Research Internship with the Person-Centred Complex Care (PCCC) theme

Background: Too many people with learning disabilities are admitted to hospital due to presenting with behaviours that challenge or risk of placement breakdown. To address this, the National Transforming Care agenda (NHS England, 2015) requested that commissioners hold a local database of people with a learning disability who are at risk of inpatient admission. This database is held by the learning disabilities team and a service user is placed on it if they are identified as being at risk of admission which results in additional support being put in place. Warrington Community Learning Disabilities Team has been implementing the dynamic support database (DSD) for several years to try to minimise inpatient admissions.

Research aims and objectives: To explore the perceptions of service users, carers, and professionals as to whether the DSD identifies the risk of early placement breakdown there by reducing or minimising inpatient admissions.

Methods: A qualitative service evaluation using semi-structured interviews. Face to face or telephone interviews with 5 service users, 5 carers, and 5 staff. Data was analysed using Normalisation Process Theory. Ethical review provided by UCLan and Mersey Care NHS Foundation Trust Research Ethics Committee.

Patient and public involvement: Two public advisors with lived experience of supporting people with learning disability and five service users with learning disability and/or Autism were involved. PPI started right from the beginning. Service users & carers were involved in reviewing patient facing materials and the research question.

Findings: The DSD with intensive support has been successful in preventing unnecessary admissions. A key part of its effectiveness lies in collective multi-disciplinary team decisions, collaborative working with care providers, commissioners, and social care. More awareness of the DSD in carers, social care professionals and primary care services is required, and more specialist care providers and housing are needed locally.

Potential impact: The findings will lead to improvements in the use of the DSD to prevent unnecessary admission. By improving the awareness of the DSD among carers, service users, primary and social care staff, the risks can be identified early, and with intensive support form LD team unnecessary admissions can be prevented.

Links:
• ARC NWC Internship Showcase Poster
• Newsletter (May 2023)

For more information, contact navakanth.rajulapati@merseycare.nhs.uk