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The purpose of this paper is to present an evaluation of a programme of training and support provided to staff, which aimed to encourage supported communication environments for people with learning disabilities.

Training, monitoring and support for communication, specifically augmentative and alternative communication (AAC) strategies, was provided by speech and language therapy staff to two residential services over 46 weeks. Staff and service user communications were observed pre- and post-intervention.

In one provision there was an increase in service user initiations and the use of some AAC strategies by support staff. In the other provision there was no change in service user initiations and a decrease in the range of AAC strategies used. It appears that some forms for AAC remain challenging for staff to implement.

This evaluation explores ways of using specialist support services to improve communication environments for people with learning difficulties. Possible reasons for differences in the outcome of the intervention are discussed. Future research into the types of communication interactions experienced by people with learning disabilities across the range of communication styles may be useful so that support staff can be better helped to provide sustained and enriched communication environments.

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The mechanical restraint restricts their freedom of movement to help prevent injury. Despite the growing literature on the use of such devices, there is very limited literature looking at the impact the use of mechanical restraints has upon service users and support staff using them. The aim of this study was to ascertain the experiences of support staff who apply the restraints to the people they support.

Qualitative methodology was utilised. A semi-structured interview was conducted with nine support workers who: directly worked with a client with intellectual disabilities who engage in self-injurious behaviours; followed positive behavioural support plans developed with a multi-disciplinary team; applied restraints as a response to severe self-injurious behaviours to prevent harm; and they had to have been directly involved in the application and removal of the mechanical restraints in the last week. Content analysis utilising emergent coding was used to analyse the data.

All participants described using mechanical restraints as having a negative impact upon them. Participants said they manage the negative impact by reframing, inhibiting their emotions, following support plans closely and gaining support from other staff. Participants described concerns and unmet needs regarding whether they were applying the restraints correctly, the responsibility of teaching others to use restraints, not feeling prepared on starting their current job and that the impact/concerns of using restraints is not talked about. Recommendations for practice are made.

This is the first study to explore the views of care staff who are required to use mechanical restraint. It provides insight on the impact of this on them.

Teachers play a vital role in the structure of their classrooms. Part of this structure is having a clear understanding of the importance of not only supporting their students, but also the teacher assistants/support staff with whom they collaborate. Providing teacher assistants/support staff with guidance, information on student needs and classroom structures, team-building strategies, training, and supervision sets the stage for a positive climate for collaboration, teamwork, and learning. Consequently, teachers should be proactive and diligent to ensure high-quality training and supervision for teacher assistants/support staff, as this will have a direct impact on the services and learning opportunities being provided to the students.

This paper introduces some of the research that has been conducted into staff stress in learning disability services. It also examines how some individual characteristics of service users, particularly challenging behaviour and mental health problems, may influence the levels of staff stress reported. Service changes as a result of the development of supported living are also considered briefly. Some suggestions are made as to how these changes might influence staff. The importance of new research investigating these developments from a staff perspective is highlighted.

The purpose of this paper is to examine how faculty staff on health and social care programmes support students with mental health issues.

The study used a qualitative survey design to gain in-depth information on faculty staff experiences. Seventy-one faculty staff at two universities in the South East of England out of an eligible population of 115 staff responded to an anonymous online questionnaire which were thematically analysed.

The findings indicated that faculty staff faced uncertainties in providing support to students with mental health needs. They reported tensions between their academic, professional and pastoral roles. There was a wide recognition that supporting students was physically and emotionally demanding for faculty staff and especially challenging when their roles and expectations were unclear. This was compounded by lack of explicit guidelines and an apparent severed connection between faculty staff and student support services.

A need for clearly defined roles and responsibilities for faculty staff in supporting students with mental health needs including a review of their pastoral role were identified. The study reinforces the need for effective collaborative arrangements and collective decision making and clearer procedures in the planning and implementation of students' personal support plans. A concerted effort into adopting a transpersonal approach which incorporates mental health staff awareness training, restorative spaces for reflection and supportive pathways for faculty staff are recommended.

This paper provides rare empirical evidence of faculty staff views on their role in supporting students with mental health needs on health and social care programmes.

The health and well-being of healthcare staff came into focus during the coronavirus disease-2019 (COVID-19) pandemic as already strained workforces responded to new and additional challenges. Organisational support services made efforts to adapt staff support provision. However, most literature and recommendations are centred on surveys of medical and clinical staff. The present study included staff across clinical and non-clinical workforces within a mental health trust over the course of the COVID-19 pandemic to date, and aimed to understand workforces' access to and experiences of organisational support.

The current study was a qualitative one using convenience and purposive sampling. Semi-structured individual and group interviews were conducted using a topic guide. Reflexive thematic analysis was used in a phenomenological framework to analyse data.

35 staff, broadly representative of the trust workforce, were recruited. Six global themes summarised the experiences of staff in relation to work practices, personal well-being and support access over the first year of the COVID-19 pandemic: COVID-19 disease, interpersonal relationships, individual considerations, change, working environment and support.

The findings from the study have implications for organisational support provisions for healthcare workers and the dissemination of these services.

Acknowledging the multi-various experiences of different workforces within National Healthcare Service organisations and how these change over time will facilitate innovative changes to staff support provision.

Staff working in forensic inpatient settings are at increased risk of harm perpetrated by patients. Support offered in response to such incidents can have a significant impact on how staff recover. The purpose of this paper is to explore how staff support procedures implemented in one low-secure forensic service impacted on staff recovery.

In total, 11 members of staff who had direct patient contact volunteered from an opportunity sample. Semi-structured interviews were conducted with each participant, asking about experiences of abuse at work and subsequent staff support procedures. Interviews were analysed using thematic analysis.

Four overarching themes were identified; experiences of harm, supported recovery, missed opportunities and therapeutic relationships. This led to a better understanding of how staff coped with incidents of abuse at work and how support procedures impacted on their recovery.

The service evaluation was limited by transferability of the findings. The process of sampling may have meant there were biases in those who volunteered to take part. Further projects such as this are required to develop the themes identified.

Findings led to the development of a new integrated model of staff support.

This was one of the first studies in the UK to formally evaluate a staff support procedure in forensic low-secure services and include experiences of both clinical and non-clinical staff who are regularly exposed to potentially harmful events.

The purpose of this paper is to explore the perceived needs of junior nurses working with women with learning disabilities in a secure setting who display violence and aggression; and to contribute to this specialised area of research and to identify potential areas for further post registration education.

The study adopted a qualitative design using thematic analysis. Initial questionnaires were distributed and the results analysed in order to form initial themes. These initial themes were then used to carry out a one-off focus group and this was transcribed verbatim and then analysed using Braun and Clarke thematic analysis to develop final themes.

The findings identified a need for staff to be able to access effective immediate support following incidents of violence and aggression and support be offered within a clear structured environment. Staff indicated that peer supervision be made available and that they also receive adequate education relating to gender specific issues and the use of seclusion.

The research had several limitations. These included a small sample size which was also largely self-selected. Bias may have to be acknowledged in respect of completion of questionnaires depending on their view of participation and what they might be contributing to. Despite this the results do raise further questions such as staff decision making around the use of seclusion.

Implications centred around the organisation’s delivery of education to staff in relation to the clinical decision-making skills they require in order to effectively support women with learning disabilities who display violent and/or aggressive behaviour. The study also has implications for potential supervision structures currently offered within these services.

This paper fulfils a need to explore services for women with a learning disability further and how services can be shaped using current perspective and up to date research in line with recent policy, e.g. Corston Report (Home Office, 2007).

Lámh is the Irish approach to key word signing (KWS). It was designed to support children and adults with intellectual and developmental disabilities (IDD) (including people with autism) and/or communication needs in Ireland. The purpose of this paper is to determine the level of Lámh use in a large organisation for children and adults with IDD and identify factors influencing use.

An online questionnaire was distributed to 950 staff members in the aforementioned organisation.

The response rate was 23 per cent (n = 217), with the majority of respondents indicating a belief that all staff should know some key signs (96 per cent) and that Lámh has a positive impact on communication (89 per cent). In sum, 18 per cent of staff who supported a Lámh user reported that they rarely or never use signs. There was a significant association between client group (children or adults) and frequency of Lámh use by staff, with greater use reported in children’s services.

Overall, a positive attitude towards Lámh was identified amongst staff within the organisation. Despite this, there is evidence of inadequate support for Lámh users, particularly in adult services. Identified barriers which impacted the implementation of Lámh included inconsistencies in organisational culture, levels of support and access to training. A consistent Lámh signing environment is crucial to the successful use of Lámh as a communication method. This study suggests that the level of support required to create a consistent signing environment may be underestimated.

This is the first study to evaluate the reported use of key word sign in an Irish disability setting. The findings will be of benefit to any staff members supporting KWS users and, in particular, those involved in the provision of KWS training.

Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person‐centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid both to training staff and to the motivational structures within the organisation. Both the quality of support provided by staff and the level of engagement increased significantly after the introduction of person‐centred active support. In addition, people experienced decreased self‐stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learnt about the implementation are provided.