Resources for Secure Environments

Appendix

Caring for people with learning disabilities: Crib cards

Kindly provided by Ann Norman, Royal College of Nursing

In this section, there are definitions and short explanations that will be useful to share with, for example, nursing students and other health professionals new to working with people with learning disabilities. The 'bite-size' essential information points can be transferred onto crib cards. 

What is a learning disability?

A learning disability affects the way a person understands information and how they communicate. Individuals may have difficulty in:

• understanding new or complex information
• learning new skills
• coping independently.

They often have significantly higher health needs, which are commonly unmet and not recognised, and result in premature deaths.

Duty of care

All health services must ensure that reasonable adjustments are made to ensure that people with a learning disability have equal access to health care. Recommended adjustments include:

• information in a format accessible to the person
• longer appointment times
• managing environmental factors
• providing funded additional support
• undertake an assessment of risks and support needs by speaking to the person and others that know them well

Diagnostic over shadowing

This occurs when a clinician attributes symptoms or behaviours to a person’s learning disability rather than another medical cause.

Consent

No-one can consent on behalf of an adult with a learning disability unless they have been appointed as a deputy by the Court of Protection. Parents or support staff should not be asked to consent on the person’s behalf. Instead the Best Interest process must be followed if an individual is assessed as unable to make a decision in line with Mental Capacity Act 2005.

Communication

It is important that you listen to the person, their family members and/or care staff. And ensure information is provided in the person’s preferred format. This may include, easy-read content, large print text, sign language and/or pictures. Review the person’s records to ensure the correct method is used.

Hospital passports

The person using the health service may be able to provide you with their hospital passport which will contain vital information on how best to support them.

Discharge planning

There are many different living arrangements, so no assumptions should be made about the type of support a person receives. Establish where the person lives, who they live with, what support they receive, and what skills their support has. Agree the discharge plan with all who will be involved in supporting them. They may have a health action plan where their discharge health needs can be added. Registered learning disability nurses may be available as hospital liaison nurse or community nurses to offer support and assistance.

Abbreviations:

LD – Learning Disability

NG – NICE Guideline

QS – Quality Standard

PHE – Public Health England

NHS – National Health Service

MCA – Mental Capacity Act

OMU – Offender Management Unit