Redesigning a community-based challenging behaviour intensive support service
| Pages | 123-132 |
| Date | 12 June 2019 |
| DOI | https://doi.org/10.1108/AMHID-11-2018-0047 |
| Published date | 12 June 2019 |
| Author | Jasmin White,Matt Symes,Carrie Pearce |
Redesigning a community-based
challenging behaviour intensive
support service
Jasmin White, Matt Symes and Carrie Pearce
Abstract
Purpose –The purpose of this paper is to discuss outcomes of a service redesign, involving an Intensive
Support Team (IST) for adults with learning disabilities and challenging behaviour, working in conjunction with
a Community Learning Disability Service (CLDS).
Design/methodology/approach –Two IST staff were physically based as “Inreach workers”within a CLDS
for six months. Inreach workers provided support with existing resources and consultation forspecific clients
presenting with challenging behaviour. CLDS staff confidence, understanding and implementation of existing
challenging behaviour resources was evaluated before and after service redesign. An online questionnaire
was used to gather further data relating to experiences of the Inreach project.
Findings –CLDS staff confidence, understanding and implementation of existing challenging behaviour
resources increased over the six-month inreach period. Questionnaire results indicated CLDS staff found
Inreach support to be beneficial, having a perceived positive impact for clients, and providing clarity on the
skills and resources provided by the IST.
Research limitations/implications –The long-term effects of this pilot have yet to be established.
Consideration is given to how demand characteristics may have influenced CLDS responses.
Practical implications –Careful consideration should be given in terms of how ISTs interface with CLDSs.
ISTs may consider being based physically within CLDSs, to provide more readily accessible support.
Originality/value –Providing CLDS staff with more accessible support from ISTs may increase the effective
implementation of available resources for adults with learning disabilities and challenging behaviour.
Keywords Intellectual disabilities, Service evaluation, Learning disabilities, Challenging behaviour,
Community learning disability service, Intensive support team, Inreach
Paper type Technical paper
Introduction
Approximately 10–22.5 per cent of people with a learning disability engage in behaviours that
challenge services (Emerson et al., 2001; Jones et al., 2008; Holden and Gitlesen, 2006).
Behaviours have been described as “challenging”when they are:
[…] of such an intensity, frequency or duration as to threaten the quality of life and/or the physical
safety of the individual or others and [are] likely to lead to responses that are restrictive, aversive or
result in exclusion. (Royal College of Psychiatrists, British Psychological Society and Royal College of
Speech & Language Therapists, 2007, p. 10)
Several decades ago, a peripatetic support model began to replace many inpatient institutions in
the UK that supported individuals with challenging behaviour. This resulted in more focus being
placed on providing care for adults with learning disabilities in community settings (Emerson
et al., 1999). Community Learning Disability Services (CLDS) aim to provide focussed health
support for adults with learning disabilities when their needs are unable to be met by mainstream
services. CLDSs provide health-related education and advice to clients, families and other
professionals, as well as linking with other stakeholders including health and social care services
Received 27 November 2018
Revised 14 February 2019
Accepted 2 April 2019
The authors would like to thank
staff working in the Southampton
and Hampshire Intensive Support
Team, and West Hampshire
Community Learning Disability
Service, for their participation in
this service redesign, and also
Dr Sarah Horsley (Principle Clinical
Psychologist) and Samuel Berry
(Assistant Psychologist) for their
involvement in the local service
evaluation.
Jasmin White is based at
Southampton and Hampshire
Intensive Support Team,
Southern Health NHS
Foundation Trust,
Hampshire, UK.
Matt Symes is based at West
Hampshire Community
Learning Disability Service,
Southern Health NHS
Foundation Trust,
Hampshire, UK.
Carrie Pearce is based at
Southampton and Hampshire
Intensive Support Team,
Southern Health NHS
Foundation Trust,
Hampshire, UK.
DOI 10.1108/AMHID-11-2018-0047 VOL. 13 NO. 3/4 2019, pp.123-132, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE123
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