Involving people with learning disabilities in a secure service in risk assessment supports holistic approach and promotes trust

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A keystone of policy relating to the support of people with learning disabilities in England is the involvement of service users in planning and delivering their support. This is also reflected in policy relating to risk assessment and management processes. However, the evidence from the literature at present suggests that this involvement is not yet routine and that levels of involvement can depend on the motivation and approach of individuals rather than as a result of policy. This study looked at the impact of the development of a screening tool used in Merseyside, known as the “Keeping me Safe and Well” screen. The tool was developed as part of a human rights healthcare project.
Following a piloting of the original screening tool, changes were made to ensure a participative and holistic approach to risk, working in partnership with service users.

The study took place in a medium secure unit for people with learning disabilities and personality disorder.  Five of the 16 residents took part in the pilot. The authors audited records to analyse the extent to which service users had been involved in the risk assessment process. In addition, they also carried out individual interviews and ran focus groups to provide more detailed feedback on the usefulness of the tool.

They found that all the service users who took part in the process experienced an increased awareness and knowledge of the risk assessment process and also of the issues relating to human rights.  The authors suggest that in addition, the use of the screening tool helped services users to focus on issues relating to their own risk but also the rights of others. Interestingly, the views of services users of their own risks matched the views of professionals working with them helping to validate assessment methods and in the view of the authors, helping to promote increased trust between service users and professionals.

The authors  conclude  that the screen “added value to the risk assessment process by engaging service users in the risk process and supporting the adoption of a more participative, holistic approach to risk by maximising autonomy and empowerment and working in partnership with the service user.”

“We know about our risks, so we should be asked.” A tool to support service user involvement in the risk assessment process in forensic services for people with intellectual disabilities, Hall S & Duperouzel H, in Journal of Learning Disabilities and Offending Behaviour, 2,3,122-126

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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