Dynamic support database clinical support tool: inter-rater reliability

Date03 February 2020
Published date03 February 2020
AuthorFaye Bohen,Ceri Woodrow
Dynamic support database clinical support
tool: inter-rater reliability
Faye Bohen and Ceri Woodrow
Purpose The dynamic support database (DSD) clinical support tool structures the risk of admission
rating for individuals with intellectual disabilities. This study aims to investigate inter-rater reliability
betweenmulti-disciplinary health care professionalswithin the North West ofEngland.
Design/methodology/approach A small-scale quantitative study investigated reliability between
raters on the DSD clinical support tool. A data set of 60 rating tools for 30 individuals was used.
Descriptivestatistics and Kappa coefficientexplored agreement.
Findings The DSD clinical support tool was found to have strong inter-rater reliability between
individual items and thedifferences between individual scores were spreadsuggesting variance found
could notbe attributed to specific questions.Strong inter-rater reliability wasfound in the overall ratings.
Research limitations/implications Results suggest the DSD clinical support tool provides
stratification for risk of admission ratings independent of who completes it. Future studies could
investigate inter-raterreliability between organisations, i.e. healthand social care professionals, and use
a larger data sample to ensure generalisability. Replication of the study within child and adolescent
servicesusing the children’s DSD clinical supporttool is also recommended.
Originality/value The DSD clinical support tool has been implemented within the child and adult
intellectual disability services across the North West. As more teams across England consider its
implementation,the study provides reassurance that codingagreement is high, allowing for stratification
for risk of admissionindependent of the rater.
Keywords Intellectual disabilities, Learning disabilities, Risk register, Dynamic support database,
Inter-rater reliability, Intensive support
Paper type Research paper
As the Transforming Care Programme for people with intellectual disabilities comes to an
end, services are reviewing the impact of what has been achieved and ensuring positive
change is embedded in practice. The government focus on changing services for people
with an intellectual disability and/or autism spectrum condition (ASC) who display
challenging behaviour or have complex mental health difficulties ensured rigorous
evaluation of services and changes in service delivery. This followed the panorama
exposure of the Winterbourne View care home (Transforming Care and Commissioning
Steering Group, 2014), where individuals with intellectual disabilities were subject to abuse
and received poor quality care from staff within a residential home in England. The scandal
triggered a national response to improve the care and support for people with intellectual
disabilities and/or ASC (Department of Health, 2012). It highlighted that individuals were
being admitted to the hospital for long durations and were placed at great distances from
their family and home (Transforming Care and Commissioning Steering Group, 2014). The
“building the right support” national plan suggested that admissions to the hospital could
have been prevented if these individuals were able to receive the right support in the
community. The plan emphasised that these individuals should have the same rights as
Faye Bohen is based at the
Centre for Autism, Neuro-
Developmental Disorders
and Intellectual Disability
(CANDDID), Community
Learning Disabilities Team,
Cheshire and Wirral
Partnership NHS
Foundation Trust, Cheshire,
UK. Dr Ceri Woodrow is
based at CANDDID,
Greenways Assessment
and Treatment Unit for
Adults with a Learning
Disability, Cheshire and
Wirral Partnership NHS
Foundation Trust, Cheshire,
Received 11 September 2019
Revised 6 November 2019
5 December 2019
Accepted 9 December 2019
DOI 10.1108/AMHID-09-2019-0027 VOL. 14 NO. 2 2020, pp. 25-32, ©Emerald Publishing Limited, ISSN 2044-1282 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jPAGE 25

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