Home visits: a reflection on family contact in a specialist forensic intellectual disability service

Date06 July 2015
Pages186-195
DOIhttps://doi.org/10.1108/AMHID-02-2015-0010
Published date06 July 2015
AuthorLucinda Cheshire,Verity Chester,Alex Graham,Jackie Grace,Regi T Alexander
Subject MatterHealth & social care,Learning & intellectual disabilities
Home visits: a reflection on family contact
in a specialist forensic intellectual
disability service
Lucinda Cheshire, Verity Chester, Alex Graham, Jackie Grace and Regi T. Alexander
Lucinda Cheshire is Forensic
Social Worker, Verity Chester is
Research Assistant, Alex
Graham is Lead Hospital Social
Worker and Jackie Grace is
Senior Social Worker, all at
Partnerships in Care Learning
Disability Services, Diss,
Norfolk, UK.
Dr Regi T. Alexander is
Consultant Psychiatrist at
Partnerships in Care Learning
Disability Services, Diss,
Norfolk, UK and Norwich
Medical School, University of
East Anglia, Norwich, UK.
Abstract
Purpose There is little published literature about the number of home visits provided to patients
within forensic intellectual disability units, and there is no published data on variables that affect home visits.
There is a need for a baseline audit that can formulate standards for future practice. The paper aims to
discuss these issues.
Design/methodology/approach This paper describes the home visit programme within a forensic
intellectual disability service, and a baseline audit of the programme. The audit measured the number of home
visits, any factors that adversely affect home visits, and the extent of family contact. The authors propose
audit standards for evaluation of good practice in this area.
Findings The audit involved 63 patients over a one-year period. In total, 81 per cent of patients had some
form of family contact and 54 per cent of patients at least one home visit. However, 19 per cent of patients
had no contact with their family due to a variety of reasons. There were no significant differences in the
number of home visits between men and women, patients on civil vs criminal sections or those treated
within areaor out of area. Patients in rehabilitation wards had significantly more visits than those in low or
medium secure.
Originality/value Conventional wisdom is that reduced family contact is the direct result ofpatients being
placed out of area. The results of this audit suggest that, at least in this group, the reasons may be much
more nuanced and that the current definition of out of areahas to be improved to incorporate the actual
distance between the patients current family home and the service. Audit standards have been proposed to
monitor family contact and home visits. Future work should focus on the relationship between family contact
and treatment outcomes.
Keywords Learning disability, Family contact, Forensic, Secure, Social support, Social work
Paper type Research paper
Introduction
The events at Winterbourne View and the subsequent investigation reports placed inpatient
hospital care for people with an intellectual disability in the spotlight (BBC One, 2011). What
emerged was a critical review of inpatient placements for people with intellectual disabilities, with
the practice of placing patients out of areahighlighted as a particular concern. The term out of
areais used when a person with mental health/social care needs is using medium-long-term
treatment/rehabilitation services away from their home area (Royal College of Psychiatrists,
2011). Out of areaplacements are typically used when demand for beds outstrips capacity or
where specialist services are not available locally (Department of Health, 2012). The Department
of Health (2012) review highlighted a widespread failure to design, commission and provide
services which give people the support they need close to home.
Received 17 February 2015
Revised 24 April 2015
Accepted 25 April 2015
PAG E 18 6
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 4 2015, pp. 186-195, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-02-2015-0010

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