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Mitigating the impact of SARS-CoV-2 on residential facilities for persons with intellectual disability and/or autism spectrum disorder: two experiences from the Italian red zone
- Authors:
- SANTAMBROGIO Jacopo, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 15(4), 2021, pp.132-140.
- Publisher:
- Emerald
Purpose: Persons with intellectual disability and/or low-functioning autism spectrum disorder are with high support need (ID/ASD-HSN) are among the people who are most vulnerable to the COVID-19 pandemic. The specific vulnerability and the protective factors for persons with ID/LF-ASD attending residential and rehabilitative facilities have however received little attention. This paper aims to describe how two facilities located in the Italian COVID-19 red zone faced the risks associated with the spread of the pandemic and the results they have achieved so far. Design/methodology/approach: Interventions to contrast the spread of the pandemic and preserve clients’ health conditions have been systematically monitored and recorded since the very beginning of the pandemic. Findings: 26/138 clients had to undergo clinical screening and laboratory tests for COVID-like symptomatology, but only one resulted affected by COVID-19 and survived. Considering that Lombardy had 89,595 cases and 16,262 deaths (January–May 2020), one COVID-19 case/138 clients is a good result. Temporarily limiting physical contacts with friends/family in favor of reducing the burden of risk and adopting a system of prevention/safety strategies directed for persons with ID/LF-ASD attending and their caregivers have been useful measures. Research limitations/implications: Structured or semi-structured interviews (using professional caregivers as informant) to confirm behavioral and emotional changes in the clients could not be carried out because of lack of time and resources (which were captured by the management of the pandemic) and could be the next goal for our residential facilities to implement the management of epidemic acute phases in a research-oriented view. Originality/value: This study is a service evaluation report about facing COVID-19 pandemic. Only few such studies are present in medical literature about ID/ASD. (Edited publisher abstract)
Challenging behaviour: principles and practices
- Author:
- HEWETT Dave
- Publisher:
- David Fulton
- Publication year:
- 1999
- Pagination:
- 240p.
- Place of publication:
- London
Collection of essays by professionals from various backgrounds on approaches to challenging behaviour in people with learning difficulties, with case studies and practical techniques.
Trends in the provision of residential educational placements available for young people with learning disabilities/autism in England
- Authors:
- TOMLINSON Serena Rose Louisa, et al
- Journal article citation:
- Tizard Learning Disability Review, 22(4), 2017, pp.222-229.
- Publisher:
- Emerald
Purpose: Little is known about the characteristics of residential educational settings for young people with intellectual or developmental disabilities (IDD) in England. Previous research has focussed on the characteristics and experiences of the young people attending such settings rather than the setting itself; therefore, an overview of national provision is needed. The paper aims to discuss these issues. Design/methodology/approach: As part of a larger project, data were collected for all residential schools and colleges in England. Data relate to settings offering residential provision for at least 4 nights per week for 30 weeks per year, either at the school/college itself, or in an associated residential home. Due to the remit of the main project, settings offering placements only to young people aged under 16 were excluded. Data were collected from a range of sources, including school/college websites, Ofsted and Department for Education resources, and liaison directly with the setting. Findings: In total, 342 residential educational settings were identified with 57 of these offering post-16 provisions only. A range of data is presented about these settings, including location, placement numbers and types available, age range catered for, special educational needs categories registered for, governance arrangements (e.g. LA maintained, privately owned, and charitable organisation), and Ofsted educational ratings. Originality/value: These data provide a national overview of residential educational settings for young people with IDD. This enables a clearer picture of the location and type of provision offered and allows comparisons both within and between areas. (Publisher abstract)
Choice is key: where next for accommodation and support for people with learning disabilities?
- Author:
- DONOVAN Tristan
- Publisher:
- Association of Directors of Adult Social Services
- Publication year:
- 2017
- Pagination:
- 12
- Place of publication:
- London
This report brings together a range of views on accommodation and support for people with learning disabilities or autism or both. The report argues that central to delivering change is ensuring there are more ‘settled accommodation’ options, namely accommodation in the community where individuals have security of tenure in the medium to long term, while acknowledging the important role played by residential care. Conversely, there are concerns that some residential care homes are rebranding as supported living but doing little more than deregistering from the CQC. The report calls for new, innovative approaches, including: the creation of a small fund to support families to buy a house for a person with learning disabilities; the creation of a multi-disciplinary community forensic service to help people whose behaviours and disabilities have led to them experiencing very extended stays in secure hospitals, move into community based accommodation; improving the design of accommodation to reduce social isolation; and changing culture and mind-set barriers that hinder efforts to re-engineer accommodation and support for people with learning disabilities or autism. (Edited publisher abstract)
The abuse of vulnerable adults at Winterbourne View Hospital: the lessons to be learned
- Author:
- PLOMIN Joe
- Journal article citation:
- Journal of Adult Protection, 15(4), 2013, pp.182-191.
- Publisher:
- Emerald
This article seeks to consider the lessons from the abuse of a number of patients with learning disabilities or autism and challenging behaviour over a number of years at Winterbourne View private hospital in the outskirts of Bristol. The abuse persisted, irrespective of a number of attempts to alert a broad range of regulatory authorities and health professionals about the situation. The article provides a detailed analysis of the lessons for professionals responsible for adult protection by one of the journalists most responsible for exposing the abuse at Winterbourne View private hospital. Drawing on information the BBC uncovered during the making of its two films about the subject, the author shares details of relevance to professionals responsible for adult protection and considers the implications of the catastrophic failure to protect vulnerable people. This article shows how the lessons from the abuse at Winterbourne View have permeated only to some areas and professionals, not necessarily to where those lessons are most needed. The author suggests that further efforts are required to prevent another, similar scandal happening elsewhere in the UK. (Edited publisher abstract)
Making it personal for everyone: from block contracts towards individual service funds
- Authors:
- SCOWN Steve, SANDERSON Helen
- Publisher:
- Dimensions
- Publication year:
- 2011
- Pagination:
- 126p.
- Place of publication:
- Stockport
Dimensions is a not-for-profit organisation which supports people with learning disabilities and people with autism, including providing "traditional" care services such as residential care homes. In the context of the personalisation agenda, Dimensions considered how it could help people in traditional services take control of their funding and determine and control their own support. This book is designed to share learning about how the organisation changed its services and practice. It covers the testing of new approaches in an existing home for people with learning disabilities, financial aspects, personalisation and the person-centred approach, providing "just enough support", implementation, and impact on service users. It also reviews what the organisation learnt and top tips for other providers facing similar challenges.
Service innovations: Maple House- an autistic-friendly NHS facility
- Authors:
- JABARIN Z., et al
- Journal article citation:
- Psychiatric Bulletin, 25(3), March 2001, pp.109-111.
- Publisher:
- Royal College of Psychiatrists
This paper describes Maple House, a unique in-patient facility for learning disabled adults with autism which has recently been developed in Exeter. The design of this facility has been based on the principles of Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). The design tenet of Maple House was that the environment should reflect these principles, facilitating communication and, therefore, allowing the comprehensive assessment of autistic individuals. Overall, the service provision for this group in the UK is deficient. Maple House may be a model for future NHS facilities for people with autism.
The Oversight Panel's interim conclusions and recommendations
- Author:
- INDEPENDENT CARE (EDUCATION) AND TREATMENT REVIEWS OVERSIGHT PANEL
- Publisher:
- Great Britain. Department of Health and Social Care
- Publication year:
- 2021
- Place of publication:
- London
This document summarises the interim conclusions of the Independent Care (Education) and Treatment Reviews Oversight Panel. It outlines the headline findings from a thematic review of 26 independently chaired Care (Education) and Treatment Reviews (IC(E)TRs), from discussions with IC(E)TR independent chairs, and Panel meetings. These have been grouped in to 6 ‘improvement areas’. Against each of these improvement areas we have described ‘what we want to see’ – that is what we consider to be the correct aims and objectives in those areas. The Oversight Panel has identified some actions which need to commence immediately but require a funded project plan. The Panel has also identified other actions and recommendations which need further development and would be completed for a final report in 2021. These actions and proposed recommendations are specifically intended to improve outcomes and the immediate circumstances for people in long term segregation (LTS). However, the Oversight Panel also strongly recommends that these areas for improvement should apply more generally for all people with learning disabilities and/or autistic people who are inpatients or at risk of admission. The improvement areas identified by the Panel are: to improve substantially the quality of diagnosis, treatment and care in hospitals; to commission, skilled, safe, kind and appropriate person-centred support; to ensure there is accountability for action particularly by commissioners; to listen to patients and families, put them at the centre of care planning and ensure skilled and appropriate representation/ advocacy; to make money work; to continue to provide oversight and independent scrutiny. (Edited publisher abstract)
Thematic review of the Independent Care (Education) and Treatment Reviews
- Author:
- HOLLINS Sheila
- Publisher:
- Great Britain. Department of Health and Social Care
- Publication year:
- 2021
- Place of publication:
- London
This thematic review highlights common themes and findings from detailed analysis of 26 (a third) of the 77 IC(E)TRs to derive thematic learning and identify the common concerns and issues relating to the care and treatment of people with learning disabilities and/or autism in long-term segregation (LTS). The analysis reveals that some individuals who had their cases reviewed were placed in segregation in order to cater to individual needs (for example to experience less noise or overstimulation). For most, however, segregation was being used in response to challenging behaviour in the absence of the right therapeutic care and environment. Some hospitals attempted to create a more ‘home like’ environment by adapting a room or suite of rooms in a part of the hospital, with nearly half of the 26 cases in the sample being segregated in this way. While the other half ranged from more ‘acceptable’ single rooms to high security environments, some without facilities or comfort, including some bare cells with hatches for surveillance, communication and to deliver food. In this review the findings, aims, actions and recommendations are separated into 7 improvement areas. These are: to improve substantially the quality of diagnosis, treatment and care in hospitals; to commission, skilled, safe, kind and appropriate person-centred support; to ensure there is accountability for action particularly by commissioners; to listen to patients and families, put them at the centre of care planning and ensure skilled and appropriate representation or advocacy; to make money work; to continue to provide oversight and independent scrutiny; other areas or findings. (Edited publisher abstract)
Experience of children and young people cared for in mental health, learning disability and autism inpatient settings
- Author:
- NATIONAL INSTITUTE FOR HEALTH RESEARCH
- Publisher:
- National Institute for Health Research
- Publication year:
- 2021
- Place of publication:
- London
This themed review explores the experience of young people with mental health problems, learning disability or autism in specialist inpatient mental health care. A young person may require admission if their disorder means that they are at high risk of self-harm or pose a risk to others. They may also be admitted if they need more intensive treatment and assessment than is possible in a community setting. This Themed Review does not cover young people's experience of inpatient paediatric care (for physical needs) or issues such as inappropriate admission to adult mental health services. Overall, we identify four key influences on how children and young people experience inpatient care. These are drawn from the research evidence base, but also from the experiential evidence provided by children, young people and their parents. The four themes are: quality of relationships; normality; use of restrictive practices; expectations and outcomes. The review identifies three key action points to address this significant area of need; recognise the interdependence of experience, treatment outcomes, and other factors; promote timely identification and action to address unmet needs; and equip staff with the resources, capacity and authority to improve experience. (Edited publisher abstract)