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Deprivation of Liberty Safeguards: what determines the judgements of best interests assessors? A factorial survey
- Authors:
- CARPENTER John, et al
- Journal article citation:
- Journal of Social Work, 14(6), 2014, pp.576-593.
- Publisher:
- Sage
Summary: The Deprivation of Liberty Safeguards were introduced in England and Wales to protect the interests of people with learning disabilities, dementia and neurological conditions resident in hospitals and care homes. The Safeguards apply when residents lack capacity to make decisions about their care and treatment in circumstances that may amount to a deprivation of their liberty. Best interests assessors must establish whether a deprivation of liberty has occurred. However, there is no definition in statute; instead, the identification of factors which define a deprivation of liberty is evolving through case law. A factorial survey was used to identify the factors which influenced the professional judgements of 93 best interests assessors (three-quarters social workers) who generated 798 responses to randomly generated vignettes. Findings: Coercive staff behaviour was the strongest statistical predictor of a deprivation of liberty judgement, followed by the resident’s response. Other indicators of staff control, including the use of medication to reduce agitation, restriction of movement and family unhappiness with care were also significant. The resident’s condition, gender/age and the setting were not significant predictors. Best interests assessors were generally confident in their decision making; there were no differences in confidence associated with best interests assessors’ professions. Applications: Reviews of the operation of the Safeguards stress significant complexity in defining a deprivation of liberty. Nevertheless, this study suggests that the factors which best interests assessors take into account are rooted in the fundamental principles of the Safeguards and an informed appreciation of case law. Best interests assessors and local authorities, in their role as supervisory bodies, must keep up to date with developments. (Edited publisher abstract)
Dementia in people with learning disability: a preliminary study into care staff knowledge and attributions
- Authors:
- WHITEHOUSE Richard, CHAMBERLAIN Paul, TUNNA Kate
- Journal article citation:
- British Journal of Learning Disabilities, 28(4), December 2000, pp.148-153.
- Publisher:
- Wiley
The present paper describes the findings of a pilot study funded by the NHS Executive Primary and Community Care Research Initiative Small Projects Scheme that investigated the knowledge and attributions of dementia held by care staff who work with older adults with learning disability. Meetings took place with 21 members of care staff identified as keyworkers to older adults with learning disability living in residential houses provided by Solihull Healthcare NHS Trust, Solihull, UK. The results suggest that staff have knowledge of ageing at a similar level to that of college students. Forgetfulness was the sign that they would most expect to see if they thought someone was suffering from dementia. When a change in behaviour was attributed to dementia, it was most likely to be viewed as ‘stable, uncontrollable’ with staff feeling pessimistic about being able to change the behaviour.
Dementia questionnaire for persons with mental retardation (DMR): modified criteria for adults with Down's Syndrome
- Author:
- PRASHER V.P.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 10(1), 1997, pp.54-60.
- Publisher:
- Wiley
Reports on independent assessment of the validity of the Dementia Questionnaire for Persons with Mental Retardation (DMR) questionnaire) in screening for dementia in adults with Down's syndrome. Changes to criteria were required for use in the general Down's Syndrome population. Using the new criteria both sensitivity and specificity of new criteria were 82%. The sensitivity of longitudinal score-changes was found to be relatively low (60%), suggesting a limited role in the screening for dementia. Concludes that the DMR questionnaire, using the modified criteria, can aid screening for dementia in the general Down's Syndrome population .
Understanding and addressing underrepresentation in a postal survey of social care users
- Authors:
- SMITH Nick, MALLEY Juliette
- Publisher:
- Quality and Outcomes of Person-centred Care Policy Research Unit
- Publication year:
- 2012
- Pagination:
- 91
- Place of publication:
- Canterbury
This report draws together the findings of a review of postal surveys, examining the potential causes of underrepresentation and looking at methods of improving representation, such as such as the Adult Social Care Survey (ASCS). Evidence from postal surveys is increasingly being used in England to monitor and improve the performance of social care services. This review has highlighted that it is not only the characteristics of users but the behaviour of the organisation delivering the survey that can affect response rates. It outlines a range of approaches when participation is not possible and highlights four key methods that can be used to enable participation in postal surveys: recognising that the study information section of a postal survey can be a barrier to participation if it does not appear to be relevant to the respondent; adapting the questionnaire to reflect the 'individualised' needs of the participant, such as versions in other languages and Easy Read versions for adults with learning disabilities; employing alternative methods of data collection, such as face-to-face or telephone interview, alongside the postal survey; and encouraging or even providing support to complete the survey. (Edited publisher abstract)
How does the community care?: public attitudes to community care in Scotland
- Authors:
- CURTICE Lisa, PETCH Alison
- Publisher:
- Scotland. Scottish Executive. Social Research
- Publication year:
- 2002
- Pagination:
- 49p.
- Place of publication:
- Edinburgh
As part of the 2001 Scottish Social Attitudes Survey, the Scottish Executive funded a module of 40 questions on the attitudes of people in Scotland to a range of community care issues. Interviews were completed with 1605 individuals across Scotland. Three quarters of respondents felt comfortable about living next door to a frail older person and more than half about living next door to a person with a learning disability. Less than half, however, felt comfortable about living next door to a person with mental illness or with dementia. Respondents were strongly in favour of individuals with support needs living in the community rather than in care homes or hospitals. This view was most common for a person with a learning disability and least common (but still the majority) for a person with dementia. Most people interviewed thought that a person with a mental illness or a learning disability should not serve on a jury. Support needs, it was felt, should in the main be met by paid workers. The exception was for the person with a learning disability needing to be accompanied to a club where the potential contribution of family members and volunteers was cited. A substantial majority considered the funding of support to be the responsibility of the government. Respondents with personal experience of care were even more likely than others to take this view. There was strong support for individuals remaining within their own homes when this was their wish, even when this was a more expensive option. Only a fifth of respondents thought that those able to pay should be able to access better quality provision, suggesting strong support for equity. Respondents expressed a willingness to pay higher taxes to generate funds for increased expenditure on health, support for older people and pensions. The top priorities for additional government spending on older people were home helps, special housing provision, and district nurses.
Dementia-related care decision-making in group homes for persons with intellectual disabilities
- Authors:
- JANICKI Matthew P., MCCALLION Philip, DALTON Arthur J.
- Journal article citation:
- Journal of Gerontological Social Work, 38(1/2), 2002, pp.179-195.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Alzheimer’s disease and related dementias affects a significant number of adults with intellectual disability (ID), in particular those with Down syndrome. Many affected adults live in small community group homes or with their families. How to provide sound and responsive community care is becoming a challenge for agencies faced with an increasing number of affected adults. This study reports the outcome of a survey of group homes serving adults with ID and dementia, explores the onset, duration and effects of dementia, and speaks to the impact of these on planning for community care of adults with ID. It also examines emerging community care models that provide for “dementia capable” supports and services. Two models, “aging in place” and “in place progression” are examined, as well as “referral out” reactions, with regard to care practices and critical agency decision making.
Misplaced and forgotten: people with learning disabilities in residential services for older people
- Authors:
- THOMPSON David, WRIGHT Sarah
- Publisher:
- Mental Health Foundation
- Publication year:
- 2001
- Pagination:
- 21p.,bibliog.
- Place of publication:
- London
The reason why people with learning disabilities enter residential homes for older people is largely unrelated to their own ageing. Most people coming from living with family move because of their relative's ageing or death. Others move because of closure of services. The people with learning disabilities in the homes for older people lead very impoverished lives with few opportunities to get out. There are financial incentives for local authorities to use older people's services rather than developing a good quality learning disability provision. Until this addressed, the common practice of misplacing people with learning difficulties and then forgetting them will continue.
The patchwork quilt
- Author:
- LINDSAY Meg
- Journal article citation:
- Community Care, 26.5.94, 1994, p.20.
- Publisher:
- Reed Business Information
Respite care is often made from bits and pieces from services which are meant to be integrated, but not at the top of many agendas. This means that respite care uses borrowed funding and secondhand policies and practices. A survey in Scotland examined four types of respite care: hospital, residential, family-based, and domiciliary for seven main groups: older people, people with dementia, those with mental health problems, and children and adults with learning and physical disabilities, to find out the reality for carers. Also explores the possibilities for improving services for them.