Investigating the experience of professional carers supporting individuals with intellectual disability who were at risk of admission – a qualitative study

Abstract

Purpose This study aims to understand the experiences of professional paid carers providing community support to people with intellectual disability “at risk of admission”. This study explores factors that were helpful or lacking in terms of the support the carers received from NHS health services during this time. Design/methodology/approach This study conducted semi-structured interview with eight participants. Thematic analysis was used to analyse the data. Findings Three main themes and ten subthemes were identified. The first main theme was “support systems” that were available or lacking for the client and their carers. The second main theme was “training and supervision” available to the carers and their team when the individual they supported needed additional support. The third theme was “change” clients encountered which included changes in the environment as well as changes because of COVID-19 pandemic. Originality/value To the best of the authors’ knowledge, this is the first study on experiences of carers during specifically high stress periods, such as when the clients they are supporting are at risk of hospital admission.

A study of the clinical and demographic characteristics of adults with an intellectual disability who remain in learning disability assessment and treatment units despite being clinically ready for discharge

“…This represents a significant deficit in the research literature, which is especially stark given the emphasis and broader developments on service user involvement in health services. It would also be beneficial to gain further qualitative information from the independent care providers who supported people before a hospital stay, building on previous related studies (Manandhar‐Richardson et al, 2023). This may help to better understand what would be required for individuals to avoid unnecessary inpatient stays or for them to be supported by those organisations more effectively following discharge.…”

“…A strength of the current study was the use of standardised collection of routine data sets to look at factors affecting delayed discharge, which has enabled the analysis of clinical and demographic factors affecting delay. This adds further information to the established literature on delayed discharges, some of which have focused on other important factors such as recorded reasons for delay (Gibson et al, 2023;Manandhar-Richardson et al, 2023;Washington et al, 2018). One limitation of the current study is the gaps in the availability of some aspects of the data set.…”

“…Where admission cannot be avoided, services should ensure that hospital stays are only as long as clinically indicated (Department of Health, 2012;Devapriam et al, 2018;Learning Disability Professional Senate, 2017;Taylor & Rose, 2020;Manandhar-Richardson et al, 2023). Inpatient admissions should be as close to the person's home as possible (Bubb, 2014;Learning Disability Professional Senate, 2017;HM Government, 1983;National Institute of Clinical Excellence, 2015;NHS England, 2017).…”

“…A key factor in people experiencing a delay in discharge is the lack of availability of suitable community support and accommodation for people to move on to upon discharge (Abraham et al, 2022; Devapriam et al, 2018; Manandhar‐Richardson et al, 2023; Rojas‐García et al, 2018; Washington et al, 2018). This has significant implications for the lives of those experiencing delay, reduces the availability of beds for those entering a crisis who need inpatient treatment, and is a significant cost and staffing resource pressure on health service resources.…”