Figure 2: Types of change which can be assessed in relation to human rights There is a complex and interconnected relationship between these different types of change25, 26. The changes may occur for service users, staff, carers and advocates or at the level of the team or organisational culture. Effectiveness of Community Learning Disability Teams The role of CLDTs initially involved coordinating and gate-keeping the services and resources available to people with learning disabilities5. More recently, CLDTs have evolved to provide coordinated high-quality healthcare services for people with learning disabilities which enable them to engage in activities of everyday life27. CLDTs aim to the ‘provide right level of intervention and support to enable people to achieve maximum independence and control over their However, it is widely recognised that delivering a service for lives28’. people with learning disabilities who have complex behavioural, mental or physical health needs (or a combination of these) as community team is challenging5. In the current economic climate, community learning disabilities teams are working within a This requires CLDTs to prove both the quality and effectiveness of ‘target driven culture.’ their service by meeting targets, usually demonstrated through outcome measures such as the Health of the Nation Outcome Scale-Learning Disability (HoNOS-LD) 29. An outcome is defined as an of an . In CLDT settings this usually means ‘end stage intervention’5 ‘problem have been This reflects one of the difficulties with utilising outcome behaviours’ ‘fixed.’ measures in this client group; the majority of outcome measures reflect process rather than the outcome itself29. For example, a CLDT intervention supporting a person to reduce their challenging behaviour, has a profound positive effect on the physical and person’s emotional, psychological wellbeing in addition to preventing the from occurring. ‘target’ behaviour Research suggests that it is very difficult to assess the effectiveness of CLDT interventions as practice is not standardised across teams5. Effective CLDTs should help people with learning disabilities enjoy better health outcomes and healthcare access, in ways which promote independence and inclusion. This should also involve reducing inequality so that people with learning disabilities can use mainstream
Figure 2: Types of change which can be assessed in relation to human rights There is a complex and interconnected relationship between these different types of change25, 26. The changes may occur for service users, staff, carers and advocates or at the level of the team or organisational culture. Effectiveness of Community Learning Disability Teams The role of CLDTs initially involved coordinating and gate-keeping the services and resources available to people with learning disabilities5. More recently, CLDTs have evolved to provide coordinated high-quality healthcare services for people with learning disabilities which enable them to engage in activities of everyday life27. CLDTs aim to ‘provide the right level of intervention and support to enable people to achieve maximum independence and control over their lives28’. However, it is widely recognised that delivering a service for people with learning disabilities who have complex behavioural, mental or physical health needs (or a combination of these) as community team is challenging5. In the current economic climate, community learning disabilities teams are working within a ‘target driven culture.’ This requires CLDTs to prove both the quality and effectiveness of their service by meeting targets, usually demonstrated through outcome measures such as the Health of the Nation Outcome Scale-Learning Disability (HoNOS-LD) 29. An outcome is defined as an ‘end stage of an intervention’5 . In CLDT settings this usually means ‘problem behaviours’ have been ‘fixed.’ This reflects one of the difficulties with utilising outcome measures in this client group; the majority of outcome measures reflect process rather than the outcome itself29. For example, a CLDT intervention supporting a person to reduce their challenging behaviour, has a profound positive effect on the person’s emotional, physical and psychological wellbeing in addition to preventing the ‘target’ behaviour from occurring. Research suggests that it is very difficult to assess the effectiveness of CLDT interventions as practice is not standardised across teams5. Effective CLDTs should help people with learning disabilities enjoy better health outcomes and healthcare access, in ways which promote independence and inclusion. This should also involve reducing inequality so that people with learning disabilities can use mainstream
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