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It is widely known that a relatively small number of very expensive, often out‐of‐area, placements consume a relatively large proportion of the social care budget. Valuing People Now (DH, 2009) acknowledged that too often people are sent to expensive out‐of‐area placements. There is, however, little research in this area and no routinely collected information. In this collaborative piece of work between the Valuing People Now Team, the Challenging Behaviour National Strategy Group and the Tizard Centre we aimed to identify the characteristics of the highest‐cost placements in the South‐East of England.

Due to the increasing incidence of dementia in Ireland, there is a need to prepare occupational therapy students for future careers in dementia-focused health care. The purpose of this study are to measure the knowledge and attitudes of Irish undergraduate occupational therapy students towards older people with dementia and examine related variables including year of study, personal and placement dementia experiences and future career choice.

Data was gathered using a cross-sectional online survey, incorporating the Alzheimer’s Disease Knowledge Scale and the Dementia Attitudes Scale, which was analysed using descriptive and inferential statistics.

Seventy-five responses were gathered and analysed, indicating more advanced occupational therapy students demonstrate higher levels of dementia knowledge, but dementia attitudes remain similar across different year groups. Students with clinical dementia experiences displayed comparable levels of dementia knowledge and attitudes to those without. However, students with familial dementia experiences displayed significantly more positive attitudes. The likelihood of selecting a future career with older adults with dementia significantly related to students’ positive dementia attitudes but not dementia knowledge.

To the best of the authors’ knowledge, this is the first Irish study that focuses on undergraduate occupational therapy students’ dementia knowledge and attitudes. The results could be used to inform and develop Irish undergraduate occupational therapy programmes.

There is substantial evidence that young people moving from child and adolescent mental health services to adult services are more likely to experience poor transitions. However, little is known about the care pathways of young people transitioning from forensic services. This retrospective case note review sought to examine the clinical characteristics, transition pathways and psychosocial indicators of transition outcomes amongst young people in forensic medium secure services discharged to adult services.

The electronic records of 32 young people, who transitioned from six adolescent medium secure units in England to adult services between May 2015 and June 2016, were examined.

Approximately 65% of young people were between 18 and 19 years at the time of transition and the average waiting time from referral to discharge was six months. A total of 63% young people transitioned to community placements and adult medium secure services. Four pathways describing the journey into and out of adolescent medium secure services were identified in a subsample of 12 young people. A total of 25% young people with neurodevelopmental problems moved to specialist services.

The results suggest that diagnosis, severity of offence and clinical background are associated with transition pathway. Promoting a person-centred approach and gradual independence of the young person may improve current practice.

These results inform existing policy and clinical practice in an effort to reform transition guidelines around young people’s needs during transition times. Further studies in adolescent forensic services are needed to understand complex neurodevelopmental problems and comorbidities.

The purpose of this paper is to provide a commentary on “Learning disability services: user views on transition planning”.

The commentary provides a discussion of the concept of continuity of care (Forbes et al., 2001; Freeman et al., 2000) in relation to transition from children’s to adults’ services for young people with intellectual/developmental disabilities.

Continuity of care is an important consideration for this population and is emphasised in recent policy initiatives in England, as well as being highlighted by young people and their families as a significant aspect of their transition experience. Despite this, evidence suggests it is not currently achieved for many young people and their families, and a number of challenges that may contribute to this are highlighted.

The commentary emphasises that continuity of care should be a key consideration for services supporting young people and their families at transition.

The White Paper Valuing People (DoH, 2003) promises to increase choice and control for adults with a learning disability, housing being one area specifically highlighted in this respect. However, lack of knowledge about the preferences of adults with a learning disability makes it very difficult for services to be planned effectively and based on the views of the very group who will use them. This paper discusses the findings of a project which aimed to involve adults with a learning disability in service planning, by asking them to identify their own needs and preferences in relation to housing. The project clearly emphasises that adults with a learning disability are often very well able to articulate their own needs about housing, and should thus be the focus of all decisions.

This article describes one of the issues that arose from my research into the Longcare abuse scandal: how local authorities place learning‐disabled adults in out‐of‐area settings far from their original homes, and then fail to visit them regularly to check on their welfare. It describes the failings of three local and health authorities in the Longcare case, and then reveals that the problem was not confined to those authorities that placed adults at the Longcare homes. It also suggests that placing vulnerable adults in out‐of‐area homes puts them at a greater risk of abuse. The article concludes that, ten years on from the exposure of the Longcare regime, many local authorities are still placing vulnerable adults in out‐of‐area homes and failing to visit them. It calls for a national audit of out‐of‐area placements and for measures to be introduced to allow learning‐disabled adults to live in placements closer to their families and friends… and care managers.

Approximately 3000 children and young people with learning disabilities attend residential schools or other residential placements. Many of these young people have complex needs, and their placement reflects a failure of local provision to support their families and provide inclusive local services. Such placements reduce family contact, increase young people's vulnerability and accentuate the difficulties of transition to local adult provision. We should reduce the need for residential school placements by substantially improving the quality of family support and the capacity and inclusiveness of local services. Returning young people to their local communities requires a significant improvement in local authority planning so that local capacity can be developed to meet their needs.

The purpose of this paper is to investigate the characteristics of the highest cost residential placements provided for adults with learning disabilities in the South East of England, comparing findings with a previous survey.

Lead commissioners for NHS and Local Authority teams in the South-East of England were asked to provide information on the five highest cost placements that they currently commissioned.

The average placement cost was £200,000 per annum with a range from £81,000 to £430,000 per annum. Individual characteristics of people placed were broadly similar to those identified in previous studies.

Significant resources are used to support relatively few individuals. These individuals’ needs and characteristics suggest areas for research and practice development.

The purpose of this paper is to report on the views and experiences of older people using Shared Lives (adult placement) in 2012/2013.

As part of a survey collecting information about outcomes for older users of Shared Lives issues of whether it had made a difference to quality of life, and positive and negative experiences of support were explored.

Questionnaires were returned by 150 older people using Shared Lives services. Findings suggest that this model of community-based support has a number of advantages for some older people, such as reducing social isolation and loneliness, promoting independence, choice and control, providing emotional support and increased well-being.

The questionnaire was self-completed and so responses were not followed up to provide deeper insights.

Shared Lives is not appropriate for everyone but it is suggested that this option should form part of local commissioning strategies, be part of a range of options for social care practitioners to consider in their work with older people and helps to meet various current policy imperatives.

The potential of Shared Lives for older people is under-researched and this paper contributes to the literature in exploring the views of older people about family-based support in the community.

Findings from a comparative qualitative study with parents in the USA and China increase the understanding of experiences of adults with autism in both countries.

Semi-Structured interviews were conducted with families in the USA and in China. In total, 18 families participated in the study – 7 in the USA, 11 in China.

Analysis of the comparative data led to the emergence of three overarching themes, expressing both similarities and differences in experiences: 1) transition to adult services plays out differently in the two nations, 2) parent advocacy and efforts in supporting and securing services for their children are strong in both countries but are also defined by the variability in access to services and 3) due to the scarcity of adult services in their country, Chinese parents express significantly more worries about their own aging and mortality as compared with USA parents.

Practical implications and directions for future research are discussed.

By examining the experiences of families of adults with autism in the USA and China, the research reveals themes that would not be visible in a single-nation study.