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‘Planning live’: using a person-centred intervention to reduce admissions to and length of stay in learning disability inpatient facilities
- Authors:
- BARTLE Janet, CROSSLAND Tom, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 44 (4), 2016, pp.277-283.
- Publisher:
- Wiley
Background: Recent government policy has focused on reducing the number of people with a learning disability receiving treatment for challenging behaviour or mental health difficulties in hospitals (including in assessment and treatment units; ATU). People with a learning disability should be supported to remain in their community when receiving support for challenging behaviour or mental health difficulties whenever possible. Methods: This study considered a novel intervention based on person-centred planning practice, which aimed to coordinate a person's support, identify outstanding needs and increase communication. This intervention intended to reduce rates of inpatient admission, and support the person to remain in their community, whilst ensuring their needs are met. This intervention was assessed by considering the number of people admitted to the inpatient services before and after the intervention, the length of inpatient admissions before and after the intervention, and by analysing qualitative feedback from participants in the intervention. Results: ‘Planning Live’ meetings were held for 102 people. Forty-five meetings were held retrospectively following an emergency admission. Following the ‘Planning Live’ meeting, five people had a planned admission and 52 people did not have an inpatient admission. The median length of inpatient stay fell from 143.5 days before the introduction of ‘Planning Live’ to 66 days (a statistically significant reduction). Qualitative feedback shows that the process was largely seen as helpful by professionals, families and individuals taking part in the meetings. Conclusions: The results suggest this person-centred intervention contributed towards a reduction in the amount of time individuals stayed in hospital. However, the total number of hospital admissions rose following the intervention. (Publisher abstract)
Exorcising restraint: reducing the use of restrictive interventions in a secure learning disability service
- Author:
- RIDING Tim
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 7(4), 2016, pp.176-185.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe the nature and impact of a restraint reduction strategy implemented within a secure learning disability service in response to the national Positive and Safe programme. Design/methodology/approach: The strategy was comprised of three primary interventions – Safewards, positive behavioural support and data-informed practice – and utilised a programme management approach to ensure effective delivery. Baseline measures were collected from 12 months of data prior to implementation of the programme and the frequency of each category of restrictive intervention was then measured prospectively on a monthly basis throughout the duration of the programme. Findings: Upon completion of the programme the following results were achieved: elimination of prone restraint – elimination of mechanical restraint – 42 per cent reduction in general use of restraint – 42 per cent reduction in use of seclusion – 52 per cent reduction in rapid tranquilisation. Originality/value: The paper adds to the growing body of evidence that carefully designed interventions can reduce the frequency of seclusion and restraint. In this case, Safewards and PBS have combined to exert their effect. Data-led practice and senior leadership were also found to be of critical importance. Finally, the need for a stable workforce is considered. (Publisher abstract)
‘I walk from trouble’: exploring safeguards with adults with intellectual disabilities – an Australian qualitative study
- Authors:
- OTTMANN Goetz, McVILLY Keith, MARAGOUDAKI Margarita
- Journal article citation:
- Disability and Society, 31(1), 2016, pp.47-63.
- Publisher:
- Taylor and Francis
People living with intellectual disabilities have a right to be safe from abuse and neglect and have a right to be included in the decision-making process determining safeguards that will affect them. However, the research evidence that could underpin good professional practice in terms of co-producing safeguards against abuse and neglect directly involving people with intellectual disabilities is largely missing. This article, based on qualitative research involving semi-structured interviews conducted during the first half of 2014, seeks to strengthen this evidence base. It reports on the prevention strategies identified by 12 adults with intellectual disabilities about how to stay safe and compares these with the findings of similar research. The article suggests that a comprehensive safeguarding approach comprises both life course-focused safety training and access to assisted decision-making. The article argues that given the plethora of risk situations encountered by people living with intellectual disability, assisted decision-making should take the form of a co-creation process that is situation specific and grounded in everyday life. (Publisher abstract)
Mental health problems in people with learning disabilities: prevention, assessment and management: NG54
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2016
- Place of publication:
- London
Practice guideline which covers preventing, assessing and managing mental health problems in children, young people and adults with learning disabilities. The guideline aims to improve assessment and support for mental health conditions, and help people with learning disabilities and their families and carers to be involved in their care. The recommendations include that: the person's communication needs and level of understanding should be considered throughout their assessment, treatment and care; that professionals with expertise in mental health problems in people with learning disabilities should coordinate mental health assessments; the impact of the social and physical environment on the mental health of people with learning disabilities should be considered when developing care plans; adults with learning disabilities should be supported to participate in paid or voluntary work. The recommendations also provide guidance on delivering psychological and pharmacological interventions. The guideline covers all settings, including health, social care, education, and forensic and criminal justice. (Edited publisher abstract)