Clinical Care Pathways – Learning disabilities

Skills audit findings

Sophie Orton

Learning DisabilitiesThe over arching aim of the care pathway work is to improve the quality of services for people with a learning disability by ensuring staff in the community and hospital (across the NHS, social care and the private, independent and voluntary sector) are well trained.

The aim of this project is to identify the workforce competences and skills required to meet the needs of people with learning disabilities within a clinical pathway that crosses the community and acute sectors, using an acute surgical episode such as appendicitis as an example.

Methodology

Phase 1 - Developing the interview schedule

Phase 1 - findings

Service users identified five overarching performance critical behaviours linked to the quality-of-care being provided:

1. Making reasonable adjustments

2. Recognition

3. Co-ordination of care

4. Communication.

5. Continuity of care

Phase 1 - findings

Phase 2 - findingsThe experiences of service users identified in phase 1 were independently

mapped to the Skills for Health Functional Map, and validated at a Stakeholder event, and formed the premise of the skills audit:

Phase 3 - Purpose of skills audit

Phase 3 - Sample

• We sampled from primary care, acute services and social care sectors and allied health professionals across the localities

• Sampled were: Wolverhampton, Walsall, North Staffordshire and South Staffordshire

• 144 members of staff participated in the skills audit

Allied health

professional

Social worker

GP

Doctor

Nurse

Receptionist

Clerical staff

Other (including social

care sector staff)

Phase 3 - Sample

Phase 3 - findings• Only 39.6% of the sampled workforce had received learning

disabilities specific training within the last 12 months.

• Across all localities and occupational groups, the activities presented within the questionnaire were rated on median to be ‘essential’ to the participant’s roles

Phase 3 - findingsThe activities for which lower confidence levels were reported were:

• Selecting the most appropriate advocate or advocacy service• Knowing when and how to use a health passport • Carrying out extended feeding techniques to ensure individuals’ nutritional and fluid intake other than oral feeding• Recognise and make reasonable adjustments to respond appropriate to a learning disabled client with orthopaedic problems particularly regarding joint contractures and osteoporosis• Manage obstacles and generate solutions for effective liaison with community carers and support workers

Conclusions• A lack of understanding and poor communication characterises the

patient journey across the community and acute sectors

• The workforce competences, independently mapped to patient concerns, were unanimously ranked as being role relevant to a multidisciplinary audience

• Whilst reasonably self-confident in service user related issues, respondents were unsure of their ability to advocate, to use health passports, feeding techniques, manage orthopaedic problems, and inter-agency communication.

• These findings highlight the need amongst mainstream workers for disability awareness training

Thank you

Any questions?