• Commentary on "Older carers of people with learning disabilities: Their experiences with local authority assessment processes and personnel"

      Gant, Valerie; University of Chester
      Purpose - The purpose of this paper is to provide a commentary on "Older carers of people with learning disabilities: their experiences with local authority assessment processes and personnel" written by Rachel Forrester-Jones. Design/methodology/approach - The commentary considers the experiences of older carers in the context of research, legislative and policy changes over the last 30+ years. Findings - The needs of older carers of adults with learning disabilities are well recognised within the (limited) literature. Less attention has been given to practical strategies to identify and support such carers or to their broader family context. Originality/value - This commentary highlights that assessors carrying out carers' needs assessments should consider whether adults with learning disabilities are providing care to their older relative. The recognition of possible mutual or reciprocal care needs to be acknowledged and appropriate support offered.
    • The discrepancy between actual and unreported incidents of violence in a learning disability nursing service

      Skellern, Joanne; Lovell, Andy; University of Chester (South West Yorkshire Mental Health NHS Trust and the University of Huddersfield, 2008-10)
      This study reports on research carried out within the Learning Disability Division of a major Mental Health NHS Trust in the North of England, and relates to the discrepancy between the actual number of incidents of violence and aggression and those reported. The literature review demonstrated that violence is a particular issue for nurses, particularly those working in the areas of mental health and learning disability where studies have indicated that as many as one in five may be affected. A questionnaire was distributed to all learning disability nurses currently employed in the Trust, a total of 411, with a response rate in excess of 40%. The study revealed that a discrepancy does exist between actual and reported incidents of violence within the Trust. It confirmed previous claims that the predominant difficulty is cultural, violence being regarded as part of the job and non-reporting primarily revolving around perceptions of incidents being considered 'minor', not worth the time to complete the paperwork. The paper concludes that more work is needed to achieve a united, consistent approach across the NHS, in order that a high quality, accessible service for people with learning disabilities and complex needs can be delivered without violence being considered an acceptable part of the job.
    • Employment

      Skellern, Joanne; University of Chester (SAGE, 2010-02-28)
      This book chapter discusses people with learning disabilites and employment, including the benefits and risks of the workplace for those with learning disabilities.
    • The health consultation experience for people with learning disabilities: A constructivist grounded theory study based on symbolic interactionism

      Chapman, Hazel M. (University of Chester, 2014-06-09)
      Aims. The aim of this study was to explore the effects of the health consultation experience for people with learning disabilities, particularly in terms of their self-concept Background. Annual health checks have been introduced as a reasonable adjustment for health providers to make in meeting the needs of people with learning disabilities, who experience significantly poorer health outcomes than the general population. Evaluation of the health consultation from the service user perspective can inform this service provision. Design. A constructivist grounded theory approach, based on symbolic interactionism, was used to explore the meaning of the health consultation experience for the person with learning disabilities, and its effects on their sense of self. Methods. Purposive and snowballing sampling was used to recruit 25 participants with learning disabilities through a GP practice, self-advocacy groups and a health facilitator. Nine individual interviews, three interviews with two participants, three focus groups (n=7, n=5 and n=3), and an audio-recorded health check consultation were carried out (with two participants interviewed twice and four attending two focus groups), as well as a member check used to assess the resonance of the findings. Data collection was undertaken in different primary care trusts across the north west of England. Data were subjected to constant comparative analysis, using a symbolic interactionist approach, to explore all aspects of the health consultation experience and its effects on the self. Findings. Current expectations, attitudes and feelings about health consultations were strongly influenced by previous experience. Participants negotiated their own reality within the consultation, which affected their self-concept and engagement with their health care. Respectful and secure health professional – service user relationships, developed over time, were central to an effective consultation. Perspectives on the consultation, and engagement within it, were co-constructed with a companion, who could help to promote the personhood of the service user with support from the health professional. Anxiety, embarrassment and felt stigma were identified as significant barriers to communication and engagement within the consultation. Conclusions. People with learning disabilities have similar health consultation needs and expectations to other people, but may have more difficulties in engaging with the process and building trusting relationships with the health professional, due to previous negative experiences, anticipated stigma and loss of self within health settings leading to a fear of disclosure. This, combined with difficulties in communication and cognitive processing, results in less satisfactory outcomes persisting over time. The effects of triadic consultations are generally positive, particularly where relatives or health facilitators are involved. However, continuity of companion as well as health professional is needed, and more service user engagement should be supported. Fundamental attitude change by health professionals, supported by specific educational initiatives to enhance their understanding of the service user perspective, is needed to reduce health inequalities. Participatory research by people with learning disabilities should inform future health care practice.
    • Investigation of the development of a 'career' of aggressive behaviour by people with learning disabilities

      Lovell, Andy; Skellern, Joanne; University of Chester (Kavanah, 2010)
      This paper aims to study the development of aggression over time in the lives of a group of individuals with learning difficulties.
    • Key concepts in learning disability

      Talbot, Pat; Astbury, Geoff; Mason, Tom; Faculty of Health and Social Care, University of Chester (SAGE, 2010-02-15)
      This book offers an A-Z format which covers a wide variety of topics on learning disabilities.
    • Managing risk: A qualitative study of community-based professionals working with learning-disabled sex offenders

      Hutchinson, John; Lovell, Andy; Mason, Tom; University of Chester (2012-02-19)
      This study reports on research conducted to examine how community practitioners manage the difficulties of risk assessment in relation to people with a learning disability and a history of sexually offensive or abusive behaviour. Semi-structured interviews were conducted with a number of key professionals from various disciplines, all currently involved in the assessment process with the aim of determining potential referral to community settings. Data analysis revolved around a thematic exposition of factors influencing the relationship between the objective science of psychiatric investigation and the subjective interpretation of real-world practicalities in working with this group. Findings surrounded three major themes, frame conflict, relating to the difficulties of decision making in this area, therapeutic performance, whereby professionals were expected to engage in some form of active intervention, and safety outcomes, involving consideration of the problematic nature of judging the likelihood of re-offending.
    • Siblings of Adults with Learning Disabilities: An Empirical Study

      Gant, Valerie; University of Chester (Social Work and Society, 2018-01-01)
      Adult siblings are frequently providers of care for their brother or sister with a learning disability* and many take on many levels of responsibility, which often lasts for decades. The majority of research focusing on siblings of people with learning disabilities comes from the perspective of those aged under 18. This paper draws on the work of Rawson (2012) and Pompeo (2009) to focus attention on adult siblings. This study, examined the relationships adult siblings have with their brother or sister with a learning disability. Fourteen participants were involved, in-depth interviews were conducted to gather data that was thematically analysed. The findings revealed that siblings want to be involved in the life of their brother or sister and to be seen as next of kin by professionals when their parents have died, but yet are unsure how best to approach this prospect. Based on these findings, implications for practitioners are discussed.
    • A study investigating the discrepancy between actual and reported incidents of violence and aggression perpetrated by service users against nursing staff in one NHS learning disability service

      Lovell, Andy; Skellern, Joanne; University of Chester (Kavanah, 2008)
      This presentation reports on research carried out within the learning disability division of a major Mental Health NHS Trust in the North of England and relates to the violence and aggression directed towards staff by service users. It sought to identify the extent of the discrepancy between the actual and reported number of incidents of violence and aggression. A further aim of the research concerned the reasons given for such under-reporting, particularly whether these accorded with the literature. The literature review demonstrated that violence is a particular issue for nurses, especially those working in the areas of mental health and learning disability services, where studies have indicated that as many as 1 in 5 may be affected. The population selected were nursing staff currently working with people with learning disabilities in a variety of NHS settings. These settings comprised respite, assessment & treatment, medium secure, residential and community areas of care. A questionnaire was subsequently distributed to all learning disability nurses currently employed in the Trust, a total of 411, with a response rate in excess of 40%. The study revealed that a discrepancy does exist between actual and reported incidents of violence and aggression within the learning disability service. It also clearly differentiated between the reasons attributed to the prevalence of such under-reporting. It confirmed previous claims that the predominant difficulty is cultural, violence being regarded as part of the job and non-reporting primarily revolving around perceptions of incidents being considered 'minor', not worth the time to complete the paperwork. The study concludes that more work is needed to achieve a united, consistent approach across the NHS, in order that a high quality, accessible service for people with learning disabilities and complex needs can be delivered without violence being considered an acceptable part of the job; it needs to be acknowledged, though, that the systems are already in place to achieve this, they need to be utilized more effectively. It also suggests that services should re-think the notion of 'minor', which is misleading at best, when applied to the issue of violence and aggression.
    • Tolerating violence: A follow up study to a survey identifying the extent of, and reasons for, the non-reporting of incidents of aggression in one NHS Trust

      Lovell, Andy; Skellern, Joanne; University of Chester (Kavanah, 2009-10)
      This paper reports on a study of people in NHS Trusts working with people with learning difficulties where aggression and violence is a concern.