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Mellow Futures - an adapted parenting programme for mothers with learning difficulties in England and Scotland. Professionals' views on the outcomes
- Authors:
- TARLETON Beth, HESLOP Pauline
- Journal article citation:
- Health and Social Care in the Community, 29(5), 2021, pp.1275-1284.
- Publisher:
- Wiley
The Mellow Futures programme is a specially adapted parenting programme for mothers with learning difficulties that combines group work with home-based support. This paper reports on the findings of prospective and retrospective interviews with professionals who had referred mothers to the programme in England or Scotland between 2013 and 2015. The aim was to explore their perceptions of the programme as a whole, and its impact on the mothers they had referred to it. Mothers attending the Mellow Futures programme were invited to consent for a key professional to be contacted as part of the evaluation, generally those social workers who had referred the mothers to the programme. The ‘referrers’ were interviewed at the start and end of the programme. Thirty referrers contributed their views on the impact of the programme. Twenty-six were very positive about the impact of the Mellow Futures programme on the mothers: the programme was thought to have increased the mothers' confidence and self-esteem; supported them to work through issues; and helped them strengthen their relationship-building skills. Four referrers felt that the programme had not had any impact on the mothers they were supporting. The Mellow Futures programme focused on relationships, rather than parenting techniques, and three fundamentally important relationships in the mothers and babies' lives were targeted: the relationship/attachment between mother and baby; the supportive, ongoing relationships between the mothers in the group; and the mothers' more positive engagement with the professionals concerned with the welfare of their baby. The research confirms that, from the perspectives of referrers, linking group and home-based support can successfully help mothers with learning difficulties to care for their children. (Edited publisher abstract)
Developing an outcomes model for disabled children in Scotland
- Author:
- CHILDREN IN SCOTLAND
- Publisher:
- Scotland. Scottish Government Social Research
- Publication year:
- 2013
- Pagination:
- 67
- Place of publication:
- Edinburgh
Disabled children have broadly the same aspirations as non-disabled children and the outcomes they would like to achieve are therefore similar. However, for many disabled children and young people, there are fundamental outcomes that need to be achieved as a foundation for others, including and especially, communication. This project focused on better understanding ‘outcome models’ for all children and young people and for children and young people in the diverse and challenging context of disability. This research was commissioned by the Scottish Government’s Children’s Rights and Wellbeing Division to identify and develop an outcomes model based on Getting It Right for Every Child (GIRFEC), and the SHANARRI indicators of wellbeing (“Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible, Included”) for disabled children and young people in Scotland. It was to include both children with disabilities as defined by the Equality Act 2010 and those defined as having additional support needs in the context of the Education (Additional Support for Learning) (Scotland) Act 2004. The project was modified early on to focus on mapping outcomes work that is already in progress, and to identify the essential components of outcomes models. (Edited publisher abstract)
Learning disability policy in the UK
- Authors:
- WHITEHEAD Simon, et al
- Journal article citation:
- Tizard Learning Disability Review, 13(3), October 2008, pp.4-11.
- Publisher:
- Emerald
This article provides separate, but linked, overviews of learning disability policy in the four countries of the UK, commenting on current policy and its links to the wider policy agenda, delivery strategies and challenges for the future.
Stakeholders' views on measuring outcomes for people with learning disabilities
- Authors:
- YOUNG Anita F., CHESSON Rosemary A.
- Journal article citation:
- Health and Social Care in the Community, 14(1), January 2006, pp.17-25.
- Publisher:
- Wiley
This study aimed to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement. A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised that outcome measurement was expected but were uncertain how to go about it.
Making a difference? Ten years of managing people with intellectual disability and forensic needs in the community
- Authors:
- DE VILLIERS Jana, DOYLE Michael
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 6(3/4), 2015, pp.165-174.
- Publisher:
- Emerald
Purpose: Nationally community services for patients with intellectual disability and forensic needs are limited, and research to guide service development for this patient group with highly complex needs is sparse. The purpose of this paper is to provide an overview of referrals to and case management by the multi-agency Fife Forensic Learning Disability Service (FFLDS), including demographic data, treatment, risk assessments and outcomes. Design/methodology/approach: All referrals received between 2004 and 2014 were reviewed to identify key demographic factors and to clarify the outcome of the referrals. Risks levels and presence of factors related to ongoing risk management were identified. For those accepted, final outcomes were noted. Findings: In total, 145 referrals were received by FFLDS between 1 January 2004 and 31 December 2014. Of these 117 were accepted for ongoing case management. In total 106 patients were discharged from FFLDS over the review period, with the vast majority remaining in community settings. Patients were overwhelmingly male, with an age range of 16-79 (mean age of 30). Approximately half of referrals were from criminal justice agencies, and sexual and violent offences predominated. Alcohol and/or illicit substance use was problematic in 49 per cent of patients. Research limitations/implications: FFLDS needs to consider building links with Drug and Alcohol Services, for assistance in developing expertise in managing problematic alcohol and/or illicit substance use. Links with professionals working with female offenders may increase the rate of referral of female patients. Originality/value: Policy and legal frameworks emphasise the need to manage people with learning disabilities and forensic needs in the least restrictive environment possible. This paper provides information on a cohort of forensic patients over a ten-year period, including characteristics and outcomes, to inform the evaluation of these frameworks and the planning of both community and in-patient services for this patient group. (Publisher abstract)
Spaces of social inclusion and belonging for people with intellectual disabilities
- Author:
- HALL E.
- Journal article citation:
- Journal of Intellectual Disability Research, 54(Supplement 1), April 2010, pp.48-57.
- Publisher:
- Wiley
It is well documented that people with intellectual disabilities are marginalised within society, and long-standing social, cultural and personal discrimination has produced a situation where people with intellectual disabilities are more likely to be deprived, not in employment, be in poorer health, and to be absent from mainstream social spaces. This has led people with intellectual disabilities to be described as socially excluded, and policies of social inclusion have been called upon to counter this through a focus on paid work and independent living. However, for many people with intellectual disabilities this is either not desired or not possible, and as a result many have sought out alternative spaces and activities of inclusion. The article provides a critique of social exclusion and inclusion, and then goes onto examine the ways in which people with intellectual disabilities develop feelings of attachment and belonging within artistic spaces. The author uses two brief case studies to highlight the benefits – one of a high profile theatre company, the other an arts and crafts organisation. The author concludes that not only do these spaces provide mostly positive outcomes for individual people, but also have a potential role in re-establishing the social and cultural understanding of people with intellectual disabilities.
Cost estimation of a health-check intervention for adults with intellectual disabilities in the UK
- Authors:
- ROMEO R., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(5), May 2009, pp.426-439.
- Publisher:
- Wiley
High rates of health needs among adults with intellectual disabilities flag the need for information about the economic consequences of strategies to identify and address unmet needs. Health-check interventions are one such strategy, and have been demonstrated to effect health gains over the following 12-month period. However, little is known about their effects on service use and costs, and hence how affordable such interventions are. The authors examined service use patterns and costs over a 12-month period for 50 adult participants with intellectual disabilities who received a health-check intervention and 50 individually matched control participants who received standard care only. The health-check intervention was cheap, and it did not have associated higher costs in terms of service usage. Indeed, mean cost of care for the adults who received standard care only was greater than for the adults who received the health-check intervention. The higher costs were due to differences in unpaid carer support costs. This is the first study to report the associated service use, and costs of a health-check intervention to improve the health of adults with intellectual disabilities and reduce health inequalities. Results suggest this intervention is cheap and affordable compared with standard care, supporting clinical outcome evidence for its introduction into health care policy and implementation. However, further research is needed to confirm this finding with a larger sample.
Joint inspection of services for people with learning disabilities in Scotland: compliance or commitment?
- Author:
- CAMPBELL Martin
- Journal article citation:
- International Journal of Integrated Care, 6(4), 2006, Online only
- Publisher:
- International Foundation for Integrated Care
The article describes the development of a practical model of joint, integrated inspection of managed care services for people with learning disabilities in Scotland. The model will give a reliable measure of the impact services are making to people's lives and the quality of service that individuals are actually receiving. At present health, social services and education services for people with learning disabilities in Scotland are inspected separately, by up to nine different agencies. The first joint, integrated inspections of all services for people with learning disabilities in Scotland will take place in 2006. This is the first inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Quality Outcome Indicators were developed in 21 different areas, or domains. Evidence based best practice, and evaluative data from previous inspections were the primary sources of data. This paper reviews the background and rationale for the integrated, joint inspection process. Strengths and constraints of this approach to inspection are discussed, including the crucial importance of commitment from services and from inspectors, rather than mere compliance with demands. Some guidance on how to fully involve staff, carers and services users in the inspection process is given. It is concluded that the model will produce data to inform decision-making for managers in integrated services and give services users clear information about how well local needs are being met, what areas need development, and what capacity the organisations have to improve. The model of inspection may be of interest to practitioners in a national and international context. The model will be evaluated, following the first joint inspection.