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Background There are few available tools for screening and assessing mental distress in people with intellectual disabilities. Method Comparison of the Clinical Outcomes in Routine Evaluation: Learning Disabilities (CORE-LD) tool with other psychometrically robust but more specific measures. Results Scores derived from CORE-LD correlate with those of established measures that have been adapted for use with people with learning disabilities. Conclusions As a tool for measuring mental health problems and levels of distress, CORE-LD is as valid as established tools for measuring anxiety, depression and self-esteem. [ABSTRACT FROM AUTHOR]

The insertion of an indwelling urethral catheter is a considered, invasive intervention that places the patient in a position of increased vulnerability. It requires the nurse to have the knowledge, skills and understanding to prepare and perform the procedure while supporting the patient. Such a procedure may evoke a range of emotions and responses in a person with a learning disability. It is important that nurses address the needs of the individual and tailor the care to their needs in a sensitive and respectful manner. [ABSTRACT FROM AUTHOR]

Strengthening the Commitment, the Modernising Learning Disabilities Nursing Review, highlighted the importance of learning disability nurses providing support across the lifespan. This article describes an activity undertaken at the Living the Commitment Conference in Cardiff in November 2016, at which delegates were asked to identify the roles of learning disability nurses at different lifespan stages. The article examines the responses, which were thematically analysed, and highlights a range of support, some of which is provided across all lifespan stages, and some at specific periods. Responses also identified new and emerging roles across a range of settings, and the importance of influencing policy and commissioning of services. It is not possible to determine whether these roles are fulfilled across the UK, and the article recommends scoping these roles, and using the findings to inform development of learning disability nursing practice, education and research. [ABSTRACT FROM AUTHOR]

This article describes a qualitative study in which people with intellectual disabilities (learning disabilities in the UK) living in residential homes were asked to describe family life and loss. Interviews with eight such individuals revealed the significance of their family lives, and how their grief at the loss of a parent is compounded by disruptions in familial networks and living arrangements. In such situations, this article concludes that personal plans should include the opportunity for people with an intellectual disability to express their grief to help them cope with their bereavement and loss. [ABSTRACT FROM AUTHOR]

This article describes the role of Mingle, a support group for people with learning disabilities who identify as lesbian, gay, transgender or bisexual. The service was reviewed, with members, three years after it was launched; its main value seems simple, that it is a safe place to be different. [ABSTRACT FROM AUTHOR]

This article examines the theoretical approaches to understanding and managing individuals with a learning disability who display behaviours that challenge. The authors explain how drawing on these approaches can help professionals from different disciplines to provide effective, patient-centred care. [ABSTRACT FROM AUTHOR]

Safeguarding is an important role for learning disability nurses and other professionals. Their clients have increased vulnerability for many reasons, requiring nurses to be constantly watchful. Empowerment of service users and improved access to advocacy are positive ways of protecting them from abuse. Nurses need to be able to understand these responsibilities, as well as thresholds of abuse, the potential need to whistleblow, their own protection from subsequent repercussions and what can be done at an organisational level to safeguard people with learning disabilities. [ABSTRACT FROM AUTHOR]

Individualised recovery values are becoming increasingly important in the care of people with intellectual disabilities and mental health needs. This article describes how a man with a mild intellectual disability and mental health problems, and his multidisciplinary team, collaborated in the development of written and video-recorded recovery materials based partly on cognitive behavioural ideas. These materials have helped the client to cope better with extreme thoughts, strong feelings and strange experiences, and to understand and manage his feelings of distress. It is hoped that recovery videos similar to the one discussed in this article will become widely available to help people become experts in their own mental health. [ABSTRACT FROM AUTHOR]

In the UK, the use and misuse of restrictive practices with people who have intellectual disabilities are common. There is a lack of regulation to ensure that non-statutory standards and guidance are adhered to or to check on their outcomes. This article explores how, in the Australian states of Victoria and Queensland, exemplary legislation on restrictive practices has been implemented and how a similar programme of statutory change may help to reduce the use of restrictive practices in the UK. [ABSTRACT FROM AUTHOR]

The presentation of challenging behaviour by people with learning disabilities can be persistent and can have a huge effect on the individuals concerned and their carers. Applied behavioural analysis has offered much promise in this area, but concerns regarding the use of aversive procedures, such as punishment, along with recognition of the human rights of people with intellectual disabilities, has led to the development of positive behaviour support (PBS). This article argues that, as an emerging concept, PBS is particularly vulnerable to corruption. To guard against this, PBS should always be based on data-based functional assessment and use empirically tested intervention strategies. [ABSTRACT FROM AUTHOR]

This article presents a case study of how positive behaviour support improved the quality of life of a client, a young woman with a rare chromosomal disorder, in an Irish residential service for people with intellectual disability. The client's biological, psychological and social presentations are outlined, including one of her challenging behaviours, scatolia which appeared to be linked to each of these elements of her life. In addition, her behaviour support plan, based on a full assessment, is described. INSET: Case study. [ABSTRACT FROM AUTHOR]

Health checks for adults with learning disabilities were introduced in England in 2009, following a recommendation in the Department of Health (DH) (2008) document, Healthcare for All. Since then, the number of adults with learning disabilities who have had health checks has increased year on year, yet the number who undertook such checks last year still represents less than half the number eligible for them, despite evidence of unmet needs. In addition, uptake of health checks varies, with 10 per cent of primary care trusts (PCTs) providing health checks to nearly 70 per cent, and another 10 per cent of PCTs providing them to fewer than 25 per cent, of eligible adults in their catchment areas. This variation indicates that uptake can be increased and, as the DH (2010b) document Equity and Excellence: Liberating the NHS suggests, this can be achieved by members of the public who exert pressure on service providers in their areas. In Oxford, a client-led, self-advocacy group called My Life My Choice has sought to increase take up of health checks. This article sets out the reasons for implementing health checks, summarises their implementation in England and describes how My Life My Choice has successfully ensured that local healthcare providers have drawn up plans to increase access to health checks for people with learning disabilities in Oxfordshire. [ABSTRACT FROM AUTHOR]

People with learning disabilities experience health inequalities and are at greater risk than the general population of developing problems associated with an unhealthy lifestyle. Obesity is also higher in this group as are the mortality and morbidity from related conditions. Lack of education, income and medical attention mean that people with learning disabilities are vulnerable to poor nutrition, inadequate physical activity and excessive weight gain. Appropriate training and support for health professionals are essential. [ABSTRACT FROM AUTHOR]

Being a patient in an intensive care unit can be extremely stressful. As well as having to cope with being critically ill, patients are subjected to an environment that can cause acute anxiety and confusion. This article describes the importance of the role of learning disability nurses in helping patients and their families to cope with this unfamiliar and demanding situation. [ABSTRACT FROM AUTHOR]

This article describes a systematic review of approaches to measuring the satisfaction of people with learning disabilities with their health care. Methods to enable people with learning disabilities and communication difficulties to give meaningful feedback on the services they receive are evaluated, and factors that contribute to their satisfaction with care are discussed. [ABSTRACT FROM AUTHOR]

Health and education staff collaborated to run a group named 'Show Club' which aimed to develop emotion management in students with learning disabilities. The group, which ran for 13 sessions, used visual and physical props, sensory storytelling and role play, games, music, discussion, coping plans and relaxation. Most of the participants enjoyed the sessions and learned some feelings-management skills. Future work may involve a greater variety of groups and tools. [ABSTRACT FROM AUTHOR]

This article describes a study that examined how the largely unmet mental health needs of people with learning disabilities were being identified and met by a Scottish community learning disabilities team. It identifies barriers to recognising and responding to these needs, and how services could be improved. [ABSTRACT FROM AUTHOR]

A weight reduction club for people with learning disabilities helped participants to each lose 5.9kg on average over a 12-month period. In this article Jeff Bartley describes how the club was set up and the important factors that led to its success. He suggests how other clubs could be created using the learning gained during this pilot project. [ABSTRACT FROM AUTHOR]

People with learning disabilities have traditionally been excluded from the job market but, due to changes in national policies, such as those outlined in the Department of Health’s 2001 document Valuing People, they are being offered roles in the delivery of services. This article discusses the preparation and implementation of such a role, health access champion, in an NHS trust. The article also explains the effects of the appointment on trust staff and practices. [ABSTRACT FROM AUTHOR]

People who care for a family member who has learning disabilities face many of the same challenges as those in other family carer roles, but with distinct differences. Many people with learning disabilities depend on family support all their lives, regardless of where they live, or until the carer dies. This article explores the experiences, challenges and rewards of being a family carer, focusing in particular on what happens when the person with learning disabilities moves out of the family home. Recognising carers' experience, expertise, involvement and what is important to them can have a positive impact on outcomes. [ABSTRACT FROM AUTHOR]

It is more than six years since the government published its response to the Winterbourne View Hospital scandal. [ABSTRACT FROM AUTHOR]

The evidence base for assertive outreach services in the UK is limited. Five established outcome measures were used in an attempt to capture the clinical complexities of an assertive outreach team caseload. The findings suggested that the Health of the Nation Outcome Scales: Learning Disabilities, risk scores and hospital data were appropriate outcome measures, whereas the service user questionnaire and Maslow Assessment of Needs Scale: Learning Disabilities required shortening to be acceptable to clients. Analysis indicated that the assertive outreach model is slightly more effective than a conventional service in meeting the needs of adults with learning disabilities and mental-health problems who find engagement with generic services challenging. [ABSTRACT FROM AUTHOR]

As people with learning disabilities live longer, they become more likely to experience or encounter dementia. Many will live with fellow service users who have been diagnosed with the condition. This article explains why such people should be given information about dementia, tailored to meet their individual needs. It also includes a case study describing how the authors devised a computer-aided diagnostic information program for three people with learning disabilities whose housemate had been diagnosed with dementia. [ABSTRACT FROM AUTHOR]

In December 2012 the Department of Health published Transforming Care: A National Response to Winterbourne View Hospital, which sets out a programme of action to transform services for people with learning disabilities or autism, and with mental health conditions or behaviours that are described as challenging. This article is a summary of the report. INSET: What happened to former residents. [ABSTRACT FROM AUTHOR]

Evidence shows that people with learning disabilities have poorer health outcomes and less access to health services than the rest of the population. In Cumbria, learning disability and NHS dental services work together to provide person-centred care for people with learning disabilities, and have produced a 'dental passport' to improve access to dental care. The layout and content of this document are similar to those of hospital passports but include additional details on the holders' ability to communicate, mobility, previous dental treatment and seating preferences for treatment. There are ten specialist dental services for adults with severe learning disabilities in Cumbria, all of which provide expert care for people with disabilities. [ABSTRACT FROM AUTHOR]

Making information accessible involves deciding which format to use and prioritising the information that is provided. Prioritisation is often not taken into account and materials are produced in which the same information is given to everyone. This article explores the factors that must be taken into account and what information to include by referring to a new approach called the information challenge model. Use of personal screening and different provision structures are also introduced. These techniques are distinct from easy read or other formats, and should result in a planned approach including systematic review of outcomes or success attained. [ABSTRACT FROM AUTHOR]

Infection with cytomegalovirus (CMV) can have devastating and enduring effects on fetuses. In this article, the parent of a daughter born with several severe disabilities due to the effects of CMV describes her and her family's life caring for the child. The author discusses the family's battles to obtain statutory care and the lack of empathy of some healthcare professionals. Permission from family members has been sought and their consent to reproduce their conversations has been given. [ABSTRACT FROM AUTHOR]

This article describes the introduction of individualised support plans for people with learning disabilities who exhibit challenging behaviours. These positive behavioural support interventions, which comply with national and local guidelines, are designed to help front line staff and service providers manage aggression among service users by helping them to acquire a repertoire of social and communication skills. [ABSTRACT FROM AUTHOR]

Learning disability affects up to 1.5 million people in the UK, about 2 per cent of the population, and people vary widely in their abilities. To ensure they, and their families, receive optimal care, service providers must commit themselves to constant improvement in service delivery. This article discusses an example of individualised, recovery-orientated care for adults with learning disabilities at an assessment and treatment unit in Doncaster. [ABSTRACT FROM AUTHOR]

This article describes the adoption of a person-centred approach to support people with learning disabilities, complex needs and challenging behaviours who live in the community. It includes a series of case studies that show how service users' goals can be identified and achieved, and how service users can be empowered to make meaningful choices and gain control over their lives, to the benefit of all concerned. [ABSTRACT FROM AUTHOR]

The author describes how the Gloucestershire reasonable adjustment outcome tool was developed and what it is intended to achieve. Along with details of how the tool was implemented, its structure and content are also described to aid effective use. The author hopes that others will use the concept and the design of this approach to enhance the development of reasonable adjustments and access to mainstream services in their areas. [ABSTRACT FROM AUTHOR]

Aim: There is increasing evidence to support the effectiveness of parent management training programmes with families of typically developing children. This pilot study assessed the validity of a modified version of the Incredible Years Parent Training programme as an intervention for parents of children with moderate to severe learning disability. Method: Five carers and four children completed the programme. A repeated measures design was used, incorporating observation to analyse changes in parent.child interactions, and self-report measures of perceived parent stress and child behaviour problems both pre- and post-intervention. Parent satisfaction was also explored. Results: The results showed a decrease in observed negative parent.child interactions and stress, and an increase in observed positive interactions. Conclusion: The Incredible Years Parent Training Programme may be a useful early intervention for some families of children with a learning disability. The effects on child problem behaviours were equivocal, and longer-term, larger trials are needed. [ABSTRACT FROM AUTHOR]

Completing mental capacity assessments for individuals is a complicated process that presents professionals with many challenges. The authors set up a system to develop materials and protocols to evaluate the capacity of a varied population. They recommend ways of achieving a balance between reducing risks to vulnerable individuals and acknowledging how their abilities might improve. In addition, they suggest that multidisciplinaryteams should explore how they can develop the skills required by using their experience to provide case examples for others to use. INSET: Case study. [ABSTRACT FROM AUTHOR]

The challenges of caring can cause severe stress to all concerned in ways that must be recognised, acknowledged and managed. This is important to prevent stressors, particularly the vicious circle of controlling aggression by aggression, becoming chronic. If this happens an organisation can become dysfunctional and ultimately toxic to those who work in it and those it seeks to support. In a corrupted culture, the needs of the service user become secondary to the needs of staff, who have become demoralised without adequate trainingand support. Leadership is seen as critical in the reduction of coercive interventions, but effective staff training can bring about positive changes. [ABSTRACT FROM AUTHOR]

Uptake of cancer screening by people with learning disabilities in England is poor. Data were collected using a short online questionnaire to estimate awareness of cancer screening programmes among community learning disability nurses, doctors and health facilitation nurses in Birmingham Community Healthcare NHS Trust. Knowledge of cancer screening was limited and few people had been offered formal training in this area. More needs to be done, including increased training, to raise awareness of cancer screening issues on a local and national level to improve and promote the health of people with learning disabilities. [ABSTRACT FROM AUTHOR]

The Mental Capacity Act and the code of practice (Department of Health (DH) (2005) make it clear that people should not be treated as unable to make a decision about their own lives unless all practicable steps to help them to do so have been taken without success. In the case of Peter, not his real name, a young man with severe learning disabilities and a degree of sexual frustration, the multidisciplinary learning disabilities community team used guidance from the act to discern his capacity to consent to treatment and how to work with him. This ensured that he, his family and the staff involved were fully supported throughout. [ABSTRACT FROM AUTHOR]

Persistent sleep disturbance is common among children and young people with an intellectual impairment, but the issue has rarely been addressed. A child and adolescent learning disability service in north Wales uses five effective approaches for the assessment and management of sleep problems. Improved education of health professionals in this area, the development of more dedicated sleep clinics and further research into the long-term effectiveness of these approaches are recommended. [ABSTRACT FROM AUTHOR]

Analysis of interviews conducted by Mencap Liverpool suggest that hospital patients with learning disabilities on Merseyside continue to experience difficulties when accessing hospital care. This article presents a discussion of the interview structure used in the investigation and the themes generated by an analysis of the interview transcripts. The article concludes with a plea to hospital staff to heed the suggestions of this and other investigations when providing care to people with learning disabilities. [ABSTRACT FROM AUTHOR]

The media has recently reported high-profile cases of people with a learning disability being taken advantage of or victimised by people they know or consider friends. This has been dubbed 'mate crime' (Williams 2010) and is an area where research and resources are lacking. This study outlines the development, delivery and evaluation of a small-scale pilot group intervention related to keeping people with a learning disability safe. Group members reported finding the group helpful and enjoyable and said it improved their safety. It was, however, hard to draw strong conclusions. The study is a starting point and more work needs to take place. [ABSTRACT FROM AUTHOR]

This article draws on Melanie Chapman's experiences of supporting Daniel Docherty, who has a learning disability and Asperger syndrome, to write his life story. It explains the reasons for, and processes of, collaborating on this in the hope that it will help others contemplating life story work. It also describes some of the issues encountered when working on the life story, such as dealing with sensitive issues and how stories can change over time. [ABSTRACT FROM AUTHOR]

The Mental Capacity Act 2005 altered the way that everyone should practise when working with people who may lack the capacity to give consent. This article discusses the implications of the legal framework on foot care, exploring the challenges faced by families/carers, care home staff and foot health professionals in their work. While this article focuses on foot care, it is relevant to all staff providing care to people who lack the capacity to give consent. [ABSTRACT FROM AUTHOR]

This article introduces a three-phased approach to reducing healthcare inequalities experienced by people with learning disabilities. It provides the contextual backdrop of the work, describes the integral process of collaboration and partnership working used in the development of an educational toolkit for healthcare professionals, and shows how people with learning disabilities were central in its development. [ABSTRACT FROM AUTHOR]

This article describes the experiences of a prisoner with a mild-to-moderate learning disability and epilepsy, with whom the author worked during a student placement. [ABSTRACT FROM AUTHOR]

The article discusses the author's views with regards to the challenges facing people with learning disabilities. Topics covered include the highlights of the film "I, Daniel Blake" directed by Ken Loach, the different degrees of humiliation experienced by people with learning disabilities, and the long-term effects of humiliation on people with learning disabilities. It also discusses the author's efforts in providing learning disability service for people with learning disabilities.

'Challenging behaviour' is often associated with a crisis-driven approach to service delivery in which behaviours are assumed to be inherent in the people who exhibit them. Because this approach can lead to labelling, stereotyping and diagnostic overshadowing, the authors of this article argue that the term 'challenging behaviour' should be replaced with 'behaviour of concern' to highlight the ideal response of support staff rather than the challenge they must overcome. [ABSTRACT FROM AUTHOR]

The article presents the highlights of published studies relating to learning disability nursing. Topics covered include "Alzheimer's disease in people with Down's syndrome: the prospects for and the challenges of developing preventative treatments" published in the "Journal of Neurology," a study about workforce development for people with intellectual disabilities, and "Ethics Case Study: Fulfulling Lives?" conducted by the National Co-ordinating Centre for Public Engagement.

The article focuses on the struggle of parents in helping their children with disabilities live independent lives despite transition services improvements. It relates stories of transition and the mixed results, government advice and the teaching resource with information on mental health and emotional well being, mainstream education and transition to adulthood. It also notes health transition planning principles including planning, impact assessment and exploration of opportunities.

The article reports on the selection of mental health service provider Beyond Limits by Plymouth Hospitals National Health Service (NHS) Trust to offer tailor-made services to nine individuals with challenging behaviors.

The article reports that researchers from the Royal College of Art are looking for ways to encourage people with learning disabilities to participate in activities such as cooking, cleaning and other household chores.

Staff face many challenges when caring for patients with a learning disability in a general hospital ward, and the author describes how clients' confusion and anxiety can arise. Daily activities of living can be compromised for patients with communication difficulties if staff do not try to see situations from their viewpoints. Continuous nursing assessment, empathy and multidisciplinary input are necessary to respond appropriately to patients' varying communication abilities and requirements. [ABSTRACT FROM AUTHOR]