Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.338-351.
Publisher:
Emerald
Purpose: The purpose of this paper is to look at whether a move to a supported living model of care from traditional residential group homes could improve the quality of life for those with a severe intellectual disability and other challenging needs.
Design/methodology/approach: Six men with severe intellectual disabilities moved from two residential homes into new-build individual flats. Their quality of life was measured using a battery of assessments looking at; environment, relationships, community participation, interactions, mood interest and pleasure, activities, physical health and challenging behaviour. These measures were taken before the move, immediately after and six months after the move. The views of staff and family carers were also assessed at each stage.
Findings: The move had a positive effect on the tenants in that it caused an improvement in their mood and a decrease in their challenging behaviours. Further improvements could be made in the tenant’s quality of life by introducing more activities. The initial concerns of family members about the move decreased over time. However staff found the changes to their working practices stressful.
Research limitations/implications: The study was a small scale one because of the small number of tenants. The tenants were unable to express their own views because of their limited communication abilities so a combination of direct observation and indirect measures were used.
Practical implications: In the light of the Winterbourne view report by Stephen Bubb this study looks at the impact on quality of life of a move to supported living for a group of people with complex and challenging needs who might otherwise be placed in an out of borough placement similar to Winterbourne view.
Social implications: The study also looks at the impact of such a move on the family members of the individuals and on the staff who had to change their working practices to adapt to both a new working environment and model of care.
Originality/value: This study also looks at the impact of a model of supported living for people with severe intellectual disabilities and complex needs rather than those with mild intellectual disabilities. This is particularly important in the post Winterbourne view climate when the authors need to look carefully at positive alternative models of care for these individuals.
(Publisher abstract)
Purpose: The purpose of this paper is to look at whether a move to a supported living model of care from traditional residential group homes could improve the quality of life for those with a severe intellectual disability and other challenging needs.
Design/methodology/approach: Six men with severe intellectual disabilities moved from two residential homes into new-build individual flats. Their quality of life was measured using a battery of assessments looking at; environment, relationships, community participation, interactions, mood interest and pleasure, activities, physical health and challenging behaviour. These measures were taken before the move, immediately after and six months after the move. The views of staff and family carers were also assessed at each stage.
Findings: The move had a positive effect on the tenants in that it caused an improvement in their mood and a decrease in their challenging behaviours. Further improvements could be made in the tenant’s quality of life by introducing more activities. The initial concerns of family members about the move decreased over time. However staff found the changes to their working practices stressful.
Research limitations/implications: The study was a small scale one because of the small number of tenants. The tenants were unable to express their own views because of their limited communication abilities so a combination of direct observation and indirect measures were used.
Practical implications: In the light of the Winterbourne view report by Stephen Bubb this study looks at the impact on quality of life of a move to supported living for a group of people with complex and challenging needs who might otherwise be placed in an out of borough placement similar to Winterbourne view.
Social implications: The study also looks at the impact of such a move on the family members of the individuals and on the staff who had to change their working practices to adapt to both a new working environment and model of care.
Originality/value: This study also looks at the impact of a model of supported living for people with severe intellectual disabilities and complex needs rather than those with mild intellectual disabilities. This is particularly important in the post Winterbourne view climate when the authors need to look carefully at positive alternative models of care for these individuals.
(Publisher abstract)
Subject terms:
supported living, learning disabilities, models, quality of life, severe learning disabilities, challenging behaviour, complex needs;
Serous case review of Richard Handley, referred to as ‘James’, a 33 year old adult with Down’s syndrome and a moderate learning disability who was also diagnosed with a mental illness and hypothyroidism. He had lifelong problems with constipation. He lived in a Supported Living scheme, Goshawk Close, run by United Response. On 14 November 2012 he was admitted to Ipswich Hospital and following a surgical procedure under anaesthetic to remove impacted faeces, he died in hospital on 17 November 2012. Failings identified in the review include: poor monitoring of physical health needs; a lack of understanding about the use of the Mental Capacity Act; no specific arrangements for the supported living scheme to obtain support from specialist learning disabilities services; and lack of a multi-disciplinary approach to supporting physical and mental health needs. Recommendations include: named care coordinators for adults with learning disabilities and complex support needs; an annual review of health and social care needs; and ensuring services providing care to people with complex support needs have explicit access arrangements with NHS providers such as Community Learning Disability Teams.
(Original abstract)
Serous case review of Richard Handley, referred to as ‘James’, a 33 year old adult with Down’s syndrome and a moderate learning disability who was also diagnosed with a mental illness and hypothyroidism. He had lifelong problems with constipation. He lived in a Supported Living scheme, Goshawk Close, run by United Response. On 14 November 2012 he was admitted to Ipswich Hospital and following a surgical procedure under anaesthetic to remove impacted faeces, he died in hospital on 17 November 2012. Failings identified in the review include: poor monitoring of physical health needs; a lack of understanding about the use of the Mental Capacity Act; no specific arrangements for the supported living scheme to obtain support from specialist learning disabilities services; and lack of a multi-disciplinary approach to supporting physical and mental health needs. Recommendations include: named care coordinators for adults with learning disabilities and complex support needs; an annual review of health and social care needs; and ensuring services providing care to people with complex support needs have explicit access arrangements with NHS providers such as Community Learning Disability Teams.
(Original abstract)
Subject terms:
learning disabilities, complex needs, adults, supported living, death, health needs, mental health problems, serious case reviews, needs, Downs syndrome;
Serious case review of Amy, a woman with learning disabilities, epilepsy, cerebral palsy and known bowel problems, who died aged 52. She lived in a Supported Living scheme, Crane Court, run by Leading Lives. Amy was subject two safeguarding referrals, the first due concerns about supported living staff’s understanding of Amy’s health care needs discharge and the second following her discharge from hospital which took place without apparent full investigation or consideration of her health problems. Following her discharge from hospital Amy’s condition deteriorated and she died in hospital on 7 May 2013. Recommendations include: named care coordinators for adults with learning disabilities and complex support needs; an annual review of health and social care needs; and ensuring services which are providing care to people with complex support needs have explicit access arrangements with NHS providers such as Community Learning Disability Teams.
(Edited publisher abstract)
Serious case review of Amy, a woman with learning disabilities, epilepsy, cerebral palsy and known bowel problems, who died aged 52. She lived in a Supported Living scheme, Crane Court, run by Leading Lives. Amy was subject two safeguarding referrals, the first due concerns about supported living staff’s understanding of Amy’s health care needs discharge and the second following her discharge from hospital which took place without apparent full investigation or consideration of her health problems. Following her discharge from hospital Amy’s condition deteriorated and she died in hospital on 7 May 2013. Recommendations include: named care coordinators for adults with learning disabilities and complex support needs; an annual review of health and social care needs; and ensuring services which are providing care to people with complex support needs have explicit access arrangements with NHS providers such as Community Learning Disability Teams.
(Edited publisher abstract)
Subject terms:
adults, learning disabilities, complex needs, death, health needs, mental health problems, supported living, cerebral palsy, epilepsy;