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The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use.

Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing.

Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care.

This paper is a first attempt to compare national social care statistics concerning day services and home care for 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.

Having paid work, relationships and a choice of where to live are common policy priorities for adults with intellectual disabilities. The purpose of this paper is to compare outcomes with respect to these three priorities between adults with intellectual disability and the general population in Jersey.

Data were collected from 217 adults with intellectual disability known to services, and 2,350 adults without intellectual disability using a stratified random sample. Data on employment, marital status and accommodation profiles were compared.

In sum, 87 per cent of adults with intellectual disability were currently single vs 16 per cent of adults without intellectual disability; 23 per cent of working-age adults with intellectual disability were in paid employment vs 92 per cent of working-age adults without intellectual disability; and 57 per cent of adults with intellectual disability lived-in sheltered housing vs 2 per cent of adults without intellectual disability.

Very few adults with intellectual disability are in paid employment or intimate relationships, and the majority live in sheltered, supported housing, with very few owning their own home. There is a significant disconnect between policy and reality. Considerable work is required to make an ordinary life the reality for adults with intellectual disability.

This study adds to the body of evidence that suggests people with intellectual disabilities are less likely to experience an ordinary life. Furthermore, it illustrates that despite Jersey being an affluent society, the same difficulties and barriers exist there for persons with an intellectual disability as in other jurisdictions.

People with learning disabilities are at risk of poor health and premature death. Due to these inequalities, NHS trusts are required to make reasonable adjustments to their care, such as longer appointment times, with the legal duty on them being “anticipatory”. The paper aims to discuss these issues.

Secondary analysis of CQC acute hospital inspection reports asking the following research questions: Do CQC inspection reports mention people with learning disabilities? Where issues concerning people with learning disabilities are reported in CQC hospital inspection reports, what issues and reasonable adjustments are reported? Are there any relationships between comments made in the inspection reports and CQC ratings of the trusts?

In total, 29 of the 30 trust-wide inspection reports (97 per cent) and 58 of the 61 specific site reports (95 per cent) included at least one mention of people with learning disability/ies. Most comments about practices for people with learning disabilities were positive across all CQC inspection output types and across all CQC overall ratings, although the proportion of positive comments decreased and the proportion of negative comments increased as CQC ratings became less positive.

Overall the authors found that CQC inspection reports routinely contained some information regarding how well the hospitals were working for people with learning disabilities. The depth of information in reports varied across trusts, with the potential for CQC reports to more consistently report information collected during inspections.

The report updates and extends a report published by the Public Health England Learning Disabilities Observatory in 2015.

The purpose of this paper is to examine data on absences and exclusions from school amongst children with learning disabilities and autistic children in England in 2016/2017.

Data were drawn from Department for Education statistics for the school year 2016/2017 on school absences (authorised and unauthorised) and school exclusions (fixed-period and permanent) for children in the primary special educational needs categories of moderate learning difficulty (MLD), severe learning difficulty (SLD), profound and multiple learning difficulty (PMLD) and autistic spectrum disorder (ASD).

Authorised school absence rates were higher for all groups of children investigated compared to children without special educational needs, primarily due to illnesses and health-related appointments. Rates of unauthorised school absences were low. Rates of fixed-period and permanent school exclusions were higher for children with MLD and ASD compared to children without SEN, and lower for children with SLD and PMLD. Reasons given for exclusions were similar across children (persistent disruptive behaviour, physical assault against a pupil, verbal abuse against an adult), although physical assault against an adult was also commonly mentioned for children with SLD, PMLD or ASD.

Reducing school absences for children with learning disabilities and autistic children will involve co-ordination of health and social care support arrangements to ensure they are convenient and efficient for children and families. In terms of exclusions, schools need to consider the extent to which they are making reasonable adjustments for children with learning disabilities and autistic children.

This paper presents in one place statistics concerning school absences and school exclusions for children with learning disabilities and autistic children in England.

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

The purpose of this paper is to examine trends over time and geographical variation in rates of paid employment amongst working age adults with learning disabilities receiving long-term social care in England.

Data were drawn from NHS Digital adult social care statistics examining paid/self-employment for working age (18-64 years) adults with learning disabilities known to social care (2008/2009 to 2013/2014) or receiving long-term social care (2014/2015 to 2016/2017).

In 2016/2017, councils reported that 5.7 per cent of working age adults (7,422 people) with learning disabilities receiving long-term social care were in paid/self-employment, with higher employment rates for men than women and most people working less than 16 hours per week. Paid employment rates seem to be slightly declining over time, and there is wide variation across councils in reported paid/self-employment rates.

Despite good evidence for the cost effectiveness of supported employment support, employment rates for adults with learning disabilities receiving long-term social care remain extremely low.

This paper presents in one place statistics concerning the paid employment of working age adults with learning disabilities in England.

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.

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.

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.

Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences.

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.

The purpose of this paper is to analyse trends over time and geographical variation in Deprivation of Liberty Safeguards (DoLS) applications for adults with learning disabilities.

Secondary analysis of national- and local authority-level statistics collected and reported by NHS Digital.

There has been a sharp national increase in the number of completed and granted DoLS applications regarding adults with learning disabilities since the 2014 “Cheshire West” Supreme Court judgement, with a greater proportion of completed DoLS applications being granted. There is extreme geographical variation across local authorities in England in the rates at which DoLS applications are being made and granted.

The extreme variation in DoLS applications regarding adults with learning disabilities is highly unlikely to be a function of differences in mental capacity and living circumstances experienced by adults with learning disabilities across local authorities, and urgent attention needs to be paid to this variation.

This is the first paper to analyse the geographical variation at local authority level for completed and granted DoLS applications regarding adults with learning disabilities.

People with learning disabilities may experience discrimination which prevents them from exercising choice and control over their right to participate in democratic processes. The paper aims to discuss this issue.

Taking data collected by social workers during a campaign from the 2015 UK General Election, this paper analyses the variables associated with higher rates of democratic participation by people with learning disabilities.

The present authors undertook secondary analysis on data collected by social workers supporting adults with learning disabilities who were living in community housing units. In total, 1,019 people with learning disabilities who were living in 124 community housing units in one English county gave consent to participate. In total, 84 per cent were registered to vote and 26 per cent cast a vote on polling day. People were significantly more likely to cast a vote if they lived in a housing unit where they understood their rights (Wald χ² =4.896, p=0.027).

The analyses are consistent with the hypothesis that supporting people with learning disabilities to understand their right to participate in elections increases the likelihood they will cast a vote on a polling day. There are practical implications from this finding for commissioning practices, support planning, and education of health and social care practitioners.

This is the first study of this size which examines data from people with learning disabilities on their experience of democratic participation and the role of social work.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions of people worldwide. Individuals with intellectual disability are at a disproportionate risk of mortality, given the health inequalities they experience. This puts a significant burden of responsibility on staff who support these individuals. Consequently, this study aims to establish a baseline of the well-being of staff working in intellectual disability services in Ireland during the COVID-19 pandemic.

An online survey was carried out using the Copenhagen Burnout Inventory, a brief measure of depression (Patient Health Questionnaire-9) and a brief measure of anxiety (General Anxiety Disorder-7).

In total, 285 staff in the Republic of Ireland completed the survey. These staff reported moderate levels of personal and work-related burnout and mild levels of anxiety and depression. Higher mean scores were recorded across scales from staff who worked in independent living settings and from staff who supported individuals with challenging behaviour.

This study, an audit, provides initial data on the well-being of staff working with individuals with intellectual disability in Ireland during the COVID-19 pandemic. It highlights that employers need to consider staff well-being, given the levels of personal and work-related burnout, and anxiety and depression that were found. This is particularly true for staff who work in independent living settings and with adults with challenging behaviour. Future research should focus on proactive strategies for improving staff well-being in the short term, given the current resurgence of COVID-19 in Ireland.