Annette Hames

Investigating Four Evaluation Measures that Aim to Capture the Impact of Service Intervention for Children being Seen by a Community Learning Disability Team

Government guidelines state that health services must measure outcomes for patients. However, there is only limited evidence on outcome measures for children with learning disabilities. This paper reports on a study designed to investigate the suitability and effectiveness of four outcome measures (Health of the Nation Outcome Scales for Children and Adolescents ‐ HoNOSCA, Childrens Global Assessment Scale ‐ C‐GAS, Strengths and Difficulties Questionnaire ‐ SDQ, and Commission for Health Improvement Experience of Service questionnaire ‐ CHI) for a community team working with children with learning disabilities. The paper highlights the difficulties in capturing the impact of service intervention in a multidisciplinary community setting. The implications of the research for clinical practice are discussed.

Investigating the Experiences of People who Have Been Homeless and are in Contact with Learning Disability Services

This paper explores the experiences of people who have been homeless and in contact with learning disability services. The research adds to the very limited evidence, particularly in the UK, on how services can better meet the health and social needs of this group. All people with learning disabilities who were homeless and known to either local social services or health learning disability services in a large city in the North East of England were identified. Semi‐structured interviews were conducted with 14 participants at their current accommodation. Content analysis was used to identify common themes. Interview data indicated that breakdown of social support was the main cause of homelessness, and that in temporary accommodation people with learning disabilities were vulnerable to exploitation by other residents. Concerns were also expressed about the quality of housing, mental health was a recurring theme and the importance of ensuring that people with learning disabilities receive adequate treatment for these difficulties is discussed. Access to health care in general is facilitated by support in arranging and attending appointments. Mediation services may play a key role in preventing people with learning disabilities from becoming homeless through relationship breakdown. The study also suggests that improvements in temporary accommodation are needed, including housing designed specifically for people with learning disabilities, in order to react effectively to episodes of homelessness.

Investigating the Experiences of Professionals Working with People who are Homeless and in Contact with Learning Disability Services

People who are homeless and have a learning disability tend to be more vulnerable and have greater health needs than homeless people who do not have a learning disability (Leedham, 2002). However, the literature on the experiences of this population is very limited. This paper investigates the experiences and views of professionals from a range of settings who work with people who are homeless and have a learning disability. Semi‐structured interviews were conducted with 23 professionals working for health, social care, probation, employment and voluntary agencies. Professionals described how people who are homeless and have a learning disability have a range of complex personal, health and social needs that are often not met by current accommodation and support provision. Improvements to the quality of temporary accommodation and the on‐site support offered are needed in order to react effectively to episodes of homelessness. In addition, improvements in the quality of outreach support and a greater choice of suitable housing might help to prevent homelessness among this client group. Another paper on a difference aspect of this research (Hebblethwaite et al, this issue) will report on the personal experiences of homeless people with a learning disability.