improving care of people with a learning disability… · 2020. 9. 1. · julie royle-evatt rnld...
TRANSCRIPT
Improving Care of People With a Learning Disability
Julie Royle-Evatt RNLD
Strategic Health Facilitation Manager
Target 2020
Health Facilitation Team
• We work together with other professionals and services to improve their understanding, skills and resources to more effectively work with a person with a learning disability.
• Our support is free and we can help with sign posting, resources, consultation and training within practice
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Aim of the session
• Improve knowledge around legal frameworks and responsibilities.
• Have better understanding of what a learning disability is
• Support understanding of how to improve communication, inclusion and engagement of people with a learning disability.
• Understand the resources and support networks that are there to help you.
• Improve the uptake and quality of the LD annual health check to help reduce the mortality rate.
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What is a Learning Disability
A person with learning disabilities will have:
A significantly reduced ability to understand new or complex information and to learn new skills (impaired intelligence) and
a reduced ability to cope independently (impaired social functioning) which started before adulthood, with a lasting effect on
development (Valuing People, DoH 2001).
https://www.youtube.com/watch?v=tfkVA2BKIyY
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Learning Disability not Learning Difficulty
Please, please remember that the language you use is very important.
A learning disability (Intellectual Disability) should not be confused with a learning difficulty
i.e. things like dyslexia and dyspraxia.
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Why is Improving Healthcare so important? LeDeR (2017)
Median age at death 2017 2020
LD Males (4 – 92yrs) 59 years 22.8 years less
23 years less
General population males 81.8 years - -
LD Females (4 – 97yrs) 56 years 29.3 years less
27 years less
General population females 85.3 years - -
Profound and or multiple impairment/disabilities
41 years 42.5 years less
-
Mild or moderate learning disabilities
63 years 20.5 years less
-
Other references and evidence of the early mortality: Cipold (2013), 6 Lives (2008), Death By Indifference (2007), Valuing People (2001)
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Whole team training
NASA believe that from the person who cleans, to the man who walks on the moon. Every single employee makes a valuable contribution to the process. It would be unusual for a GP to send the letters out, code everyone, do all of the health checks etc. so this is why from reception to clinic room we are all part of this training. This ethos reflects that we are all an important part of this process. Should any member of the team leave the practice the process is sustainable.
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Triangle of Care
Always consider each participant in the triangle of
care. Let the principles of inclusion of all participants
guide your practice.
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Making an accessible difference Carol is 58 years old. She has a mild learning disability and lives with her nephew who also has a mild learning disability. Carol has support workers coming in for 5 hours per week. By the time they have helped her do her shopping, cleaning, preparing meals and paying bills they don’t have time for anything else.
Carol can’t read and she has been receiving letters from her GP inviting her to an annual health check. Carol hasn’t known what the letters are and so she just stores them in a drawer.
The GP continues to send the letters out but after 5 letters they disregard her from the recall list.
A Learning Disability Community nurse comes to assess Carole. When the nurse goes to the house she notices fresh blood on Carol’s slippers when she stands.
The nurse asks Carol if she is okay and
Carol replies “I’m fine, the bleeding stops when I sit down”.
The nurse supports carol to the GP and finds out that they have not seen her because she doesn’t attend appointments they send to her via a letter but Carole cannot read.
We supported the GP to utilise the easy read letter template. Carol now knows if she gets a letter with the picture of the GP surgery on she knows that she has to call them to see why they want her.
Alerts were placed on the patient file. Now staff know they have to send easy read information out to Carol or phone her or her staff.
Carol was successfully treated for a kidney tumour and following this episode of ill health she was monitored more closely and found to have breast cancer which was successfully treated.
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Using the Accessible Information Standard to Communicate appropriately
Had Carol received a copy of an easy read invite she may have realised that she needed to contact the practice, or she may have asked her staff what the letter was about after recognising the picture of the GP practice.
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The Equality Act (2010) – Reasonable Adjustments
This document identifies any adjustments patients might need to help them engage with and attend the practice appropriately.
It is a legal requirement that you should log and meet reasonable adjustments.
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What is the Accessible Information Standard (AIS) 2016
By law, all NHS and adult social care providers must:
1. Record communication and Information needs
2. Record them clearly and consistently on patients records
3. Flag these needs on alerts
4. Share these when referring to another service
5. Take action to give the right support according to these needs.
The city wide collaboration is working to: • Standardise the use of the reasonable
adjustments care plan in the city across all health and adult social care providers.
• We are working with Leeds Care Records to ensure that this information is placed in one place on the patients records so that all organisations can see it and act upon it.
• Create information in an easy read format for you to provide to the patient
• When using accessible information you are supporting positive Mental Capacity Assessment and provide evidence why you have made a best interest decision.
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If you go to an appointment and you have no idea what will happen in that
appointment how would you feel?
• I would feel anxious.
• I might ask someone about what they thought would happen in the appointment.
• I would know to choose someone with medical knowledge.
• I might Google search the name of the procedure.
• I might ask my best friend to come with me.
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Support communication so the service user can engage with you.
Allows the service user a chance to take their time to think about and respond to the questions that you may ask in the appointment.
This means that you are offering the service user an opportunity to take part in their health care.
All adult social care providers in the city are contracted to utilise the “Get Checked Out Leeds” documents.
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Now that you know what is going to happen, how would you feel about the
appointment?
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I am sure that if you had this sort of clear information before an appointment, you would feel a little bit more relaxed about the situation.
It is no different for a person with a learning disability.
Remember to include families and carers
Empowering service users and carers is an important role so that appointments are successful.
Think of the information the family and carers know and can provide about their loved one. History and presentation of a patient is key to getting good diagnosis.
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9. Health Action Plan
• Document for people what their health needs are.
• Tell them what the action is that they need to resolve the health issue
• Name who will support them
• Put a review date in place so that issues are followed up.
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10 Steps AHC Success Summary We are there to help you with any of the steps.
Can you make your own Easy Read information?
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10 Steps AHC Success Summary • Feel free to utilise the
help and standard documentation available to support you.
• Is there something that you would like to create for your practice? We can help you do this free of charge.
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Community Support • Everything is available
on: www.getcheckedoutleeds.nhs.uk
• 0113 8555049 (Not manned every day during COVID)
• You can email me on:
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Acute Support
If you are sending a patient to hospital either for admission or outpatient. Please contact the Learning Disability and Autism Team who will help ensure reasonable adjustments are made to facilitate the appointment where possible.
• Telephone: 0113 2066836
• Email: [email protected]
• Twitter: @getmebetter
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