UK MODERNISING LEARNING DISABILITIES NURSING REVIEW. Co-production Steering Group
Publisher:
Scotland. Scottish Government
Publication year:
2012
Pagination:
76p.
Place of publication:
Edinburgh
There are approximately 1.5 million people in Britain living with learning disabilities, and the number is likely to grow by 14% per cent between 2001 and 2021. The UK Modernising Learning Disabilities Nursing Review wants to ensure that people with learning disabilities of all ages have access to the expert learning disabilities nursing they need. This report seeks to ensure that people with learning disabilities of all ages have access to expert Learning Disabilities Nurses and that their families and carers get the best support and care. It also seeks to make best use of Learning Disabilities Nurses throughout the entire health and social care system and improve the career image of learning disabilities nursing as a whole. It sets out a number of detailed recommendations for the 4 UK Governments aimed at strengthening the commitment to learning disabilities nursing across the public sector. Underlying the recommendations are 4 organising principles for supporting reform: strengthening capacity through developing the learning disabilities nursing workforce; strengthening capability to ensure a competent and flexible learning disabilities nursing workforce; strengthening quality and demonstrating quality outcomes; and strengthening and modernising the profession.
There are approximately 1.5 million people in Britain living with learning disabilities, and the number is likely to grow by 14% per cent between 2001 and 2021. The UK Modernising Learning Disabilities Nursing Review wants to ensure that people with learning disabilities of all ages have access to the expert learning disabilities nursing they need. This report seeks to ensure that people with learning disabilities of all ages have access to expert Learning Disabilities Nurses and that their families and carers get the best support and care. It also seeks to make best use of Learning Disabilities Nurses throughout the entire health and social care system and improve the career image of learning disabilities nursing as a whole. It sets out a number of detailed recommendations for the 4 UK Governments aimed at strengthening the commitment to learning disabilities nursing across the public sector. Underlying the recommendations are 4 organising principles for supporting reform: strengthening capacity through developing the learning disabilities nursing workforce; strengthening capability to ensure a competent and flexible learning disabilities nursing workforce; strengthening quality and demonstrating quality outcomes; and strengthening and modernising the profession.
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)
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)
Learning Disability Today, October 2012, pp.28-29.
Publisher:
Pavilion
Place of publication:
Hove
When the Care Quality Commission withdrew its star ratings system for residential care services, Care Management Group (CMG) decided to create its own internal rating system to assess quality across its service models. The new internal rating system was designed by CMG’s senior management team, managers, and also crucially by service users. The underlying aim of the rating scheme is to ensure that service users are ultimately the judges and beneficiaries of all improvements. The Care Management Group Quality Rating Framework has now been rolled out across CMG’s 98 services. The framework focuses on 8 main areas, all underpinned by the principle of person-centred active support. The areas are: service user voice; outcome focus; documentation; staffing; environment; safeguarding; health; external relationships; and reputation. This provides clear criteria for each service to be judged upon, resulting in an evidence-based rating. A 4-step assessment process ensures consistency of assessment across all CMG services. The process involves: monthly assessment by service managers of their own services; 3-monthly assessment of services by regional directors; review of regional directors’ scores by senior directors; and annual independent audits by CMG’s senior Quality Support Team.
When the Care Quality Commission withdrew its star ratings system for residential care services, Care Management Group (CMG) decided to create its own internal rating system to assess quality across its service models. The new internal rating system was designed by CMG’s senior management team, managers, and also crucially by service users. The underlying aim of the rating scheme is to ensure that service users are ultimately the judges and beneficiaries of all improvements. The Care Management Group Quality Rating Framework has now been rolled out across CMG’s 98 services. The framework focuses on 8 main areas, all underpinned by the principle of person-centred active support. The areas are: service user voice; outcome focus; documentation; staffing; environment; safeguarding; health; external relationships; and reputation. This provides clear criteria for each service to be judged upon, resulting in an evidence-based rating. A 4-step assessment process ensures consistency of assessment across all CMG services. The process involves: monthly assessment by service managers of their own services; 3-monthly assessment of services by regional directors; review of regional directors’ scores by senior directors; and annual independent audits by CMG’s senior Quality Support Team.
Subject terms:
learning disabilities, management, person-centred care, quality assurance, residential care, user participation;
A survey was conducted of managers, clinicians, directors and chief executives who had received the Audit’s self-assessment questionnaire and those whose service had subsequently been visited by the one of the Healthcare Commission’s peer review teams. Two hundred and forty two responses were received. Findings showed that only half of respondents made actual changes as a result of the Audit. Those who received a visit as well as a questionnaire were more likely to have implemented changes than those that received a questionnaire alone. The changes implemented and planned were wide ranging including an increase in user involvement, improved staff training and the development of service user plans amongst many others.
A survey was conducted of managers, clinicians, directors and chief executives who had received the Audit’s self-assessment questionnaire and those whose service had subsequently been visited by the one of the Healthcare Commission’s peer review teams. Two hundred and forty two responses were received. Findings showed that only half of respondents made actual changes as a result of the Audit. Those who received a visit as well as a questionnaire were more likely to have implemented changes than those that received a questionnaire alone. The changes implemented and planned were wide ranging including an increase in user involvement, improved staff training and the development of service user plans amongst many others.
Green Light is a framework and self audit toolkit for improving mental health support services for people with learning disabilities. It provides a picture of what services should be aiming to achieve, including quality outcomes, and a self assessment checklist. It is aimed at Mental Health Local Implementation Teams and Learning Disability Partnership Boards. The pack was produced on behalf of the Valuing People Support Team and the National Institute for Mental Health in England by the Foundation for People with Learning Disabilities working in partnership with the South West London NHS Mental Health Trust and St George's Hospital Medical School.
Green Light is a framework and self audit toolkit for improving mental health support services for people with learning disabilities. It provides a picture of what services should be aiming to achieve, including quality outcomes, and a self assessment checklist. It is aimed at Mental Health Local Implementation Teams and Learning Disability Partnership Boards. The pack was produced on behalf of the Valuing People Support Team and the National Institute for Mental Health in England by the Foundation for People with Learning Disabilities working in partnership with the South West London NHS Mental Health Trust and St George's Hospital Medical School.
Extended abstract:
Author
COLE Angela, GREGORY Margaret.
Title
Green Light for mental health: a service improvement toolkit.
Publisher
Foundation for People with Learning Disabilities, 2004
Summary
Green Light is a framework and self audit toolkit for improving mental health support services for people with learning disabilities, providing a picture of what services should be aiming to achieve, including quality outcomes, and a self assessment checklist, and aimed at Mental Health Local Implementation Teams and Learning Disability Partnership Boards.
Contents
Part A is a guide to the pack itself and to improving services and support for people with mental health problems who have learning disabilities. Section One introduces Green Light, telling users about the pack and what it's for and giving some ideas about getting the most benefit from the toolkit. Section Two is an easy to read summary designed primarily for use with and by people with learning disabilities. Section Three has two parts which, when added together, give an overall picture of what services should be aiming to achieve. The first gives the national policy context and highlights what the government expects of services in relation to people with mental health problems who have learning disabilities. The second is about quality outcomes for people with mental health problems who have learning disabilities and for their carers, from their own perspectives. Section Four creates a concrete picture of what needs to happen ‘out there' in the reality of services. It highlights key challenges for services in moving towards integrated mental health services for people with learning disabilities; explores what the national policy objectives actually look like in practice, i.e., accessible, integrated mental health support services, using examples from around the UK wherever possible. Section Five is about how to work out what needs to be sustained or changed locally. It introduces the self-assessment checklist and some ready-to-use survey tools which are found in Part B. The self-assessment checklist is at the core of the service improvement toolkit. There is guidance about getting information and evidence to underpin your local self-assessment, and about presenting findings to the Local Implementation Teams and Partnership Board. Part B – the toolkit – has four sections. Section One contains the self-assessment checklist and an action planning proforma. Section Two is a survey of in-patient experience Section Three is a survey of community support experiences. Section Four is a survey of carers' experiences. Throughout the guide there are quotations from the test sites and from people with mental health problems who have learning disabilities, which reinforce points in the text, and references to publications, resources and sources of information. These are listed at the end.
23 references
Subject terms:
learning disabilities, long term outcomes, quality assurance, vulnerable adults, vulnerable children, assessment;
University of Lancaster. Institute for Health Research
Publication year:
1999
Pagination:
24p.
Place of publication:
Lancaster
This report provides a brief summary of the results of a large-scale research project commissioned by the Department of Health. The aims of the project were to identify or explore the nature, quality and costs of residential or village communities and community-based dispersed housing schemes for people with learning disabilities.
This report provides a brief summary of the results of a large-scale research project commissioned by the Department of Health. The aims of the project were to identify or explore the nature, quality and costs of residential or village communities and community-based dispersed housing schemes for people with learning disabilities.
Subject terms:
learning disabilities, quality assurance, residential care, community care, cost effectiveness, costs;
University of Lancaster. Institute for Health Research
Publication year:
2002
Pagination:
24p.
Place of publication:
Lancaster
The aim was to compare the quality and costs of two approaches to providing community-based residential supports to people with learning disabilities and challenging behaviour: non-congregate settings where the minority of residents have challenging behaviour; and congregate settings where the majority of residents have challenging behaviour. Congregate care was associated with higher costs, higher staffing ratios, and better quality internal working practices. However, these inputs did not translate to better outcomes for residents. Non-congregate care was associated with greater access to day activities, less reliance of medication and physical restraint to control challenging behaviour, and less risk. Levels of staff contact and participant engagement were low across both models of care.
The aim was to compare the quality and costs of two approaches to providing community-based residential supports to people with learning disabilities and challenging behaviour: non-congregate settings where the minority of residents have challenging behaviour; and congregate settings where the majority of residents have challenging behaviour. Congregate care was associated with higher costs, higher staffing ratios, and better quality internal working practices. However, these inputs did not translate to better outcomes for residents. Non-congregate care was associated with greater access to day activities, less reliance of medication and physical restraint to control challenging behaviour, and less risk. Levels of staff contact and participant engagement were low across both models of care.
Subject terms:
learning disabilities, quality assurance, residential care, challenging behaviour, community care, cost effectiveness, costs;
UNIVERSITY OF LANCASTER. Institute for Health Research
Publisher:
University of Lancaster. Institute for Health Research
Publication year:
1999
Pagination:
128p.
Place of publication:
Lancaster
This report provides the results of a large-scale research project commissioned by the Department of Health. The aims of the project were to identify or explore the nature, quality and costs of residential or village communities and community-based dispersed housing schemes for people with learning disabilities.
This report provides the results of a large-scale research project commissioned by the Department of Health. The aims of the project were to identify or explore the nature, quality and costs of residential or village communities and community-based dispersed housing schemes for people with learning disabilities.
Subject terms:
learning disabilities, quality assurance, residential care, community care, cost effectiveness, costs;
Research Policy and Planning, 28(1), 2010, pp.17-27.
Publisher:
Social Services Research Group
As the effects of the financial recession begin to bite, there is a danger that the quality of social care provision for children, young people and adults with intellectual disability in the UK will significantly decline. As the provision of social care services are being increasing opened up to market forces there is a danger that the ‘not for profit’ organisations may be squeezed out, leaving commercial companies to dominate the market. In 2009 the Care Quality Commission (CQC) took over responsibility for adult social care and health care, leading to concerns about its ability to balance both its health and social care responsibilities and effectively monitor developments in the social care field. This article explores some of the factors contributing to this anticipated deterioration of social care provision: the commercialisation of social care; the expansion of the ‘for profit’ private sector at the expense of the ‘not for profit’ voluntary sector; the uncertainties occasioned by frequent changes in regulatory structures; the move to self-regulation of care services; and the neutering of the power and influence of advocacy services.
As the effects of the financial recession begin to bite, there is a danger that the quality of social care provision for children, young people and adults with intellectual disability in the UK will significantly decline. As the provision of social care services are being increasing opened up to market forces there is a danger that the ‘not for profit’ organisations may be squeezed out, leaving commercial companies to dominate the market. In 2009 the Care Quality Commission (CQC) took over responsibility for adult social care and health care, leading to concerns about its ability to balance both its health and social care responsibilities and effectively monitor developments in the social care field. This article explores some of the factors contributing to this anticipated deterioration of social care provision: the commercialisation of social care; the expansion of the ‘for profit’ private sector at the expense of the ‘not for profit’ voluntary sector; the uncertainties occasioned by frequent changes in regulatory structures; the move to self-regulation of care services; and the neutering of the power and influence of advocacy services.
Subject terms:
learning disabilities, private sector, quality assurance, regulation, social services, social care, social care provision, voluntary sector, advocacy, cutbacks;
This review uses a rapid evidence assessment to investigate the scope for improving the quality of care provided by residential care homes in the United Kingdom through learning from other providers. The review focused on three settings: residential services for children and young people; residential services and supported housing for people with learning disabilities; and hospice care. The review looked at the international and national literature, evaluations and opinions of people using services; and feedback from frontline practitioners on the accuracy of findings and transferability of learning from others. Findings are discussed in the following areas: regulation, risk management, safeguarding, person-centred approaches, co-ordination of care and advanced care planning, staff selection and skills, and ongoing support for staff. The report found that although evidence of effectiveness is limited, there are promising ideas that could improve the culture of care homes, experiences of care and support for staff. It presents evidence of how residential care homes in other sectors have created positive organisational cultures and increased relationship-based care to improve the quality of care offered. It also discusses how how greater involvement of people who use services and their families can improve experiences of care. Examples of practice are included throughout the report.
(Edited publisher abstract)
This review uses a rapid evidence assessment to investigate the scope for improving the quality of care provided by residential care homes in the United Kingdom through learning from other providers. The review focused on three settings: residential services for children and young people; residential services and supported housing for people with learning disabilities; and hospice care. The review looked at the international and national literature, evaluations and opinions of people using services; and feedback from frontline practitioners on the accuracy of findings and transferability of learning from others. Findings are discussed in the following areas: regulation, risk management, safeguarding, person-centred approaches, co-ordination of care and advanced care planning, staff selection and skills, and ongoing support for staff. The report found that although evidence of effectiveness is limited, there are promising ideas that could improve the culture of care homes, experiences of care and support for staff. It presents evidence of how residential care homes in other sectors have created positive organisational cultures and increased relationship-based care to improve the quality of care offered. It also discusses how how greater involvement of people who use services and their families can improve experiences of care. Examples of practice are included throughout the report.
(Edited publisher abstract)
Subject terms:
residential child care, supported housing, learning disabilities, hospices, inspection, residential care, regulation, risk management, safeguarding adults, recruitment, quality assurance, care homes, organisational culture, person-centred care, user participation, care planning, staff development, older people, good practice;