Focussed visit summary: Visits to care facilities for people with learning disability
Number of visits 14
Number of recommendations 48
Recurring themes and areas for improvement:
1.Privacy and dignity issues in care environments
People with learning disability have the same right to privacy and dignity as anyone else. Any interference with that right must be lawful and proportionate. Environments and practices in some place we visited did not seem to give people this right. We made recommendations about:
- Provision of secure personal space for people
- Maintenance of buildings and gardens
- Policies for observation, particularly video surveillance (see the section on visits in our annual report and the joint statement on our website on this topic)
Example of improvements following our visit:
Our recommendation where we found a hospital where there was a bedroom door that had been broken and not replaced, along with other examples of poor upkeep of buildings and gardens:
Maintenance of the building and garden should be completed timeously and be of a good standard. The missing bedroom door should be replaced immediately. A programme of improvements with appropriate completion dates should be provided for the Commission
The hospitals response:
The managers made sure that immediate work was carried out. They carried out other improvements over the next three months. (There is still some work needed and we will follow this up).
2.Range of services available
Legislation includes principles of benefit, reciprocity and a range of services to meet individuals' needs. We made recommendations where we found gaps in service provision. These included
- Generally poorly constructed care plans,
- Lack of access to psychological therapies
- Lack of provision of activity that meets the person's individual needs and preferences
Example of improvements following our visit:
Our recommendation where we visited several people in one unit who were not able to get out much. This was blamed on a shortage of occupational therapy staff.
Service manager will update the Commission on provision of activities and progress filling the OT post by the spring.
The unit's response:
An activities co-ordinator had recently taken up post within the ward.Since the visit a number of patients have safely increased their time off the ward and are now accessing time in the local community to facilitate their own shopping, exercise or a sociable meal. This has been achieved by the formulation of individually tailored progress plans based on information gained through the close assessments of patients. Nursing staff and the activity co-ordinator have been working together to create on-ward activities including art and craft sessions and a gardening group.The activity co-ordinator has also recently been able to increase his 1:1 work with patients which has created more opportunities within the main hospital hall and physiotherapy led gym.One of the nursing team has been tasked with securing information about local college courses on offer and plans are also near completion for a relaxation group within the ward.
3.Physical health
People with disabilities have the right to the highest possible standard of physical and mental health (UN Convention on the rights of persons with disabilities). We made recommendations where we found a lack of physical health checks and offers of screening tests. This was a common finding in hospitals and care homes.
Example of improvements following our visit:
Our recommendation where we visited people who were not getting regular physical health checks in a care home:
The GP Practice covering this care home should be asked about undertaking routine annual health checks for residents.
The care home's response:
The care home manager confirmed that arrangements were made with GP to undertake physical health checks.
