Supporting people with learning disabilities

1. Introduction

People with a learning disability have worse physical and mental health than people without a learning disability and are more likely to experience a number of health conditions.

On average, males with a learning disability die 22 years younger than males from the general population, and females die 26 years younger than females from the general population (Learning Disability Mortality Review (LeDeR) 2021).

Legally, additional measures must be taken to reduce inequalities and remove barriers to access for these people (Equality Act 2010). At The Rotherham NHS Foundation Trust, we want to ensure staff:

• are referring anyone with a learning disability to the ‘Learning Disability and Autism Team’ or encouraging self-referral

• are making reasonable adjustments for them

• are equipped to deal more effectively with the particular needs of each individual

2. What is a learning disability?

Learning disability is different for every person; this can be mild, moderate or severe and the person will require varying levels of support.

‘Valuing People’ (2001) explains that a learning disability includes the presence of:

• A significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence with an IQ below 70)

• A reduced ability to cope independently (impaired social functioning), which started before adulthood, with a lasting effect on development

Many people with a learning disability live independent lives.

3. How do I identify a patient with a learning disability?

Patients with a learning disability have a special indicator (flag) on the Trust Electronic Patient Record system Meditech.

Learning disability patients may need assistance with;

• Following instructions

• Understanding and processing information

• Understanding abstract concepts such as time or directions

• Phrases used in conversation without expanding on the content

If the person coming to the Trust does not live in Rotherham, they will not have a flag on their record, as that information comes from the Rotherham GP register.

Another way to find out if someone has a learning disability is by asking them if they have a Hospital Passport.

4. The Hospital Passport

Please take time to read through the important information in someone’s Hospital Passport; information inside often saves time and avoids unnecessary negative situations. We are required by law to record, meet and share their communication needs (Accessible Information Standard, 2016).

The Hospital Passport gives important information about a person’s everyday needs and wishes. The Hospital Passport information should be completed by the person themselves, or someone who knows that person really well, ideally before they attend for their care.

This document should be regularly reviewed, as a person’s health and social needs will change over time.

This information can be used to assess whether someone’s condition has changed.

This document does not serve as consent to treatment or any other intervention. Consent must still be sought in every single context and the mental capacity of that person assessed. The passport is available on the Hub, or you can ask the Learning Disability and Autism Team or the Community Learning Disability Team. It is also included as an appendix in the Trust’s Learning Disability Policy.

5. The Learning Disability and Autism Team (LD + A Team)

The LD + A Team is made up of a Learning Disability and Autism Matron and Nursing Associates. The team is available Monday to Friday 8am – 4pm. Outside of these hours please consult the patient, their Hospital Passport and family / carers.

Email: rgh-tr.learningdisabilityandautismteam@nhs.net

Telephone: 01709 42 8371 (answerphone service available)

Nursing Associates visit autistic people and people with learning disability throughout the day and give them the help and support they need while in hospital, ensuring reasonable adjustments are made to their care pathway. The team also give support to people coming through Urgent and Emergency Care, Outpatients and planned surgery.

They can help you to support patients in the following ways:

• Facilitate open and easy access for young people and adults with learning disabilities and/or autism accessing Trust services

• Give specialist advice and support for professionals in relation to personalised care and reasonable adjustments

• Provide accessible information

• Actively assist patients with learning disabilities and/or autism and their carers when using our services

• Provide support and advice regarding best interests, consent, advocacy, mental capacity and safeguarding

• Coordinate and assist the facilitation of learning disability or autism awareness training and further education to professionals to meet the needs of young people and adults with learning disabilities and/or autism

• Ensure that the views of patients and their carers are taken into account