Verity Chester, Anthony Scott Brown, John Devapriam, Sharon Axby, Claire Hargreaves and Rohit Shankar
There is increasing emphasis on caring for people with intellectual disabilities in the least restrictive, ideally community settings. Therefore, the purpose of this paper is to…
Abstract
Purpose
There is increasing emphasis on caring for people with intellectual disabilities in the least restrictive, ideally community settings. Therefore, the purpose of this paper is to explore the risk factors considered by clinicians involved in discharging people from secure services.
Design/methodology/approach
The views of five senior clinicians were sought in semi structured interviews. Data were analysed thematically.
Findings
Themes related to risk assessment, risk management, and multidisciplinary and multiagency working. Illustrative quotes are used to evidence themes.
Practical implications
This study described the risk assessment and management factors considered during the discharge of patients from secure to community services, which are of direct relevance to multiple stakeholders post-Winterbourne.
Originality/value
Challenges when facilitating discharge were highlighted, such as ongoing risk management issues, or unexpected discharge from tribunals, and how these were addressed, via the development of extensive risk assessment and management processes, and interdisciplinary and interagency working.
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Rachel Dodds, Sonya Graci, Soyoung Ko and Lindsay Walker
While global wine consumption is growing, environmental sustainability in the wine industry is also receiving increased attention from retailers, governments, environmental…
Abstract
Purpose
While global wine consumption is growing, environmental sustainability in the wine industry is also receiving increased attention from retailers, governments, environmental groups, and consumers. New Zealand has experienced a winery boom over the past two decades with a 173 per cent increase in the number of wineries. Along with this growth, wineries are also facing issues such as water consumption, its impact on community, and waste management. The study therefore seeks to examine: the current sustainability initiatives undertaken by wineries; what drives the wine industry to engage in sustainable practices; and barriers to implementing sustainable practices.
Design/methodology/approach
Using a mixed method research approach, this study uses a triangulated approach to examine interviews and questionnaires to determine motivations and elements of influence.
Findings
This study found that the strong drivers for the sustainability initiatives are their concern about the state of the environment and social responsibility, followed by requirements for exporting and protection of agricultural land.
Research limitations/implications
A limitation of this study was a low response rate from the online questionnaire, which may influence or bias study results. However, detailed face‐to‐face interviews help to gain clarification on concepts and study results.
Practical implications
While global wine consumption is growing, environmental sustainability in the wine industry is also receiving increasing attention from retailers, governments, environmental groups and consumers. New Zealand has experienced a winery boom over the past two decades with a 173 per cent increase in the number of wineries. Along with this growth, wineries are also facing issues such as water consumption, its impact on community, and waste management.
Originality/value
Although there are many studies about the wine industry, relatively few studies have examined sustainability elements from a mixed‐method approach to determine practical elements which may influence practices undertaken. It also examines practices undertaken by wineries, barriers to implementation and incentives to further implementation.
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Mahesh Odiyoor, Samuel Joseph Tromans, Regi T. Alexander, Srinaveen Akbari, Gill Bell, Sandy Bering, Sujeet Jaydeokar and Amrith Shetty
The purpose of this paper is to provide a professional consensus position with regard to the provision of specialist inpatient rehabilitation services for people with intellectual…
Abstract
Purpose
The purpose of this paper is to provide a professional consensus position with regard to the provision of specialist inpatient rehabilitation services for people with intellectual disability (ID), autism and mental health, behavioural or forensic needs in the UK.
Design/methodology/approach
The concept of rehabilitation is discussed, as well as the functions and goals of specialist inpatient rehabilitation services with regard to the aforementioned contexts. Current use of rehabilitation beds is considered, both on a regional and national scale, as well as various outcome measures, including effectiveness, patient safety and patient experience.
Findings
There is a clear need for specialist inpatient rehabilitation services, though historically there have been instances of inappropriate admissions, as well as lengthy inpatient stays that could have been significantly reduced with the right type of community support package. Such services should be subjected to rigorous measurement of outcome measures, to determine that patients within such services are receiving a consistently high standard of care. Additionally, amendments to current legal frameworks should be considered, with a view to accommodating for individuals with capacity who require continuous community-based supervision.
Originality/value
To the best of the author’s knowledge, this is the first article detailing a professional consensus position for specialist inpatient rehabilitation services for people with ID, autism and mental health, behavioural or forensic needs.
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Loretta Newman-Ford, Sophie Leslie and Sue Tangney
This chapter discusses the pilot study of an Education for Sustainable Development Self-Evaluation Tool (ESD-SET), created by the Quality Enhancement Directorate (formerly the…
Abstract
This chapter discusses the pilot study of an Education for Sustainable Development Self-Evaluation Tool (ESD-SET), created by the Quality Enhancement Directorate (formerly the Learning and Teaching Development Unit) at Cardiff Metropolitan University, as both a means of auditing the extent to which academic programs embed ESD and a catalyst for curriculum development.
The chapter evaluates the effectiveness and usefulness of the self-evaluation for both auditing ESD and curriculum development. Responses to the self-evaluation questions by Programme Directors were analyzed and follow-up interviews carried out with the Programme Directors to explore their experiences of the tool.
Results indicate that the self-evaluation tool is fit-for-purpose as a means of auditing the integration of ESD within academic programs. The self-evaluation exercise promoted team discussion around sustainability issues and raised staff awareness and understanding of the concept of ESD and how to effectively embed sustainability-related themes within their discipline. The exercise had a transformative impact on the way some program teams approached curriculum design and delivery. There was evidence that engagement with the tool contributed to further embedding of sustainability within curricula across all disciplines involved in the pilot study.
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William Lindsay and Fiona Macleod
This paper reviews several issues in relation to offenders with intellectual disabilities. Although some authors have indicated an increased prevalence of offenders amongst the…
Abstract
This paper reviews several issues in relation to offenders with intellectual disabilities. Although some authors have indicated an increased prevalence of offenders amongst the population of individuals with intellectual disabilities, other carefully controlled studies using recognised IQ tests have found only slightly increased incidences. Studies conducted in forensic settings have reported results somewhat different to those conducted in clinical settings with respect to both prevalence and characteristics. It is noted that individuals with learning disabilities commit offences across the spectrum of criminal behaviours but there may be some over‐representation in sexual offences and arson. Issues of assessment and treatment are also addressed with comments being made on extensions of interventions into community settings. With the amount of research increasing over the last 10 years, we are becoming clearer about the relevant issues involved in designing studies, developing assessments and providing treatment to this client group.
Helen Walker, Lindsay Tulloch, Karen Boa, Gordon Ritchie and John Thompson
A major difficulty identified many years ago in psychiatric care is the shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments…
Abstract
Purpose
A major difficulty identified many years ago in psychiatric care is the shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments which are behaviourally based and therefore appropriate for use in a variety of contexts. The aim of this project was to ascertain the utility of a forensic nursing risk assessment tool - Behavioural Status Index (BEST-Index). The paper aims to discuss these issues.
Design/methodology/approach
A multi-site cross-sectional survey was undertaken using mixed method design. Quantitative data was generated using BEST-Index to allow comparisons across three different levels of security (high, medium and low) in Scotland and Ireland. Qualitative data were gathered from patients and multi-disciplinary team (MDT) members using semi-structured interviews and questionnaire.
Findings
Measured over an 18-month period, there was a statistically significant improvement in behaviour, when comparing patients in high and medium secure hospitals. Two key themes emerged from patient and staff perspectives: “acceptance of the process” and “production and delivery of information”, respectively. The wider MDT acknowledge the value of nursing risk assessment, but require adequate information to enable them to interpret findings. Collaborating with patients to undertake risk assessments can enhance future care planning.
Research limitations/implications
Studies using cross-section can only provide information at fixed points in time.
Practical implications
The BEST-Index assessment tool is well established in clinical practice and has demonstrated good utility.
Originality/value
This project has served to highlight the unique contribution of BEST-Index to both staff and patients alike and confirm its robustness and versatility across differing levels of security in Scottish and Irish forensic mental health services.
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Lindsay Tulloch, Helen Walker and Robin Ion
Incidents of violence and aggression are a regular occurrence within adult forensic mental health inpatient settings and often lead to the use of restrictive practices such as…
Abstract
Purpose
Incidents of violence and aggression are a regular occurrence within adult forensic mental health inpatient settings and often lead to the use of restrictive practices such as seclusion. Such events are frequently attributed to the complexity of the patients. Research commonly focuses on patient’s characteristics and their association with seclusion use. Less attention has been centred on forensic mental health nurses’ attitudes to seclusion and the association of nursing staff characteristics.
Design/methodology/approach
A cross-sectional survey was undertaken using a standardised questionnaire, “Survey of Nurses’ Attitudes to Seclusion”. Responses were received from n = 147 nurses at a high secure forensic mental health hospital in the UK.
Findings
Key findings indicate that most participants believed seclusion should remain part of clinical practice. A correlation was identified between forensic mental health nurses’ attitudes to seclusion use and their characteristics: gender, age range, educational level and experience.
Practical implications
This paper presents novel information on seclusion reduction opportunities through modifiable workforce factors such as gender-sensitive rostering and staff training and development. Furthermore, recruitment and retention strategies should be prioritised so forensic mental health is perceived as an attractive career and a safe workplace.
Originality/value
The paucity of research in this area has prompted calls for further research to explore nursing staff characteristics and seclusion use. This is particularly important now due to the current global difficulty in the recruitment and retention of mental health nurses.
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Gregory O'Brien, John Taylor, William Lindsay, Anthony Holland, Derek Carson, Lesley Steptoe, Karen Price, Claire Middleton and Jessica Wheeler
This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning disabilities (LD)…
Abstract
This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning disabilities (LD). The study covered three health regions in the UK and included 477 people with LD referred to services because of antisocial or offending behaviour during a 12‐month period. Data were collected concerning demographic, individual, offending behaviour and service characteristics. The findings of the study are broadly consistent with contemporary research concerning this population, particularly in relation to the nature and frequency of offending, history of offending, psychopathology, age and gender distribution. However, very few of those referred had any form of structured care plan, despite having significant offending histories, and this may have compromised early identification of their needs and communication between the health, social and other services involved.
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The purpose of this paper is to introduce counterfactual analysis and reasoning to the study of accounting history. The counterfactual focus is the institutionalisation of public…
Abstract
Purpose
The purpose of this paper is to introduce counterfactual analysis and reasoning to the study of accounting history. The counterfactual focus is the institutionalisation of public accountancy in the UK.
Design/methodology/approach
The study adopts a counterfactual research design using Ferguson and Bunzl and asks a “what if” question of an event of importance to accounting historians in order to create a plausible counterfactual outcome that is grounded in rationality and causal analysis. The specific counterfactual question relates to the royal charter granted to public accountants practicing in Edinburgh in 1854. The counterfactual outcome is compared to the actual timeline of public accountancy institutionalisation in the UK.
Findings
The “alternative” history reveals uncertainties that confronted public accountants in the past and provides a basis for suggesting that the current fractured and inefficient state of institutionalised public accountancy in the UK has its origins at least partially in the 1854 royal charter. It also suggests that attempts to register and unify public accountants in the UK have been hindered by nineteenth century royal charters.
Research limitations/implications
The study argues that counterfactual analysis is a useful historical tool with which to understand the consequences of historical decisions made in the professional project of British public accountancy. In addition, the study reveals the potential for counterfactual analysis to illumine the consequences of decisions in other areas of accounting and auditing history.
Originality/value
This study is the first counterfactual analysis in the accounting history literature and therefore provides a template for further studies and improved research design.