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Incentives for private sector change: a report of the local services for local people: learning disability private sector hospitals project
- Authors:
- GREIG Rob, CAMERON Anita
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2011
- Pagination:
- 20p.
- Place of publication:
- Bath
There has been a growth in the number of private sector hospitals for adults with learning disabilities. The design of these hospital facilities is at odds with the evidence base and recognised good practice, but continues to operate because no-one with power has the incentive to change it. This report describes the work of the ‘Learning Disability Private Sector Hospitals Project’, which aimed to explore how to support private sector hospitals to modernise their services in line with Valuing People Now and the Mansell Report. The aim was to help them reduce large-scale institutional provision and explore other approaches to offering to commissioners and providers the skills to support people who present significant challenges. Two private providers expressed an interest in joining the project and demonstrated a strong organisational intent to change elements of their existing hospital provision. This report describes the work undertaken with these providers and the issues that were raised during the work. It discusses the positive forces for change, the obstacles and challenges, and the key lessons. It concludes that the key to change rests in local commissioning and outcomes based procurement and contracting.
Prescribing patterns in a Hong Kong institution for adults with severe to profound learning disabilities
- Author:
- LIM Woon Chu Winston
- Journal article citation:
- Tizard Learning Disability Review, 10(4), October 2005, pp.3-9.
- Publisher:
- Emerald
There has been increasing concern about inappropriate or excessive medication of people with learning disabilities. This paper reports on a survey of prescribing patterns in an institution that cares for adults with severe to profound learning disabilities in Hong Kong. The survey found that 27% of the 294 hospital patients were receiving psychotropic drugs, but this rate was significantly higher (90%) in the ward for people with challenging behaviours. Most patients (67%) received a single psychotropic drug, 26% received two and 7%, three. Around half the patients (151) had epilepsy, of whom 90% received anticonvulsants. Of these, 52% received a single anticonvulsant, 37% received two and 11% received three or more. Dosages were generally within the recommended ranges. This survey revealed several good aspects of prescribing practice at Siu Lam Hospital, but also areas that need improvement. The latter include a drug-reduction programme for the people with challenging behaviours, trials of drug-free periods for seizure-free patients receiving anticonvulsants and replacement of phenytoin and phenobarbitone with safer alternatives.
Service users’ experiences, understanding and hopes about care in an inpatient intellectual disability unit: a qualitative study
- Authors:
- LLOYD Lisa Claire, HEMMING Claire, TRACY Derek K.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(4), 2013, pp.201-210.
- Publisher:
- Emerald
Semi-structured interviews of eight (three male, five female, mean age 33) resident service users with severe intellectual disabilities were conducted to explore the views of individuals who were resident inpatients on an NHS ward on what helped or hindered their care. Sub-categories of staff personality, helpful relationships, and the concept of balanced care emerged under a core category of needing a secure base. Clients were very clearly able to identify and delineate: personal attributes of staff; clinical means of working; and the need to balance support with affording independence and growth. They further noted factors that could help or hinder all of these, and gave nuanced answers on how different personality factors could be utilized in different settings. The authors’ data show that exploring the views of more profoundly disabled and vulnerable individuals is both viable and of significant clinical value. It should aid staff in contemplating the needs of their clients; in seeking their opinions and feedback; and considering that most “styles” of personality and work have attributes that clients can value and appreciate. (Edited publisher abstract)
Advocating beyond the institution
- Author:
- THOMPSON David
- Journal article citation:
- Learning Disability Today, 8(1), February 2008, pp.16-21.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Advocacy Partners is a large independent advocacy service that provides a variety of advocacy support in London and south-east England. Advocacy Partners have been providing a service to people living at Orchard Hill for almost 10 years. This article discusses some of the successes and challenges of providing this service.
An evaluation of the introduction of facilitated person-centred planning with people with learning disabilities leaving a hospital setting: sharing knowledge
- Authors:
- COOK Tina, ABRAHAM Lucy
- Journal article citation:
- Tizard Learning Disability Review, 12(4), December 2007, pp.11-19.
- Publisher:
- Emerald
This article considers some of the issues raised by an evaluation of facilitated person-centred planning (PCP) for six people with severe and complex learning disabilities residing in a long-stay hospital. The hospital is earmarked for closure, and all six are to be resettled. Using a realistic approach, evaluators explored such questions as whether the views of people with severe learning disabilities had been accessed, what makes PCP person-centred and who should participate in a plan. These questions raised awareness of the effect of timescales and a selective training programme in relation to PCP, and the impact this has had on effective person-centred planning.
Respecting people: a fantasy
- Author:
- SENKER Jonathan
- Journal article citation:
- Community Connecting, 9, Summer 2007, pp.4-5.
- Publisher:
- Community Connecting
The Healthcare Commission found poor quality of services and widespread institutional abuse of people with profound and multiple disabilities who were supported at Sutton and Merton PCT at Orchard Hill, a long stay hospital. The author, Chief Executive of Advocacy Partners, explores the lessons from the investigation.
Individual and service factors affecting deinstitutionalization and community use of people with intellectual disabilities
- Author:
- BAKER Peter A.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(2), March 2007, pp.105-109.
- Publisher:
- Wiley
The aim was to evaluate the effect of the closure of a small intellectual disability hospital on the community use of those people involved. In addition, the study sought to identify those factors that might influence the community use of people with intellectual disabilities. The study sample involved 60 individuals with severe/profound intellectual disabilities residing in NHS-provided residential services. The impact of resettlement was investigated using a mixed design in which changes in the dependent variable (The Guernsey Community Participation and Leisure Assessment, GCPLA scores) were measured within-subjects (before and after leaving hospital) and between-subjects (using a comparison group of people who lived in the community throughout the study). In addition, a standard multiple regression design was employed to explore the relative contribution of client and service variables to GCPLA scores. Resettlement from hospital corresponded with significant increase in the range and frequency of leisure and community contacts, although community use remained low in comparison with the general population and in relation to other people with intellectual disabilities. Community and leisure use was found to be related to the place of residence, adaptive behaviour and the robustness of community goals within the service user's individual plan.
Home at last?: the same as you?: National Implementation Group report of the short-life working group on hospital closure and service reprovision
- Author:
- SCOTLAND. Scottish Executive. Community Care Division. National Implementation Group
- Publisher:
- Scotland. Scottish Executive,|Stationery Office
- Publication year:
- 2004
- Pagination:
- 63p.
- Place of publication:
- Edinburgh
The same as you? review of services for people with learning disabilities was published in May 2000. A key recommendation was that all long-stay learning disability hospitals should close by 2005. People should not have a hospital as their home. In order to achieve this successfully, appropriate arrangements have to be in place in the community, not just for people leaving hospital, but also for those who in the past would have relied on hospitals for support. The needs of all people with learning disabilities should be considered as part of the hospital closure strategy. This recommendation is only one of 14 recommendations that relate directly to hospital closures, and implementation of these other recommendations impact on this programme. This report starts with a brief look at the role of learning disability hospitals in Scotland. It goes on to describe the work of the short-life working group, the information gathered, and the recommended action to ensure successful implementation by the end of 2005. It includes real stories from people with learning disabilities and carers. Their views and experiences have influenced the key objectives in setting out what now needs to happen.
Progress with learning disability hospital closures in Scotland
- Author:
- WHORISKEY Margaret
- Journal article citation:
- Tizard Learning Disability Review, 8(1), January 2003, pp.4-9.
- Publisher:
- Emerald
Since the late 1950s the focus of UK policy for people with learning disabilities has been on deinstitutionisation and care in the community. This article considers four aspects of the current hospital closure programme in Scotland: involving people with a learning disability and families, managing hospital closure, service reprovisioning, and strategic planning.
Effects of relocation on the communication and challenging behaviours of four people with severe learning disabilities
- Authors:
- MACLEOD Fiona J., et al
- Journal article citation:
- British Journal of Learning Disabilities, 30(1), March 2002, pp.32-37.
- Publisher:
- Wiley
Describes an evaluation of the effects of relocation on the challenging and communicative behaviours of four individuals with severe learning disabilities who moved from a hospital for people with learning disabilities into a community project home. The study was longitudinal, spanning a period of 3 years. Results found that there was an overall decrease in the individuals' adaptive behaviours and inactivity levels, whilst there were increases in their communicative and challenging behaviours. Concludes that the participants appeared to increase all their interactions within the community environment, including their communication and challenging behaviours.