Policy briefing

Putting person-centred care at the heart of learning disability services

A national framework in Ireland aims to provide person-centred services for people with learning disabilities, their families and carers

A national framework in Ireland aims to provide person-centred services for people with learning disabilities, their families and carers

Picture shows mental health professional sitting at a table with a woman with Down’s syndrome woman. A national framework in Ireland aims to provide person-centred services for people with learning disabilities and their families and carers.
Picture: iStock

Essential facts

In Ireland about 28,388 people with a learning disability receive services funded by the state and the voluntary sector (Hourigan et al 2018). Most support is provided in institutions and large congregated settings, although some individualised independent supported living exists, and this is increasing slowly (Keenan 2017a).

Following the scandals of Winterbourne View in the UK (Flynn and Citarella 2012), Oswald D. Heck Center in the US (Hartocollis 2015), Áras Attracta in Ireland (Health Service Executive (HSE) 2016) and many others there is an increased impetus by health policymakers to promote and develop person-centred approaches to the care of people with a learning disability.

Ireland is no exception and the HSE  has published a national framework for person-centred planning (HSE 2018). This aspirational policy, like NHS policies such as NHS Wales’ person-centred care manual (NHS Wales 2019), aims to create care cultures that enhance quality care and begin to eradicate approaches that foster habitual poor nursing practices evidenced in contemporary registration inspection reports.

What’s new?

People with a learning disability should be helped, in a multidisciplinary context and to the best of their capability, to engage in the decision-making processes that govern much of their lives.

While many learning disability nurses in UK and Ireland  continue to debate the value and nature of person-centred practice (Keenan 2008, 2017a, b), there can be no justification for not actively listening and bringing about active participation of such people in shaping their own lives.

Informed by evidence (HSE 2017), a person-centred planning framework was developed as an urgent response to an identified need for a more dependable approach (HSE 2018) . It is intended to improve people’s lives.

The framework aims to:

  • Introduce and nurture a service culture dedicated to person-centredness.
  • Ensure consistent quality care outcomes based on the person’s needs, aspirations and choices.

The framework emphasises the need for services to enable:

  • Ordinary homes to be provided in the community.
  • People to set their own goals and, in striving to achieve these, receive the correct level of service support.
  • People to have maximum choice and control in their day-to-day living.
  • Active participation by the person in social and civic life.
  • Optimum health and social well-being.

The framework identifies tools and resources that can guide the practitioner in implementing effective person-centred approaches.

Implications for nurses

  • The person and their family should, if possible, be involved in decisions that affect them in their life, not just the service.
  • Practitioners should listen attentively and actively engage with the person they serve to ensure the person’s needs, wishes and aspirations are understood and that services respond to this by promoting effective, individualised care.
  • Practitioners should work together with their multidisciplinary team colleagues to develop person-centred plans.

Picture of Paul Keenan, assistant professor intellectual disability nursing, University of Dublin. A national framework in Ireland aims to provide person-centred services for people with learning disabilities and their families and carers.Paul Keenan is assistant professor intellectual disability nursing, University of Dublin – Trinity College Dublin, Ireland

 

 

References

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