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1 – 10 of over 20000This article reviews the literature on personality disorder in offenders with learning disabilities, using Medline, PsychoInfo and CINAHL databases, and search terms ‘offending’…
Abstract
This article reviews the literature on personality disorder in offenders with learning disabilities, using Medline, PsychoInfo and CINAHL databases, and search terms ‘offending’, ‘personality disorder and intellectual disabilities’, ‘learning disabilities’ and related terms. Methods of defining offending population, personality disorder and learning disabilities vary greatly, and few studies focus specifically on personality disorder, learning disability and offending. The definition of learning disability often encompasses both borderline learning disability and low average intelligence. Personality disorder, especially anti‐social personality disorder, is prevalent in offenders with learning disabilities, but less than in the general population, and is associated with higher levels of security and poorer outcomes. The study concludes that there is a continuum of offenders with borderline and mild learning disabilities, reflected in learning disability forensic services.
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Pauline Heslop and Anna Marriott
This paper aims to outline the process of undertaking the Confidential Inquiry (CI) into the deaths of people with learning disabilities and discusses three particular issues…
Abstract
Purpose
This paper aims to outline the process of undertaking the Confidential Inquiry (CI) into the deaths of people with learning disabilities and discusses three particular issues: engaging with professionals; maintaining confidentiality; and the tension between wanting to base the findings on a sufficiently large number of cases so that the findings are robust and reliable, but also wanting to make immediate changes to any potentially modifiable factors found to contribute to the deaths of people with learning disabilities.
Design/methodology/approach
The CI into the deaths of people with learning disabilities reviews the deaths of all people with learning disabilities living in the (former) Avon and Gloucestershire areas. It has been commissioned by the Department of Health to run until March 2013. One of the key drivers for a CI has been the work of Mencap in exposing the unequal health care that some people with learning disabilities received in the NHS.
Findings
The principal goal of the CI is to improve the standard and quality of care for people with learning disabilities and ultimately their health outcomes. The CI team aims to detect potentially modifiable contributory factors in the care of a person with learning disabilities who has subsequently died, share any examples of good practice in their care and provide information to guide the commissioning of services.
Originality/value
It is anticipated that the findings of the CI will provide a considerable amount of evidence on which to improve the standard and quality of care for people with learning disabilities and ultimately their health outcomes.
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Indermeet Sawhney, John Morgan and Afsaneh Tajer
The National Health Service Plan (DoH, 2000) requires that patients receive copies of correspondence between health professionals about them, as of right. Patients with learning…
Abstract
The National Health Service Plan (DoH, 2000) requires that patients receive copies of correspondence between health professionals about them, as of right. Patients with learning disabilities are not exempt from this rule. Copying letters to patients with learning disabilities is undoubtedly going to be challenging and complex for professionals working with them and, because of the heterogeneous nature of this group, specific guidelines need to be in place to support professionals in this task. The aim of the study was to ascertain the views of various professionals working in learning disability teams, on the copying of clinical letters to patients and their carers. The majority of respondents commented that, if letters are copied to patients with learning disabilities, then the persons may find it difficult to understand them, and a separate ‘simpler’ letter may need to be sent. Despite expressing concerns about this policy, the majority stated that they will be sending copies of letters regularly in their clinical practice in the future.
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Susannah Baines and Chris Hatton
Joint Strategic Needs Assessments (JSNAs) are required for every local authority in England, and should contain information to allow for strategic health and wellbeing planning…
Abstract
Purpose
Joint Strategic Needs Assessments (JSNAs) are required for every local authority in England, and should contain information to allow for strategic health and wellbeing planning for the local population, including disabled people. A 2013 analysis of JSNAs showed that JSNAs were not routinely including information on the numbers and health needs of people with learning disabilities, particularly children. The purpose of this paper is to compare the information included in 2013 and 2014 JSNAs.
Design/methodology/approach
JSNAs for 141 local authorities in England were sought. Local authorities were contacted when JSNAs were not initially found online. All 137 JSNAs found were analysed for mentions and specific sections concerning people with learning disabilities, and content analysed concerning the specific information they contained.
Findings
In total, 72 per cent of JSNAs mentioned people with learning disabilities (vs 82 per cent in 2013); 24 per cent mentioned children (vs 39 per cent in 2013) and 72 per cent mentioned adults (vs 81 per cent in 2013). Overall, 13 per cent of JSNAs included a section on children with learning disabilities (vs 9 per cent in 2013), 65 per cent included a section on adults (vs 48 per cent in 2013) and 11 per cent included a section on older adults (vs 8 per cent in the 2013). More JSNAs contained information on current and projected future populations, health needs, social context and service usage concerning adults with learning disabilities compared to children. There was large regional variation in all these indicators.
Originality/value
Further work is needed for JSNAs to contain sufficient information on people with learning disabilities to allow for strategic planning, and for JSNAs to be accessible to the public.
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The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and…
Abstract
Purpose
The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland.
Design/methodology/approach
National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use.
Findings
There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK.
Social implications
Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences.
Originality/value
This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.
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Richard Parrott, Nigel Tilley and John Wolstenholme
This article describes the changes in the population of people with learning disabilities in Sheffield and the associated demand for specialist learning disability services…
Abstract
This article describes the changes in the population of people with learning disabilities in Sheffield and the associated demand for specialist learning disability services, primary and acute health services and the wider public realm. It comments particularly on people with the most complex needs. The study to produce this data was in two parts: an analysis of changes in the overall number of people with a learning disability which included a projection of how the number might change over the next ten years, and an analysis of the health and support needs of young people with profound and multiple learning disabilities (PMLD), and how these might change in the future. The findings are compelling. The overall number of people with a learning disability in Sheffield increased by 25% in the 10 years from 1998 to 2008, the number of children and young people with a learning disability increased by nearly 120% and young people with PMLD were found to have an unprecedented level of health and social care need, which will increase further as they enter adulthood. The implications of the findings are discussed and suggestions for further research are offered.
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Janet Cobb, Alison Giraud‐Saunders and Mike Kerr
This article addresses the need for health checks for people with learning disabilities as a proven route to identifying and tackling health inequalities, what health checks…
Abstract
This article addresses the need for health checks for people with learning disabilities as a proven route to identifying and tackling health inequalities, what health checks should look like (covering physical and mental health) and how they should be followed up, and how practices and primary care trusts (PCTs) can implement health checks, involving people with learning disabilities and family carers and drawing on the expertise of community learning disability teams. Experience from Wales and England of offering health checks is described, and some key learning points are drawn out. In particular we recommend the appointment of a strategic health facilitator to lead the introduction of health checks and to ensure that the results are used to improve the health and health care of the population of people with learning disabilities.
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Shamim Dinani, Wendy Goodman, Charlotte Swift and Teresa Treasure
This paper reports on the first eight years of a community‐based forensic team for people with learning disabilities. The authors give an overview of current research and…
Abstract
This paper reports on the first eight years of a community‐based forensic team for people with learning disabilities. The authors give an overview of current research and government guidance regarding the prevalence, care pathway and treatment of people with learning disabilities who offend. The role and function of the community forensic team is described and an analysis of referrals to the service is given. The authors reflect on the frustrations as well as the achievements associated with providing this service.
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Neill Simpson, Margaret Whoriskey and Michael McCue
Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations…
Abstract
Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations are responding to the spectrum of mental health needs by working in partnership to improve quality. This article describes this system and the key organisations, and presents some findings of the National Overview Report of services undertaken by NHS Quality Improvement Scotland.
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Alison Giraud‐Saunders, Margaret Gregory, Richard Poxton, Cathy Smith and David Towell
Findings and good practice are reported from a project promoting engagement of PCTs with the health experiences of people with learning disabilities. Project work was most…
Abstract
Findings and good practice are reported from a project promoting engagement of PCTs with the health experiences of people with learning disabilities. Project work was most successful where it linked into mainstream NHS priorities, using good information and specialists' expertise to support mainstream practitioners.
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