09 October 2017

People with learning disabilities and behaviour that challenges should be better cared for in the community, says NICE

Local authorities and NHS bodies should provide specialist community care for people with learning disabilities who behave in a way that challenges to avoid admissions to psychiatric wards or residential homes, new draft guidance from NICE says.

They should only be admitted as a last resort after all other options have been considered. If they are admitted, they should be as close as possible to their home, the draft guidance advises.

Estimates suggest that there are 1.2 million people with a learning disability in England, and between 10-17% of those have behaviour that challenges.

Behaviour is challenging if it is harmful to the person or others around them, which can include hitting or kicking, and if it stops them from being able achieve things in their daily life, such as making friends.

Jonathan Senker, Chief Executive of VoiceAbility and chair of the guideline committee, said: “Our draft guideline recognises that some people with learning disabilities and behaviour that challenges are not receiving the care they deserve. Good, specialist support in the community is often lacking and this can make life for people and their families extremely difficult.

“They can find themselves in a crisis and admitted to hospital as an inpatient. We want services to provide better support in the community to break this disruptive pattern of care.”

The draft guidance recommends that a specialist lead commissioner is appointed by local authorities to make sure that the right support is available for people and their families, for example, providing an out-of-hours helpline to use during a crisis.

A ‘named worker’ from the community learning disability team should be responsible for coordinating someone’s care, the draft guidance also recommends.

Professor Gillian Leng, director of health and social care and deputy chief executive at NICE, said: “We know that services for people with learning disabilities, and their families, can be hugely difficult to navigate.

“Providing better and local support will ensure that someone who needs treatment doesn’t have to be away from home. Our advice, once final, will set out how services can deliver good care to meet their needs.”

The proposed recommendations are out for consultation until 20 November. Stakeholders and members of the public are invited to comment.

Our draft guideline recognises that some people with learning disabilities and behaviour that challenges are not receiving the care they deserve.

Jonathan Senker, Chief Executive of VoiceAbility and chair of the guideline committee

Providing better and local support will ensure that someone who needs treatment doesn’t have to be away from home.

Professor Gillian Leng, director of health and social care and deputy chief executive at NICE