Out‐of‐area provision for adults with intellectual disabilities and challenging behaviour in England: policy perspectives and clinical reality

Barron, Diana Andrea; Hassiotis, Angela; Paschos, Dimitrios

doi:10.1111/j.1365-2788.2011.01405.x

Cited by 10 publications

(10 citation statements)

References 21 publications

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“…While Barron et al . (2011) touch on some of the regulatory problems in the social care sector in the UK, the picture that is presented is a partial one.…”

Section: Regulationmentioning

confidence: 99%

Invited review: Challenges of residential and community care: ‘the times they are a‐changin’

Jackson¹

2011

J intellect Disabil Res

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This paper seeks to examine a number of issues which relate to the provision of appropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the Journal of Intellectual Disability Research are identified and explored: (1) normalisation; (2) inclusion; (3) choice; and (4) regulation. It is concluded that the research community has an obligation to assume a higher profile at a time when the quality of life of people with an intellectual disability and their families is under threat. This can be done in a number of ways through: (1) the establishment of demonstration projects, either independently or in association with the voluntary and statutory sector, to explore innovative and practical approaches of enhancing the quality of services offered to people with an intellectual disability; (2) looking at ways of improving the quality of training programmes for care staff by moving away from current approaches that emphasise narrow instrumental competencies to strategies that develop essential expressive and relational aspects of care practice; and (3) offering a more considered and rigorous critique of current professional practice and assuming a leadership role at a time when leadership in this field is lacking.

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“…While Barron et al . (2011) touch on some of the regulatory problems in the social care sector in the UK, the picture that is presented is a partial one.…”

Section: Regulationmentioning

confidence: 99%

Invited review: Challenges of residential and community care: ‘the times they are a‐changin’

Jackson¹

2011

J intellect Disabil Res

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“…These placements, however, tend to be costly and vary in quality or, in some cases, perpetrate abusive practices (Department of Health (DoH), 2012) and decrease likelihood of community integration (SCIE, 2004;Barron et al, 2011;Chinn et al, 2011). UK data demonstrate that challenging behaviours are a major predictor of costs (Knapp et al, 2005) with one study reporting that relocation of ten service users with challenging behaviour into community living not only improved quality of life but saved around £900,000 per year (Association of Supported Living, 2011).…”

Section: Introductionmentioning

confidence: 99%

Complex Behaviour Service: enhanced model for challenging behaviour

Inchley-Mort

Rantell²,

Wahlich³

et al. 2014

Advances in Mental Health and Intellectual Disabilities

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Purpose -Positive Behaviour Support (PBS) is thought to be an important model for working with people with intellectual disabilities who display behaviours challenging to service. The purpose of this paper is to explore clinical and service user outcomes associated with the delivery of PBS by a Complex Behaviour Service (CBS). Design/methodology/approach -Clinical outcomes of 24 service users treated by the CBS team were assessed at baseline, six and 12 months and compared with those of 22 peers who received usual care. The main outcome was reduction in challenging behaviour measured by the Aberrant Behaviour Checklist (ABC). Secondary outcomes included measures of mental health needs, risk and social care supports. Findings -At six months improvements were seen across all ABC domains in both groups, with greater improvement in the CBS group, compared to usual care in irritability and stereotypy. Between group differences were maintained only for stereotypy at 12 months. No other differences were found. Originality/value -This paper suggests that PBS delivered by trained and dedicated staff may provide clinical benefits to individuals with challenging behaviours. However, there are issues around integration into existing services that need to be addressed in order to maximise efficiency.

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“…Among individuals with intellectual disabilities, problem behaviors include physically or verbally aggressive, destructive, disruptive, socially offensive, and other behaviors that pose a risk to the health and safety or negatively affect the quality of life of themselves or others (Royal College of Psychiatrists, 2001). Problem behaviors can have serious consequences for individuals with intellectual disabilities, such as emergency department visits and loss or change of work, day placement, and residential setting (Barron, Hassiotis, & Paschos, 2011; Cooper et al, 2009). Problem behaviors are a major reason for mental health referral and treatment with psychoactive drug therapy (Lunsky & Palucka, 2004), resulting in a high rate psychoactive drug use in residential facilities (20–50%; Deb & Fraser, 2004).…”

Section: Introductionmentioning

confidence: 99%

Modifying a social problem‐solving program with the input of individuals with intellectual disabilities and their staff

Ailey

Friese

Nezu

2012

Research in Nursing & Health

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Social problem-solving programs have shown success in reducing aggressive/challenging behaviors among individuals with intellectual disabilities in clinical settings, but have not been adapted for health promotion in community settings. We modified a social problem-solving program for the community setting of the group home. Multiple sequential methods were used to seek advice from community members on making materials understandable and on intervention delivery. A committee of group home supervisory staff gave advice on content and delivery. Cognitive interviews with individuals with intellectual disabilities and residential staff provided input on content wording and examples. Piloting the program provided experience with content and delivery. The process provides lessons on partnering with vulnerable populations and community stakeholders to develop health programs.

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Out‐of‐area provision for adults with intellectual disabilities and challenging behaviour in England: policy perspectives and clinical reality

Cited by 10 publications

References 21 publications

Invited review: Challenges of residential and community care: ‘the times they are a‐changin’

Invited review: Challenges of residential and community care: ‘the times they are a‐changin’

Complex Behaviour Service: enhanced model for challenging behaviour

Modifying a social problem‐solving program with the input of individuals with intellectual disabilities and their staff

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