are highlighted and overall conclusions are drawn. (Publisher abstract)
Adult protection in Scotland in 1857 and in 2015: what have we learned?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Adult Protection, 18(2), 2016, pp.96-108.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to compare recent developments in adult protection legislation, policy and practice in Scotland in 2015 with the first attempts at protection of adults at risk of harm, in 1857-1862, with a particular focus on people with learning disabilities. Design/methodology/approach: The paper uses comparative historical research, drawing on primary archive material from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers. Findings: Growing public awareness of the extent of neglect and abuse, and the need for overarching legislation were common factors in the development of both the “The Lunacy Act” of 1857 and the Adult Support and Protection (Scotland) Act of 2007. Both pieces of legislation also had the common aim of “asylum”, and shared some other objectives. Practical implications: Total prevention of abuse of vulnerable adults is an aspiration in law and in policy. There is an evidence base of effectiveness, however, in protecting adults at risk of harm from abuse. Some ecological factors recur as challenges to effective safeguarding activity. These include problems of definition, uncovering abuse, enforcing legislation, evaluating impact and protection of people who are not a risk of harm to others. Originality/value: This paper compares common themes and common challenges in two separate time periods to investigate what can be learned about the development of legislation and practice in adult protection. (Publisher abstract)
Wales’ safeguarding policy and practice: a critical analysis
- Author:
- PHILLIPS Carys
- Journal article citation:
- Journal of Adult Protection, 18(1), 2016, pp.14-27.
- Publisher:
- Emerald
Purpose: The safeguarding and protection components of the Social Services and Well-being (Wales) Act 2014 offers the culmination of four years consultation in England and Wales by the Law Commission and many years of evolving policy and practice with a view to protecting adults from harm. The purpose of this paper is to offer both scrutiny and challenge for Wales’ policy makers and practitioners alike. Design/methodology/approach: The paper is a critical analysis of both current responses and forthcoming changes. Findings: The paper proposes that Wales has failed to implement previous recommendations in relation to institutional abuse. Currently in Wales, there are individuals employed in safeguarding lead roles who have no social care qualification. This apparent “loophole” has not to date been highlighted to date by either of the regulatory bodies within Wales (CSSIW/CCfW). Research limitations/implications: The paper offers a viewpoint but leaves some questions unanswered. Practical implications: The Williams Review in April 2014 is set to change the local authority landscape in Wales. There is scope for developing the function of adult safeguarding. Social implications: Wales’ failure to recognize institutionalized abuse as a distinct category may have had impacted on its ability to respond to abuse in nursing and care as well hospital settings. (Edited publisher abstract)
Realising the vision of communication inclusion
- Author:
- KEAN Kim Hartley
- Journal article citation:
- Tizard Learning Disability Review, 21(1), 2016, pp.24-29.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide a commentary on Clare Mander’s paper entitled “An investigation of the delivery of health-related accessible information for adults with learning disabilities”. The commentary discusses issues identified by the author in the field of accessible information and, more generally, inclusive communication practice. Design/methodology/approach: This commentary reviews factors which influence the communication accessibility of services and the policy, legislative and economic case for mainstreaming inclusive communication approaches. It highlights diversity in the definition of inclusive communication and the scope of its necessary implementation before proposing an approach to establishing consensus on the way forward. The commentary suggests how the task of mainstreaming inclusive communication throughout public services could be addressed, reflects on progress to date and proposes next steps for the growing numbers of those with an interest. Findings: Many factors influence communication accessibility. The communication attitude, knowledge, skills and resources individual providers and recipients bring to each interaction are as important as the whole organisation’s approach towards and investment in inclusive communication approaches. Legislation, policy, demographics and reducing budgets increase the requirement to mainstream inclusive communication approaches. Achieving this objective is an enormous task. Originality/value: Reflecting on all the drivers and influences on the objective of achieving mainstreamed quality inclusive communication practice throughout public services, the author offers potential suggestions for starting to address this enormous but worthwhile task with a view to generating discussion and collaboration among those with an interest. (Publisher abstract)
Investigating the lived experience of people with Down syndrome with dementia: overcoming methodological and ethical challenges
- Author:
- WATCHMAN Karen
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(2), 2016, p.190–198.
- Publisher:
- Wiley
Adults with Down syndrome are at increased risk of dementia at a significantly younger age and remain under-represented as participants in dementia-related research. Because little is known about their personal experiences either immediately postdiagnosis or as dementia progresses, there is little opportunity that shared individual experiences can shape future policy and practice. To remedy this omission, the author examined methodological and ethical challenges identified as part of a research study that included people with Down syndrome affected by dementia. It has been contended that traditional qualitative approaches are less effective when participants are affected by changing cognitive functioning and reduced verbal communication. To counteract this contention overt participant observation and an adapted narrative research method were used as part of a three-year longitudinal study to help better understand the lived experiences of three adults with Down syndrome affected by dementia. Methodological and ethical challenges were shown to collide, and factors contributing to this effect included identifying process consent, accurate representation of participants, the role of and relationship with the researcher, participants, lack of awareness of their diagnosis of dementia, and need to recognize the importance of social interaction while maintaining academic rigor. Reflections are proffered on two conceptual and practice issues, with a call for both to be recognised and addressed in terms of future policy and practice. First is a lack of awareness of a sense of “self” or identity, resulting in individuals with Down syndrome and dementia being defined by their situation rather than individual preference or need. Second is the lack of information postdiagnosis about dementia being shared with people who have Down syndrome. (Publisher abstract)
Implementing UK Autism policy & National Institute for Health and Care Excellence guidance- assessing the impact of Autism training for frontline staff in community learning disabilities teams
- Authors:
- CLARK Alex, et al
- Journal article citation:
- British Journal of Learning Disabilities, 44(2), 2016, pp.103-110.
- Publisher:
- Wiley
UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire to evaluate levels of Autism knowledge. The results showed that, compared with clinical staff, administrative staff were more limited in their understanding of Autism and less able to access relevant Autism training. Autism training was provided for administrative staff. Focus group feedback about the training sessions and subsequent changes to practice concluded that the outcome of the training was positive. ‘Autism-friendly’ changes to administrative practice included alterations to waiting environments, adapted communication for people with Autism and increased communication between clinical and administrative staff about the needs of people with Autism. Future Autism training for all frontline staff and ongoing evaluation of health professionals’ Autism knowledge are discussed. (Publisher abstract)
Policy and literature review for comprehensive needs assessment of the life pathway for people with disabilities
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2016
- Pagination:
- 24
- Place of publication:
- Oxford
This paper, prepared for West Sussex County Council, covers policy and legislation in relation to children and young adults with disabilities. It is comprised of the following parts: a brief overview of the policy and legislative context, together with potential opportunities; a review of the specific learning from transitions research for children and young people with disabilities; a review of the Life Pathway Model and pathway approaches; and examples of good practice models of care in the pathway to adulthood. (Edited publisher abstract)
Family caregiving of aging adults with Down syndrome
- Authors:
- HODAPP Robert M., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(2), 2016, p.181–189.
- Publisher:
- Wiley
Although persons with Down syndrome now live to approximately 60 years, the implications of increased longevity on family caregiving have received inadequate attention. Even compared with adults with other types of intellectual disabilities, by their late 40s and 50s adults with Down syndrome often show multiple health problems, cognitive-adaptive declines, and changes in daily work and activities. If alive, their parents are more often elderly, as mothers give birth to newborns with Down syndrome at a median age of 32 years (with high percentages age 40 and older). In addition, higher percentages of adults with (vs. without) Down syndrome live in their family homes and greater percentages may ultimately reside with siblings. Compared with caring for other adults with intellectual disabilities, ageing adults with Down syndrome may present earlier—and possibly more severe and more health-related—caregiving challenges to their parents and siblings. As a field and as a society, the authors note that there is a need to promote revisions of family support policies and interventions; recognise the inter-relations of aeging-related changes and their effects; and anticipate how aeging-related changes in the brother–sister with Down syndrome and the parent(s) might affect sibling caregivers. (Edited publisher abstract)
Working with women with a learning disability experiencing domestic abuse: how social workers can negotiate competing definitions of risk
- Authors:
- DIXON Jeremy, ROBB Megan
- Journal article citation:
- British Journal of Social Work, 46(3), 2016, pp.773-788.
- Publisher:
- Oxford University Press
Women with a learning disability who experience domestic abuse receive intervention from both social services and the police. Responses from these services have increasingly become focused on notions of risk. This article uses governmentality theory to examine how risk is understood and managed by both services through a focus on policy and practice. The article examines how policy directs social workers to promote positive risk taking whilst assessing and managing risk for those deemed vulnerable or lacking mental capacity to self-protect. It is argued that, whilst social work decision making around risk has primarily been based on the judgement of individual workers, the police have increasingly adopted assessments utilising calculative measures. In addition, the article explores the extent to which these women are treated as autonomous agents responsible for managing their own risk. It is argued that social workers and the police should adopt a common screening process to highlight groups of women who may be at risk of abuse. In addition, social workers should draw on their interpersonal skills to enable women with a learning disability to recognise and make informed choices about abuse. (Publisher abstract)