Is Hospital Admissions For Adults With A Learning Disability?

Valuing People: A New Strategy for Learning Disability in the 21st Century’. Published 2001 The Protection of Vulnerable Adults Scheme (POVA) for England and Wales. Published 2004.

The assessment process is the back bone to any package of care and it is vital that it is personal and appropriate to the individual concerned. Although studies have found that there is no singular theory or understanding as to what the purpose of assessment is, there are different approaches and forms of assessment carried out in health and social care. These different approaches can sometimes result in different outcomes.

It is therefore fair to say that adults with learning disabilities health and social wellbeing is severely compromised when they come in contact with the justice system with little seeming to work properly, leaving these vulnerable individuals open to all sorts of abuse.

Gurney et al (2006) and Nocon (2006) both acknowledge that children with learning disabilities have a greater need for the health services compared to the general population and this high level of need extends into adulthood. A recent Confidential inquiry into premature deaths of patients with LD has found that the average age of death of people with LD (sixty-five years for males and 63 years for females) as being significantly less than the United Kingdom population of seventy-eight years for men and eighty-three for women (Heslop et al

The existence of services for students with milder levels of impairment is a relatively recent occurrence. Why do you think this is so?

Ways of supporting an individual to lead the assessment and the planning process would be the participation of people with high support and care needs themselves, (people with severe/profound intellectual disability and/or complex disability) in the process of focusing on what is important to them now, and in the future. And acting upon this in alliance with their family and friends.

Assessment tools are used in the care planning process to build up a holistic picture of an individual’s needs. When all the details have been recorded an assessment can be made and suitable care and support can be identified. A few of the assessment tools are information from the individual such as diaries, observations, medical histories and checklists.

Explain how legislation and local and national practice guidelines affect the planning of the transition for a young person with a disability from childhood into adulthood.

Valuing People (Department of Health 2001) it was introduced by the labour government who were keen to promote independent living. This white paper on learning disabilities was for the first in England in 30 years. It made direct payments available to more people with a learning disability and was the first paper where we officially come across the term ‘Person Centred Planning’. It stresses the importance of Personal Centred Planning in helping people with learning difficulties take charge of their own lives. This paper has been ‘refreshed’ in 2009 titling it Value People Now and is a new three year strategy for people with learning disabilities, and will lead to better lives for people.

Prior to the Community Care Act 1990 adults and children with learning disabilities were cared for in large institutions where their basic needs were met but there

Whilst undertaking the initial assessment, I always make sure that the service user is present and make sure that I am talking to them as opposed to about them with a family member or friend that also may be present. If I am doing an assessment with the service user who has Dementia or Alzheimer’s then again, I ensure that I am asking them what they would like, how they would like the care to progress and what they want to achieve from having care works. If they are unable to answer then I will look to the family for guidance, but it is important to make the service involved in their own care planning and assessment process

The National Disability Insurance Scheme (NDIS) is being implemented to provide long term, high quality support to people with a permanent disability that significantly affects their communication, mobility, self-care or self-management. The Scheme focus on intensive early intervention, particularly for people where there is good evidence that it will substantially improve functioning, or delay or lessen a decline in functioning and comprehensive information and referral service, to assist people with a disability who need access to mainstream, disability, specialist and community supports. (Nursing and Midwifery Board of Australia, 2008)

In both plans a physician advisor reviews cases but within HH the case manager compiles all the clinical data and reviews, seeking the advice of physician advisor if necessary. Equally, the plans provide for utilization review to be initiated within the first twenty-four hours of the patient’s admission, if not prior to admission. In addition, both plans provide opportunities for the admitting physician to provide proof or argument for discrepancies in treatments or length of stays. Although the UK HealthCare UR plan provides a single physician review of inadequate treatment or length of stay, HH UR plan stipulates a minimum of two physician members review additional information submitted via the admitting physician. Specifically, in the HH UR plan exists a component of a continuous medical care evaluation studies to provide provisions for the Continuous Quality Improvement Committee. In addition, physicians continually need to be educated on detail specific care in HH, as physicians occasionally do not want the prescribed orders challenged. Pre-printed patient progress notes with check boxes assist some of HH’s physicians in considering necessary or unnecessary treatments

Rather each patient has his or her own set of values and beliefs, and that is what should be responsible for driving their care. Variability in healthcare quality has long existed due to a disparity between evidenced based guidelines and actual care provided. However, this rule offers a shift that allows variation to exist, while still providing high quality care. Not every patient has significant social needs that require addressing. And for those that do, these needs often differ from person to person. That is not to say that standardized processes should not be put in place to identify and intervene on high risk patients. However, it does mean that these processes should be flexible enough to address patients’ needs in a meaningful and effective way.

Local authorities have been duty bound to carry out assessments of need for community care services with individuals ever since the NHS and Community Care Act 1990. This is where the “needs led approach” came in. Legislation and policy from the last 50 years has shaped outcome-based practice. In the 1960’s and 1970’s the dissatisfaction of the care system saw the start of the civil rights movement. In the 1980’s and 1990’s, the service user was starting to be put at the centre of the decision making process and in 1986, the Social Security Act came in to force. This act brought about the move to an Income Support and Disabled Persons Act which focused on the assessment of needs for every disabled person. From 1990’s to 2003, choice was at the