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Outcomes and costs of skilled support for people with severe or profound intellectual disability and complex needs
- Authors:
- BEADLE-BROWN Julie, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.42-54.
- Publisher:
- Wiley
Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time, and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality. (Edited publisher abstract)
Enhancing personal outcomes; organizational strategies, guidelines, and examples
- Authors:
- SCHALOCK Robert L., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 5(4), December 2008, pp.276-285.
- Publisher:
- Wiley
Education and rehabilitation programs in the field of intellectual disabilities are developing specific strategies related to demonstrated personal outcomes, quality of life (QOL)-related services and supports, evidence-based practices, and quality improvement. The purpose of this article is to summarize key aspects of these strategies within a two-component framework: the concept of QOL and systems thinking. Based on collective experiences and published literature, four specific strategies are presented and discussed: mental models, assessment, service delivery practices, and quality improvement (QI). Essential guidelines for the successful implementation of these strategies are then presented, along with an exemplary application of each strategy. Each example shows the significant role of the consumer, the organization, and the larger system in organizational change, QI, and the enhancement of personal outcomes.
Pie in the sky? Not at all
- Author:
- BROACH Steve
- Journal article citation:
- Community Care, 8.2.07, 2007, pp.32-33.
- Publisher:
- Reed Business Information
Despite Every Child Matters, outcomes for disabled children and their families are still very poor. The Every Disabled Child Matters campaign believes that services for disabled children need more funding, coupled with prioritisation within the performance management frameworks for local government and health agencies. The 2007 comprehensive spending review is the ideal time to address the inequalities in outcomes for disabled children and their families.
Costs and outcomes of community services for people with intellectual disabilities
- Editors:
- STANCLIFFE Roger J., LAKIN K. Charlie, (eds.)
- Publisher:
- Paul H. Brookes
- Publication year:
- 2005
- Pagination:
- 346p.
- Place of publication:
- London
This book presents information about costs and outcomes of services and supports for people with intellectual and developmental disabilities. The main focus is on community services in the USA, but there are also contributions from the UK and Australia.
Planning and action
- Authors:
- EMERSON Eric, STANCLIFFE Roger J.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(1), March 2004, pp.23-26.
- Publisher:
- Wiley
Raises a a number of concerns about the possible impact of the systematic introduction of person-centred planning (PCP) across services for people with intellectual disabilities in the UK. The authors foresee a danger that system-wide adoption of PCP will be characterised over zealous 'selling' of the purported benefits without sufficient attention to the difficulties and without the necessary changes to system architecture to ensure that those involved in PCP have the authority or resources to achieve the plan's goals. If so, PCP will become another fad, and service users, and their families will become even more discouraged, disheartened and alienated by a system characterised by rhetoric rather than meaningful action. Where the authors differ, is in the interpretation of the existing evidence regarding the impact of individual planning systems in general and, perhaps, in the way forward.
Ways to measure quality of outcome: an essential ingredient in quality assurance
- Author:
- FELCE David
- Journal article citation:
- Tizard Learning Disability Review, 1(2), April 1996, pp.38-44.
- Publisher:
- Emerald
Policy rhetoric, encompassing terms such as contraction for quality, effectiveness-led health and social care, quality assurance and value for money, implies the need to measure the quality of service outcome. Systematic measurement of outcome is rarely undertaken and generally viewed as the province of research. Argues that quality monitoring needs to be an integral part of routine service operation. A framework for thinking about outcome is offered and possible measures from the research literature are listed. Argues that while services will need to put effort and resources into developing a capacity to monitor quality, the task should not be seen as too complicated or resource intensive to make it impossible to do, at least in a more coherent way than is currently being attempted.
Community housing costs
- Author:
- FELCE David
- Journal article citation:
- Tizard Learning Disability Review, 1(1), January 1996, pp.39-43.
- Publisher:
- Emerald
Small-scale community residential services are often held to be costly. However, such a simple assertion obscures a greater complexity which underlies the relationship between the nature of services, their resource requirements and their quality outcome. The article asserts that there are some economies of scale to be found but not as strong as popular belief would hold.
Social care for adults aged 18-64
- Authors:
- IDRISS Omar, ALLEN Lucinda, ALDERWICK Hugh
- Publisher:
- Health Foundation
- Publication year:
- 2020
- Pagination:
- 48
- Place of publication:
- London
An analysis of publicly available data to understand the social care needs of younger adults in England, how they differ from those of older people, and how these needs are changing. The analysis explores: system context - what the social care system for younger adults looks like; care needs - including data on self-reported disability and levels of care needs; system performance - how well the social care system cares for younger adults and their carers; and outcomes - including data on the quality of life for service users and unpaid carers. The document reports that people aged 18–64 with learning disabilities, mental health problems, and other social needs make up around a third of care users accessing long-term support in England and over half of local authority spending on social care. Key findings from the analysis show that: the number of younger adults with care needs is growing but the number of people accessing public support has fallen; quality and outcomes for younger adults accessing social care vary; workforce problems are chronic across the social care system, with learning disability nursing courses struggling to attract students. Unpaid carers of younger adults also experience worse outcomes in some areas than carers of older people, for example they are more less likely to be satisfied with services and more likely to report financial difficulties. The report concludes that policies to reform adult social care will not be successful unless they understand and address the needs of younger adults. The report identifies five implications for policy based on the data in the analysis. (Edited publisher abstract)
Commissioning effective employment supports (for people with learning disabilities and people with mental health problems): a practical review tool for commissioners
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2014
- Pagination:
- 27
- Place of publication:
- Bath
A practical tool to help commission and provide cost effective employment support that also achieves good outcomes for people with learning disabilities and people with mental health problems. The review tool provides a number of questions and identifies data to collect to help commissioners gain an insight into the effectiveness of current provision and identify further action. The questions focus more on individualised employment support (supported employment for people with learning disabilities and Individual Placement and Support for people with mental health problems) and self-employment as the NIHR School for Social Care commissioned research on which the toolkit is based found these options delivered the best employment outcomes. Key findings from the research are also included. (Edited publisher abstract)
Getting unstuck along the clinical pathway: an integrated multi-agency approach
- Authors:
- RICHARDS Luci, UCHENDU Nwamaka, O'HARA Jean
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(3), 2014, pp.192-196.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to highlight how the management of an adult with intellectual disabilities and complex medical conditions by a multi-disciplinary and multi-agency team approach across a clinical pathway (primary, secondary and tertiary care, health, social and third sector agencies) can be used to improve the person's physical and mental health outcome. Design/methodology/approach: Literature review and case report in which the paper describes the presentation of the patient with multiple complex physical health conditions, mild intellectual disability and challenging behaviour and description of the management process and the observed outcome. Findings: The patient required input from the multi-disciplinary community intellectual disabilities team and multi-agency team including social services and community support team, admission to a specialist intellectual disabilities ward to optimise her management. She improved relatively well and was discharged to the community. On discharge she continued to receive ongoing psychiatric, psychological and community psychiatric nurse input and maintains the sustained improvement in her mental health. She no longer displays risky or challenging behaviour, her mood has improved and there is no self-harm ideation. She remains anxious at times, however, her symptoms are much improved and do not affect her daily functioning. Originality/value: This case highlights the profound and enduring psychiatric and behavioural sequelae following brain malignancy and treatment and how essential a multi-disciplinary and multi-agency approach is in the successful management of complex issues. Her symptoms appeared relatively treatment resistant until she had a specialist inpatient admission. This case study also demonstrates the strengths and advantages of having specialist care pathway for such complex presentations, allowing for integrated community, secondary and tertiary care, and for the care system to work together in a coordinated and managed way. (Publisher abstract)